Depression und Suizid: Sind antidepressive Therapien bei der Akut- und Langzeittherapie uni- und bipolarer affektiver Erkrankungen suizidpräventiv?

T. Bronisch

doi:10.1055/s-2005-870990

Krankenhauspsychiatrie, Table of Contents

Krankenhauspsychiatrie 2005; 16: 27-33
DOI: 10.1055/s-2005-870990

Originalarbeit

Depression und Suizid: Sind antidepressive Therapien bei der Akut- und Langzeittherapie uni- und bipolarer affektiver Erkrankungen suizidpräventiv?

Depression and Suicide: Antidepressive Therapies in the Acute and Chronic Treatment of Unipolar and Bipolar Affective Disorders - are they Preventive According to Suicide?T. Bronisch¹

¹Max-Planck-Institut für Psychiatrie, Klinik, München

Herrn Prof. Dr. med. Hans-Jürgen Möller zum 60. Geburtstag gewidmet.

Abstract

Zusammenfassung

Die pharmakologische Behandlung der Suizidalität bei unipolaren und bipolaren Störungen umfasst Antidepressiva, Neuroleptika, Lithium und Mood Stabilizer. Für eine antisuizidale Wirksamkeit bei diesen Störungen bietet Lithium derzeit die beste empirische Evidenz, für Antidepressiva wird eine starke bis schwächere oder gar fehlende Wirksamkeit postuliert. Indirekte Studien (Post-mortem, psychologische Autopsie, epidemiologische und Interventionsstudien) geben den besten Hinweis für eine starke Wirksamkeit von Antidepressiva. Für Neuroleptika und Mood Stabilizer ist die Datenlage zu schwach, um eine Aussage machen zu können. Insgesamt sind dringend prospektive, möglichst plazebo-kontrollierte Studien, an akut und chronisch suizidalen, unipolar und bipolar Depressiven notwendig.

Abstract

The antisuicidal pharmacological treatment comprises antidepressants, neuroleptics, lithium, and mood stabilizers. Lithium seems to have at the moment the best empirical results in treatment of suicidality, whereas a weak, moderate or strong efficacy is postulated for antidepressants. Indirect studies (post-mortem, psychological autopsy, epidemiological, and intervention studies) give indicators for a strong efficacy of antidepressants. Data are not sufficient for evaluating the antisuicidal properties of neuroleptics and mood stabilizers. In summary, there is an urgent need for, if possible prospective placebo controlled studies of acute or chronic unipolar and bipolar depressives.

Schlüsselwörter

Suizid - Suizidversuche - Depression - Pharmakotherapie

Key words

Suicide - suicide attempt - depression - pharmacotherapy

Full Text

References

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Prof. Dr. med. Thomas Bronisch

Max-Planck-Institut für Psychiatrie · Klinik

Kraepelinstr. 10

80804 München

Phone: 089-30622-239

Fax: 089-30622-223

Email: bronisch@mipsykl.mpg.de