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Fortschr Neurol Psychiatr 2015; 83(03): 142-148
DOI: 10.1055/s-0034-1399243
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Akute pharmakologische Therapieoptionen von ängstlicher Symptomatik bei Patienten mit Depression

Acute Pharmacotherapy for Anxiety Symptoms in Patients with Depression
A. Quante
1   Klinik für Psychiatrie und Psychotherapie, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin
2   Klinik für Psychiatrie und Psychotherapie, Friedrich von Bodelschwingh Klinik, Berlin
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Publication History

Publication Date:
20 March 2015 (online)

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Zusammenfassung

Depressive Episoden gehen häufig mit ängstlicher Symptomatik und Agitiertheit einher. Initial erhalten Patienten daher häufig neben einer antidepressiven Medikation auch Benzodiazepine. Aufgrund des Abhängigkeitspotenzials sowie kognitiver und anderer körperlicher Nebenwirkungen von Benzodiazepinen, teilweise bestehender Kontraindikationen und auch des Wunsches nach Verzicht auf Benzodiazepine von einigen Patienten besteht ein dringender Bedarf für alternative pharmakologische Therapien zur akuten Behandlung von ängstlich-agitierter Symptomatik. In der aktuellen Übersichtsarbeit wurde eine selektive Medline-/Pubmed-Recherche durchgeführt mit Fokus auf pharmakologischer Akutbehandlung ängstlich-agitierter Symptome bei depressiven Patienten. Für Quetiapin, Olanzapin, die Olanzapin-Fluoxetin-Kombination, Pregabalin und Silexan konnten bei insgesamt sehr dünner Studienlage zumindest Hinweise für eine akute Wirksamkeit in dieser Indikation gefunden werden.

Abstract

Patients with depression often also present symptoms of anxiety. First-line pharmacotherapy of comorbid symptoms of depression and anxiety is often a combination therapy of an antidepressant agent, which is combined with benzodiazepines. However, benzodiazepines pose the drawbacks of being associated with cognitive and motor impairments and hold a significant risk for dependence. For some patients, benzodiazepines are contraindicated or patients refuse to take them. Therefore, alternative therapy strategies for the acute treatment of anxiety symptoms in depressed patients are urgently needed. A selective Medline/Pubmed search with focus on acute pharmacological treatment strategies for anxiety and agitation in depressed patients was undertaken. In the light of the paucity of studies in this field, positive effects could be assumed for quetiapine, olanzapine, olanzapine-fluoxetine combination, pregabaline and silexan.

Schlüsselwörter

Depression - Ängstlichkeit - Agitiertheit - Pharmakotherapie

Key words

depression - anxiety - agitation - pharmacotherapy
 

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