Biologische Prädiktoren für eine erfolgreiche antidepressive medikamentöse Behandlung

  • E. Fähndrich
Conference paper
Part of the Tropon-Symposium book series (BAYERZNS, volume 5)

Zusammenfassung

Auch nach 30 Jahren spezifischer antidepressiver medikamentöser Therapie ist im konkreten Einzelfall die Entscheidung noch immer sehr schwer zu treffen, welches der vielen, sich auf dem Markt befindlichen Antidepressiva für einen bestimmten Patienten hier und jetzt wohl das erfolgreichste sein wird. 15 Jahre intensiver Forschung haben nicht zu praktisch anwendbaren Prädiktoren bezüglich einer Differentialindikation der Antidepressiva geführt. Abgewandelt nach Klett u. Moseley (1965) gilt es, die Forderung nach dem „right antidepressant drug for the right depression“ noch zu erfüllen. Sicher ist heute, daß die nosologische Zuordnung eines Patienten zur Vorhersage des Behandlungserfolges im Einzelfall nicht taugt, da Patienten sowohl mit endogener als auch neurotischer Depression auf Antidepressiva ansprechen (Ananth 1978; Cavi et al. 1974; Goldberg u. Finnerty 1977; Klerman et al. 1974; Prusoff u. Paykel 1977; Razani et al. 1983; Reisby et al. 1977; Stefanis et al. 1982). Schon 1969 formulierte Freyhan dieses Dilemma: „Die Vorstellung von nosologisch bezogener Therapie stirbt um so langsamer, als es immer wieder neue Illusionen von Einheitsursachen für Einheitskrankheiten zu geben scheint.“ Aber nicht nur auf der Ebene der nosologischen Krankheitsgruppen, sondern auch auf der Symptomebene wurde kein sicherer Prädiktor für eine erfolgreiche antidepressive Behandlung gefunden (Fähndrich 1983b; Woggon 1983). Im folgenden soll versucht werden, einen Überblick über die biologische Prädiktorforschung zu geben sowie die Ergebnisse dieser intensiven Bemühungen einer kritischen Würdigung zu unterziehen.

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  • E. Fähndrich

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