Download PDF
Fortschr Neurol Psychiatr 2002; 70(4): 210-217
DOI: 10.1055/s-2002-24644
Originalarbeit
© Georg Thieme Verlag Stuttgart · New York

Augmentation von selektiven Serotonin-Wiederaufnahme-Hemmern (SSRI) mit atypischen Antipsychotika in der Depressionsbehandlung

Augmentation of Selective Serotonin Reuptake Inhibitors (SSRI) with Atypical Antipsychotics in the Treatment of DepressionE.  Weimer1 , D.  F.  Braus1 , I.  Cavus2 , J.  Thome1, 2
  • 1Zentralinstitut für Seelische Gesundheit Mannheim (Direktor: Prof. Dr. Dr. F. A. Henn)
  • 2Division of Molecular Psychiatry, Yale University School of Medicine (Direktor: Prof. Dr. Dr. R. S. Duman)
Further Information

Publication History

Publication Date:
05 April 2002 (online)

    Permissions and Reprints

Zusammenfassung

Die Behandlung schwerer Depressionen stellt eine komplizierte Aufgabe in der täglichen psychiatrischen Praxis dar. Augmentationstherapien zur Verbesserung der Wirkung von SSRIs können in bestimmten Fällen hilfreich sein. Seit kurzem besteht die Möglichkeit, zur SSRI-Augmentation atypische Antipsychotika einzusetzen. Diese Option bereichert die bisher bestehenden Strategien in der Depressionstherapie und erste systematische Anwendungsstudien zeigen ermutigende Resultate. In dieser Übersichtsarbeit wird die Möglichkeit einer SSRI-Augmentation insbesondere durch zusätzliche Gabe von Risperidon oder Olanzapin kritisch diskutiert.

Abstract

The treatment of severe depression represents a difficult task in the daily psychiatric practice. In certain cases, augmentation therapies in order to improve the efficacy of SSRIs can be useful. Recently, it has become possible to use atypical antipsychotics for SSRI augmentation. This option adds to the existing strategies in the treatment of depression and primary systematic studies show encouraging results. In this review, the possibility of a SSRI augmentation by additionally administering risperidone or olanzapine is critically discussed.

Literatur

  • 1 Landén M, Björling G, Agren H, Fahlén T. A randomized, double-blind, placebo-controlled trial of Buspirone in combination with an SSRI in patients with treatment-refractory depression.  J Clin Psychiatry. 1998;  59 664-668
    PubMedGoogle Scholar
  • 2 Aubry J M, Simon A, Bertschy G. Possible induction of mania and hypomania by olanzapine or risperidone: a critical review of reported cases.  J Clin Psychiatry. 2000;  61 649-655
    CrossrefPubMedGoogle Scholar
  • 3 Fava M. New approaches to the treatment of refractory depression.  J Clin Psychiatry. 2000;  61 26-32
    PubMedGoogle Scholar
  • 4 Nelson J C. Augmentation strategies in depression 2000.  J Clin Psychiatry. 2000;  61 13-19
    PubMedGoogle Scholar
  • 5 Marangell L B. Augmentation of standard depression therapy.  Clin Ther. 2000;  22 25-38
    PubMedGoogle Scholar
  • 6 Li P P, Young L T, Tam Y K, Sibony D, Warsh J J. Effects of chronic lithium and carbamazepine treatment on G-protein subunit expression in rat cerebral cortex.  Biol Psychiatry. 1993;  34 162-170
    CrossrefPubMedGoogle Scholar
  • 7 Wiborg O, Kruger T, Jakobsen S N. Region-selective effects of long-term lithium and carbamazepine administration on cyclic AMP levels in rat brain.  Pharmacol Toxicol. 1999;  84 88-93
    PubMedGoogle Scholar
  • 8 Post R M, Weiss S R, Chuang D M. Mechanisms of action of anticonvulsants in affective disorders: comparison with lithium.  J Clin Psychopharmacol. 1992;  12 23-35
    PubMedGoogle Scholar
  • 9 Sheline Y I, Wang P W, Gado M H, Csernansky J G, Vannier M W. Hippocampal atrophy in recurrent major depression.  Proc Natl Acad Sci USA. 1996;  93 3908-3913
    CrossrefPubMedGoogle Scholar
  • 10 Biver F, Goldman S, Delvenne V. et al . Frontal and parietal metabolic disturbances in unipolar depression.  Biol Psychiatry. 1994;  36 381-388
    CrossrefPubMedGoogle Scholar
  • 11 Thomas P, Vaiva G, Samaille E. et al . Cerebral blood flow in major depression and dysthymia.  J Affect Disord. 1993;  29 235-242
    CrossrefPubMedGoogle Scholar
  • 12 Hurwitz T A, Clark C, Murphy E, Klonoff H, Martin W R, Pate B D. Regional cerebral glucose metabolism in major depressive disorder.  Can J Psychiatry. 1990;  35 684-688
    PubMedGoogle Scholar
  • 13 Sapolsky R M. The possibility of neurotoxicity in the hippocampus in major depression: a primer on neuron death.  Biol Psychiatry. 2000;  48 755-765
    CrossrefPubMedGoogle Scholar
  • 14 Smith M A, Makino S, Kvetnansky R, Post R M. Effects of stress on neurotrophic factor expression in the rat brain.  Ann N Y Acad Sci. 1995;  29 234-239
    PubMedGoogle Scholar
  • 15 Duman R S, Heninger G R, Nestler E J. A molecular and cellular theory of depression.  Arch Gen Psychiatry. 1997;  54 597-606
    CrossrefPubMedGoogle Scholar
  • 16 Duman R S, Malberg J, Thome J. Neural plasticity to stress and antidepressant treatment.  Biol Psychiatry. 1999;  46 1181-1191
    CrossrefPubMedGoogle Scholar
  • 17 Stewart C A, Reid I C. Repeated ECS and fluoxetine administration have equivalent effects on hippocampal synaptic plasticity.  Psychopharmacology. 2000;  148 217-223
    CrossrefPubMedGoogle Scholar
  • 18 Madsen T M, Treschow A, Bengzon J, Bolwig T G, Lindvall O, Tingstrom A. Increased neurogenesis in a model of electroconvulsive therapy.  Biol Psychiatry. 2000;  47 1043-1049
    CrossrefPubMedGoogle Scholar
  • 19 Thome J, Sakai N, Shin K. et al . cAMP response element-mediated gene transcription is upregulated by chronic antidepressant treatment.  J Neurosci. 2000;  20 4030-4036
    PubMedGoogle Scholar
  • 20 Suda S, Nibuya M, Ishiguro T, Suda H. Transcriptional and translational regulation of phosphodiesterase type IV isozymes in rat brain by electroconvulsive seizure and antidepressant drug treatment.  J Neurochem. 1998;  71 1554-1563
    PubMedGoogle Scholar
  • 21 Malberg J E, Eisch A J, Nestler E J, Duman R S. Chronic antidepressant treatment increases neurogenesis in adult rat hippocampus.  J Neurosci. 2000;  20 9104-9110
    PubMedGoogle Scholar
  • 22 Harrow M, Yonan C A, Sands J R, Marengo J. Depression in schizophrenia: are neuroleptics, akinesia, or anhedonia involved?.  Schizophr Bull. 1994;  20 327-338
    PubMedGoogle Scholar
  • 23 Jarema M, Murawiec S, Szafranski T, Szaniawska A, Konieczynska Z. Subjective and objective evaluation of treating schizophrenia with classic or atypical drugs.  Psychiatr Pol. 2001;  35 5-19
    PubMedGoogle Scholar
  • 24 Keck P E J, Strakowski S M, McElroy S L. The efficiacy of atypical antipsychotics in the treatment of depressive symptoms, hostility and suicidality in patients with schizophrenia.  J Clin Psychiatry. 2000;  61 4-9
    PubMedGoogle Scholar
  • 25 Naber D, Lambert M, Krausz M. Atypische Neuroleptika in der Behandlung schizophrener Patienten. 2. Auflage. In: Haasen C, (Ed). Bremen: UNI-MED 2000
    Google Scholar
  • 26 Peuskens J, van Baelen B, de Smedt C, Lemmens P. Effects of Risperidone on affective symptoms in patients with schizophrenia.  Int Clin Psychopharmacol. 2000;  15 343-349
    PubMedGoogle Scholar
  • 27 Collaborative working Group on clinical Trial Evaluations . Atypical antipsychotics for treatment of depression in schizophrenia and affective disorders.  J Clin Psychiatry. 1998;  59 41-45
    PubMedGoogle Scholar
  • 28 Healy D. The case for an individual approach to the treatment of depression.  J Clin Psychiatry. 2000;  61 18-23
    PubMedGoogle Scholar
  • 29 O’Connor M, Silver H. Adding Risperidone to selective serotonin reuptake inhibitor improves chronic depression.  J Clin Psychopharmacol. 1998;  18 89-91
    CrossrefPubMedGoogle Scholar
  • 30 Ostroff R B, Nelson J. Risperidone augmentation of selective serotonin reuptake inhibitors in major depression.  J Clin Psychiatry. 1999;  60 256-258
    CrossrefPubMedGoogle Scholar
  • 31 Lane H-Y, Chiu W-C, Chang W-H. Risperidone monotherapy for mania and depression.  Am J Psychiatry. 1999;  156 1115
    PubMedGoogle Scholar
  • 32 Braus D F, Schmitt A, Czekalla J, Severa L. Therapy-resistant psychotic-depressive disorder. Remission with a selective serotonin reuptake inhibitor in combination with Olanzapin.  Clin Drug Invest. 2000;  20 455-459
    PubMedGoogle Scholar
  • 33 Carlos A ZJ, Narendran R, Tohen M. et al . Clinical predictors of acute response with Olanzapine in psychotic mood disorders.  J Clin Psychiatry. 1998;  59 24-28
    CrossrefPubMedGoogle Scholar
  • 34 Malhi G S, Checkley S A. Olanzapine in the treatment of psychotic depression.  Br J Psychiat. 1999;  174 460
    PubMedGoogle Scholar
  • 35 Rothschild A J, Bates K S, Boehringer K L, Syed A. Olanzapine response in psychotic depression.  J Clin Psychiatry. 1999;  60 116-118
    PubMedGoogle Scholar
  • 36 Schmitt A, Braus D F. Die effektivere Behandlung einer depressiven Störung mit psychotischen Symptomen durch Kombination mit Olanzapin.  Dtsch Med Wschr. 2000;  125 1526-1529
    Article in Thieme ConnectPubMedGoogle Scholar
  • 37 Bymaster F P, Rasmussen K, Calligaro D O. et al . In vitro and in vivo biochemistry of olanzapine: a novel, atypical antipsychotic drug.  J Clin Psychiatry. 1997;  58 28-36
    PubMedGoogle Scholar
  • 38 Smeraldi E. Amisulpride versus Fluoxetine in patients with dysthymia or major depression in partial remission. A double-blind, comparative study.  J Affect Dis. 1998;  48 47-56
    CrossrefPubMedGoogle Scholar
  • 39 Wolfersdorf M, König F RS. Pharmacotherapy of delusional depression: Experience with combinations of antidepressants with the neuroleptics Zotepine and Haloperidol.  Neuropsychobiol. 1994;  29 189-193
    PubMedGoogle Scholar
  • 40 Fulton B, Goa K. Olanzapine - a review of its pharmacological properties and therapeutic efficiancy in the management of schizophrenia and related psychoses.  Drugs. 1997;  53 281-298
    CrossrefPubMedGoogle Scholar
  • 41 Jacobsen F M. Risperidone in the treatment of affective illness and obsessive-compulsive disorder.  J Clin Psychiatry. 1995;  56 423-429
    PubMedGoogle Scholar
  • 42 McDougle C J, Epperson C N, Pelton G H, Wasylink S, Price L H. A double-blind, placebo-controlled study of Risperidone addition in serotonin reuptake inhibitor-refractory obsessive-compulsive disorder.  Arch Gen Psychiatry. 2000;  57 794-801
    CrossrefPubMedGoogle Scholar
  • 43 Pfanner C, Marazziti D, Dell'¿Osso L. et al . Risperidone augmentation in refractory obsessive-compulsive disorder: an open-label study.  Int Clin Psychopharmacol. 2000;  12 297-301
    PubMedGoogle Scholar
  • 44 Bogetto F, Bellino S, Vaschetto P, Ziero S. Olanzapine augmentation of fluvoxamine-refractory obsessive-compulsive disorder (OCD): a 12-week open trial.  Psychiatry Res. 2000;  96 91-98
    CrossrefPubMedGoogle Scholar
  • 45 Weiss E L, Potenza M N, McDougle C J, Epperson C N. Olanzapine addition in obsessive-compulsive disorder refractory to selective serotonin reuptake inhibitors: an open-label case series.  J Clin Psychiatry. 1999;  60 524-527
    PubMedGoogle Scholar
  • 46 Pitchot W, Ansseau M. Addition of Olanzapine for treatment-resistant depression.  Am J Psychiatry. 2001;  158 1737-1738
    CrossrefPubMedGoogle Scholar
  • 47 König F, von Hippel C, Petersdorff T, Neuhöffer-Weiss M, Wolfersdorf M, Kaschka W P. First experiences in combination therapy using Olanzapine with SSRIs (Citalopram, Paroxetine) in delusional depression.  Neuropsychobiology. 2001;  43 170-173
    PubMedGoogle Scholar
  • 48 Knopf U, Hubrich-Ungureanu P, Thome J. Paroxetin-Augmentation mit Risperidon bei therapieresistenter Depression.  Psychiatrische Praxis. 2001;  im Druck
    PubMedGoogle Scholar
  • 49 Shelton R C, Tollefson G D, Tohen M. et al . A novel augmentation strategy for treating resistant major depression.  Am J Psychiatry. 2001;  158 131-134
    CrossrefPubMedGoogle Scholar
  • 50 Linnet K, Olesen O V. Monitoring of serum Olanzapine during antipsychotic treatment.  Ugeskr Laeger. 2000;  162 4802-4805
    PubMedGoogle Scholar
  • 51 Heykants J, Huang M, Mannens G. et al . The pharmacokinetics of Risperidone in humans: a summary.  J Clin Psychiatry. 1994;  55 13-17
    PubMedGoogle Scholar
  • 52 Mannens G, Meuldermans W, Huang M, Snoeck E, Heykants J. Plasma protein binding of risperidone and its distribution in blood.  Psychopharmacology. 1994;  114 566-572
    PubMedGoogle Scholar
  • 53 Barbey J T, Roose S P. SSRI safety in overdose.  J Clin Psychiatry. 1998;  59 42-48
    PubMedGoogle Scholar
  • 54 Capel M M, Colbridge G, Henry J A. Overdose profiles of new antipsychotic agents.  Int J Neuropsychopharmacol. 2000;  3 51-54
    CrossrefPubMedGoogle Scholar
  • 55 Kopala L C, Day C, Dillman B, Gardner D. A case of Risperidone overdose in early schizophrenia: a review of potential complications.  J Psychiatry Neurosci. 1998;  23 305-308
    PubMedGoogle Scholar
  • 56 Ravin D S, Levenson J W. Fatal cardiac event following initiation of Risperidone therapy.  Ann Pharmacother. 1997;  31 867-870
    PubMedGoogle Scholar
  • 57 Isbister G K, Whyte I M, Smith A J. Olanzapine overdose.  Anaesthesia. 2001;  56 400-401
    PubMedGoogle Scholar
  • 58 Stephens B G, Coleman D E, Baselt R C. Olanzapine-related fatality.  J Forensic Sci. 1998;  43 1252-1253
    PubMedGoogle Scholar
  • 59 Gerber J E, Cawthon B. Overdose and death with Olanzapine: two case reports.  Am J Forensic Med Path. 2000;  21 249-251
    CrossrefPubMedGoogle Scholar
  • 60 Fogel J, Diaz J E. Olanzapine overdose.  Ann Emerg Med. 1998;  32 275-276
    PubMedGoogle Scholar
  • 61 Lane H-Y, Chang W-H. Risperidone monotherapy for psychotic depression unresponsive to other treatments.  J Clin Psychiatry. 1998;  59 624
    PubMedGoogle Scholar
  • 62 Shelton R C. Mood-stabilizing drugs in depression.  J Clin Psychiatry. 1999;  60 37-40
    PubMedGoogle Scholar
  • 63 Ereshefsky L, Lacombe S. Pharmacological profile of Risperidone.  Can J Psychiatry. 1993;  38 80-88
    PubMedGoogle Scholar
  • 64 Keck P E, McElroy S L, Strakowski S M, Soutullo C A. Antipsychotics in the treatment of mood disorders and risk of tardive dyskinesia.  J Clin Psychiatry. 2000;  61 33-38
    PubMedGoogle Scholar
  • 65 Sechi G, Agnetti V, Masuri R. et al . Risperidone, neuroleptic malignant syndrome and probable dementia with Lewy bodies.  Prog Neuropsychopharmacol Biol Psychiatry. 2000;  24 1043-1051
    CrossrefPubMedGoogle Scholar
  • 66 Tachikawa H, Suzuki T, Kawanishi Y, Hori M, Hori T, Shiraishi H. Tardive dystonia provoked by concomitantly administered risperidone.  Psychiatry Clin Neurosci. 2000;  54 503-505
    CrossrefPubMedGoogle Scholar
  • 67 Preskorn S H. Klinische Pharmakologie der selektiven Serotonin-Wiederaufnahmehemmer. In: Caddo, ed. Professional Communications 1997
    Google Scholar
  • 68 Preskorn S H. Clinically relevant pharmacology of selective serotonin reuptake inhibitors. An overview with emphasis on pharmacokinetics and effects on oxidative drug metabolism.  Clin Pharmacokinet. 1997;  32 1-21
    PubMedGoogle Scholar
  • 69 Hiemke C, Hartter S. Pharmacokinetics of selective serotonin reuptake inhibitors.  Pharmacol Ther. 2000;  85 11-28
    CrossrefPubMedGoogle Scholar
  • 70 Ereshefsky L. Pharmacologic and pharmacokinetic considerations in choosing an antipsychotic.  J Clin Psychiatry. 1999;  60 20-30
    PubMedGoogle Scholar

Priv.-Doz. Dr. med. Dr. phil. J. Thome

Zentralinstitut für Seelische Gesundheit

J5

68159 Mannheim

Email: thome@zi-mannheim.de

      >