Pirlindol - instructions for use, dose, side effects, contraindications

Clinical and pharmacological group: & nbsp

Antidepressants

Included in the formulation

Pyrazidol®

pills inwards

PHARMSTANDART-FORESTRY, OJSC Russia

АТХ:

N.06.A.X Other antidepressants

Pharmacodynamics:

Antidepressant, reversible inhibitor MAO type A. It has a mild activating effect. Unlike tricyclic antidepressants, it does not possess anticholinergic activity.

Combines a timoleptic effect with a regulating effect on the central nervous system (activating effect on patients with apathetic and anergic depression and sedative - in agitated states). It shows nootropic properties and improves cognitive (cognitive) functions. Normalizes the exchange of neurotransmitter monoamines in the central nervous system. Reversibly inhibits MAO (especially MAO type A), blocks deamination of serotonin, to a lesser extent - norepinephrine and slightly - tyramine. Stimulates adrenergic (alleviates depression caused by reserpine, and potentiates the effects of phenamine and the predecessor of norepinephrine - L-dopa) and serotonergic (enhances the action of the precursor of serotonin - 5-hydroxytryptophan) structure. Partially inhibits the reuptake of serotonin.

Pharmacokinetics:

Quickly absorbed after ingestion, easily passes through the histohematological barriers, including the blood-brain barrier; creates high concentrations in the brain.

Pirlindol is almost completely absorbed from the gastrointestinal tract.After taking a single dose, the maximum concentration of the active substance in the blood plasma is reached after 2-8 hours. Pirlindole is subject to enterohepatic circulation. Elimination from the blood plasma is carried out in three phases. Absolute bioavailability is 20-30%, as there is a pronounced metabolism at the first passage through the liver. Pirlindole It binds strongly to plasma proteins (95%), so the terminal half-life period is long - 185 hours. Pirlindole almost completely metabolized and only a very small amount of it is excreted in the urine unchanged. About 50-70% of metabolites are excreted in the urine, 25-45% - with bile through the intestine.

Indications:

Depression of various origins, preferably with psychomotor retardation, with anxious-depressive or anxiety-delusional components. Manic-depressive psychosis, schizophrenia with mood disorders and involutional psychosis occurring with depression, depression, including psychomotor retardation and asthenic disorders accompanied by anxiety and depression and anxiety and delusional components, anesthetic,hypochondriac and neurosis-like symptoms, senile, involutional depression.

Depressive and anxiety-depressive conditions in patients with alcoholism, especially during the period of withdrawal.

ICD-10

V.F40-F48.F48.0 Neurasthenia

V.F40-F48.F45 Somatoform disorders

V.F40-F48.F44 Dissociative [conversion] disorders

V.F40-F48.F43.2 Disorder of adaptive reactions

V.F40-F48.F43.1 Post-Traumatic Stress Disorder

V.F00-F09.F06.3 Organic mood disorders [affective]

V.F00-F09.F06 Other mental disorders due to damage and dysfunction of the brain or somatic disease

V.F00-F09.F03 Dementia, unspecified

V.F20-F29.F20 Schizophrenia

V.F30-F39.F32 Depressive episode

V.F30-F39.F34.1 Dysthymia

V.F50-F59.F50.0 Anorexia nervosa

V.F30-F39.F34.0 Cyclothemia

VI.G30-G32.G30 Alzheimer's disease

Contraindications:

Individual hypersensitivity to the drug. Acute inflammatory diseases of the liver and hematopoietic system, infantile age, preceding (1-2 weeks) administration of MAO inhibitors.

Carefully:

Pregnancy and lactation.

After the application of MAO inhibitors, therapy is started no earlier than 14 days later.

Pregnancy and lactation:Category of recommendations FDA is not defined. There are no adequate and well-controlled clinical studies of the use of the drug during pregnancy and during lactation. It is known that the use of tricyclic antidepressants and similar drugs in the third trimester of pregnancy can cause a newborn tachycardia, increased excitability, muscle spasms. The use of the drug is permissible only if the benefit to the mother exceeds the possible risk to the fetus.

Dosing and Administration:

Inside - 50-75 mg per day in 2 divided doses, gradually increasing the dose by 25-50 mg per day; The therapeutic effect is achieved after 1-2 weeks at doses of 150-300 mg per day. If necessary and good tolerability - up to 400 mg per day. After achieving the effect, treatment in an individual dose is continued with a selected dose of 2-4 weeks, then gradually canceled.

With neurotic and reactive depression, smaller doses are used.

Side effects:Dry mouth, sweating, tremor, tachycardia, nausea, dizziness.

Overdose:

It is manifested by an increase in the severity of side effects. Treatment: gastric lavage, reception of activated charcoal, symptomatic therapy.

Interaction:

Incompatible with MAO inhibitors, including with drugs that have similar activity (furazolidone, procarbazine, selegiline and others). Pirlindole Do not apply simultaneously with MAO inhibitors and within 2 weeks after their withdrawal.

Can increase the response to adrenaline and other sympathomimetics. With simultaneous application increases the effectiveness of epinephrine.

Special instructions:

Work that requires increased mental and physical responses (management of complex, potentially dangerous and transport mechanisms) should be avoided.

The absence of anticholinergic action makes it possible to use in patients with glaucoma and adenoma of the prostate

Instructions

Pirlindole (Pirlindolum)