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Antidepressivakombinationen

  • P. Mavrogiorgou
  • G. Juckel

Zusammenfassung

Eine Indikation für Kombinationen von Antidepressiva bei therapieresistenten depressiven Patienten besteht erst bei Nichtansprechen auf eine hinsichtlich Dosis und Dauer ausreichend durchgeführte Antidepressivamonotherapie und bei Vorliegen von medizinischen und persönlichen Gründen gegen den Einsatz gängiger Standardverfahren wie z. B. Lithiumaugmentation. Klinisch sinnvoll sind Kombinationen von Antidepressiva mit unterschiedlichem Wirkprofil, so z. B. das Hinzufügen eines selektiven Serotonin-Wiederaufnahmehemmers zu einem trizyklischem Antidepressivum wie Amitriptylin. Bei der Kombination von Antidepressiva muss das erhöhte Nebenwirkungsrisiko durch die Addition von gleichartigen unerwünschten Wirkungen sowie mögliche Plasmaspiegelerhöhungen bei gleichen hepatischen Metabolisierungswegen beachtet werden. Regelmäßige Plasmaspiegelkontrollen und ggf. eine Dosisreduktion sollten hierbei durchgeführt werden. Um den zukünftigen Stellenwert der neu zugelassenen, mehr selektiv wirksamen Antidepressiva bei der Kombinationsbehandlung besser einschätzen zu können, sind weitere kontrollierte Untersuchungen wünschenswert.

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Copyright information

© Springer Medizin Verlag Heidelberg 2005

Authors and Affiliations

  • P. Mavrogiorgou
  • G. Juckel

There are no affiliations available

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