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Monoaminoxidase-Hemmstoffe

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Akute und therapieresistente Depressionen

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Zusammenfassung

In Deutschland spielen Tranylcypromin als irrreversibler Monoaminoxidase-(MAO-)A/B-Hemmstoff und Moclobemid als reversibler MAO-A-Hemmstoff eine Rolle bei der Behandlung depressiver Störungen. Während Moclobemid als gut verträgliche Alternative zunächst als »Hoffnungsträger« galt, wird es mittlerweile hauptsächlich bei sozialer Phobie und kaum bei therapiere-sistenter Depression eingesetzt. Tranylcypromin scheint stärker antidepressiv wirksam, aber auch schlechter verträglich und schlechter kombinierbar zu sein. Obwohl mittlerweile seltener als vor 10–20 Jahren eingesetzt, stellen insbesondere irreversible Monoaminoxidasehemmstoffe (MAOH) bei ansonsten therapieresistenten Depressionen eine erwägenswerte Behandlungsoption dar. Auf eine ausreichende Dosierung, die großen individuellen Unterschieden unterliegt, ist zu achten. Hinsichtlich der Sicherheit sind pharmakodynamische und -kinetische Besonderheiten zu berücksichtigen (tyraminarme Diät, Kombination-sbehandlung und dosisabhängige und -unabhängige Nebenwirkungen). Bei der Kombination-sbehandlung von irreversiblen MAOH mit anderen Antidepressiva muss auf ausgeprägt serotonerg wirksame Substanzen wie selektive Serotonin- Wiederaufnahmehemmer (SSRI), Venlafaxin oder Clomipramin verzichtet und bei anderen die Reihenfolge des Einsatzes beachtet werden (1. Non- MAOH, 2. MAOH).

Es besteht weitgehend Übereinstimmung darin, dass die Gabe von MAOH bei Therapieresistenz z. B. auf trizyklische Antidepressiva (TZA) eine wichtige Therapieoption darstellt. Obwohl die Literatur hierzu meist schon vor einigen Jahren und Jahrzehnten entstanden ist und die besonders häufige Anwendung bereits einige Jahre zurückliegt, wird diese Behandlungsmaßnahme nach wie vor angewandt und hat ihren Stellenwert.

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Authors
  1. I. Anghelescu
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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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Anghelescu, I. (2005). Monoaminoxidase-Hemmstoffe. In: Bauer, M., Berghöfer, A., Adli, M. (eds) Akute und therapieresistente Depressionen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-28049-9_16

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  • DOI: https://doi.org/10.1007/3-540-28049-9_16

  • 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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