Medikamentöse Behandlung der Depression im Alter – Empfehlungen aus Internationalen Leitlinien und aktueller Literatur

Zusammenfassung

Depressive Erkrankungen im Alter zählen zu den häufigsten Erkrankungen und sind oft mit geringerer Lebensqualität und einem erhöhten körperlichen Erkrankungsrisiko verbunden. Die vorliegende Arbeit fasst pharmakologische Empfehlungen aktueller Leitlinien und Übersichtsarbeiten für diese spezielle Patientengruppe zusammen.

Die Behandlung mit Antidepressiva bei Depression im Alter (65 +) wird in den meisten Leitlinien empfohlen. Zur Wahl des Antidepressivums unter dem Aspekt möglicher Nebenwirkungen bzw. moderierender Faktoren liegen kaum Aussagen bzw. Empfehlungen vor.

Die spezifische Zielgruppe wird in den aktuellen Leitlinien unterschiedlich ausführlich betrachtet. Zu vielen Besonderheiten ihrer Behandlung liegen keine evidenzbasierten Behandlungsempfehlungen vor. Es besteht dringender Bedarf an aussagekräftigen Studien zu diesem Thema als Grundlage für zukünftige Leitlinienempfehlungen.

Abstract

Late life depression is associated with severe health consequences, e. g. elevated risk of medical comorbidity and decreased quality of life.

This paper summarizes the recommendations of the international guidelines on evidence-based pharmacological treatment of depression in late life in a systematic review.

Pharmacological treatments for depression recommended by most of the guidelines, however, hardly address the issue of the possible side effects of antidepressants and other factors of multi-medication on the elderly.

Different guidelines pay different degrees of attention to the specific group of geriatric patients. There is a lack of evidence-based treatment recommendation that takes into consideration the specific age-related issues of sensitivity to adverse effects or pharmacokinetic interaction. Further research is required to provide a database for more refined recommendations in guidelines.

Schlüsselwörter

Depression - Alter - Leitlinie - medikamentöse Behandlung - Antidepressiva

Key words

antidepressants - antidepressant medication - depression - late life - elderly - guidelines

• Literatur

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