Akutbehandlung schwerer depressiver Zustandsbilder

Zusammenfassung

Akute Notfälle bei depressiven Erkrankungen mit hoher Symptomlast und Selbstgefährdung wie Suizidalität erfordern ein schnelles, multimodales und individuell angepasstes Vorgehen. Der Beitrag stellt aktuelle klinisch erprobte Behandlungsoptionen vor – von Benzodiazepinen über Ketamin bis hin zur Elektrokonvulsionstherapie (EKT) – und betont die Bedeutung persönlicher therapeutischer Begleitung.

Abstract

High symptom burden and self-endangerment require rapid and reliable recognition and treatment in the presence of acute severe depressive syndromes. Essentially, these are suicidal, agitated, and psychotic states. Since these are usually exclusion criteria for randomized trials, the levels of evidence and recommendation for treatments are often low. Consequently, interventions are often administered off-label and, if available, in a method-integrative manner, including innovative strategies and brain stimulation procedures. In this article, the frequently observed positive clinical effects are presented and discussed using the examples of ECT and ketamine treatment.

Schlüsselwörter

Depression - psychiatrische Krisensituation - Suizidalität - Selbstgefährdung - Esketamin - Ketamin

Keywords

depression - psychiatric crisis - suicidal tendencies - self-harm - esketamine - ketamine

Publikationsverlauf

Artikel online veröffentlicht:
12. September 2025

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