Gründer G, Veselinović T, Paulzen M
Klinik für Psychiatrie, Psychotherapie und Psychosomatik, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Deutschland,
Nervenarzt. 2014 Sep;85(9):1108-16. doi: 10.1007/s00115-014-4092-9.
In the last 2 years the discussions on the question whether antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) can lead to suicidality, aggression and violence, flared up again. The available data on the problem, which has been discussed since the introduction of this substance group in the late 1980s, is presented in this article. A systematic literature search showed that a scientific consensus exists that the benefits of antidepressant pharmacotherapy in general, and of treatment with SSRIs and selective serotonin/norepinephrine reuptake inhibitors (SSNRIs) in particular, outweigh the risks of their use. This also applies to the treatment of children, adolescents and young adults. The agitation occasionally occurring at the beginning of treatment, which can be experienced as aversive in susceptible patients, can intensify or even trigger suicidal thoughts or impulses. This has to be paid particular attention to especially at the beginning of treatment. It is recommended that the indications for antidepressant pharmacotherapy of children, adolescents and young adults are assessed by a specialist.
在过去两年里，关于抗抑郁药尤其是选择性5-羟色胺再摄取抑制剂（SSRIs）是否会导致自杀倾向、攻击行为和暴力行为的讨论再度升温。本文呈现了自20世纪80年代末这类药物问世以来就一直被讨论的该问题的现有数据。一项系统的文献检索表明，科学界已达成共识，即总体而言抗抑郁药物治疗的益处，尤其是使用SSRIs和选择性5-羟色胺/去甲肾上腺素再摄取抑制剂（SSNRIs）治疗的益处，超过了用药风险。这同样适用于儿童、青少年和青年的治疗。治疗初期偶尔出现的激越情绪，在易患患者中可能会感觉不适，这种情绪可能会强化甚至引发自杀念头或冲动。在治疗开始时尤其需要特别关注这一点。建议由专科医生评估儿童、青少年和青年使用抗抑郁药物治疗的适应症。
