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Differenzialindikation atypischer Neuroleptika: Amisulprid, Clozapin, Olanzapin, Quetiapin und Risperidon

Ergebnisse einer Pilotstudie zu Verordnungsgewohnheiten in psychiatrischen Versorgungskliniken der BRD

Differential indications for atypical neuroleptics

Results of a pilot study for prescriptions in German psychiatric hospitals

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Zusammenfassung

Mit der Einführung der atypischen Neuroleptika steht der Behandlung schizophrener Erkrankungen eine Gruppe von antipsychotisch wirksamen Medikamenten zur Verfügung, die sich im Vergleich zu den klassischen Neuroleptika durch eine günstigere Verträglichkeit bezüglich extrapyramidal-motorischer Nebenwirkungen sowie durch eine bessere Wirksamkeit auf Negativsymptome auszeichnet. Hierbei handelt es sich jedoch nicht um eine homogene Substanzklasse, sondern um eine Reihe von Medikamenten, die zum Teil sehr unterschiedliche neurobiologische, pharmakologische und nicht zuletzt auch klinische Charakteristika zeigen. Daraus und aus der zunehmenden Vielfalt der zur Verfügung stehenden atypischen Antipsychotika resultiert aber auch, dass es nicht immer einfach ist, für den einzelnen Patienten das „richtige“ Atypikum zu finden. Ziel der vorliegenden Untersuchung war es daher, mittels einer Befragung von 192 Ärzten an 10 psychiatrischen Kliniken der Arbeitsgemeinschaft Biologische Psychiatrie der Bundesdirektorenkonferenz erste empirische Daten zu einer möglichen Differenzialindikation zu sammeln.

Summary

With the introduction of atypical neuroleptics, the therapy of schizophrenia has been improved by a group of antipsychotic substances characterized by better tolerability concerning extrapyramidal side effects and higher efficiency against negative symptoms. However, these atypical antipsychotics are not a homogeneous class of drugs but rather represent a group of substances with very different neurobiologic, pharmacologic, and clinical features. This fact and the growing variety of available atypical neuroleptics illustrate the difficulty in choosing the “right” antipsychotic drug for each patient. The aim of this investigation was to evaluate preliminary empirical data for possible differential indication of atypical neuroleptics by a questionnaire-based survey of 192 physicians in ten psychiatric hospitals active in the biological psychiatry work group of the German Federal Directors’ Conference.

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Authors and Affiliations

  1. Klinik für Psychiatrie und Psychotherapie, Nervenklinik, Sozialstiftung Bamberg

    W. Günther, W. Trapp & N. Mitznegg

  2. Klinik für Psychiatrie und Psychotherapie, Bezirksklinikum Gabersee, Wasserburg

    G. Laux

  3. Psychiatrische Universitätsklinik, Klinikum Innenstadt, München

    N. Müller

  4. Klinik für Psychiatrie und Psychotherapie, St-Rochus-Hospital, Telgte

    H. Schulze-Mönking

  5. Klinik für Psychiatrie und Psychotherapie, Pfalzklinikum, Landeck

    R. Steinberg

  6. Klinik für Psychiatrie und Psychotherapie, Bezirksklinikum, Bayreuth

    M. Wolfersdorf

  7. Nervenklinik, Sozialstiftung Bamberg, St.-Getreu-Straße 14–18, 96049, Bamberg, Deutschland

    W. Günther

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  1. W. Günther
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  2. G. Laux
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  3. W. Trapp
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  4. N. Müller
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  6. H. Schulze-Mönking
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  7. R. Steinberg
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  8. M. Wolfersdorf
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Günther, W., Laux, G., Trapp, W. et al. Differenzialindikation atypischer Neuroleptika: Amisulprid, Clozapin, Olanzapin, Quetiapin und Risperidon . Nervenarzt 76, 278–286 (2005). https://doi.org/10.1007/s00115-004-1795-3

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  • DOI: https://doi.org/10.1007/s00115-004-1795-3

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