Therapie der Depression bei kardiometabolischen Erkrankungen

KW. Sühs; M. Reuther

doi:10.1055/s-0038-1628166

Nervenheilkunde, Table of Contents

Nervenheilkunde 2012; 31(05): 311-315
DOI: 10.1055/s-0038-1628166

Depression

Schattauer GmbH

Therapie der Depression bei kardiometabolischen Erkrankungen

Therapy of depression in cardiometabolic diseases

KW. Sühs

¹Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover (MHH)

,

M. Reuther

¹Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover (MHH)

› Author Affiliations

Abstract

Zusammenfassung

In der klinischen Praxis findet sich bei der Depression häufig eine Assoziation mit bestimmten kardiometabolischen Erkrankungen. Teils führt diese Komorbidität zu einer negativen Verstärkung wie einer höheren Sterblichkeit nach Schlaganfall oder Myokardinfarkt. Pathophysiologisch bestehen verschiedene Verbindungen zwischen Depression und den assoziierten kardiometabolischen Erkrankungen. Dies bietet neben der Psychotherapie, die zur Behandlung der Depression eine tragende Rolle spielt, die Möglichkeit durch die Auswahl der medikamentösen Therapie neben der Depression parallel die assoziierte kardiometabolische Erkrankung positiv zu beeinflussen. Insgesamt lässt der Ausblick auf die Studienlage den Schluss zu, dass bei Komorbidität von Depression und Erkrankungen wie Diabetes mellitus Typ II, Myokardinfarkt und Schlaganfall, die Substanzklasse der SSRI durch teils synergistische Effekte einen Vorteil bei der Behandlung bietet, sofern spezifische Nebenwirkungen, wie beispielsweise die Verlängerung der QT-Zeit, den Einsatz nicht unmöglich machen.

Summary

In clinical practice depression is commonly associated with other cardiometabolic diseases. Partly this causes a negative impact like an increased mortality after stroke or myocardial infarction. Pathophysiologically there are different links between depression and the associated cardiometabolic disease. Next to psychotherapy, which plays an essential role in treating depression, this offers the opportunity to positively influence depression and the associated cardiometabolic disease in parallel with a single drug. With regard to the literature it seems that treating a patient with depression and a co morbid disease like diabetes type II, myocardial infarction or stroke SSRI provide an advantage by a positive, partly synergistic, impact on both diseases and can be recommended for treatment unless specific side effects like QT prolongation prevent their use.

Schlüsselwörter

Depression - Diabetes mellitus - Myokardinfarkt - Schlaganfall - Antidepressiva

Keywords

Depression - diabetes mellitus - myocardial infarction - stroke - antidepressants

Full Text

References

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