[Dermatological side effects during therapy with serotonin noradrenaline reuptake inhibitors]. / Dermatologische Nebenwirkungen unter Therapie mit Serotonin-Noradrenalin-Wiederaufnahmehemmern.

Bleeding complications during therapy with serotonin norepinephrine reuptake inhibitors are a well-known phenomenon. We report a patient who developed ecchymosis during administration of duloxetine. As a correlate we detected a transient platelet dysfunction. After converting to venlafaxine therapy, another antidepressant with a dual mechanism of action, the patient showed normal platelet function. We finally achieved remission of the episode.

[Mental health care in developing countries: the example of Nigeria]. / Die Versorgung psychisch Kranker in den Ländern der dritten Welt am Beispiel von Nigeria.

The availability of mental health resources in most developing countries is poor due to scarcity of resources, competing health problems, and the low priority given to mental health issues. In Nigeria, modern psychiatric care is developing, but as yet most people have no access to it because they cannot afford the treatment. Moreover, treatment facilities are mainly concentrated in large urban centers. The cooperation between the authors of this article is aimed at improving the provision of psychiatric care for people living in Ibadan, Nigeria and rural areas close to the city. We report about the foundation of an association to provide help for mentally ill patients in Africa.

[Current use of ECT in the treatment of depressive disorders]. / Zur Behandlung depressiver Störungen mit modernen Verfahren der Elektrokonvulsionstherapie.

If used with correct indication, electroconvulsive therapy (ECT) is a very effective and safe treatment for some forms of major depression, provided due consideration is given to possibly concomitant somatic conditions and that the cardiovascular reactions during and after the ECT treatments are managed carefully. Despite this, ECT remains controversial, especially in Germany. This article provides an overview of the current state of the art in ECT: appropriate indications, best practice in conducting ECT, side effects and recent developments in the use of ECT as maintenance therapy. This, it is hoped, will contribute to a more factually grounded discussion of the use of ECT.

[Comorbidity of depressive disorders and cardiovascular diseases. Implications for diagnosis, pharmaco- and psychotherapy]. / Komorbidität von depressiven Störungen und kardiovaskulären Erkrankungen. Implikationen für Diagnostik, Pharmako- und Psychotherapie.

Controlled studies and meta-analyses show not only that depression and cardiovascular disease often occur together, but that depressive illnesses are an independent risk factor in the development and the progression of coronary heart disease. It can be difficult to distinguish between reactive mood disturbance after myocardial infarction and depressive episodes that may have preceded the infarction and which require treatment. Due to this difficulty, depressive disorders are rarely diagnosed, and only a minority of patients receive adequate treatment. However, owing to the introduction of new antidepressants in recent years, the number of treatment options has increased. Specifically, selective serotonin reuptake inhibitors (SSRI) offer a valuable alternative to tricyclic antidepressants, which are problematic in heart disease. The authors describe on the one hand controlled studies of SSRIs and discuss differential therapeutic consequences. On the other hand, studies of psychotherapeutic interventions in comorbid patients with depression and coronary heart disease are reported. Finally, the authors discuss which psychotherapeutic interventions may be suitable.

Depression and panic disorder after heart transplantation--treatment with sertraline.

This report focuses on a case of major depression and panic disorder after heart transplantation. Due to these disorders, the male patient's compliance with cardiological treatment became increasingly insufficient. There are no controlled studies on psychopharmacological opportunities in cases such as this one. The patient was treated with sertraline and the outcome was healthy, without cardiovascular adverse effects or drug-drug interactions.