Wetenschappelijk onderzoek over de behandeling van depressie

Het protocol voor de behandeling een depressie is op basis van wetenschappelijke publicaties ontwikkeld. Hierbij is gebruik gemaakt van de National Library of Medicine (PubMed). Daar waar mogelijk werden studies die opgezet zijn volgens het “placebo controlled cross-over” principe gebruikt. Andere vormen die vaak werden gebruik zijn reviews en epidemiologisch onderzoek. Publicaties uit bladen als The Lancet, American Journal of Cardiology, The New England Journal of Medicine hadden de voorkeur

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Wetenschappelijk onderzoek depressie (depressiviteit)

National Library of Medicine (PubMed)

Referenties depressie (depressiviteit) – St. Janskruid (hypericum)


  1. Kasper S1, Gastpar M, Möller HJ, Müller WE, Volz HP, Dienel A, Kieser M. Int Clin Psychopharmacol. 2010 Jul;25(4):204-13. Better tolerability of St. John’s wort extract WS 5570 compared to treatment with SSRIs: a reanalysis of data from controlled clinical trials in acute major depression
    In conclusion, WS 5570 exhibits substantially lower incidence rates of adverse events than paroxetine and other SSRIs.[Abstract]
  2. META

  3. Rahimi R1, Nikfar S, Abdollahi M. Prog Neuropsychopharmacol Biol Psychiatry. 2009 Feb 1;33(1):118-27. doi: 10.1016/j.pnpbp.2008.10.018. Efficacy and tolerability of Hypericum perforatum in major depressive disorder in comparison with selective serotonin reuptake inhibitors: a meta-analysis
    Hypericum does not differ from SSRIs according to efficacy and adverse events in MDD. Lower withdrawal from study due to adverse events by Hypericum is an advantage in management of MDD.[Article]
  4. META

  5. Kasper S1, Gastpar M, Müller WE, Volz HP, Dienel A, Kieser M, Möller HJ. Eur Arch Psychiatry Clin Neurosci. 2008 Feb;258(1):59-63. Efficacy of St. John’s wort extract WS 5570 in acute treatment of mild depression: a reanalysis of data from controlled clinical trials
    The analysis shows that St. John’s wort extract WS 5570 has a meaningful beneficial effect during acute treatment of patients suffering from mild depression and leads to a substantial increase in the probability of remission.[Abstract]
  6. The efficacy of St. John’s Wort in patients with minor depressive symptoms or dysthymia – a double-blind placebo-controlled study
    We observed, a tendency toward a more frequent significant improvement of the non-dysthymic patient treated with PM235, though this did not reach the level of statistical significance. In a secondary analysis, pooling both hypericine-treated groups concluded that Hypericum has a clinical significant effect in minor depressed patients with HAM-D up to 17. This finding was significant only in non-dysthymic patients.
  7. Predicting stable treatment response in patients with major depression treated with hypericum extract WS 5570/5572
    A substantial fraction of the patients treated with Hypericum extracts WS(R) 5570/5572 showed a meaningful reduction of depressive symptoms during the first two weeks of treatment (early improvement), which was found to be a sensitive predictor of sustained response. The results determined for the herbal extracts were comparable to those for effective synthetic antidepressants investigated previously.
  8. A Double-blind, randomized trial of St John’s wort, fluoxetine, and placebo in major depressive disorder
    St John’s wort was significantly more effective than fluoxetine and showed a trend toward superiority over placebo. A (25%) smaller than planned sample size is likely to account for the lack of statistical significance for the advantage (indicating a moderate effect size, d = 0.45) of St John’s wort over placebo.
  9. St John’s wort for depression: meta-analysis of randomised controlled trials
    Current evidence regarding Hypericum extracts is inconsistent and confusing. In patients who meet criteria for major depression, several recent placebo-controlled trials suggest that Hypericum has minimal beneficial effects while other trials suggest that Hypericum and standard antidepressants have similar beneficial effects.
  10. Efficacy and tolerability of Hypericum extract STW 3-VI in patients with moderate depression: a double-blind, randomized, placebo-controlled clinical trial
    The study provided evidence that Hypericum extract STW 3-VI in a once-daily dosing regimen may be an effective and well-tolerated option for patients with moderate depressive disorders.
  11. Efficacy of St. John’s wort extract WS 5570 in major depression: a double-blind, placebo-controlled trial
    H. perforatum extract WS 5570 was found to be safe and more effective than placebo for the treatment of mild to moderate depression.

Referenties depressie (depressiviteit) – 5-HTP


  1. Jangid P1, Malik P, Singh P, Sharma M, Gulia AK. Asian J Psychiatr. 2013 Feb;6(1):29-34. doi: 10.1016/j.ajp.2012.05.011. Comparative study of efficacy of l-5-hydroxytryptophan and fluoxetine in patients presenting with first depressive episode
    l-5-HTP has definitely got antidepressant effect in patients of depression. Antidepressant effect was seen within 2weeks of treatment and was apparent in all degrees of depression. The therapeutic efficacy of l-5-HTP was considered as equal to that of fluoxetine.[Abstract]

  3. Jacobsen JP1, Krystal AD2, Krishnan KR3, Caron MG4. Trends Pharmacol Sci. 2016 Nov;37(11):933-944. doi: 10.1016/j.tips.2016.09.001. Adjunctive 5-Hydroxytryptophan Slow-Release for Treatment-Resistant Depression: Clinical and Preclinical Rationale
    A slow-release (SR) delivery mode would be predicted to overcome the pharmacokinetic limitations of 5-HTP, substantially enhancing the pharmacological action and transforming 5-HTP into a clinically viable drug. Animal studies bear out this prediction. Thus, adjunct 5-HTP SR could be an important new treatment for TRD.[Abstract]
  4. OTHER

  5. Jacobsen JP1, Rudder ML1, Roberts W1, Royer EL1, Robinson TJ1, Oh A1, Spasojevic I2, Sachs BD1, Caron MG1,2,3. Neuropsychopharmacology. 2016 Aug;41(9):2324-34. doi: 10.1038/npp.2016.35. SSRI Augmentation by 5-Hydroxytryptophan Slow Release: Mouse Pharmacodynamic Proof of Concept
    In humans, adjunct treatment with the 5-HT precursor 5-hydroxytryptophan (5-HTP) elevates 5-HTExt beyond the SSRI effect. Small pilot trials suggest that adjunct 5-HTP can confer antidepressant response in treatment-resistant depression (TRD). However, sustained, stable 5-HTExt elevation is required for antidepressant effect; therefore, the rapid absorption and elimination of standard 5-HTP immediate release (IR) likely curtail 5-HTP IR’s antidepressant potential. Slow-release (SR) drug delivery can crucially improve efficacy and safety of rapidly absorbed and eliminated compounds. Integrated with a body of clinical data, our mouse data suggest that an adjunct 5-HTP SR drug could safely and effectively elevate 5-HTExt beyond the SSRI effect and represent a novel treatment for TRD[Abstract]

  7. Meyers S1. Altern Med Rev. 2000 Feb;5(1):64-71. Use of neurotransmitter precursors for treatment of depression
    In the late 1970s and 1980s, numerous studies were performed in which depressed patients were treated with the serotonin precursors L-tryptophan and 5-hydroxytryptophan (5-HTP), and the dopamine and norepinephrine precursors tyrosine and L-phenylalanine. .[Article]

  9. Birdsall TC1. Altern Med Rev. 1998 Aug;3(4):271-80. 5-Hydroxytryptophan: a clinically-effective serotonin precursor
    Therapeutic administration of 5-HTP has been shown to be effective in treating a wide variety of conditions, including depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.[Article]

  10. .[Abstract]

  11. .[Abstract]

Referenties depressie (depressiviteit) – SAMe (S-adenosylmethionine)

  1. Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence
    SAMe is well tolerated and relatively free of adverse effects, although some cases of mania have been reported in bipolar patients. Overall, SAMe appears to be safe and effective in the treatment of depression, but more research is needed to determine optimal doses. Head-to-head comparisons with newer antidepressants should help to clarify SAMe’s place in the psychopharmacologic armamentarium.
  2. AS-adenosyl-l-methionine (SAMe) as antidepressant: meta-analysis of clinical studies
    The efficacy of SAMe in treating depressive syndromes and disorders is superior with that of placebo and comparable to that of standard tricyclic antidepressants. Since SAMe is a naturally occurring compound with relatively few side-effects, it is a potentially important treatment for depression
  3. Double-blind, placebo-controlled study of S-adenosyl-L-methionine in depressed postmenopausal women
    There was a significantly greater improvement in depressive symptoms in the group treated with SAMe compared to the placebo group from day 10 of the study. Side effects were mild and transient.
  4. Oral S-adenosylmethionine in depression: a randomized, double-blind, placebo-controlled trial
    The results suggest that oral S-adenosylmethionine is a safe, effective antidepressant with few side effects and a rapid onset of action. S-Adenosylmethionine induced mania in a patient with no history of mania. S-Adenosylmethionine may be useful for patients who cannot tolerate tricyclic anti-depressants. These findings support a role for methylation in the pathophysiology of depression.

Referenties depressie (depressiviteit) – Tryptofaan

  1. Serotonin a la carte: supplementation with the serotonin precursor 5-hydroxytryptophan
    This paper reviews the preclinical and clinical evidence regarding the use of the dietary supplement 5-hydroxytryptophan (5-HTP) for the treatment of depression
  2. 5-Hydroxytryptophan: a clinically-effective serotonin precursor
    Therapeutic administration of 5-HTP has been shown to be effective in treating a wide variety of conditions, including depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.
  3. f=”http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9727088&query_hl=35&itool=pubmed_docsum” target=_blank>5-Hydroxytryptophan: a clinically-effective serotonin precursor
    Therapeutic administration of 5-HTP has been shown to be effective in treating a wide variety of conditions, including depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.

Referenties depressie (depressiviteit) – omega-3


  1. Freeman MP1, Hibbeln JR, Wisner KL, Davis JM, Mischoulon D, Peet M, Keck PE Jr, Marangell LB, Richardson AJ, Lake J, Stoll AL. J Clin Psychiatry. 2006 Dec;67(12):1954-67. Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry
    Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry
    The preponderance of epidemiologic and tissue compositional studies supports a protective effect of omega-3 EFA intake, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), in mood disorders. Meta-analyses of randomized controlled trials demonstrate a statistically significant benefit in unipolar and bipolar depression.[Abstract]

  3. Logan AC1. Altern Med Rev. 2003 Nov;8(4):410-25. Neurobehavioral aspects of omega-3 fatty acids: possible mechanisms and therapeutic value in major depression
    Omega-3 fatty acids have been the subject of volumes of international research, the results of which indicate these substances may have therapeutic value in a number of medical conditions. An emerging area of research is examining the neurobehavioral aspects of omega-3 fatty acids (alpha-linolenic, eicosapentaenoic, docosahexaenoic) and the critical role of these essential fats in the functioning of the central nervous system. Investigations have linked omega-3 fatty acids to a number of neuropsychiatric disorders, including depression.[Article]
  4. META

  5. Grosso G1, Pajak A2, Marventano S3, Castellano S1, Galvano F1, Bucolo C1, Drago F1, Caraci F4. PLoS One. 2014 May 7;9(5):e96905. doi: 10.1371/journal.pone.0096905. eCollection 2014. Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials
    The use of omega-3 PUFA is effective in patients with diagnosis of MDD and on depressive patients without diagnosis of MDD.[Article]
  6. META

  7. Sublette ME1, Ellis SP, Geant AL, Mann JJ. J Clin Psychiatry. 2011 Dec;72(12):1577-84. doi: 10.4088/JCP.10m06634. Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression
    Supplements containing EPA ≥ 60% of total EPA + DHA, in a dose range of 200 to 2,200 mg/d of EPA in excess of DHA, were effective against primary depression. Translational studies are needed to determine the mechanisms of EPA’s therapeutic benefit.[Article]
  8. META

  9. Sarris J1, Mischoulon D, Schweitzer I. J Clin Psychiatry. 2012 Jan;73(1):81-6. doi: 10.4088/JCP.10r06710. Omega-3 for bipolar disorder: meta-analyses of use in mania and bipolar depression.
    The meta-analytic findings provide strong evidence that bipolar depressive symptoms may be improved by adjunctive use of omega-3. The evidence, however, does not support its adjunctive use in attenuating mania.[Abstract]
  10. META

  11. Lin PY1, Huang SY, Su KP. Biol Psychiatry. 2010 Jul 15;68(2):140-7. doi: 10.1016/j.biopsych.2010.03.018. A meta-analytic review of polyunsaturated fatty acid compositions in patients with depression
    The results showed lower levels of EPA, DHA, and total n-3 polyunsaturated fatty acids in patients with depression, thus implying that n-3 polyunsaturated fatty acids play a role in the pathogenesis of depression. Our findings provide further support to the phospholipid hypothesis of depression and a rationale for using n-3 polyunsaturated fatty acids as an alternative treatment for depression.[Abstract]
  12. META

  13. Martins JG1. J Am Coll Nutr. 2009 Oct;28(5):525-42. EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials
    The current meta-analysis provides evidence that EPA may be more efficacious than DHA in treating depression. However, owing to the identified limitations of the included studies, larger, well-designed, randomized controlled trials of sufficient duration are needed to confirm these findings.[Abstract]
  14. META

  15. Am J Clin Nutr. 2010 Mar;91(3):757-70. doi: 10.3945/ajcn.2009.28313. Appleton KM1, Rogers PJ, Ness AR. Updated systematic review and meta-analysis of the effects of n-3 long-chain polyunsaturated fatty acids on depressed mood
    The evidence available provides some support of a benefit of n-3 PUFAs in individuals with diagnosed depressive illness but no evidence of any benefit in individuals without a diagnosis of depressive illness.[Article]
  16. META

  17. Montgomery P1, Richardson AJ. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD005169. doi: 10.1002/14651858.CD005169.pub2. Omega-3 fatty acids for bipolar disorder
    Results from one study showed positive effects of omega-3 as an adjunctive treatment for depressive but not manic symptoms in bipolar disorder.[Article]
  18. RCT

  19. Zanarini MC1, Frankenburg FR. Am J Psychiatry. 2003 Jan;160(1):167-9. omega-3 Fatty acid treatment of women with borderline personality disorder: a double-blind, placebo-controlled pilot study
    The results of this study suggest that E-EPA may be a safe and effective form of monotherapy for women with moderately severe borderline personality disorder.[Article]

  21. Peet M1, Horrobin DF. Arch Gen Psychiatry. 2002 Oct;59(10):913-9. A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs
    Treatment with ethyl-eicosapentaenoate at a dosage of 1 g/d was effective in treating depression in patients who remained depressed despite adequate standard therapy.[Article]
  22. REVIEW

  23. Mischoulon D1, Fava M. Psychiatr Clin North Am. 2000 Dec;23(4):785-94. Docosahexanoic acid and omega-3 fatty acids in depression
    Geographic areas where consumption of DHA is high are associated with decreased rates of depression. DHA deficiency states, such as alcoholism and the postpartum period, also are linked with depression. Individuals with major depression have marked depletions in omega-3 FAs (especially DHA) in erythrocyte phospholipids compared with controls. These data suggest that DHA may be associated with depression, and the limited data available on supplementation with DHA or other omega-3 FAs seem to support the hypothesis that DHA may have psychotropic effects.[Abstract]

Referenties depressie (depressiviteit) – Curcumin


  1. Al-Karawi D1, Al Mamoori DA2, Tayyar Y3. Phytother Res. 2016 Feb;30(2):175-83. doi: 10.1002/ptr.5524. The Role of Curcumin Administration in Patients with Major Depressive Disorder: Mini Meta-Analysis of Clinical Trials
    The administration of new formulation of curcumin (BCM-95) had non-significantly higher effect on depression as compared with the conventional curcumin-piperine formula. We conclude that there is supporting evidence that curcumin administration reduces depressive symptoms in patients with major depression.[Abstract]

  3. Kaufmann FN1, Gazal M2, Bastos CR3, Kaster MP1, Ghisleni G4. Eur J Pharmacol. 2016 Aug 5;784:192-8. doi: 10.1016/j.ejphar.2016.05.026. Curcumin in depressive disorders: An overview of potential mechanisms, preclinical and clinical findings
    Curcumin is a natural compound with multi-faceted pharmacological properties, interacting with several neurotransmitter systems and intracellular signaling pathways involved in mood regulation. Also, curcumin has anti-inflammatory, antioxidant and neurotrophic effects, suggesting a strong potential to manage conditions associated with neurodegeneration, such as psychiatric disorders.[Abstract]

  5. Schmidt FM1, Kirkby KC, Lichtblau N. Curr Neuropharmacol. 2016;14(7):674-87. Inflammation and Immune Regulation as Potential Drug Targets in Antidepressant Treatment
    Growing evidence supports a mutual relationship between inflammation and major depression. A number of clinical trials have focused on agents with immunmodulatory properties in the treatment of depression, of which this review covers nonsteroidal anti-inflammatory drugs (NSAIDs), cytokine inhibitors, ketamine, polyunsaturated fatty acids, statins and curcumin. Concluding from the available data, markers of inflammation may become relevant factors for more personalised planning and prediction of response of antidepressant treatment strategies. Agents with anti-inflammatory properties have the potential to serve as clinically relevant antidepressants. [Abstract]

  7. Tizabi Y1, Hurley LL2, Qualls Z3, Akinfiresoye L4. Molecules. 2014 Dec 12;19(12):20864-79. doi: 10.3390/molecules191220864. Relevance of the anti-inflammatory properties of curcumin in neurodegenerative diseases and depression
    It is concluded that curcumin, or better yet, an analog with better and longer bioavailability could be of important therapeutic potential in PD and/or major depression.[Article]

  9. Rosenblat JD1, Cha DS2, Mansur RB3, McIntyre RS4. Prog Neuropsychopharmacol Biol Psychiatry. 2014 Aug 4;53:23-34. doi: 10.1016/j.pnpbp.2014.01.013. Inflamed moods: a review of the interactions between inflammation and mood disorders
    Current evidence shows improved outcomes in mood disorder patients when anti-inflammatory agents are used as an adjunct to conventional therapy; however, further research is needed to establish the therapeutic benefit and appropriate dosage.[Abstract]
  10. REVIEW

  11. Pathak L1, Agrawal Y, Dhir A. Expert Opin Investig Drugs. 2013 Jul;22(7):863-80. doi: 10.1517/13543784.2013.794783. Natural polyphenols in the management of major depression
    There is an exciting prospect in the discovery of natural polyphenols (curcumin) as therapeutic agents in the treatment of major depression.[Abstract]
  12. REVIEW

  13. Lopresti AL1, Hood SD, Drummond PD. J Psychopharmacol. 2012 Dec;26(12):1512-24. doi: 10.1177/0269881112458732. Multiple antidepressant potential modes of action of curcumin: a review of its anti-inflammatory, monoaminergic, antioxidant, immune-modulating and neuroprotective effects
    With increasing interest in natural treatments for depression, and efforts to enhance current treatment outcomes, curcumin is presented as a promising novel, adjunctive or stand-alone natural antidepressant.[Article]

  15. Yu JJ1, Pei LB, Zhang Y, Wen ZY, Yang JL. J Clin Psychopharmacol. 2015 Aug;35(4):406-10. doi: 10.1097/JCP.0000000000000352. Chronic Supplementation of Curcumin Enhances the Efficacy of Antidepressants in Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled Pilot Study
    These findings indicate the potential benefits of further implications of supplementary administration of curcumin to reverse the development of depression and enhance the outcome of antidepressants treatment in major depressive disorder.[Abstract]

  17. Esmaily H1, Sahebkar A, Iranshahi M, Ganjali S, Mohammadi A, Ferns G, Ghayour-Mobarhan M. Chin J Integr Med. 2015 May;21(5):332-8. doi: 10.1007/s11655-015-2160-z. An investigation of the effects of curcumin on anxiety and depression in obese individuals: A randomized controlled trial
    Curcumin has a potential anti-anxiety effect in individuals with obesity.[Abstract]
  18. RCT

  19. Lopresti AL1, Maes M2, Meddens MJ3, Maker GL4, Arnoldussen E3, Drummond PD5. Eur Neuropsychopharmacol. 2015 Jan;25(1):38-50. doi: 10.1016/j.euroneuro.2014.11.015. Eur Neuropsychopharmacol. 2015 Jan;25(1):38-50. doi: 10.1016/j.euroneuro.2014.11.015.
    Our findings demonstrate that curcumin supplementation influences several biomarkers that may be associated with its antidepressant mechanisms of action.[Abstract]

  21. Panahi Y1, Badeli R, Karami GR, Sahebkar A. Phytother Res. 2015 Jan;29(1):17-21. doi: 10.1002/ptr.5211. Investigation of the efficacy of adjunctive therapy with bioavailability-boosted curcuminoids in major depressive disorder
    One hundred and eleven subjects were assigned to standard antidepressive therapy plus curcuminoids-piperine combination (1000-10 mg/day; n=61) or standard antidepressive therapy alone (n=50) for a period of 6 weeks. Co-administration of curcuminoids with piperine may be used as a safe and effective add-on to standard antidepressants in patients with MDD.[Abstract]
  22. ANIMAL

  23. Kulkarni SK1, Bhutani MK, Bishnoi M. Psychopharmacology (Berl). 2008 Dec;201(3):435-42. doi: 10.1007/s00213-008-1300-y. Antidepressant activity of curcumin: involvement of serotonin and dopamine system
    The study provides evidences for mechanism-based antidepressant actions of curcumin. The coadministration of curcumin along with piperine may prove to be a useful and potent natural antidepressant approach in the management of depression.[Abstract]

  25. .[Abstract]

Referenties depressie (depressiviteit) – Amitriptyline

  1. Management of sleep disorders in fibromyalg
    Tricyclic drugs, such as amitriptyline and cyclobenzaprine, may provide long term benefit for improving sleep but may not have a continuing benefit beyond one month for reducing pain

Referenties depressie (depressiviteit) – probiotica


  1. McKean J1, Naug H1,2, Nikbakht E1,2, Amiet B1,2, Colson N1,2. J Altern Complement Med. 2016 Nov 14. Probiotics and Subclinical Psychological Symptoms in Healthy Participants: A Systematic Review and Meta-Analysis
    These results show that probiotic consumption may have a positive effect on psychological symptoms of depression, anxiety, and perceived stress in healthy human volunteers.[Abstract]

  3. Pirbaglou M1, Katz J2, de Souza RJ3, Stearns JC4, Motamed M1, Ritvo P5. Nutr Res. 2016 Sep;36(9):889-98. doi: 10.1016/j.nutres.2016.06.009. Probiotic supplementation can positively affect anxiety and depressive symptoms: a systematic review of randomized controlled trials
    Despite methodological limitations of the included trials and the complex nature of gut-brain interactions, results suggest the detection of apparent psychological benefits from probiotic supplementation.[Abstract]
  4. Dinan TG1, Cryan JF. Neurogastroenterol Motil. 2013 Sep;25(9):713-9. doi: 10.1111/nmo.12198. Melancholic microbes: a link between gut microbiota and depression?
    There is a growing awareness of the potential for microbiota to influence gut-brain communication in health and disease. A variety of strategies have been used to study the impact of the microbiota on brain function and these include antibiotic use, probiotic treatments, fecal microbiota transplantation, gastrointestinal infection studies, and germ-free studies.[Article]

  5. .[Abstract]

Referenties depressie (depressiviteit) – andere methoden

  1. Molecular mechanisms of depression: perspectives on new treatment strategies
    Hence, GABA, AMPA, EAAT, NMDA- and metabotropic glutamate receptors (mGluR1 to mGluR8) have gained interest in depression recently. Alternative, causative or also easy available treatment strategies beyond serotonin and noradrenaline reuptake inhibition might be a major topic of future psychiatric care. In this review, an attempt is made to overview concepts of the disease and search for perspectives on antidepressant treatment strategies beyond approved medications