[Therapy of depression]

Somatic treatment and psychotherapy are available for the treatment of depressive episodes. Regarding the side-effect profile, tetrazyclic antidepressants, selective serotonin reuptake inhibitors and selective MAO inhibitors are recommended as therapy of first choice. In less severe cases phytopharmaca and major tranquilizers in low dosage are possible alternatives. In case of resistance to therapy with high subjective strain electroconvulsive therapy may be indicated. Psychotherapy can also be applied as treatment of first choice. The cognitive behavioural therapy intends a normalization of activity rate, cognitive attitude and social competence, which are characteristically changed in depressives. The combination of drug therapy with psychotherapy has no clear advantage over monotherapy, but it possibly reduces the relapse rate.