Antidepressive Pharmakotherapie bei komorbider kardialer Erkrankung

Zusammenfassung

Die Komorbidität von Depression und Herzkrankheit ist häufig; die antidepressive Behandlung erfordert ein übergreifendes Therapiekonzept. Eine antidepressive Pharmakotherapie ist in der Regel bei mittelschweren und schweren depressiven Episoden indiziert, Mittel der Wahl sind SSRI. Bei der Depression, die in Zusammenhang mit einem akuten koronaren Ereignis auftritt, sollten Antidepressiva nur bei schweren oder rezidivierenden Episoden verschrieben werden, oder wenn die Depression schon vor dem koronaren Ereignis bestand. Es gibt keine eindeutige Grundlage für den Einsatz von Antidepressiva bei depressiven Patienten mit komorbider Herzinsuffizienz.

Abstract

Depression and cardiac disease are frequently comorbid and necessitate a thorough treatment plan. Antidepressant pharmacotherapy is indicated for moderately severe or severe depression with selective serotonin reuptake inhibitors as treatment of choice. When depression arises in the context of an acute coronary syndrome, antidepressants should be prescribed only for severe or recurrent depression, or when affective symptoms started before the cardiac event. There is no evidence indicating efficacy of antidepressant pharmacotherapy in patients with heart failure.

Schlüsselwörter

Depression - Pharmakotherapie - Komorbidität - Herzkrankheit

Key words

depression - pharmacotherapy - comorbidity - heart disease

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