[Alternative therapy in the acute phase of endogenous depression--antiepileptics and new benzodiazepines and their comparison].
The average therapeutic effect of classical tricyclic antidepressants and antidepressants of the second and third generation varies between 60-70%. Moreover, tricycklic antidepressants are associated with undesirable effects mostly anticholinergic and "cardiotoxic", which may be a contraindication in particular in patients with multiple diseases and in older age groups. The authors compared two new alternative therapeutic procedures, represented by new highly effective benzodiazepines and anticonvulsants, as regards the therapeutic effect and side-effects. From this comparison ensues that their general therapeutic effect is on average comparable with the effect of tricyclic antidepressants, however, in the spectrum of their undesirable symptoms the anticholinergic effects are absent. Recent benzodiazepines have a better effect on depressions where anxiety and agitation are in the foreground. Their effect on depressive core symptoms is more marked, as compared with anticonvulsants. The most frequent side-effects are fatigue, somnolence and vertigo. Anticonvulsants have a balanced effect in different syndromological forms of depression. Undesirable effects are mostly gastrointestinal. In the authors' trials it did not lead to hypomania.