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Antidepressiva: Neue Konzepte zur Behandlung der Therapieresistenz

  • M. Schmauß
  • M. Schölderle
Conference paper

Zusammenfassung

Die gezielte medikamentöse Therapie depressiver Störungen hat eine nunmehr 30jährige Geschichte, nachdem erstmals von R. Kuhn (1957) die antidepressive Wirksamkeit von Imipramin durch sorgfältige klinische Beobachtung entdeckt wurde. Ausgehend von dieser Substanz wurden verschiedene trizyklische Antidepressiva, wie z. B. Amitriptylin, Clomipramin und Desipramin entwickelt. Die Wirksamkeit dieser und anderer trizyklischer Substanzen ist in einer großen Anzahl von Studien bestätigt worden (Morris u. Beck 1974). Die Tatsache, daß die Modifizierung des trizyklischen Grundgerüsts der Imipraminstruktur zwar zu jeweils anderen, nicht aber wirksameren und nebenwirkungsfreieren Antidepressiva führte, gab schließlich den Anstoß zur Entwicklung neuer Substanzen mit nichttrizyklischer Molekülstruktur. Diese Substanzen unterscheiden sich in pharmakologischer und biochemischer Hinsicht z. T. erheblich von den klassischen trizyklischen Antidepressiva (Shopsin etal. 1981). Die antidepressive Wirksamkeit einzelner dieser Medikamente ist jedoch noch immer umstritten, eine therapeutische Überlegenheit einer dieser Substanzen über ein trizyklisches Antidepressivum konnte bisher nicht gezeigt werden.

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© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • M. Schmauß
  • M. Schölderle
    • 1
  1. 1.Psychiatrische KlinikUniversität MünchenMünchen 2Deutschland

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