Neurol. praxi. 2018;19(2):114-122 | DOI: 10.36290/neu.2019.031

Depression in multiple sclerosis

prof. MUDr. Ivana Štětkářová, CSc.¹, PhDr. Alena Javůrková, Ph.D.^{2, 3}, PhDr. Jaroslava Raudenská, Ph.D.^{3, 4}

¹ Neurologická klinika, 3. lékařská fakulta Univerzity Karlovy a FNKV, Praha

² Oddělení klinické psychologie, FNKV, Praha

³ Ústav ošetřovatelství 2. LF UK a FNM, Praha

⁴ Oddělení klinické psychologie FNM, Praha

Major depression has a relatively high incidence in patients with multiple sclerosis (MS). It needs to be recognized and treatedin a timely manner, as it significantly improves the quality of life and the course of the main disease. From an etiological point ofview, it is not yet clear why major depression in MS occurs so often. Biological, psychological and social factors are involved in itsdevelopment, but it is also influenced by MS treatment itself (corticoids, interferons). Major clinical signs of depression includedisturbances of mood, thinking, perception, and psychomotor impairment. In clinical practice we usually start with structuredinterview along with specialized questionnaire for depression. The basic methods of treatment of depression in MS includepharmacotherapy with antidepressive drugs and psychotherapy. Cognitive behavioral therapy is usually used in MS patients. Thefirst choice of pharmacotherapy is selective serotonine reuptake inhibitors – citalopram, escitalopram, sertraline, that have a verygood safety profile. The therapeutic effect in relation to the main symptoms of depression is usually after 6–8 weeks of treatment.

Keywords: multiple sclerosis, major depression, biological treatment, psychotherapy, antidepressants

Received: April 3, 2019; Accepted: April 24, 2019; Prepublished online: April 24, 2019; Published: May 1, 2018  Show citation