LONG-TERM TREATMENT OF DEPRESSION - IS THERE A USE FOR DEPOT ANTIDEPRESSANTS

Depot neuroleptics have been widely introduced for long-term treatment of schizophrenia. The question of whether depot antidepressants shoul d be developed for the treatment of chronic depression and for the pro phylaxis of recurrent depression is addressed. This approach seems to be indicated in patients showing poor compliance to oral antidepressiv e medication and in patients suffering from secondary depression and w ho are already receiving depot antipsychotics, but it is also indicate d in subgroups of patients who, for social, cultural or personality re asons, have problems with regard to a regular and long-term intake of oral medication. Before the development of depot antidepressants is in itiated, the ethical issues relating to this form of medication should be discussed. Technically, the preparation of depot forms may represe nt a serious challenge. Depot antipsychotics are all esters of hydroxy lated neuroleptics and long-chain fatty acids. Potential candidates fo r antidepressants are venlafaxine, flesinoxan and E-10-OH-nortriptylin e. The possibility of developing forms for transdermal application is also discussed. In conclusion, clinical considerations support the ide a of the usefulness of a depot preparation for antidepressants but eth ical and technical aspects should not be neglected.