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Therapeutisches Drugmonitoring zur Therapieoptimierung

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Akute und therapieresistente Depressionen

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Zusammenfassung

Bei Nichtansprechen auf eine medikamentöse antidepressive Therapie ist therapeutisches Drugmonitoring (TDM) eine geeignete Maßnahme, um zu prüfen, ob individuelle pharmakokinetische Besonderheiten für das Therapieversagen verantwortlich sein könnten. Pharmakokinetische Auffälligkeiten sind anzunehmen, wenn die Steady-State-Konzentrationen des Antidepressivums im Blutserum oder -plasma bei einer üblicherweise wirksamen Dosis außerhalb des Erwartungsbereichs (therapeutisches Fenster) liegen. TDM gibt Hinweise, ob Aktivitäten von Arzneimittel abbauenden Enzymen der Leber ungewöhnlich hoch oder niedrig sind. Dies kann genetische Ursachen haben, aber auch durch Wechselwirkungen mit Begleitmedikamenten bedingt sein. In besonders gelagerten Fällen kann TDM durch gezielte Nutzung von Arzneimittelwechselwirkungen zur pharmakokinetischen Augmentierung eingesetzt werden. Eine wichtige Indikation für TDM ist die Diagnose einer therapieresistenten Depression. TDM sollte genutzt werden, um das therapeutisch mögliche Potenzial des gewählten Antidepressivums auszuschöpfen und das Risiko des Auftretens von Nebenwirkungen zu minimieren.

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Authors
  1. S. Härtter
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  2. C. Hiemke
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Editors and Affiliations

  1. Klinik für Psychatrie und Psychotherapie, Charité — Universitätsklinik Berlin, Campus Charité Mitte (CCM), Schumannstr. 20/21, 10117, Berlin

    Michael Bauer  & Mazda Adli  & 

  2. Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité — Universitätsklinik Berlin, Campus Charité Mitte (CCM), Luisenstr. 57, 10117, Berlin

    Anne Berghöfer

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© 2005 Springer Medizin Verlag Heidelberg

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Härtter, S., Hiemke, C. (2005). Therapeutisches Drugmonitoring zur Therapieoptimierung. In: Bauer, M., Berghöfer, A., Adli, M. (eds) Akute und therapieresistente Depressionen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-28049-9_13

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  • DOI: https://doi.org/10.1007/3-540-28049-9_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-40617-4

  • Online ISBN: 978-3-540-28049-1

  • eBook Packages: Medicine (German Language)

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