Augmentation von Antidepressiva mit atypischen Antipsychotika bei Nonresponse auf eine Antidepressiva-Monotherapie

Sebastian Erbe; Stefan Gutwinski; Tom Bschor

doi:10.1055/s-0031-1277013

Psychiatrische Praxis, Inhaltsverzeichnis

Psychiatr Prax 2012; 39(02): 57-63
DOI: 10.1055/s-0031-1277013

Übersicht

Augmentation von Antidepressiva mit atypischen Antipsychotika bei Nonresponse auf eine Antidepressiva-Monotherapie

Eine systematische Übersichtsarbeit randomisierter placebokontrollierter Studien bei unipolarer nicht wahnhafter DepressionAugmentation of Antidepressants with Atypical Antipsychotics in Non-Delusional Unipolar Depressed Patients with Non-Response to Antidepressant-MonotherapyA Systematic Review About Randomized Placebo Controlled Trials

Autoren

Sebastian Erbe

¹Abteilung für Psychiatrie der Schlosspark-Klinik, Berlin
Stefan Gutwinski

²Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus, Berlin
Tom Bschor

¹Abteilung für Psychiatrie der Schlosspark-Klinik, Berlin

Abstract

Zusammenfassung

Anliegen Untersuchung des Nutzens einer Augmentationsbehandlung mit atypischen Antipsychotika bei Depression.

Methode Literatursuche in der Pubmed-Datenbank der Jahrgänge 1990 – 2011. Kritische Beurteilung der gefundenen Studienlage.

Ergebnisse 14 RCT wurden gefunden. Untersucht wurden Olanzapin, Quetiapin, Risperidon und Aripiprazol. Es handelt sich um eine Alternative zur etablierten Lithiumaugmentation. In Deutschland ist nur retardiertes Quetiapin zugelassen.

Schlussfolgerung Die Kenntnisse der dargestellten Augmentationsstrategie ermöglichen eine bessere Behandlung der Depression.

Abstract

Objective Augmentation of antidepressants with atypical antipsychotics is used in depressive patients with non-response to antidepressants. We investigated the utility of this strategy.

Methods Systematic computer-based search in the online library Pubmed for randomized placebo-controlled double-blind trials (RCT) from the years 1990 to 2011.

Results We found 14 RCT about augmentation of antidepressants with atypical antipsychotics in depressive patients with non-response to antidepressants. Trials examined olanzapine, risperidone, quetiapine and aripiprazole.

Conclusions Augmentation of antidepressants with atypical antipsychotics is an alternative to the augmentation with lithium in unipolar depressive patients with non-response to antidepressants. But treatment with atypical antipsychotics as opposed to placebo increases the risk of non-compliance due to side-effects of medication. Augmentation of antidepressants with atypical antipsychotics in unipolar depression is an off-label therapy in Germany except for the augmentation with extended-release quetiapine. Knowledge about treatment strategies regarding augmentation of antidepressants with atypical antipsychotics can increase the chance of a successful treatment, but interactions and side-effects should be considered.

Schlüsselwörter

Augmentation - atypische Antipsychotika - therapieresistente Depression

Keywords

augmentation - atypical antipsychotics - treatment resistant depression

Volltext

Referenzen

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