Skip to main content
SpringerLink
Log in

Biologische Prädiktoren für eine erfolgreiche antidepressive medikamentöse Behandlung

  • Conference paper
Therapieresistenz unter Antidepressiva-Behandlung

Part of the book series: Tropon-Symposium ((BAYERZNS,volume 5))

Zusammenfassung

Auch nach 30 Jahren spezifischer antidepressiver medikamentöser Therapie ist im konkreten Einzelfall die Entscheidung noch immer sehr schwer zu treffen, welches der vielen, sich auf dem Markt befindlichen Antidepressiva für einen bestimmten Patienten hier und jetzt wohl das erfolgreichste sein wird. 15 Jahre intensiver Forschung haben nicht zu praktisch anwendbaren Prädiktoren bezüglich einer Differentialindikation der Antidepressiva geführt. Abgewandelt nach Klett u. Moseley (1965) gilt es, die Forderung nach dem „right antidepressant drug for the right depression“ noch zu erfüllen. Sicher ist heute, daß die nosologische Zuordnung eines Patienten zur Vorhersage des Behandlungserfolges im Einzelfall nicht taugt, da Patienten sowohl mit endogener als auch neurotischer Depression auf Antidepressiva ansprechen (Ananth 1978; Cavi et al. 1974; Goldberg u. Finnerty 1977; Klerman et al. 1974; Prusoff u. Paykel 1977; Razani et al. 1983; Reisby et al. 1977; Stefanis et al. 1982). Schon 1969 formulierte Freyhan dieses Dilemma: „Die Vorstellung von nosologisch bezogener Therapie stirbt um so langsamer, als es immer wieder neue Illusionen von Einheitsursachen für Einheitskrankheiten zu geben scheint.“ Aber nicht nur auf der Ebene der nosologischen Krankheitsgruppen, sondern auch auf der Symptomebene wurde kein sicherer Prädiktor für eine erfolgreiche antidepressive Behandlung gefunden (Fähndrich 1983b; Woggon 1983). Im folgenden soll versucht werden, einen Überblick über die biologische Prädiktorforschung zu geben sowie die Ergebnisse dieser intensiven Bemühungen einer kritischen Würdigung zu unterziehen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  • Aberg-Wistedt A, Jostell KG, Ross SB, Westland D (1981) Effects of zimelidine and desimipramine and serotonin and noradrenaline uptake mechanism in relation to plasma concentrations and to therapeutic effects during treatment of depression. Psychopharmacol 74:297–305

    Article  CAS  Google Scholar 

  • Amine M (1978) Response to sleep deprivation and therapeutic results with antidepressants. Lancet 2:165

    Article  Google Scholar 

  • Ananth J (1978) Clinical prediction of antidepressant response. Int Pharmacopsychiat 13:69–93

    CAS  Google Scholar 

  • Ansseau M, Kupfer D-J, Reynolds C-F, Coble PA (1985) ”Paradoxical” shortening of REM latency on first recording night in major depressive disorder: clinical and polysomnographic correlates. Biol Psychiat 20:135–145

    Article  PubMed  CAS  Google Scholar 

  • Arana GW, Baldessarini R-J, Ornsteen M (1985) The dexamethasone suppression test for diagnosis and prognosis in psychiatry. Commentary and review. Arch Gen Psychiat 42:1193–1204

    Article  PubMed  CAS  Google Scholar 

  • Asberg M, Bertilsson L, Tuck D, Cronholm B, Sjöqvist F (1973) Indolamine metabolites in the cerebral fluid of depressed patients before and during treatment with nortriptyline. Clin Pharmacol Therap 14:277–286

    CAS  Google Scholar 

  • Banki CM (1977) Correlation of anxiety and related symptoms with cerebrospinal fluid 5-hydroxyin- dolacetic acid in depressed women. J Neural Transm 47:135–145

    Article  Google Scholar 

  • Banki CM, Vojnik M (1978) Effects of intravenous infusion of amitriptyline on total blood serotonin content. Eur J Clin Pharmacol 13:259–262

    Article  PubMed  CAS  Google Scholar 

  • Beckmann H, Goodwin FK (1975) Antidepressant response to tricyclics and urinary MHPG in unipolar patients. Arch Gen Psychiat 32:17–21

    Article  PubMed  CAS  Google Scholar 

  • Bente D, Fähndrich E (1980) Klinische und elektroenzephalographische Befunde zur Wirkung von Hydroxy-Maprotilin unter besonderer Berücksichtigung der hirnelektrischen Reagibilität von Respondern und Nonrespondern. Arzneim-Forsch 30:1227

    Google Scholar 

  • Berger M, Lund R, Bronisch Th, Zerssen D v (1982) Der Einfluß eines Cholinergikums auf den REM- Schlaf gesunder Probanden und depressiver Patienten. In: Beckmann H (Hrsg) Fortschritte psychiatrischer Forschung. Thieme, Stuttgart, S 323–327

    Google Scholar 

  • Brown WA, Shuey I (1980) Response to dexamethasone and subtype of depression. Arch Gen Psychiat 37:647–751

    Article  Google Scholar 

  • Brown WA, Qualls CB (1981) Pituitary-adrenal disinhibition in depression: Marker of subtype with characteristic clinical feature and response to treatment. Psychiat Res 4:115–128

    Article  CAS  Google Scholar 

  • Cavi L, Lipman RS, Derogatis LR, Smith JE, Pattison JH (1974) Drugs and group psychotherapy in neurotic depression. Am J Psychiat 131:191–198

    Google Scholar 

  • Coble PA, Kupfer DJ, Spiker DG, Neil JF, McParland RJ (1979) EEG sleep in primary depression: A longitudinal placebo study. J Affective Disorder 1:131–138

    Article  CAS  Google Scholar 

  • Davidson JRT, McLeod MN, White HL, Raft D (1976) Red blood cell catechol-o-methyltransferase and response to imipramine in unipolar depressive women. Am J Psychiat 133:952–955

    PubMed  CAS  Google Scholar 

  • Ettigi PG, Hayes PE, Narasimhachari N, Hamer RM, Goldberg S, Second GJ (1983) d-Amphetamine response and dexamethasone suppression test as predictors of treatment outcome in unipolar depression. Biol Psychiat 18:499–504

    PubMed  CAS  Google Scholar 

  • Fähndrich E (1983a) Clinical and biological parameters as predictors for antidepressive drug response in depressed patients. Pharmacopsychiat 16:179–185

    Article  Google Scholar 

  • Fähndrich E (1983 b) Effect of sleep deprivation as a predictor of treatment response to antidepressant medication. Acta Psychiat Scand 68:341–344

    Article  PubMed  Google Scholar 

  • Fähndrich E (1987) Biological predictors of success of antidepressant drug therapy. Psychiat Develop 2:157–171

    Google Scholar 

  • Fähndrich E, Freudenthal K (1980) Charakterisierung von Respondern und Nonrespondern hinsichtlich verschiedener Antidepressiva auf der AMPD-Item-Ebene. Arzneim-Forsch/Drug Res 30:1228

    Google Scholar 

  • Fähndrich E, Herrmann WM (1985) The search for electroencephalographic variables which could predict the efficacy of antidepressants. Pharmacopsychiat 18:108–109

    Article  Google Scholar 

  • Fawcett J, Siomopoulos V (1971) Dextroamphetamine response as a possible predictor of improvement with tricyclic therapy in depression. Arch Gen Psychiat 25:247–255

    Article  Google Scholar 

  • Fawcett J, Maas JW, Dekirmenjian H (1972) Depression and MHPG excretion: Response to dextroamphetamine and tricyclic antidepressants. Arch Gen Psychiat 26:246–251

    Article  PubMed  CAS  Google Scholar 

  • Fraser AR (1983) Choice of antidepressant based on the dexamethasone suppression test. Am J Psychiat 140:786–787

    PubMed  CAS  Google Scholar 

  • Freyhan FA (1969) Depressionsforschung: Klärung oder Verdunklung? In: Hippius H, Selbach H (Hrsg) Das depressive Syndrom. Urban & Schwarzenberger, München Berlin Wien, S 211

    Google Scholar 

  • Gärtner HJ, Golfinopoulos G, Breyer-Pfaff U (1982) Response to maprotiline treatment in depressive patients, relationship to urinary MHPG excretion and plasma drug level. Pharmacopsychiat 15:170–174

    Article  Google Scholar 

  • Gastpar M (1982) Wirkung und Verträglichkeit von Langzeitinfusionen bei depressiven Patienten am Beispiel des Dibenzepins. In: Kielholz P (Hrsg) Antidepressive Infusionstherapie. Thieme, Stuttgart New York, S 53–58

    Google Scholar 

  • Gitlin MJ, Gerner RH (1986) The dexamethasone suppression test and response to somatic treatment: A review. J Clin Psychiat 47:16–21

    CAS  Google Scholar 

  • Goldberg HL, Finnerty RJ (1977) Which tricyclic for depressed outpatients, imipramine pamoate or amitriptyline? Dis Nerv Syst 38:785–789

    PubMed  CAS  Google Scholar 

  • Goodwin FK, Potter WZ (1978) The biology of affective illness: Amine neurotransmitters and drug response. In: Cole JO, Schatzberg AF, Frazier SM (eds) Depression: Biology, psychodynamics and treatment. Plenum, New York 1978

    Google Scholar 

  • Goodwin FK, Post RM, Murphy DL (1973) Cerebrospinal fluid amine metabolites and therapies for depression. Program of the Scientific Proceedings of the American Psychiatric Association, S 24–25 (zit n Joyce & Paykel 1989)

    Google Scholar 

  • Greden JF, Gardner R, King D, Grunhaus L, Carroll BJ, Kronfol Z (1983) Dexamethasone suppression test in antidepressant treatment of melancholia: The process of normalization and test-retest reproductibility. Arch Gen Psychiat 40:493–500

    Article  PubMed  CAS  Google Scholar 

  • Haug HJ, Fähndrich E (1986) Problems in defining response in therapy studies. Pharmacopsychiat 19:170–171

    Article  Google Scholar 

  • Herrmann WM, Kern U, Römel J (1986) Contribution to the search for vigilance-indicative EEG variables results of a controlled double-blind study with pyritinol in elderly patients with symptoms of mental dysfunction. Pharmacopsychiat 19:75–83

    Article  CAS  Google Scholar 

  • Höchli D, Riemann D, Zulley J, Berger M (1986 a) Initial REM-sleep suppression by clomipramine: A prognostic tool for treatment response in patients with a major depressive disorder. Biol Psychiat 21:1217–1220

    Article  PubMed  Google Scholar 

  • Höchli D, Riemann D, Zulley J, Berger M (1986b) Is there a relationship between response to total sleep deprivation and efficacy of clomipramine treatment in depressed patients? Acta Psychiat Scand 74:190–192

    Article  PubMed  Google Scholar 

  • Hollister LE, Davis KL, Berger PA (1980) Subtypes of depression based on excretion of MHPG and response to nortriptyline. Arch Gen Psychiat 37:1107–1110

    Article  PubMed  CAS  Google Scholar 

  • Holzboer F, Liebelt R, Hofschuster E (1982) Repeated dexamethasone suppression test during depressive illness: Normalization of test result compared with clinical improvement. J Affectiv Disorder 4:93–101

    Article  Google Scholar 

  • Insel TR, Murphy DL, Cohen RM, Alterman I, Kilts C, Durham NC, Linnoila M (1983) Obsessive compulsive disorder. Arch Gen Psychiat 40:605–612

    Article  PubMed  CAS  Google Scholar 

  • Joyce PR, Paykel ES (1989) Predictors of drug response in depression. Arch Gen Psychiat 46:89–99

    Article  PubMed  CAS  Google Scholar 

  • Kammern DP v, Murphy DL (1978) Prediction of imipramine antidepressant response by a one-d-am- phetamine trial. Am J Psychiat 135:1179–1184

    Google Scholar 

  • Kasper S, Yieira A (1989) Stimulation with dl-fenfluramine and antidepressive medication in major depressed inpatients. Pharmacopsychiat 22:201

    Google Scholar 

  • Kelwala S, Jones D, Sitaram N (1982) Monoamine metabolites as predictor of antidepressant response: A critique. Prog Neuropsychopharmacol Biol Psychiat 7:229–240

    Article  Google Scholar 

  • Kiloh LG, Neilson M, Andrews G (1974) Response of depressed patients to methylamphetamine. Br J Psychiat 125:496–499

    Article  CAS  Google Scholar 

  • Klerman GL, DiMascio A, Weissman M, Prusoff B, Paykel E (1974) Treatment of depression by drugs and psychotherapy. Am J Psychiat 131:186–191

    PubMed  CAS  Google Scholar 

  • Klett CJ, Moseley EC (1965) The right drug for the right patient. J Consul Psychol 29:546–551

    Article  CAS  Google Scholar 

  • Kretschmar JH, Peters UH (1973) Schlafentzug zur Behandlung endogener Depressionen. In: Jovanovic UJ (Hrsg) The nature of sleep. Fischer, Stuttgart

    Google Scholar 

  • Kupfer DJ, Spiker DG, Coble PA, Neil JF, Ulrich R, Shaw DH (1980) Depression, EEG sleep, and clinical response. Compr Psychiat 21:212–220

    Article  PubMed  CAS  Google Scholar 

  • Kupfer DJ, Spiker DG, Coble PA, Neil JF, Ulrich R, Shaw DH (1981) Sleep and treatment prediction in endogenous depression. Am J Psychiat 138:429–434

    Article  PubMed  CAS  Google Scholar 

  • Kupfer DJ, Targ E, Stack J (1982a) Electroeneephalographic sleep in unipolar depressive subjects. Support for a biological and familial classification. J Nerv Ment Dis 170:494–498

    Article  PubMed  CAS  Google Scholar 

  • Kupfer DJ, Shaw DH, Ulrich R, Coble PA, Spiker DG (1982b) Application of automated REM-analysis in depression. Arch Gen Psychiat 39:569–573

    Article  PubMed  CAS  Google Scholar 

  • Little KY (1988) Amphetamine, but not methylphenidate, predicts antidepressant efficacy. J Clin Psychopharmacol 8:177–183

    Article  PubMed  CAS  Google Scholar 

  • Maas JW, Fawcett JA, Dekirmenjian H (1972) Catecholamine metabolism, depressive illness, and drug response. Arch Gen Psychiat 26:252–262

    Article  PubMed  CAS  Google Scholar 

  • Maas JW, Kocsis JH, Bowden CL, Davis JM, Redmond DE, Hanin I, Robins E (1982) Pretreatment neurotransmitter metabolites and response to imipramine or amitriptyline treatment. Psychol Med 12:37–43

    Article  PubMed  CAS  Google Scholar 

  • Marks JM, Stern RS, Mawson D, Cobb J, McDonald R (1980) Clomipramine and exposure for obsessive compulsive rituals. Br J Psychiat 136:1–25

    Article  CAS  Google Scholar 

  • McLeod WR, Carroll B, Davies B (1970) Hypothalamic dysfunction and antidepressant drugs. Br Med J 2:480–481

    Article  Google Scholar 

  • Mendlewicz J (1980) Selective MAO-B inhibitors and 5-HTP as antidepressant therapy. Presented 12th CINP-Congress, Abstr Nr 438, Goteborg

    Google Scholar 

  • Modai J, Apter A, Golomb M, Wijsenbeck J (1979) Response to amitriptyline and urinary MHPG in bipolar depressive patients. Neurpsychobiol 5:181–184

    Article  CAS  Google Scholar 

  • Modai J, Rinsky H, Cygielma G (1986) The DST as a predictor of acute response to treatment with ECT, chlorimipramine, amitriptyline and phenelzine. J Clin Psychiat 47:139–140

    CAS  Google Scholar 

  • Möller HJ, Kissling W, Zerssen D v (1983) Die prognostische Bedeutung des frühen Ansprechens schizophrener Patienten auf Neuroleptika für den weiteren stationären Behandlungsverlauf. Pharmacopsychiat 16:46–49

    Article  Google Scholar 

  • Müller-Oerlinghausen B, Rao ML, Stieglitz RD, Volz HP (1989) Fluvoxamine challenge test, phototherapy and successive fluvoxamine treatment in patients with non-seasonal depression. Pharmacopsychiat 22:209

    Google Scholar 

  • Nedopil N, Rüther E (1981) Initial improvement as predictor of outcome of neuroleptic treatment. Pharmacopsychiat 14:205–207

    Article  CAS  Google Scholar 

  • Peselow ED, Goldring N, Stanley M, Barouche F, Fieve RR (1986) The dexamethasone suppression test (DST) in predicting response to desipramine and amitriptyline in depressed outpatients. Int Clin Psychopharmacol 1:17–23

    Article  PubMed  CAS  Google Scholar 

  • Pflug B (1973) Depression und Schlafentzug, neue therapeutische und theoretische Aspekte. Habilschrift 1973

    Google Scholar 

  • Pflug B (1978) The influence of sleep deprivation on the duration of endogenous episodes. Arch Psychiat Nervenkr 225:173–177

    Article  PubMed  CAS  Google Scholar 

  • Pflug B, Tölle R (1971) Disturbance of the 24 h rhythm in endogenous depression and the treatment of endogenous depression by sleep deprivation. Int Pharmacopsychiat 6:187–196

    CAS  Google Scholar 

  • Prusoff BA, Paykel ES (1977) Typological prediction of response to amitriptyline: A replication study. Int Pharmacopsychiat 12:153–159

    CAS  Google Scholar 

  • Razani J, White KL, White J, Simpson G, Sloane RB, Rebal R, Palmer R (1983) The safety and efficacy of combined amitriptyline and tranylcypromine antidepressant treatment. Arch Gen Psychiat 40:657–661

    Article  PubMed  CAS  Google Scholar 

  • Reisby N, Gram LF, Bech P, Nagy A, Petersen GP, Ortman J, Ibsen I, Dencker SJ, Jacobson O, Krautwald O, Sondergaard I, Christiansen J (1977) Imipramin: Clinical effects and pharmacokinetic variability. Psychopharmacol 54:263–272

    Article  CAS  Google Scholar 

  • Riemann D, Höchli D, Berger M (1986) Initiale REM-Schlafunterdrückung als Prädiktor einer Clomipramintherapie. Psycho 12:380–381

    Google Scholar 

  • Rosenbaum AH, Schatzberger AF, Maruta T, Orsulak PJ, Cole JO, Grab EL, Schildkraut JJ (1980) MHPG as predictor of antidepressant response to imipramine and maprotiline. Am J Psychiat 137:1090–1092

    PubMed  CAS  Google Scholar 

  • Rush AJ, Gilles DE, Roffwarg HP, Parker CR (1982) Sleep EEG and dexamethasone suppression test findings in outpatients with unipolar major depressive disorders. Biol Psychiat 17:327–341

    PubMed  CAS  Google Scholar 

  • Sauer H, Kick H, Minne HW, Schneider B (1986) Prediction of the amitriptyline response: Psychopathology vs neuroendocrinology. Int Clin Psychopharmacol 1:284–295

    Article  PubMed  CAS  Google Scholar 

  • Schatzberger AF, Rosenbaum AH, Orsulak PJ, Rohde WA, Maruta T, Krug ER, Cole JO, Schildkraut JJ (1981) Toward a biological classification of depressive disorders III. Pretreatment urinary MHPG levels as predictors of response to treatment with maprotiline. Psychopharmacol 75:34–38

    Article  Google Scholar 

  • Sitaram N, Mendelson WB, Wyatt RJ, Gillin JC (1977) The time dependent induction of REM-sleep and arousal by physostigmine infusion during normal human sleep. Human Sleep Brain Res 122:562–567

    CAS  Google Scholar 

  • Spiegel R (1984) Zur Voraussage des Therapieerfolges mit Antidepressiva: Sind kurze REM-Latenzen diagnostisch und prognostisch zuverlässige Merkmale? Fortschr Neurol Psychiat 52:302–311

    Article  PubMed  CAS  Google Scholar 

  • Stefanis CN, Alevizos BH, Paradimitriou GN (1982) Antidepressant effect of Ro 11–1163 - a new MAO inhibitor. Int Pharmacopsychiat 17:43–48

    CAS  Google Scholar 

  • Sullivan JL, Maltbie A, Cavenar JO, Spantield CH (1977) Platelet-monoamino-oxydase activity predicts response to lithium in manic depressive illness. Lancet 24:1325–1327

    Article  Google Scholar 

  • Svendsen K, Christensen PG (1981) Duration of REM-sleep latency in predictor of effect of antidepressant therapy - a preliminary report. Acta psychiat scand 64:238–243

    Article  PubMed  CAS  Google Scholar 

  • Targum SD (1984) Persistent neuroendocrine dysregulation in major depressive disorder: A marker for early relapse. Biol Psychiat 19:305–318

    Article  PubMed  CAS  Google Scholar 

  • van Praag HM (1977a) New evidence for serotonin-deficient depression. Neuropsychobiol 3:56–63

    Article  Google Scholar 

  • van Praag HM (1977 b) Significance of biochemical parameters in the diagnosis, treatment and prevention of depressive disorders. Biol Psychiat 12:101–131

    PubMed  CAS  Google Scholar 

  • van Praag HM, de Maan S (1980) Depression, vulnerability and 5-hydroxytryptophan prophylaxis. Psychiat Res 3:75–83

    Article  Google Scholar 

  • van Putten T, May RA, Marder SR (1984) Response to antipsychotic medication: The doctors and the consumers view. Am J Psychiat 141:16–19

    PubMed  Google Scholar 

  • van Scheyen JD, van Praag HM, Korf J (1977) Controlled study comparing nomifensine and clomipramine in unipolar depression using the probenicid technique. Br J Clin Pharmacol 4:179–184

    Google Scholar 

  • Wirz-Justice A, Pühringer W, Hole G (1976) Sleep deprivation and clomipramine in endogenous depression. Lancet 23:912

    Article  Google Scholar 

  • Wirz-Justice A, Pühringer W, Hole G (1979) Response to sleep deprivation as a predictor of therapeutic results with antidepressant drugs. Am J Psychiat 136:1222–1223

    PubMed  CAS  Google Scholar 

  • Woggon B (1983) Prognose der Psychopharmakotherapie. S Enke, Stuttgart

    Google Scholar 

  • Woggon B (1987) Pharmakotherapie affektiver Psychosen. In: Kisker KP, Lauter H, Meyer J-E, Strömgren E (Hrsg) Psychiatrie der Gegenwart, Bd 5, “Affektive Psychosen”. Springer, Berlin Heidelberg New York Tokio

    Google Scholar 

Download references

Authors
  1. E. Fähndrich
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Psychiatrie, Universitäts-Nervenklinik, Sigmund-Freud-Straße 25, D-5300, Bonn 1, Deutschland

    Hans-Jürgen Möller

Rights and permissions

Reprints and permissions

Copyright information

© 1990 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Fähndrich, E. (1990). Biologische Prädiktoren für eine erfolgreiche antidepressive medikamentöse Behandlung. In: Möller, HJ. (eds) Therapieresistenz unter Antidepressiva-Behandlung. Tropon-Symposium, vol 5. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84236-8_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-84236-8_4

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-52765-7

  • Online ISBN: 978-3-642-84236-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation