Prakt. Lékáren. 2016; 12(5e) [Psychiatr. praxi. 2016;17(2):48-52]

Some issues of antidepressant efficacy and tolerability relevant for routine clinical practice

prof. MUDr. Eva Češková, CSc.

¹ CEITEC-MU

² Psychiatrická klinika FN Brno

³ KIO LF Univerzity Ostrava

⁴ Oddělení psychiatrie, FN Ostrava

Current possibilities of available antidepressants (AD) are limited. In spite of great heterogeneity of depressive disorders, monoaminesremain the main target of psychopharmacotherapy. The differences in treatment response are associated with genetic variability. The developing field of pharmacogenetics strives for individualized treatment; however, in routine clinical practice the choice of antidepressantis based on individual efficacy, tolerability and alignment of symptoms to a biochemical alteration. The presence of an adequate quantityof the active substance in CNS targets is undoubtedly a precondition for efficacy. This raises the issue of adherence. The most frequentreasons for non-adherence are insufficient efficacy, including residual symptoms, as well as side effects, particularly sexual dysfunction,and weight gain. Attitudes to treatment may also play a significant role.

Keywords: antidepressants, side effects, adherence, attitudes to treatment

Published: October 1, 2016  Show citation