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Adjuvante Schilddrüsenhormonbehandlung

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Akute und therapieresistente Depressionen

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Zusammenfassung

Die Bedeutung der Schilddrüsenhormone für affektive Störungen wird seit langem erforscht. Das Vorkommen psychiatrischer Symptomatik, insbesondere depressiver und kognitiver Störungen, bei primären Schilddrüsenerkrankungen ist häufig, aber unspezifisch. Während der überwiegende Teil depressiver Patienten laborchemisch euthyreot ist, finden sich bei Untergruppen affektiv Erkrankter, z. B. bei bipolaren Patienten mit Rapid Cycling, gehäuft subklinische Schilddrüsenfunktionsstörungen. Die Effekte einer adjuvanten Schilddrüsenhormonbehandlung wurden in verschiedenen Indikationen bei affektiven Erkrankungen untersucht:

  1. 1.

    zur Akzeleration der Antidepressivawirkung,

  2. 2.

    zur Augmentation bei Antidepressiva-Nonresponse,

  3. 3.

    zur adjuvanten Phasenprophylaxe bei Prophylaxeresistenz.

Die Wechselwirkungen von Schilddrüsenhormonen mit anderen funktionellen Systemen des adulten ZNS sind komplex. Insgesamt scheinen die Schilddrüsenhormone im Sinne eines »crosstalks« mit verschiedenen anderen Funktionseinheiten des ZNS in Verbindung zu stehen und diese modulieren zu können bzw. durch diese selber modifiziert zu werden. Die therapeutischen Effekte einer Augmentationsbehandlung mit Trijodthyronin (T3) und L-Thyroxin (L-T4) bei affektiven Störungen gehen möglicherweise auf eine solche Wechselwirkung zurück, durch die die serotonerge Neurotransmission gesteigert wird.

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  1. M. Bauer
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  2. U. Köberle
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  3. P.C. Whybrow
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  1. Klinik für Psychatrie und Psychotherapie, Charité — Universitätsklinik Berlin, Campus Charité Mitte (CCM), Schumannstr. 20/21, 10117, Berlin

    Michael Bauer  & Mazda Adli  & 

  2. Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité — Universitätsklinik Berlin, Campus Charité Mitte (CCM), Luisenstr. 57, 10117, Berlin

    Anne Berghöfer

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Bauer, M., Köberle, U., Whybrow, P. (2005). Adjuvante Schilddrüsenhormonbehandlung. In: Bauer, M., Berghöfer, A., Adli, M. (eds) Akute und therapieresistente Depressionen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-28049-9_19

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