{"id":61456,"date":"2024-02-28T07:41:49","date_gmt":"2024-02-28T07:41:49","guid":{"rendered":"https:\/\/medsname.com\/d-mine\/"},"modified":"2026-05-01T10:49:16","modified_gmt":"2026-05-01T10:49:16","slug":"d-mine","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/d-mine\/","title":{"rendered":"D-mine"},"content":{"rendered":"

<\/p>\n

\n

\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je D-mine?<\/h3>\n
\n

D-mine<\/strong> obsahuje imipramin 25 mg<\/strong> od v\u00fdrobce certifikovan\u00e9ho WHO-GMP (Sun Pharma) \u2014 p\u016fvodn\u00ed tricyklick\u00e9 antidepresivum<\/strong>, v kontinu\u00e1ln\u00edm klinick\u00e9m pou\u017eit\u00ed od roku 1959. Terci\u00e1rn\u00ed-amin TCA: inhibice zp\u011btn\u00e9ho vychyt\u00e1v\u00e1n\u00ed serotoninu a noradrenalinu plus muskarinov\u00e9, histaminov\u00e9 H1<\/sub>, a alfa-1 antagonismus (zdroj vedlej\u0161\u00edch \u00fa\u010dink\u016f). Pro prvn\u00ed linii l\u00e9\u010dby deprese v\u011bt\u0161inou nahrazeno SSRI, ale st\u00e1le se pou\u017e\u00edv\u00e1 pro: panick\u00e1 porucha<\/strong> (jeden z nejl\u00e9pe prok\u00e1zan\u00fdch TCA pro toto), chronickou neuropatickou bolest<\/strong> v n\u00edzk\u00fdch d\u00e1vk\u00e1ch, a d\u011btskou no\u010dn\u00ed enur\u00e9zu<\/strong> (no\u010dn\u00ed pomo\u010dov\u00e1n\u00ed) kde m\u00e1 schv\u00e1len\u00ed FDA. Kardiotoxicita p\u0159i p\u0159ed\u00e1vkov\u00e1n\u00ed<\/strong> \u2014 v\u00fdchoz\u00ed EKG p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby. Siln\u00e1 anticholinergn\u00ed z\u00e1t\u011b\u017e \u2014 nen\u00ed prvn\u00ed volbou u star\u0161\u00edch dosp\u011bl\u00fdch.<\/p>\n<\/div>\n

\nCo z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n

\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<\/div>\n

D\u016fle\u017eit\u00e9 \u2014 nejedn\u00e1 se o l\u00e9k na situa\u010dn\u00ed \u00fazkost.<\/strong> D-mine je tricyklick\u00e9 antidepresivum (TCA)<\/strong>, p\u0159edepisov\u00e1n a titrov\u00e1n po t\u00fddny pro z\u00e1va\u017en\u00e1 depresivn\u00ed porucha (MDD), panick\u00e1 porucha, d\u011btsk\u00e1 no\u010dn\u00ed enur\u00e9za a chronick\u00e9 bolestiv\u00e9 syndromy<\/strong>. Nen\u00ed ne<\/strong> spr\u00e1vn\u00fdm l\u00e9kem pro akutn\u00ed, v\u00fdkonov\u011b souvisej\u00edc\u00ed \u00fazkost (l\u00e9t\u00e1n\u00ed, ve\u0159ejn\u00e9 vystupov\u00e1n\u00ed, zkou\u0161ky) \u2014 pro tyto p\u0159\u00edpady jsou klinicky vhodn\u011bj\u0161\u00ed betablok\u00e1tory (propranolol), benzodiazepiny nebo hydroxyzin. Pokud nem\u00e1te diagnostikovanou poruchu n\u00e1lady, \u00fazkostnou nebo psychiatrickou poruchu, neza\u010d\u00ednejte s u\u017e\u00edv\u00e1n\u00edm tohoto l\u00e9ku.<\/div>\n
FDA \u010dern\u00e9 varov\u00e1n\u00ed \u2014 sebevra\u017eednost.<\/strong> V\u0161echna antidepresiva nesou \u010dern\u00e9 varov\u00e1n\u00ed FDA pro zv\u00fd\u0161en\u00e9 riziko sebevra\u017eedn\u00e9ho my\u0161len\u00ed a chov\u00e1n\u00ed u d\u011bt\u00ed, dosp\u00edvaj\u00edc\u00edch a mlad\u00fdch dosp\u011bl\u00fdch do 25 let, zejm\u00e9na b\u011bhem prvn\u00edch t\u00fddn\u016f l\u00e9\u010dby nebo po zm\u011bn\u00e1ch d\u00e1vkov\u00e1n\u00ed. \u010clenov\u00e9 rodiny a p\u0159edepisuj\u00edc\u00ed l\u00e9ka\u0159i by m\u011bli pe\u010dliv\u011b sledovat zhor\u0161en\u00ed n\u00e1lady, agitovanost nebo sebevra\u017eedn\u00e9 my\u0161lenky v t\u00e9to v\u011bkov\u00e9 skupin\u011b.<\/div>\n

Co je D-mine?<\/h2>\n

D-mine je peror\u00e1ln\u00ed tableta imipramin hydrochlorid 25 mg<\/strong> vyr\u00e1b\u011bno spole\u010dnost\u00ed Sun Pharma. Imipramin (US zna\u010dka Tofranil<\/strong>) byl syntetizov\u00e1n v roce 1948 a identifikov\u00e1n jako prvn\u00ed \u00fa\u010dinn\u00e9 antidepresivum v roce 1957 \u2014 z\u00e1klad modern\u00ed psychofarmakologie. Je to tricyklick\u00e9 antidepresivum terci\u00e1rn\u00edho aminu<\/strong> kter\u00e9 inhibuje zp\u011btn\u00e9 vychyt\u00e1v\u00e1n\u00ed serotoninu a noradrenalinu a z\u00e1rove\u0148 blokuje muskarinov\u00e9, histaminov\u00e9 H1<\/sub>, a alfa-1 receptory. Serotonergn\u00ed\/noradrenergn\u00ed \u00fa\u010dinky zaji\u0161\u0165uj\u00ed \u00fa\u010dinnost; blok\u00e1da receptor\u016f zp\u016fsobuje v\u011bt\u0161inu ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f.<\/p>\n

Schv\u00e1len\u00e9 indikace<\/h2>\n
    \n
  • z\u00e1va\u017en\u00e1 depresivn\u00ed porucha<\/strong> \u2014 druh\u00e1 nebo t\u0159et\u00ed volba po SSRI\/SNRI<\/li>\n
  • panick\u00e1 porucha<\/strong> \u2014 jeden z nejl\u00e9pe prozkouman\u00fdch TCA; existuj\u00ed \u00fa\u010dinn\u00e9 a l\u00e9pe tolerovan\u00e9 alternativy<\/li>\n
  • D\u011btsk\u00e1 no\u010dn\u00ed enur\u00e9za (pomo\u010dov\u00e1n\u00ed)<\/strong> \u2014 schv\u00e1leno FDA pro v\u011bk 6+ p\u0159i selh\u00e1n\u00ed behavior\u00e1ln\u00ed terapie a desmopresinu<\/li>\n
  • Mimo indikaci: chronick\u00e1 neuropatick\u00e1 bolest, fibromyalgie, postherpetick\u00e1 neuralgie, chronick\u00e1 bolest zad<\/li>\n<\/ul>\n

    D\u00e1vkov\u00e1n\u00ed<\/h2>\n\n\n\n\n\n\n\n\n\n
    Indikace<\/th>\nStart<\/th>\nC\u00edlov\u00e1 d\u00e1vka<\/th>\nPozn\u00e1mky<\/th>\n<\/tr>\n<\/thead>\n
    MDD (dosp\u011bl\u00ed ambulantn\u00ed pacienti)<\/td>\n25\u201375 mg\/denn\u011b p\u0159ed span\u00edm<\/td>\n100\u2013200 mg\/den<\/td>\nMaxim\u00e1ln\u011b 200 mg\/denn\u011b ambulantn\u011b; a\u017e 300 mg\/denn\u011b hospitalizovan\u00fdm; titrace po dobu 2\u20134 t\u00fddn\u016f<\/td>\n<\/tr>\n
    MDD (senio\u0159i)<\/td>\n10\u201325 mg p\u0159ed span\u00edm<\/td>\n25\u2013100 mg\/den<\/td>\nNi\u017e\u0161\u00ed c\u00edlov\u00e1 d\u00e1vka; vy\u0161\u0161\u00ed riziko anticholinergn\u00edch \u00fa\u010dink\u016f a ortostatick\u00e9 hypotenze<\/td>\n<\/tr>\n
    panick\u00e1 porucha<\/td>\n10\u201325 mg p\u0159ed span\u00edm \u00d7 1 t\u00fdden<\/td>\n75\u2013200 mg\/den<\/td>\nPomal\u00e9 zvy\u0161ov\u00e1n\u00ed d\u00e1vky, aby se p\u0159ede\u0161lo \u010dasn\u00e9mu zhor\u0161en\u00ed paniky<\/td>\n<\/tr>\n
    D\u011btsk\u00e1 enur\u00e9za (v\u011bk 6\u201312)<\/td>\n25 mg jednu hodinu p\u0159ed span\u00edm<\/td>\n25\u201350 mg jednu hodinu p\u0159ed span\u00edm<\/td>\nMaxim\u00e1ln\u011b 2,5 mg\/kg\/den; p\u0159ehodnotit po 3 m\u011bs\u00edc\u00edch \u2014 \u010dast\u00e9 relapsy po vysazen\u00ed<\/td>\n<\/tr>\n
    D\u011btsk\u00e1 enur\u00e9za (v\u011bk 12+)<\/td>\n25 mg jednu hodinu p\u0159ed span\u00edm<\/td>\n25\u201375 mg jednu hodinu p\u0159ed span\u00edm<\/td>\nMaxim\u00e1ln\u011b 75 mg\/den; stejn\u00e9 p\u0159ehodnocen\u00ed<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Vedlej\u0161\u00ed \u00fa\u010dinky (Anticholinergn\u00ed z\u00e1t\u011b\u017e je hlavn\u00ed probl\u00e9m)<\/h2>\n

    Profil vedlej\u0161\u00edch \u00fa\u010dink\u016f podle mechanismu<\/h2>\n\n\n\n\n\n\n\n\n\n\n
    Mechanismus \u00fa\u010dinku<\/th>\n\u00da\u010dinky<\/th>\nPozn\u00e1mky<\/th>\n<\/tr>\n<\/thead>\n
    Anticholinergn\u00ed (blok\u00e1da muskarinov\u00fdch receptor\u016f)<\/td>\nSucho v \u00fastech, z\u00e1cpa, retence mo\u010di, rozmazan\u00e9 vid\u011bn\u00ed, kognitivn\u00ed poruchy<\/td>\nV\u00fdrazn\u00e9 \u2014 ne prvn\u00ed volba u star\u0161\u00edch pacient\u016f; opatrnost u BPH, glaukomu, demence<\/td>\n<\/tr>\n
    H1<\/sub> blok\u00e1da<\/td>\nSedace, p\u0159ib\u00fdv\u00e1n\u00ed na v\u00e1ze<\/td>\nU\u017eite\u010dn\u00e9, kdy\u017e je nespavost sou\u010d\u00e1st\u00ed deprese; m\u00e9n\u011b u\u017eite\u010dn\u00e9 p\u0159es den<\/td>\n<\/tr>\n
    Blok\u00e1da alfa-1<\/td>\nOrtostatick\u00e1 hypotenze, z\u00e1vrat\u011b, p\u00e1dy<\/td>\nZvl\u00e1\u0161t\u011b problematick\u00e9 u star\u0161\u00edch dosp\u011bl\u00fdch; kontrolovat TK vle\u017ee\/vstoje<\/td>\n<\/tr>\n
    Srde\u010dn\u00ed (blok\u00e1da sod\u00edkov\u00fdch kan\u00e1l\u016f)<\/td>\nProdlou\u017een\u00ed QT a QRS, AV blok<\/td>\nZ\u00e1kladn\u00ed EKG p\u0159ed zah\u00e1jen\u00edm u pacient\u016f >50 let nebo s kardiologickou anamn\u00e9zou; smrteln\u00e9 p\u0159i p\u0159ed\u00e1vkov\u00e1n\u00ed \u2014 neposkytovat v\u011bt\u0161\u00ed mno\u017estv\u00ed pacient\u016fm s akutn\u00edm rizikem sebevra\u017edy<\/td>\n<\/tr>\n
    Serotonergn\u00ed\/noradrenergn\u00ed<\/td>\nPocen\u00ed, t\u0159es, sexu\u00e1ln\u00ed dysfunkce<\/td>\nObecn\u011b zvl\u00e1dnuteln\u00e9<\/td>\n<\/tr>\n
    Jin\u00e9<\/td>\nSn\u00ed\u017een\u00fd pr\u00e1h pro z\u00e1chvaty, paradoxn\u00ed m\u00e1nie (u nerozpoznan\u00e9 bipol\u00e1rn\u00ed poruchy)<\/td>\nOpatrnost u epilepsie, p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby vy\u0161et\u0159it na bipol\u00e1rn\u00ed poruchu<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Interakce s l\u00e9\u010divy<\/h2>\n

    Absolutn\u00ed kontraindikace<\/strong>: MAOI (14denn\u00ed vyplavovac\u00ed perioda), ned\u00e1vn\u00fd infarkt myokardu, t\u011b\u017ek\u00e9 nekontrolovan\u00e9 srde\u010dn\u00ed onemocn\u011bn\u00ed.<\/p>\n

    Riziko pro srdce<\/strong>: vyvarujte se sou\u010dasn\u00e9ho pod\u00e1v\u00e1n\u00ed l\u00e9k\u016f prodlu\u017euj\u00edc\u00edch QT interval (citalopram > 20 mg, kvetiapin, ziprasidon, ondansetron, metadon, fluorochinolony).<\/p>\n

    Substr\u00e1t CYP2D6<\/strong>: hladiny v plazm\u011b stoupaj\u00ed p\u0159i siln\u00fdch inhibitorech (paroxetin, fluoxetin, bupropion, chinidin). Pou\u017e\u00edvejte ni\u017e\u0161\u00ed d\u00e1vky.<\/p>\n

    Potencov\u00e1n\u00ed anticholinergn\u00edch \u00fa\u010dink\u016f<\/strong>: kombinujte opatrn\u011b s dal\u0161\u00edmi anticholinergiky (difenhydramin, skopolamin, trihexifenidyl, oxybutynin).<\/p>\n

    Sedace \/ ortostatick\u00e1 hypotenze<\/strong>: alkohol, benzodiazepiny, opioidy, alfa-blok\u00e1tory.<\/p>\n

    Kardi\u00e1ln\u00ed bezpe\u010dnost a riziko p\u0159ed\u00e1vkov\u00e1n\u00ed<\/h2>\n

    TCA pat\u0159\u00ed mezi nejnebezpe\u010dn\u011bj\u0161\u00ed l\u00e9ky p\u0159i p\u0159ed\u00e1vkov\u00e1n\u00ed<\/strong> kv\u016fli blok\u00e1d\u011b sod\u00edkov\u00fdch kan\u00e1l\u016f v srdci, co\u017e vede k \u0161irok\u00fdm komplexn\u00edm tachykardi\u00edm, komorov\u00fdm arytmi\u00edm a kardiogenn\u00edmu \u0161oku p\u0159i d\u00e1vk\u00e1ch 5\u201310x vy\u0161\u0161\u00edch ne\u017e terapeutick\u00e9. Z\u00e1kladn\u00ed EKG<\/strong> je standardn\u00edm postupem p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby u pacient\u016f nad 50 let nebo s rizikov\u00fdmi faktory srde\u010dn\u00edch onemocn\u011bn\u00ed. P\u0159edepisujte pouze 1\u20132 t\u00fddenn\u00ed z\u00e1sobu l\u00e9k\u016f najednou<\/strong> u pacient\u016f se smyslupln\u00fdm rizikem sebevra\u017edy \u2014 30denn\u00ed z\u00e1soba imipraminu 25 mg m\u016f\u017ee b\u00fdt potenci\u00e1ln\u011b smrt\u00edc\u00ed.<\/p>\n

    \u010casto kladen\u00e9 dotazy<\/h2>\n

    Jak dlouho trv\u00e1, ne\u017e D-mine za\u010dne p\u016fsobit?<\/h3>\n

    Odezva n\u00e1lady u MDD se obvykle objevuje za 4\u20136 t\u00fddn\u016f. Odezva u panick\u00e9 poruchy se obvykle dostavuje za 4\u20138 t\u00fddn\u016f. Odezva u enur\u00e9zy u d\u011bt\u00ed je obvykle pozorov\u00e1na b\u011bhem 1\u20132 t\u00fddn\u016f po \u00fa\u010dinn\u00e9 d\u00e1vce.<\/p>\n

    Odezva na panickou poruchu se obvykle objev\u00ed b\u011bhem 4\u20138 t\u00fddn\u016f.<\/h3>\n

    Imipramine a amitriptyline maj\u00ed podobn\u00e9 profily. Nortriptyline (na tomto webu Primox) a desipramine (tricyklick\u00e1 antidepresiva sekund\u00e1rn\u00edch amin\u016f) jsou obvykle l\u00e9pe tolerov\u00e1ny \u2014 m\u00e9n\u011b anticholinergn\u00ed a m\u00e9n\u011b sedativn\u00ed \u2014 pokud je pot\u0159eba tricyklick\u00e9 antidepresivum.<\/p>\n

    Mohou d\u011bti bezpe\u010dn\u011b u\u017e\u00edvat D-mine na no\u010dn\u00ed pomo\u010dov\u00e1n\u00ed?<\/h3>\n

    Ano \u2014 imipramine se pou\u017e\u00edv\u00e1 pro d\u011btskou no\u010dn\u00ed enur\u00e9zu od 60. let se schv\u00e1len\u00edm FDA. V\u017edy a\u017e t\u0159et\u00ed volbou po behavior\u00e1ln\u00ed \/ alarmov\u00e9 terapii a desmopressin. Srde\u010dn\u00ed riziko je n\u00edzk\u00e9 p\u0159i standardn\u00edch d\u00e1vk\u00e1ch pro enur\u00e9zu, ale EKG by m\u011blo b\u00fdt zkontrolov\u00e1no, pokud d\u00e1vka p\u0159ekro\u010d\u00ed 75 mg\/den nebo pokud je v rodinn\u00e9 anamn\u00e9ze arytmie \/ n\u00e1hl\u00e1 smrt.<\/p>\n

    Pro\u010d ji\u017e TCA nejsou l\u00e9ky prvn\u00ed volby u deprese?<\/h3>\n

    Z\u00e1t\u011b\u017e vedlej\u0161\u00edmi \u00fa\u010dinky (anticholinergn\u00ed, sedace, ortost\u00e1za) a smrtelnost p\u0159i p\u0159ed\u00e1vkov\u00e1n\u00ed vedly od konce 80. let k posunu prvn\u00ed linie l\u00e9\u010dby na SSRI a SNRI. TCA z\u016fst\u00e1vaj\u00ed u\u017eite\u010dn\u00e1 u refraktern\u00ed deprese, neuropatick\u00e9 bolesti a paniky.<\/p>\n

    Ano \u2014 TCA zp\u016fsobuj\u00ed v\u00fdznamn\u00e9 p\u0159ib\u00edr\u00e1n\u00ed na v\u00e1ze (5\u201310 kg nebo v\u00edce b\u011bhem m\u011bs\u00edc\u016f) stimulac\u00ed chuti k j\u00eddlu. To je jeden z hlavn\u00edch d\u016fvod\u016f, pro\u010d pacienti p\u0159ech\u00e1zej\u00ed na SSRI.<\/h3>\n

    Ano \u2014 TCA zp\u016fsobuj\u00ed v\u00fdznamn\u00fd n\u00e1r\u016fst hmotnosti (5\u201310 kg nebo v\u00edce b\u011bhem m\u011bs\u00edc\u016f) prost\u0159ednictv\u00edm H1<\/sub> stimulace chuti k j\u00eddlu. To je jeden z hlavn\u00edch d\u016fvod\u016f, pro\u010d pacienti p\u0159ech\u00e1zej\u00ed na SSRI.<\/p>\n

    U\u017e\u00edvejte ho, jakmile si vzpomenete, pokud nen\u00ed bl\u00edzko dal\u0161\u00ed d\u00e1vky. Imipramin m\u00e1 dlouh\u00fd polo\u010das, tak\u017ee vynech\u00e1n\u00ed jedn\u00e9 d\u00e1vky jen z\u0159\u00eddka zp\u016fsob\u00ed abstinen\u010dn\u00ed p\u0159\u00edznaky.<\/h3>\n

    Avoid heavy alcohol \u2014 additive sedation, orthostasis, and lowered seizure threshold. Light occasional alcohol is generally tolerated but caution is warranted.<\/p>\n

    Co se stane, kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n

    Vezm\u011bte si ji, jakmile si vzpomenete, pokud nen\u00ed bl\u00edzko k dal\u0161\u00ed d\u00e1vce. Imipramine m\u00e1 dlouh\u00fd polo\u010das, tak\u017ee vynech\u00e1n\u00ed jedn\u00e9 d\u00e1vky z\u0159\u00eddka zp\u016fsob\u00ed abstinen\u010dn\u00ed p\u0159\u00edznaky.<\/p>\n

    Je D-mine bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed?<\/h3>\n

    Omezen\u00e9 \u00fadaje \u2014 nen\u00ed l\u00e9kem prvn\u00ed volby v t\u011bhotenstv\u00ed. SSRI (preferuje se sertralin) maj\u00ed mnohem rozs\u00e1hlej\u0161\u00ed bezpe\u010dnostn\u00ed datab\u00e1zi. Expozice v pozdn\u00edm t\u0159et\u00edm trimestru byla spojena s abstinen\u010dn\u00edmi p\u0159\u00edznaky u novorozenc\u016f.<\/p>\n

    Lze D-mine kombinovat s jin\u00fdmi antidepresivy?<\/h3>\n

    N\u011bkdy \u2014 n\u00edzk\u00e9 d\u00e1vky TCA se p\u0159id\u00e1vaj\u00ed k SSRI u l\u00e9\u010debn\u011b rezistentn\u00ed deprese, ale pouze pod dohledem p\u0159edepisuj\u00edc\u00edho l\u00e9ka\u0159e. Kombinace s inhibitory MAO je kontraindikov\u00e1na.<\/p>\n

    Jak by m\u011bl b\u00fdt D-mine skladov\u00e1n?<\/h3>\n

    Skladujte p\u0159i teplot\u011b 15\u201330 \u00b0C v p\u016fvodn\u00edm blistru, mimo dosah vlhkosti a slune\u010dn\u00edho sv\u011btla. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed<\/strong> \u2014 p\u0159ed\u00e1vkov\u00e1n\u00ed TCA je rychle smrteln\u00e9.<\/p>\n

    Zdravotn\u00ed upozorn\u011bn\u00ed:<\/strong> Informace na t\u00e9to str\u00e1nce jsou ur\u010deny dosp\u011bl\u00fdm u\u017e\u00edvaj\u00edc\u00edm p\u0159edepsan\u00e9 psychiatrick\u00e9 l\u00e9ky a nenahrazuj\u00ed individu\u00e1ln\u00ed l\u00e9ka\u0159skou p\u00e9\u010di. Antidepresiva, antipsychotika a p\u0159\u00edbuzn\u00e9 l\u00e9ky mohou interagovat s jin\u00fdmi l\u00e9ky, alkoholem a st\u00e1vaj\u00edc\u00edmi zdravotn\u00edmi stavy. Jak\u00e9koli nov\u00e9 l\u00e9ky, zm\u011bnu d\u00e1vkov\u00e1n\u00ed nebo pl\u00e1novan\u00e9 vysazen\u00ed konzultujte s kvalifikovan\u00fdm l\u00e9ka\u0159em. Pokud se u v\u00e1s objev\u00ed sebevra\u017eedn\u00e9 my\u0161lenky, m\u00e1nie, t\u011b\u017ek\u00e1 akathisie, p\u0159\u00edznaky serotoninov\u00e9ho syndromu (vysok\u00e1 hore\u010dka, zmatenost, svalov\u00e1 ztuhlost, zrychlen\u00fd srde\u010dn\u00ed tep) nebo neuroleptick\u00fd malign\u00ed syndrom, vyhledejte okam\u017eit\u011b l\u00e9ka\u0159skou pomoc.<\/div>\n

    <\/p>\n

    Souvisej\u00edc\u00ed alternativy<\/h3>\n

    Dal\u0161\u00ed produkty v Chronick\u00e1 onemocn\u011bn\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n