Wiener Medizinische Wochenschrift

, Volume 157, Issue 11–12, pp 255–270 | Cite as

Atypische Neuroleptika und metabolisches Syndrom

  • Andreas Baranyi
  • Renè Yazdani
  • Alexandra Haas-Krammer
  • Alexandra Stepan
  • Hans-Peter Kapfhammer
  • Hans-Bernd Rothenhäusler
Übersicht

Zusammenfassung

Die Einführung atypischer Neuroleptika führte bekanntlich zu einer entscheidenden Therapieverbesserung in der Behandlung psychotischer Erkrankungen. In zahlreichen Studien wird jedoch für einige Präparate dieser Gruppe belegt, dass sie ausgeprägte metabolische Veränderungen (u. a. starke Gewichtszunahmen, Hyperlipidämien, Diabetes mellitus Typ 2) auslösen. Als beteiligte Pathomechanismen werden zurzeit ein G-Protein beta3 subunit Gen (C825T) Polymorphismus, ein gesteigerter Kohlenhydratmetabolismus und hormonelle Veränderungen diskutiert. Bei Hochrisikopatienten (Übergewicht, Hyperlipidämie, Hyperglykämie und Diabetes vor Behandlungsbeginn, hereditäre Belastungen, Nikotinkonsum etc.) sollten Neuroleptika mit einem in diesem Bereich günstigen Nebenwirkungsprofil gewählt werden und ein regelmäßiges Diabetesscreening und eine Kontrolle der Blutfettwerte erfolgen. Ein entsprechendes Monitoring erscheint notwendig, um Folgeerkrankungen zu verhindern.

Schlüsselwörter

Atypische Neuroleptika Metabolische Veränderungen Gewichtszunahme Hyperlipidämien Diabetes mellitus Typ 2 

Atypical Antipsychotics and Metabolic Syndrome

Summary

The introduction of atypical antipsychotics in psychopharmacology represented a major advance in the treatment of psychotic disorders. However, there have been numerous studies that certain atypical antipsychotics may be associated with a greater risk of metabolic abnormalities than others, including weight gain, hyperlipidemia and new-onset typ 2 diabetes mellitus. A G-Protein beta3 subunit Gen (C825T) polymorphism, an increased carbohydrate metabolism and dyshormonism are discussed as pathogenetic mechanisms. High risk patients (adiposity, hyperlipidaemia, hyperglycaemia, preexisting diabetes) should maintain an antipsychotic agent with a favourable side effect profile. In these cases a periodical diabetes screening and blood lipid controls are required. Clinicans must balance the significant benefits of atypical antipsychotics against the risk of metabolic disturbances. In this article recent findings are reviewed.

Keywords

Atypical antipsychotics Metabolic abnormalities Weight gain Hyperlipidemia New-onset typ 2 diabetes 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Andreas Baranyi
    • 1
  • Renè Yazdani
    • 1
  • Alexandra Haas-Krammer
    • 1
  • Alexandra Stepan
    • 1
  • Hans-Peter Kapfhammer
    • 1
  • Hans-Bernd Rothenhäusler
    • 1
  1. 1.Universitätsklinik für Psychiatrie GrazMedizinische Universität GrazGrazAustria

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