Skip to main content
SpringerLink
Log in

Therapie depressiver Störungen mit selektiven Serotonin-Rückaufnahme-Inhibitoren (SSRI)

Treatment of depressive disorders with selective serotonin reuptake inhibitors (SSRI)

  • Psychiatrie
  • Published:
psychopraxis. neuropraxis Aims and scope Submit manuscript

Zusammenfassung

Antidepressiva sind eine inhomogene Gruppe von Substanzen, unter denen sich die selektiven Serotonin-Rückaufnahme-Inhibitoren (SSRI) als First-line-Medikamente bei Depressionen etabliert haben. Der Vorteil der SSRI gegenüber Antidepressiva der ersten Generation liegt in ihrem günstigeren Nebenwirkungsprofil, der hohen therapeutischen Breite und den niedrigeren Drop-out-Raten bei vergleichbarer Wirksamkeit. Escitalopram und Sertralin zeichnen sich möglicherweise durch Wirksamkeitsvorteile gegenüber den anderen SSRI aus.

Abstract

Antidepressants are an inhomogeneous group of substances. Selective serotonin reuptake inhibitors (SSRI) belong to the group of first-choice medications for depression. SSRI are as effective as first-generation antidepressants, moreover they have several advantages, including fewer side effects, a larger therapeutic index and lower drop-out rates. Escitalopram and sertraline might be more effective than other SSRI.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Möller H‑J, Laux G, Kapfhammer H‑P (Hrsg) (2011) Psychiatrie, Psychosomatik, Psychotherapie, 4. Aufl. Springer, Berlin Heidelberg

    Google Scholar 

  2. Jacobi F, Wittchen H‑U, Hölting C, Höfler M, Pfister H, Müller N, Lieb R (2004) Prevalence, co-morbiditiy and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey [GHS]. Psychol Med 34:1–15

    Article  Google Scholar 

  3. Murray C, Lopez A (1997) Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet 349:1498–1504

    Article  CAS  PubMed  Google Scholar 

  4. Kasper S, Lehofer M, Doering S, Geretsegger C, Frey R, Haring C et al (2012) Depression – Medikamentöse Therapie. Clin Neuropsy (Sonderausgabe Nov 2012):3–23

    Google Scholar 

  5. Lohoff FW (2010) Overview of the genetics of major depressive disorder. Curr Psychiatry Rep 12(6):539–546

    Article  PubMed  PubMed Central  Google Scholar 

  6. aan het Rot M, Mathew SJ, Charney DS (2009) Neurobiological mechanisms in major depressive disorder. CMAJ 180(3):305–313

    Article  Google Scholar 

  7. Linden M, Müller WE (2005) Rehabilitations-Psychopharmakotherapie: Arzneimittelbehandlung chronifizierender und chronifizierter psychischer Syndrome, 1. Aufl. Deutscher Ärzte-Verlag, Köln

    Google Scholar 

  8. Duman RS, Monteggia LM (2006) A neurotrophic model for stress-related mood disorders. Biol Psychiatry 59:1119–1127

    Article  Google Scholar 

  9. Rothenhäusler H‑B, Täschner K‑L (2007) Kompendium Praktische Psychiatrie. Springer, Wien NewYork

    Google Scholar 

  10. Müller H‑J, Laux G, Deister A (2009) Psychiatrie und Psychotherapie, 4. Aufl. Duale Reihe. Thieme, Stuttgart

    Google Scholar 

  11. Benkert O, Hippius H (2013) Kompendium der Psychiatrischen Pharmakotherapie, 9. Aufl. Springer, Berlin Heidelberg

    Book  Google Scholar 

  12. Lüllmann H, Mohr K, Hein L (2006) Pharmakologie und Toxikologie: Arzneimittelwirkungen verstehen – Medikamente gezielt einsetzen, 16. Aufl. Thieme, Stuttgart

    Google Scholar 

  13. Beubler E (2011) Kompendium der Pharmakologie. Gebräuchliche Arzneimittel in der Praxis, 3. Aufl. Springer, Wien

    Book  Google Scholar 

  14. Riederer P, Laux G, Pöldinger W (Hrsg) (2002) Neuro-Psychopharmaka, 2. Aufl. Bd. 3. Springer, Wien

    Google Scholar 

  15. DeVane CL (1999) Metabolism and pharmacokinetics of selective serotonin reuptake inhibitors. Cell Mol Neurobiol 19(4):443–466

    Article  CAS  PubMed  Google Scholar 

  16. Kriegebaum C, Gutknecht L, Schmidt A, Lesch K‑P, Reif A (2010) Serotonin Kompakt – Teil 1: Neurobiologische und entwicklungsgenetische Grundlagen. Fortschr Neurol Psychiat 78:319–331

    Article  CAS  PubMed  Google Scholar 

  17. Erfurth A, Gardier AM, Ribeiro E, Wurtman RJRJ (1994) Effects of subchronic pretreatment with D‑fenfluramine or p‑chloroamphetamine on [3 H]inositolmonophosphate accumulation in rat cortical miniprisms. Brain Res 665(1):107–114

    Article  CAS  PubMed  Google Scholar 

  18. Gardier AM, Kaakkola S, Erfurth A, Wurtman RJ (1992) Effects of methiothepin on changes in brain serotonin release induced by repeated administration of high doses of anorectic serotoninergic drugs. Brain Res 588(1):67–74

    Article  CAS  PubMed  Google Scholar 

  19. Kroeze Y, Zhou H, Homberg JR (2012) The genetics of selective serotonin reuptake inhibitors. Pharmacol Ther 136:375–400

    Article  CAS  PubMed  Google Scholar 

  20. Mascio MD, Giovanni GD, Matteo VD, Prisco S, Esposito E (1998) Selective serotonin reuptake inhibitors reduce the spontaneus activity of dopaminergic neurons in the ventral tegmental area. Brain Res Bull 46(6):547–554

    Article  PubMed  Google Scholar 

  21. Dremencov E, Mansari ME, Blier P (2009) Effects of sustained serotonin reuptake inhibition on the firing of dopamine neurons in the rat ventral tegmental area. J Psychiatry Neurosci 34(3):223–229

    PubMed  PubMed Central  Google Scholar 

  22. Dremencov E, Mansari ME, Blier P (2007) Noradrenergic augmentation of escitalopram response by risperidone: electrophysiologic studies in the rat brain. Biol Psychiatry 61:671–678

    Article  CAS  PubMed  Google Scholar 

  23. Castanon N, Leonard BE, Neveu PJ, Yirmiya R (2002) Effects of antidepressants on cytokine production and action. Brain Behav Immun 16:569–574

    Article  CAS  PubMed  Google Scholar 

  24. Tao R, Calley CS, Hart J, Mayes TL, Nakonezny PA, Lu H et al (2012) Brain activity in adolescent major depressive disorder before and after fluoxetine treatment. Am J Psychiatry 169(4):381–388

    Article  PubMed  PubMed Central  Google Scholar 

  25. Brady LS, Gold PW, Herkenham M, Lynn AB, Whitfield HJ Jr. (1992) The antidepressants fluoxetine, idazoxan and phenelzine alter corticotropin-releasing hormone and tyrosine hydroxylase mRNA levels in rat brain: therapeutic implications. Brain Res 572(1–2):117–125

    Article  CAS  PubMed  Google Scholar 

  26. Fournier JC, DeRubeis RJ, Hollon SD, Dimidjian S, Amsterdam JD, Shelton RC, Fawcett J (2010) Antidepressant drug effects and depression severity – a patient-level Meta-analysis. JAMA 303(1):47–53

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Melander H, Salmonsen T, Abadie E, v. Zwieten-Boot B (2008) A regulatory apologia – a review of placebo-controlled studies in regulatory submissions of new-generation antidepressants. Eur Neuropsychopharmacol 18:623–627

    Article  CAS  PubMed  Google Scholar 

  28. Hansen RA, Gartlehner G, Lohr KN, Gaynes BN, Carey TS (2005) Efficacy and safety of second-generation antidepressants in the treatment of major depressive disorder. Ann Intern Med 143(6):415–426

    Article  CAS  PubMed  Google Scholar 

  29. Kennedy SH, Anderson HF, Lam RW (2006) Efficacy of escitalopram in the treatment of major depressive disorder compared with conventional selective serotonin reuptake inhibitors and venlafaxine XR: a meta-analysis. Rev Psychiatr Neurosci 31(2):122–131

    Google Scholar 

  30. Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgnis J, Churchill R et al (2009) Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet 373:746–758

    Article  CAS  PubMed  Google Scholar 

  31. Barbui C, Hotopf M (2001) Amitriptyline versus the rest: still the leading antidepressant after 40 years of randomized controlled trials. Br J Psychiatry 178:129–144

    Article  CAS  PubMed  Google Scholar 

  32. Anderson IM (2000) Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability. J Affect Disord 58:19–36

    Article  CAS  PubMed  Google Scholar 

  33. Spielmans GI, Berman MI, Usitalo AN (2011) Psychotherapy versus second-generation antidepressants in the treatment of depression. J Nerv Ment Dis 199(3):142–149

    Article  PubMed  Google Scholar 

  34. Dreimüller N, Tadic A, Dragicevic A, Boland K, Bondy B, Lieb K et al (2012) The serotonin transporter promoter polymorphism [5-HTTLPR] affects the relation between antidepressant serum concentrations and effectiveness in major depression. Pharmacopsychiatry 45:108–113

    Article  PubMed  Google Scholar 

  35. Villafuerte SM, Vallabhaneni K, Sliwerska E, McMahon FJ, Young EA, Burmeister M (2009) SSRI response in depression may be influenced by SNPs in HTR1B and HTR1A. Psychiartr Genet Dec 19(6):281–291

    Article  Google Scholar 

  36. Young EA (2009) Sex differences in response to citalopram: a STAR*D report. J Psychiatr Res 43(5):503–511

    Article  PubMed  Google Scholar 

  37. Lee K‑U, Lee YM, Nam J‑M, Lee H‑K, Kweon Y‑S, Lee CT, Jun T‑Y (2010) Antidepressant-induced sexual dysfunction among newer antidepressants in a naturalistic setting. Psychiatry Investig 7:55–59

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Trindade E, Menon D, Topfer L‑A, Coloma C (1998) Adverse effects associated with selective serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis. CMAJ 159(10):1145–1252

    Google Scholar 

  39. Damsa C, Bumb A, Bianchi-Demicheli F, Vidailhet P, Sterck R, Andreoli A, Beyenburg S (2004) „Dopamine-dependent“ side effects of selective serotonin reuptake inhibitors: a clinical review. J Clin Psychiatry August 65(8):1064–1068

    Article  CAS  Google Scholar 

  40. Hodge JM, Wang Y, Berg M, Collier FM, Fernandes TJ, Constable MJ et al (2012) Selective serotonin reuptake inhibitors inhibit human osteoclast and osteoblast formation and function. Biol Psychiatry 74:32. doi:10.1016/j.biopsych.2012.11.003

    Article  PubMed  Google Scholar 

  41. Barbui C, Esposito E, Cipriani A (2009) Selective serotonin reuptake inhibitors and risk of suicide: a systematic review of observational studies. CMAJ 180(3):291–297

    Article  PubMed  PubMed Central  Google Scholar 

  42. Leon AC, Salomon DA, Li C, Diedorowicz JG, Coryell WH, Endicott J, Keller MB (2011) Antidepressants and risk of suicide and suicide attempts: a 27-year observational study. J Clin Psychiatry 72(5):580–586

    Article  PubMed  PubMed Central  Google Scholar 

  43. Dalton SO, Johansen C, Mellemkjaer L, Norgard B, Sorensen HT, Olsen JH (2003) Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal tract bleeding – a population-based cohort study. Arch Intern Med 163:59–64

    Article  CAS  PubMed  Google Scholar 

  44. Hackam DG, Mrkobrada M (2012) Selective serotonin reuptake inhibitors and brain hemorrhage. Neurology 79:1862–1865

    Article  CAS  PubMed  Google Scholar 

  45. Barbey JT, Roose SP (1998) SSRI safety in overdose. J Clin Psychiatry 59(15):42–48

    CAS  PubMed  Google Scholar 

  46. Gallagher PJ, Castro V, Fava M, Weilburg JB, Murphy SN, Gainer VS et al (2012) Antidepressant response in patients with major depressive disorder exposed to NSAIDs: a pharmacovigilance study. Am J Psychiatry 169:1065–1072

    Article  PubMed  PubMed Central  Google Scholar 

  47. Bauer M, Bschor T, Pfennig A, Whybrow PC, Angst J, Versiani M et al (2007) World Federation of Societies of Biological Psychiatry [WFSBP] guidelines for biological treatment of unipolar depressive disorders in primary care. World J Biol Psychiatry 8(2):67–104

    Article  PubMed  Google Scholar 

  48. Szegedi A, Müller MJ, Anghelescu I, Klawe C, Kohnen R, Benkert O (2003) Early improvement under mirtazapine and paroxetine predicts later stable response and remission with high sensitivity in patients with major depression. J Clin Psychiatry 64(4):413–420

    Article  CAS  PubMed  Google Scholar 

  49. Posternak M, Baer L, Nierenberg AA, Fava M (2011) Response rates to fluoxetine in subjects who initially show no improvement. J Clin Psychiatry 72(7):949–954

    Article  PubMed  Google Scholar 

  50. Rush AJ, Trivedi MH, Wisniewski SR, Stewart JW, Nierenberg AA, Thase ME et al (2006) Bupropion-SR, Sertralin, or Venlafaxin-XR after failure of SSRIs for depression. N Engl J Med 354:1231–1242

    Article  CAS  PubMed  Google Scholar 

  51. Geddes JR, Carney SM, Davies C, Furukawa TA, Kupfer DJ, Frank E, Goodwin GM (2003) Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet 361:653–661

    Article  CAS  PubMed  Google Scholar 

  52. Lattimore KA, Donn SM, Kaciroti N, Kemper AR, Neal CR Jr., Vazquez DM (2005) Selective Serotonin Reuptake Inhibitor [SSRI] use during pregnancy and effects on the fetus and newborn: a meta-analysis. J Perinatol 25:595–604

    Article  CAS  PubMed  Google Scholar 

  53. Gibbons RD, Hur K, Brown CH, Davis JM, Mann JJ (2012) Who benefits from antidepressants? Synthesis of 6‑week patient-level outcomes from double-blind placebo controlled randomized trials of Fluoxetine and Venlafaxine. Arch Gen Psychiatry 69(6):572–557

    CAS  PubMed  PubMed Central  Google Scholar 

  54. Jakubovski E, Varigonda AL, Freemantle N, Taylor MJ, Bloch MH (2016) Systematic review and meta-analysis: dose-response relationship of selective serotonin reuptake inhibitors in major depressive disorder. Am J Psychiatry 173(2):174–183

    Article  PubMed  Google Scholar 

  55. Eke AC, Saccone G, Berghella V (2016) Selective serotonin reuptake inhibitor [SSRI] use during pregnancy and risk of preterm birth: a systematic review and meta-analysis. BJOG 123(12):1900–1907

    Article  CAS  PubMed  Google Scholar 

  56. Alwan S, Friedman JM, Chambers C (2016) Safety of selective serotonin reuptake inhibitors in pregnancy: a review of current evidence. CNS Drugs 30:499–515

    Article  CAS  PubMed  Google Scholar 

  57. Viuff AC, Pedersen LH, Kyng K, Staunstrup NH, Børglum A, Henriksen TB (2016) Antidepressant medication during pregnancy and epigenetic changes in umbilical cord blood: a systematic review. Clin Epigenetics 8(1):94

    Article  PubMed  PubMed Central  Google Scholar 

  58. Kremer M, Salvat E, Muller A, Yalcin I, Barrot M (2016) Antidepressants and gabapentinoids in neuropathic pain: mechanistic insights. Neuroscience 338:183–206

    Article  CAS  PubMed  Google Scholar 

  59. Nazimek K, Strobel S, Bryniarski P, Kozlowski M, Filipczak-Bryniarska I, Bryniarski K (2016) The role of macrophages in anti-inflammatory activity of antidepressant drugs. Immunobiology:. doi:10.1016/j.imbio.2016.07.001.

    PubMed  Google Scholar 

  60. Sachs G, Erfurth A (2015) Kognition bei depressiven Störungen. Psychoprax Neuroprax 18:172–179

    Article  Google Scholar 

  61. Rosenblat JD, Kakar R, McIntyre RS (2015) The cognitive effects of antidepressants in major depressive disorder: a systematic review and Meta-analysis of randomized clinical trials. Int J Neuropsychopharmacol 19(2):pyv082. doi:10.1093/ijnp/pyv082

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 6. Psychiatrische Abteilung, Otto-Wagner-Spital, Baumgartner Höhe 1, 1140, Wien, Österreich

    Wolfgang Novak & Andreas Erfurth

Authors
  1. Wolfgang Novak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andreas Erfurth
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wolfgang Novak.

Ethics declarations

Interessenkonflikt

W. Novak und A. Erfurth geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Novak, W., Erfurth, A. Therapie depressiver Störungen mit selektiven Serotonin-Rückaufnahme-Inhibitoren (SSRI). psychopraxis. neuropraxis 20, 28–41 (2017). https://doi.org/10.1007/s00739-016-0371-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00739-016-0371-5

Schlüsselwörter

Keywords

Search

Navigation