Антидепрессант. Селективный ингибитор обратного захвата серо... Инструкция
Показания к применению
Депрессии различной этиологии, в т.ч. сопровождающиеся чувством тревоги (лечение и профилактика)
Обсессивно-компульсивные расстройства, в т.ч. у детей старше 6 лет
Панические расстройства (с агорафобией или без)
Посттравматические стрессовые расстройства
Противопоказания
Одновременное применение ингибиторов МАО и период 14 дней после их отмены
Нестабильная эпилепсия
Возраст до 18 лет (вследствие отсутствия достаточного клинического опыта применения), за исключением пациентов с обсессивно-компульсивными расстройствами
В 1 таблекте содержится: активное вещество: 50 мг сертралина (в виде 55,95 мг сертралина гидрохлорида соответственно) . вспомогательные вещества: магния стеарат, гипролоза (гидроксипропилцеллюлоза), натрия карбоксиметилкрахмал (тип А), кальция гидрофосфата дигидрат, целлюлоза микрокристаллическая . оболочка: макрогол 6000, титана диоксид, гипромеллоза.
Фармакологические свойства
Антидепрессант. Селективный ингибитор обратного захвата серотонина. Оказывает слабое влияние на обратный захват норадреналина и допамина. В терапевтических дозах сертралин блокирует также захват серотонина тромбоцитами крови человека. Не оказывает стимулирующего, седативного или антихолинергического действия. Сертралин не обладает сродством к м-холино-, серотониновым, допаминовым, гистаминовым, адрено-, GABA- и бензодиазепиновым рецепторам. При применении Стимулотона не происходит увеличения массы тела. Препарат не вызывает психической или физической лекарственной зависимости. Антидепрессивный эффект отмечается к концу второй недели регулярного приема препарата, тогда как максимальный эффект достигается только через 6 недель.
Показания к применению
Депрессии различной этиологии, в т.ч. сопровождающиеся чувством тревоги (лечение и профилактика)
Обсессивно-компульсивные расстройства, в т.ч. у детей старше 6 лет
Панические расстройства (с агорафобией или без)
Посттравматические стрессовые расстройства
Противопоказания
Одновременное применение ингибиторов МАО и период 14 дней после их отмены
Нестабильная эпилепсия
Возраст до 18 лет (вследствие отсутствия достаточного клинического опыта применения), за исключением пациентов с обсессивно-компульсивными расстройствами
Беременность
Период лактации (грудное вскармливание)
Повышенная чувствительность к компонентам препарата
Применение при беременности и в период грудного вскармливания
Контролируемых результатов безопасности применения Стимулотона у беременных женщин нет, поэтому назначение при беременности противопоказано. Женщинам репродуктивного возраста, которым предполагается назначать Стимулотон ., следует рекомендовать пользоваться эффективными средствами контрацепции. Сертралин выделяется с грудным молоком. Достоверных данных о безопасности его применения в период лактации нет. При необходимости назначения Стимулотона в период лактации грудное вскармливание следует прекратить.
Способ применения и дозы
Препарат назначают внутрь, 1 раз/сут (утром или вечером). Взрослым при депрессиях и обсессивно-компульсивных расстройствах препарат назначают в дозе 50 мг 1 раз/сут. При панических расстройствах и посттравматических стрессовых расстройствах для снижения частоты и тяжести побочных эффектов рекомендуется начинать лечение с дозы 25 мг 1 раз/сут и через неделю увеличить ее до 50 мг 1 раз/сут. При неудовлетворительном терапевтическом ответе и хорошей переносимости суточную дозу можно повышать по 50 мг в течение нескольких недель до максимальной суточной дозы 200 мг. Терапевтический эффект достигается обычно в течение 7 дней. Однако для полного проявления антидепрессивного действия требуется регулярный прием препарата в течение 2-4 недель. При обсессивно-компульсивном расстройстве терапевтический эффект развивается еще медленнее. Для поддерживающей терапии следует назначать минимальную эффективную дозу. При обсессивно-компульсивных расстройствах детям в возрасте от 13 до 18 лет препарат назначают в начальной дозе 50 мг 1 раз/сут. Детям в возрасте от 6 до 12 лет препарат назначают в начальной дозе 25 мг 1 раз/сут, через неделю суточную дозу можно увеличить до 50 мг. При неудовлетворительном терапевтическом ответе в дальнейшем дозу можно повышать еженедельно по 50 мг/сут до максимальной суточной дозы 200 мг. Во избежание передозировки при увеличении дозы более 50 мг/сут следует учитывать, что масса тела у детей меньше, чем у взрослых. При длительной поддерживающей терапии препарат следует назначать в минимальной эффективной дозе. У пациентов пожилого возраста коррекции дозы препарата не требуется. У пациентов с тяжелыми нарушениями функции печени дозу препарата следует уменьшить или увеличить интервалы между приемами. У пациентов с нарушениями функции почек специального подбора дозы не требуется.
Побочное действие
Со стороны ЦНС и периферической нервной системы: редко - сонливость, утомляемость, головокружение, головная боль, тремор, бессонница, раздражительность, акатизия, гипомания, мания. Как и при лечении другими антидепрессантами, могут наблюдаться реакции, которые трудно дифференцировать от симптомов основного заболевания в т.ч. парестезия, гипестезия, депрессия, галлюцинации, возбуждение, агрессивность, ажитация, тревожность, психоз. Со стороны пищеварительной системы: сухость во рту, снижение аппетита или повышение аппетита (возможно вследствие устранения депрессии) . редко - анорексия, спазмы в желудке, животе, метеоризм или боли, неустойчивый стул, диарея, диспепсия, тошнота, рвота. Со стороны сердечно-сосудистой системы: редко - сердцебиение. Со стороны обмена веществ: снижение массы тела. Со стороны системы кроветворения: кровотечения (в т.ч. носовое). Со стороны органов чувств: редко - нарушения зрения (включая нечеткость зрения). Со стороны половой системы: редко - дисменорея, нарушение половой функции (задержка эякуляции, снижение потенции и/или либидо, аноргазмия). Дерматологические реакции: редко - гиперемия кожи или "приливы" крови к лицу, повышенное потоотделение. Со стороны лабораторных показателей: в отдельных случаях (0.8%) - бессимптомное повышение ACT и АЛТ (эти изменения наблюдались в течение первых 9 недель приема препарата и прекращались немедленно после его отмены) . имеются сообщения об обратимой гипонатриемии (предположительно этот феномен связан с синдромом недостаточной секреции АДГ, поскольку наблюдался в основном у пациентов пожилого возраста, получающих одновременно сопутствующие диуретики или другие препараты). Прочие: редко - аллергические реакции, зевота . в отдельных случаях прекращение приема препарата вызывает синдром отмены. Иногда (причинная связь с препаратом достоверно не установлена) - двигательные нарушения (экстрапирамидные симптомы и нарушения походки), судороги, нарушения менструального цикла, гиперпролактинемия, галакторея, кожная сыпь (редко - многоформная экссудативная эритема), зуд. В большинстве случаев двигательные нарушения наблюдались у пациентов, принимающих сопутствующие антипсихотические препараты (нейролептики), а также при наличии длительного анамнеза двигательных нарушений.
Особые указания
Со стороны ЦНС и периферической нервной системы: редко - сонливость, утомляемость, головокружение, головная боль, тремор, бессонница, раздражительность, акатизия, гипомания, мания. Как и при лечении другими антидепрессантами, могут наблюдаться реакции, которые трудно дифференцировать от симптомов основного заболевания в т.ч. парестезия, гипестезия, депрессия, галлюцинации, возбуждение, агрессивность, ажитация, тревожность, психоз. Со стороны пищеварительной системы: сухость во рту, снижение аппетита или повышение аппетита (возможно вследствие устранения депрессии) . редко - анорексия, спазмы в желудке, животе, метеоризм или боли, неустойчивый стул, диарея, диспепсия, тошнота, рвота. Со стороны сердечно-сосудистой системы: редко - сердцебиение. Со стороны обмена веществ: снижение массы тела. Со стороны системы кроветворения: кровотечения (в т.ч. носовое). Со стороны органов чувств: редко - нарушения зрения (включая нечеткость зрения). Со стороны половой системы: редко - дисменорея, нарушение половой функции (задержка эякуляции, снижение потенции и/или либидо, аноргазмия). Дерматологические реакции: редко - гиперемия кожи или "приливы" крови к лицу, повышенное потоотделение. Со стороны лабораторных показателей: в отдельных случаях (0.8%) - бессимптомное повышение ACT и АЛТ (эти изменения наблюдались в течение первых 9 недель приема препарата и прекращались немедленно после его отмены) . имеются сообщения об обратимой гипонатриемии (предположительно этот феномен связан с синдромом недостаточной секреции АДГ, поскольку наблюдался в основном у пациентов пожилого возраста, получающих одновременно сопутствующие диуретики или другие препараты). Прочие: редко - аллергические реакции, зевота . в отдельных случаях прекращение приема препарата вызывает синдром отмены. Иногда (причинная связь с препаратом достоверно не установлена) - двигательные нарушения (экстрапирамидные симптомы и нарушения походки), судороги, нарушения менструального цикла, гиперпролактинемия, галакторея, кожная сыпь (редко - многоформная экссудативная эритема), зуд. В большинстве случаев двигательные нарушения наблюдались у пациентов, принимающих сопутствующие антипсихотические препараты (нейролептики), а также при наличии длительного анамнеза двигательных нарушений.
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содержится: активное вещество: 50 мг сертралина (в виде 55,95 мг сертралина гидрохлорида соответственно) . вспомогательные вещества: магния стеарат, гипролоза (гидроксипропилцеллюлоза), натрия карбоксиметилкрахмал (тип А), кальция гидрофосфата дигидрат, целлюлоза микрокристаллическая . оболочка: макрогол 6000, титана диоксид, гипромеллоза."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Антидепрессант. Селективный ингибитор обратного захвата серотонина. Оказывает слабое влияние на обратный захват норадреналина и допамина. В терапевтических дозах сертралин блокирует также захват серотонина тромбоцитами крови человека. Не оказывает стимулирующего, седативного или антихолинергического действия. Сертралин не обладает сродством к м-холино-, серотониновым, допаминовым, гистаминовым, адрено-, GABA- и бензодиазепиновым рецепторам. При применении Стимулотона не происходит увеличения массы тела. Препарат не вызывает психической или физической лекарственной зависимости. Антидепрессивный эффект отмечается к концу второй недели регулярного приема препарата, тогда как максимальный эффект достигается только через 6 недель."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["Депрессии различной этиологии, в т.ч. сопровождающиеся чувством тревоги (лечение и профилактика)","Обсессивно-компульсивные расстройства, в т.ч. у детей старше 6 лет","Панические расстройства (с агорафобией или без)","Посттравматические стрессовые расстройства"]}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["Одновременное применение ингибиторов МАО и период 14 дней после их отмены","Нестабильная эпилепсия","Возраст до 18 лет (вследствие отсутствия достаточного клинического опыта применения), за исключением пациентов с обсессивно-компульсивными расстройствами","Беременность","Период лактации (грудное вскармливание)","Повышенная чувствительность к компонентам препарата"]}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Контролируемых результатов безопасности применения Стимулотона у беременных женщин нет, поэтому назначение при беременности противопоказано. Женщинам репродуктивного возраста, которым предполагается назначать Стимулотон ., следует рекомендовать пользоваться эффективными средствами контрацепции. Сертралин выделяется с грудным молоком. Достоверных данных о безопасности его применения в период лактации нет. При необходимости назначения Стимулотона в период лактации грудное вскармливание следует прекратить."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат назначают внутрь, 1 раз/сут (утром или вечером). Взрослым при депрессиях и обсессивно-компульсивных расстройствах препарат назначают в дозе 50 мг 1 раз/сут. При панических расстройствах и посттравматических стрессовых расстройствах для снижения частоты и тяжести побочных эффектов рекомендуется начинать лечение с дозы 25 мг 1 раз/сут и через неделю увеличить ее до 50 мг 1 раз/сут. При неудовлетворительном терапевтическом ответе и хорошей переносимости суточную дозу можно повышать по 50 мг в течение нескольких недель до максимальной суточной дозы 200 мг. Терапевтический эффект достигается обычно в течение 7 дней. Однако для полного проявления антидепрессивного действия требуется регулярный прием препарата в течение 2-4 недель. При обсессивно-компульсивном расстройстве терапевтический эффект развивается еще медленнее. Для поддерживающей терапии следует назначать минимальную эффективную дозу. При обсессивно-компульсивных расстройствах детям в возрасте от 13 до 18 лет препарат назначают в начальной дозе 50 мг 1 раз/сут. Детям в возрасте от 6 до 12 лет препарат назначают в начальной дозе 25 мг 1 раз/сут, через неделю суточную дозу можно увеличить до 50 мг. При неудовлетворительном терапевтическом ответе в дальнейшем дозу можно повышать еженедельно по 50 мг/сут до максимальной суточной дозы 200 мг. Во избежание передозировки при увеличении дозы более 50 мг/сут следует учитывать, что масса тела у детей меньше, чем у взрослых. При длительной поддерживающей терапии препарат следует назначать в минимальной эффективной дозе. У пациентов пожилого возраста коррекции дозы препарата не требуется. У пациентов с тяжелыми нарушениями функции печени дозу препарата следует уменьшить или увеличить интервалы между приемами. У пациентов с нарушениями функции почек специального подбора дозы не требуется."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Со стороны ЦНС и периферической нервной системы: редко - сонливость, утомляемость, головокружение, головная боль, тремор, бессонница, раздражительность, акатизия, гипомания, мания. Как и при лечении другими антидепрессантами, могут наблюдаться реакции, которые трудно дифференцировать от симптомов основного заболевания в т.ч. парестезия, гипестезия, депрессия, галлюцинации, возбуждение, агрессивность, ажитация, тревожность, психоз. Со стороны пищеварительной системы: сухость во рту, снижение аппетита или повышение аппетита (возможно вследствие устранения депрессии) . редко - анорексия, спазмы в желудке, животе, метеоризм или боли, неустойчивый стул, диарея, диспепсия, тошнота, рвота. Со стороны сердечно-сосудистой системы: редко - сердцебиение. Со стороны обмена веществ: снижение массы тела. Со стороны системы кроветворения: кровотечения (в т.ч. носовое). Со стороны органов чувств: редко - нарушения зрения (включая нечеткость зрения). Со стороны половой системы: редко - дисменорея, нарушение половой функции (задержка эякуляции, снижение потенции и/или либидо, аноргазмия). Дерматологические реакции: редко - гиперемия кожи или \"приливы\" крови к лицу, повышенное потоотделение. Со стороны лабораторных показателей: в отдельных случаях (0.8%) - бессимптомное повышение ACT и АЛТ (эти изменения наблюдались в течение первых 9 недель приема препарата и прекращались немедленно после его отмены) . имеются сообщения об обратимой гипонатриемии (предположительно этот феномен связан с синдромом недостаточной секреции АДГ, поскольку наблюдался в основном у пациентов пожилого возраста, получающих одновременно сопутствующие диуретики или другие препараты). Прочие: редко - аллергические реакции, зевота . в отдельных случаях прекращение приема препарата вызывает синдром отмены. Иногда (причинная связь с препаратом достоверно не установлена) - двигательные нарушения (экстрапирамидные симптомы и нарушения походки), судороги, нарушения менструального цикла, гиперпролактинемия, галакторея, кожная сыпь (редко - многоформная экссудативная эритема), зуд. В большинстве случаев двигательные нарушения наблюдались у пациентов, принимающих сопутствующие антипсихотические препараты (нейролептики), а также при наличии длительного анамнеза двигательных нарушений."}}]},{"id":8,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Со стороны ЦНС и периферической нервной системы: редко - сонливость, утомляемость, головокружение, головная боль, тремор, бессонница, раздражительность, акатизия, гипомания, мания. Как и при лечении другими антидепрессантами, могут наблюдаться реакции, которые трудно дифференцировать от симптомов основного заболевания в т.ч. парестезия, гипестезия, депрессия, галлюцинации, возбуждение, агрессивность, ажитация, тревожность, психоз. Со стороны пищеварительной системы: сухость во рту, снижение аппетита или повышение аппетита (возможно вследствие устранения депрессии) . редко - анорексия, спазмы в желудке, животе, метеоризм или боли, неустойчивый стул, диарея, диспепсия, тошнота, рвота. Со стороны сердечно-сосудистой системы: редко - сердцебиение. Со стороны обмена веществ: снижение массы тела. Со стороны системы кроветворения: кровотечения (в т.ч. носовое). Со стороны органов чувств: редко - нарушения зрения (включая нечеткость зрения). Со стороны половой системы: редко - дисменорея, нарушение половой функции (задержка эякуляции, снижение потенции и/или либидо, аноргазмия). Дерматологические реакции: редко - гиперемия кожи или \"приливы\" крови к лицу, повышенное потоотделение. 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