Umstellung und Kombinationen von Antidepressiva

Zusammenfassung

Depressive Erkrankungen können heute effektiv mit Psychotherapie und mit Antidepres-siva behandelt werden. Dennoch sprechen nicht alle Patienten auf die Behandlung an. Bei fehlendem Ansprechen auf eine Behand-lungsstrategie wird nach bekannten Leitlinien empfohlen, auf eine andere Behandlung, z. B. auf ein anderes Medikament oder eine Kom-bination von Medikamenten umzustellen. Die vorliegende Arbeit befasst sich mit der gegenwärtigen wissenschaftlichen Evidenz für den therapeutischen Nutzen der Umstellung von einem Antidepressivum auf ein anderes Antidepressivum, beziehungsweise auf eine Kombination aus zwei Antidepressiva im Falle einer Non-Response auf ein Antidepressivum. Die Wirksamkeit psychotherapeutischer Behandlungen ist nicht Gegenstand dieser Arbeit.

Summary

Today, depressive disorders can be treated effectively with psychotherapy and antidepres-sants, but not every treated patient with depression is a responder. In the case of nonre-sponders, guidelines recommend a new adjustment or a combination therapy. This article gives an overview about recent medical evidence of the therapeutic benefit of an adjustment from one antidepressant to another or a combination therapy with two antidepressants in case of a nonresponse to one antidepressant. The effectiveness of psychotherapy in general is not discussed here.

Schlüsselwörter

Antidepressiva - Switching - Kombinationstherapie - Depression - affektive Störungen - Therapieresistenz

Keywords

Antidepressants - switching - combination treatment - depressive disorder - affective disorder - treatment refractory

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