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Akzeleration der Antidepressivaresponse und Augmentation mit Pindolol

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Akute und therapieresistente Depressionen

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Zusammenfassung

Aufgrund steigender Prävalenzen der Major Depression und dem Nichtansprechen antidepressiver Therapien bei einem Teil der Patienten wurden zunehmend Behandlungsstrategien untersucht, die das Ansprechen der klassischen Antidepressiva beschleunigen und/oder verbessern sollen. Dazu gehört u. a. auch Pindolol. Es wurde ursprünglich als Antihypertonikum (partieller β- Blocker) entwickelt; später wurde dann seine partielle Serotonin-(5-HT-)Rezeptoren-blockende Wirkung entdeckt sowie seine Eigenschaft, die Blut- Hirn-Schranke relativ problemlos zu passieren. Eine kürzlich durchgeführte Metaanalyse der bisher publizierten Daten ergab, dass Pindolol bei einer Gabe von 2,5 mg zweimal pro Tag zwar den antidepressiven Wirkungseintritt beschleunigt, jedoch nicht die klinische Wirkung bei bisher therapieresistenten Patienten verbessern konnte. Eine signifikante Verbesserung der antidepressiven Wirkung zeigte sich aber bei Patienten mit der kurzen Variante des 5-HT-Transporter-Promotorgens. Es wird vermutet, dass es bei einer gesteigerten Pindololdosis von etwa 5 mg zweimal pro Tag zu einer höheren Besetzung der 5-HT1A-Autorezeptoren im Gehirn kommt, was dann evtl. zur erwünschten Wirkung führt. Doch liegen zu dieser Dosierung noch keine klinischen Untersuchungen vor.

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Authors
  1. F. Artigas
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  2. A. Adell
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  3. P. Celada
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Editors and Affiliations

  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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Artigas, F., Adell, A., Celada, P. (2005). Akzeleration der Antidepressivaresponse und Augmentation mit Pindolol. In: Bauer, M., Berghöfer, A., Adli, M. (eds) Akute und therapieresistente Depressionen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-28049-9_22

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