Psychopharmaka heute pp 13-33 | Cite as
Neurobiologische Forschungskonzepte für die Pharmakotherapie affektiver Störungen
Zusammenfassung
Die wichtigsten Anregungen für die Kausalforschung affektiver Erkrankungen kamen aus der Neuropharmakologie. Nach der Entdeckung der antidepressiven Wirkung von Imipramin durch den Schweizer Psychiater Kuhn und der Beobachtung, daß bei 10–20% aller Patienten, die mit Reserpin behandelt werden, depressive Syndrome entstehen, wurde die Noradrenalin (NA)-Mangelhypothese formuliert. Sie basierte auf pharmakologischen Befunden, nach denen das Antidepressivum Imipramin durch Wiederaufnahmehemmung von NA in die präsynaptische Nervenendigung dessen postsynaptische Bioverfügbarkeit erhöht (Abb. 1). Weiter stützt sich diese Hypothese auf die pharmakologische Eigenschaft von Reserpin, das die präsynaptischen NA-Vesikel entspeichert und damit nach längerer Anwendung die noradrenerge Neurotransmission vermindert. Das Konzept der NA-Mangelhypothese war von großem heuristischem Wert und hat verschiedene neurobiologische Richtungen in der Depressionsforschung wesentlich beeinflußt.
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