Neurológia pre prax 2/2018
Výskyt deprese u roztroušené sklerózy
Depression in multiple sclerosis Major depression has a relatively high incidence in patients with multiple sclerosis (MS). It needs to be recognized and treated in a timely manner, as it significantly improves the quality of life and the course of the main disease. From an etiological point of view, it is not yet clear why major depression in MS occurs so often. Biological, psychological and social factors are involved in its development, but it is also influenced by MS treatment itself (corticoids, interferons). Major clinical signs of depression include disturbances of mood, thinking, perception, and psychomotor impairment. In clinical practice we usually start with structured interview along with specialized questionnaire for depression. The basic methods of treatment of depression in MS include pharmacotherapy with antidepressive drugs and psychotherapy. Cognitive behavioral therapy is usually used in MS patients. The first choice of pharmacotherapy is selective serotonine reuptake inhibitors – citalopram, escitalopram, sertraline, that have a very good safety profile. The therapeutic effect in relation to the main symptoms of depression is usually after 6–8 weeks of treatment.
Keywords: multiple sclerosis, major depression, biological treatment, psychotherapy, antidepressants
