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Individualized Pharmacological Treatment of Depressive Disorders State of the Art and Recent Developments

Thomas C Baghai, Christina Zirngibl, Barbara Heckel, Nina Sarubin and Rainer Rupprecht

During the past decade a variety of promising new compounds were launched onto the market. These are influencing serotonergic, noradrenergic, and dopaminergic neurotransmission, and interact with melatonergic and serotonergic receptor systems.

The main advantages of all newer drugs are a broadening of the spectrum of available treatments, better safety and tolerability profiles in comparison to older compounds and the focus on specific symptoms of depression including insomnia and cognitive disturbances.

Still unresolved issues are the relatively high non-response rate during the first weeks of antidepressant treatments, a latency of sometimes several weeks until clinical improvement and remission can be achieved, and a variety of possible side effects also present during treatment with modern compounds.

Still unresolved issues are the relatively high non-response rate during the first weeks of antidepressant treatments, a latency of sometimes several weeks until clinical improvement and remission can be achieved, and a variety of possible side effects also present during treatment with modern compounds.

This narrative review summarizes the actual knowledge of the comparative efficacy and individual effectiveness together with safety and tolerability profiles of all to date approved antidepressant classes according to their pharmacodynamic principles of action. A detailed description of the latest approvals of antidepressants is included.

The study of new treatment options is of major importance to provide better strategies for the clinical management of depression in the future, and is thus also of great socio-economic importance.