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Experimentelle Behandlungsansätze und Zukunftsperspektiven bei therapieresistenten Depressionen

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Zusammenfassung

  1. 1

    Experimentelle Behandlungsansätze können das therapeutische Spektrum bei ansonsten therapieresistenten Depressionen erweitern. Diese Verfahren umfassen die Gabe von MAO-Hemmern (hochdosiert), Psychostimulantien, Reserpin, (Östrogenen und Antiepileptika (Carbamazepin, Valproat). Weiterhin zählen zu diesen Behandlungsansätzen die Applikation von Serotonin-Rezeptorantagonisten, die präsynaptisch die Autorezeptoren inhibieren, sowie die Gabe von Inhibitoren der Cortisolproduktion.

     
  2. 2.

    Gemeinsame Wirkmechanismen dieser heterogen erscheinenden Gruppe umfassen die Beeinflussung der noradrenergen, dopaminergen und serotonergen Transmission im Sinne einer erhöhten Freisetzung oder eines verminderten Abbaus der Neurotransmitter. Antiepileptika wirken dagegen möglicherweise, indem sie einen schützenden Effekt auf die Amygdala ausüben.

     
  3. 3.

    Da bei den sogenannten experimentellen Verfahren häufig keine ausreichende Zahl klinischer Studien zu Effektivität und Nebenwirkungsrate vorliegt, muß der Patient über den Versuchscharakter der Therapie aufgeklärt werden, und es muß auf eventuell auftretende Nebenwirkungen besonders geachtet werden.

     

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© Springer-Verlag Berlin Heidelberg 1997

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