Neue Wege in der Depressionsbehandlung

Zusammenfassung

Die pharmakologische Behandlung der Depression ist trotz der enormen Fortschritte der letzten 40 Jahre noch immer nicht zufrieden stellend. Alle derzeit verwendeten Substanzen wirken über die Beeinflussung der Monoamine im zentralen Nervensystem. In der vorliegenden Übersicht sollen neben Fortentwicklungen der monoaminergen Antidepressiva neue antidepressive Wirkmechanismen vorgestellt und diskutiert werden. Neuere Entwicklungen im Bereich der monoaminergen Substanzen umfassen Metabolite gängiger Antidepressiva, direkte Serotoninagonisten oder Dreifachwiederaufnahmehemmer, die den Transport von Serotonin, Noradrenalin und Dopamin hemmen. Bei den nicht monoaminergen Strategien stehen Substanzen im Vordergrund, die auf Melatonin wirken oder Neuropeptide beeinflussen. Eine hoffnungsvolle Klasse von möglichen Antidepressiva stellen die glutamat-modulierenden Substanzen wie Ketamin und Riluzol dar. Daneben sind auch Fortschritte im Bereich der Modulierung der HPA-Achse zu verzeichnen.

Abstract

Despite the advances in the psychopharmacology, the treatment of depressive disorder is still not satisfactory. All current pharmacological substances are affecting the monoamines in the central nervous system. The present review discusses advances in the field of monoaminergic antidepressants as well as new treatment alternatives. The new monoaminergic substances include metabolites of known antidepressants, direct serotonin-agonists, and triple-reuptake inhibitors, blocking the transport of serotonin, norepinephrine, and dopamine.
Non-monoaminergic strategies include substances affecting melatonin or neuropeptides. Glutamate modulating agents such as ketamine or riluzole are another promising approach in the treatment of depression. Some advances have also been achieved in the field of HPA-axis modulation.

Schlüsselwörter

Depression - Antidepressiva - Medikamentenentwicklung

Key words

depression - antidepressants - drug discovery

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