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Behandlungsmöglichkeiten der akuten Manie mit atypischen Antipsychotika

Treatment options for bipolar mania

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Zusammenfassung

Die Diagnose und Behandlung der Manie bei bipolaren Störungen stellt eine große Herausforderung dar. Traditionell werden vorwiegend Lithium oder Valproat als Mittel der ersten Wahl verwendet. Aufgrund des begrenzten therapeutischen Wirkspektrums dieser Medikamente werden jedoch häufig auch typische Neuroleptika zur Behandlung der Manie eingesetzt. Diese sind in dieser Indikation zwar nachweislich wirksam, ihre Anwendung ist aber häufig mit erheblichen Nebenwirkungen, insbesondere extrapyramidalen Symptomen, verbunden. Daher werden für die Behandlung der Manie bei bipolar erkrankten Patienten aufgrund der aktuellen Datenlage zunehmend atypische Antipsychotika bevorzugt. In dieser Übersicht werden die Ergebnisse kontrollierter Studien mit verschiedenen atypischen Antipsychotika in der Maniebehandlung dargestellt und jene Aspekte diskutiert, die bei der Wahl geeigneter Atypika eine Rolle spielen.

Summary

The diagnosis and treatment of bipolar mania are extremely challenging. Therapeutic intervention for mania has traditionally relied on the use of lithium or divalproex as a first-line treatment option. However, due to the limited therapeutic range of these agents, typical neuroleptics have often been used. Although these have demonstrated efficacy in mania, they are often associated with significant side effects, especially extrapyramidal symptoms. Thus, atypical antipsychotics are increasingly preferred in the treatment of bipolar mania. In this review, data from controlled studies for several of the atypical antipsychotics in the treatment of mania are surveyed and issues in the selection of an appropriate atypical agent are discussed.

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  1. Klinische Abteilung für Allgemeine Psychiatrie, Medizinische Universität Wien, Währinger Gürtel 18–20, 1090, Wien, Österreich

    T. Attarbaschi & S. Kasper

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  1. T. Attarbaschi
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  2. S. Kasper
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Correspondence to T. Attarbaschi.

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Attarbaschi, T., Kasper, S. Behandlungsmöglichkeiten der akuten Manie mit atypischen Antipsychotika. Nervenarzt 77, 1310–1322 (2006). https://doi.org/10.1007/s00115-006-2096-9

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