Abstract
Depressive disorders are common, they cause great psychosocial burden of disease and significant morbidity and mortality. The knowledge of pharmacotherapy of depression is thus important not only for psychiatrists, but also for general practitioners. Psychological, social, and neurobiological factors are considered in the development of depression. Hence, treatment of depressive disorders is based on a multimodal approach with pharmacotherapy and psychotherapy as well as social therapy interventions and specialized therapies. This chapter provides a comprehensive overview on different aspects of depression treatment. Recommendations from various current national guidelines are reviewed and compared with each other under consideration of recent literature. Psychoeducation and choice of the appropriate antidepressant agent is the first step. After remission is achieved maintenance treatment is necessary. In certain cases, extended maintenance is reasonable. Inappropriate response or nonresponse require further escalation of treatment in terms of dose escalation or switching. Different augmentation strategies are available. Combination of antidepressant agents is also frequently used in clinical practice. Second-line agents or rapid acting antidepressants such as ketamine can be necessary in case of difficult-to-treat depression. Various complementary agents and chronobiological interventions are subject of current research. If pharmacotherapy fails to provide adequate improvement, different techniques of brain stimulation should be considered, electroconvulsive therapy being the most well established. Successful treatment of depressive disorders requires knowledge of each of these treatment options and how they can be combined. This chapter gives a practical and evidence-based guidance.
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Kavakbasi, E., Baune, B.T. (2022). Psychopharmacotherapy of Depressive Disorders. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_427
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