Zusammenfassung
Die Gruppe der Antidepressiva ist hinsichtlich ihrer chemischen Strukturen heterogen, dennoch ist ihnen eine Beeinflussung der monoaminergen Transmission gemeinsam. In welcher Weise die chemische Unterschiedlichkeit auch zu pharmakodynamischen Effekten außerhalb der monoaminergen Mechanismen führt, ist derzeit noch unzureichend erforscht. Zahlreiche, noch in frühen Entwicklungsstadien befindliche Substanzen sind primär auf unterschiedliche Zielstrukturen und Wirkmechanismen gerichtet, die aus der Genetik und Molekularbiologie abgeleitet wurden. Es kann noch nicht abgeschätzt werden, ob sich hieraus grundsätzlich neue und vor allem bessere Therapieoptionen ergeben werden. Obwohl fast alle heute in der Klinik eingesetzten Antidepressiva den aus der Monoamin-Hypothese (Manji et al. 2001; Haenisch u. Bönisch 2011) abgeleiteten Wirkmechanismen folgen, gibt es dennoch pharmakologische Unterschiede, die das klinische Profil der einzelnen Substanzen prägen. Dies hat wichtige Konsequenzen für die Anwendung, v. a. auch bei der Kombination mehrerer Antidepressiva.
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Holsboer-Trachsler, E., Holsboer, F. (2012). Antidepressiva. In: Gründer, G., Benkert, O. (eds) Handbuch der psychiatrischen Pharmakotherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-19844-1_53
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