Eine Person hält ein Bündel leuchtender Lichterketten in den Händen, die Hoffnung und Verbundenheit symbolisieren - ein Bild, das an Themen aus der systemischen Therapie anknüpft -, während weitere Lichter vor einem dunklen Hintergrund um ihren Oberkörper drapiert sind.

Psychotherapie statt Dauermedikation bei Depression

Lesezeit 1 Minute

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Was eine aktuelle Metaanalyse über Rückfallrisiken, Ausschleichen von Antidepressiva und die Rolle psychotherapeutischer Begleitung zeigt

Dau­er­me­di­ka­ti­on mit Anti­de­pres­si­va kommt bei depres­si­ven Pati­en­ten häu­fig zur Anwen­dung, um lang­fris­tig einen Rück­fall zu ver­hin­dern. Eine Meta­ana­ly­se vom Mai 2021 legt nun nahe, dass eine psy­cho­the­ra­peu­ti­sche Begleit­the­ra­pie eine Alter­na­ti­ve zur Dau­er­me­di­ka­ti­on sein könn­te. In der Ana­ly­se erhöh­te sich das Rück­fall­ri­si­ko nicht, wenn die Anti­de­pres­si­va aus­ge­schli­chen wur­den und par­al­lel dazu eine psy­cho­lo­gi­sche Begleit­the­ra­pie statt­fand. Die Ergeb­nis­se schei­nen vielversprechend..

Langfristige Nachbehandlung mit Antidepressiva versus Psychotherapie

Die Meta­ana­ly­se beinhal­tet vier ran­do­mi­sier­te kli­ni­sche Stu­di­en mit ins­ge­samt 714 Pati­en­ten in par­ti­el­ler oder voll­stän­di­ger Remi­si­on (Nach­las­sen der Sym­pto­me). Die Pro­ban­den erhiel­ten wäh­rend einer Nach­be­hand­lungs-zeit von durch­schnitt­lich 15 Mona­ten ent­we­der Anti­de­pres­si­va oder eine psy­cho­lo­gi­sche Begleit­the­ra­pie. Die psy­cho­lo­gi­sche Begleit­the­ra­pie fand par­al­lel zum Aus­schlei­chen der Medi­ka­ti­on statt und/oder nach Ende des Ausschleichprozesses.

Keine signifikanten Unterschiede bei Therapieergebnis und Rezidivrisiko

Es zeig­ten sich weder signi­fi­kan­te Unter­schie­de im The­ra­pie­er­geb­nis noch im Rück­fall­ri­si­ko (Rezi­div) . Selbst bei Pati­en­ten mit schlech­ter kli­ni­scher Pro­gno­se wur­de kein erhöh­tes Rück­fall­ri­si­ko der Psy­cho­the­ra­pie-Grup­pe im Ver­gleich zur Anti­de­pres­si­va-Grup­pe fest­ge­stellt. Damit könn­te die psy­cho­lo­gi­sche Begleit­the­ra­pie eine gute Alter­na­ti­ve zur medi­ka­men­tö­sen Lang­zeit­the­ra­pie sein.

Quel­len: Medi­cal Tri­bu­ne, Ori­gi­nal­stu­die auf JAMA Psychiatry

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