Moderne und klassische Antidepressiva und ihre Auswirkung auf den Krankheitsverlauf depressiver Patienten
Introduction: Mental disorders account for about 13% of the global burden of disease, ever-increasing in number and being a vital challenge to healthcare politics. According to WHO depressive disorders will rank first on DALY scale in 2030. For medical treatment we find more than 30 antidepressants (AD) with different effects on hand. The launch of modern AD showed hopes for more safety, less side effects, easy dose adjustment, simplification in outpatient care and cost reduction. Objective: Modern AD have not replaced conventional AD in treatment. We aimed to analyze the effects of applied modern versus conventional AD on the length of stay, rate of and free time until readmissions, clinical global impression (CGI) and global assessment of functioning (GAF). Methods: We used descriptive statistics analyzing a systematic review in a psychiatric hospital on 312 inpatients with depressive disorder, admitted within one and surveyed for another year. Standardized data collection were retrieved from clinical record keeping according to DGPPN guidelines. Single and combined AD medication was compared in different subsets. Results: 49% patients received single modern AD, 25% a modern combination. We found the shortest length of stay on single modern AD, the longest time until readmission on single conventional AD. 67 patients were readmitted, 84% had kept their inpatient medication. The maximum improvement of CGI and GAF occurred on single modern AD. Conclusions: Modern single AD are outlined as favourite for first line treatment, yet combination often shows vital because of poor efficacy or side effects. The trend is towards simplification by monotherapy before discharge. Modern monotherapy shows a clear benefit according to cognitive and social function. Apart from the analyzed parameters factors like clinical care, psychosocial facts, conditions related to clinical process and much else are important elements affecting the clinical course of depressive patients.
Subject HeadingsAntidepressivum [GND]
Stationäre Verweildauer [GND]
Depressive disorder [MeSH]
Drug therapy [MeSH]
Psychotropic drugs [MeSH]