Es ist nicht klar, wie groß die Rolle von Antibiotika https://antibiotika-wiki.de/ in den Wettbewerbsbeziehungen zwischen Mikroorganismen unter natürlichen Bedingungen ist. Zelman vaxman glaubte, dass diese Rolle minimal ist, Antibiotika werden nicht anders als in reinen Kulturen auf reichen Umgebungen gebildet. Anschließend wurde jedoch festgestellt, dass bei vielen Produzenten die Aktivität der antibiotikasynthese in Gegenwart anderer Arten oder spezifischer Produkte Ihres Stoffwechsels zunimmt.

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Psychiatric Medications
• Post-traumatic stress disorder (PTSD)
↑↑ role of psychological therapies with EMDR (eye movement desensitisation and reprocessing)
First line
SSRI: paroxetine
Second line
ANXIETY DISORDERS
TCA: amitryptiline
NASSA: mirtazapine
• All patie
nts should be offered psychological interventions as a first line option or as an adjunct
Third line
to pharmacological therapy
MAOI: phenelzine
Se lf help materials
DEPRESSION
BT in groups or individually
Anxiety management therapy: combination of education, relaxation and graded exposure
• Mild depression
Ps ychodynamic psychotherapy
Do not use antidepressants routinely
• If patient
s present in an anxiety CRISIS they may require a short course of anxiolytic therapy to
Offer psychological interventions: self-help materials, CBT, or counselling
provide r apid response whilst longer-term treatment is being established
Consider medication if:
MAXIMUM OF 4 WEEKS’ ANXIOLYTIC THERAPY due to high risk of dependency
Past history of moderate/severe depression Be nzodiazepines: diazepam 2mg TDS, chlordiazepoxide 10mg TDS
Persistent subthreshold depressive symptoms (i.e. lasting over 2 years) Az apirones: buspirone 5mg BD/TDS
Mild depression persists after psychological interventions Sedative antihistamines: promethazine 25-50mg OD
• Moderate to severe depression
• Generalised anxiety disorder (GAD)
First line
Fir st line
SSRI: fluoxetine or citalopram
SSRI: fluoxetine, citalopram, paroxetine, or sertraline
Second line
SNRI: venlafaxine or duloxetine
NASSA: mirtazapine
SARI: trazodone
NARI: reboxetine or lofepramine
Se cond line
MAOI: moclobemide
Third line (severe depression)
Specialist
SNRI: venlafaxine or duloxetine
Clonidine (off-patent indication) TCA: clomipramine, imipramine or amitryptiline
• Panic dis order
• Refractory depression (failure to respond to 2 or more antidepressants)
First line
Consider PRN propranolol if attacks are infrequent/predictable
Combinations of antidepressants e.g. SSRI + NASSA, SNRI + NASSA SSRI: fluoxetine, citalopram or paroxetine
NARI: reboxetine or lofepramine
Augment therapy with lithium or atypical antipsychotics Se cond line
TCA: clomipramine or imipramine
Third line
BIPOLAR DISORDER
MAOI: phenelzine or moclobemide
Sp ecialist
• Acute manic episode (manic symptoms lasting >1 week)
Clonidine (off-patent indication) First line
• Phobic disorder
Atypical antipsychotics: olanzapine, risperidone or quetiapine
Fir st line
Second line
Consider PRN propranolol for situational anxiety or predominating physical symptoms
Augment antipsychotics with lithium, sodium valproate, carbamazepine or lamotrigine
SSRI: fluoxetine, citalopram or paroxetine
• Acute depressive episode (depressive symptoms lasting >2 weeks)
Se cond line
Antidepressants are not used routinely in bipolar disorder, as they increase risk of rebound
TCA: clomipramine or imipramine
don’t prescribe them without antimanics Th ird line
First line
MAOI: phenelzine or moclobemide
Atypical antipsychotics: quetiapine, olanzapine in combination with fluoxetine
• Obsessive compulsive disorder (OCD)
Antiepileptics: lamotrigine
First line
• Long-term treatment (prevention of relapse through mood stabilisation)
SSRI: paroxetine
Again, antidepressants aren’t used routinely
Second line
First line
TCA: clomipramine
Third line
Second line
MAOI: phenelzine or moclobemide
Either replace or augment lithium therapy with other drugs Specialist
Antiepileptics: sodium valproate, carbamazepine or lamotrigine
Clonidine (off-patent indication) Atypical antipsychotics: quetiapine, olanzapine or aripiprazole
Atypical antipsychotics e.g. olanzapine Laura Jayne Watson 2011

Source: http://watsonsnotes.files.wordpress.com/2012/01/psychiatric-medications.pdf