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Pharmakotherapie der Schizophrenie

Pharmacotherapy for schizophrenia

Der Nervenarzt volume 77, pages S77–S98 (2006)Cite this article

Zusammenfassung

Das Management von Schizophreniepatienten ist eine der größten Herausforderungen in der Psychiatrie. Trotz der unbestrittenen Effektivität von Antipsychotika sind Patienten und Ärzte nach wie vor mit beträchtlichen Schwierigkeiten konfrontiert. Diese beziehen sich im Wesentlichen auf unvollständiges (oder ganz fehlendes) Ansprechen auf die Behandlung und die Unmöglichkeit individuell Wirksamkeit und Verträglichkeit vorherzusagen. In dieser Arbeit geben wir einen Überblick über die wichtigsten Elemente der pharmakologischen Behandlung der Erkrankung. Akut- und Langzeitmanagement sowie spezifische Behandlungsprobleme, die von akut erregten bis hin zu therapieresistenten Patienten rangieren, werden abgehandelt. Nach einer Übersicht über allgemeine Therapieprinzipien soll die vorliegende Arbeit spezifische Informationen über Wirksamkeit und Sicherheit von Antipsychotika vermitteln. Viele der zurzeit verfügbaren Behandlungsempfehlungen/Richtlinien basieren auf der Evidenz, die in diesem Manuskript zusammengefasst wird. Diese Übersicht soll dem Kliniker, der in die Behandlung von Schizophreniepatienten involviert ist, Leitfaden sein, unabhängig davon ob er im Rahmen einer Fachklinik oder als niedergelassener praktischer Arzt tätig ist.

Summary

The management of schizophrenia patients remains one of the great challenges in psychiatry. Despite the undisputed effectiveness of antipsychotic drugs, patients and their physicians still face considerable difficulties mainly related to incomplete or lacking treatment response and the inability to predict the individual efficacy and tolerability. In this manuscript we review the key elements of pharmacological treatment of this disorder, encompassing acute and long-term management as well as specific management problems ranging from acutely violent patients to treatment-resistant subjects. Along with general treatment principles, the document provides specific information regarding efficacy and safety features of antipsychotics. Many of the currently available treatment recommendations/guidelines are based on the evidence reviewed here. This review is meant to serve as a guide for clinicians involved in managing schizophrenia, whether in a psychiatric hospital setting or as family physicians in private practice.

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Interessenkonflikt

Der korrespondierende Autor weist auf eine Verbindung mit folgender Firma/Firmen hin: Prof. Fleischhacker hat von folgenden Firmen Forschungszuschüsse und Honorare erhalten: Astra Zeneca, Bristol Myers Squibb, Eli Lilly, Novartis, Organon, Olsuka, Pfitzer, Sanofi Aventis.

Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.

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  1. Abteilung für Biologische Psychiatrie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich

    W. W. Fleischhacker & M. Hummer

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  1. W. W. Fleischhacker
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  2. M. Hummer
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Correspondence to W. W. Fleischhacker.

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Fleischhacker, W.W., Hummer, M. Pharmakotherapie der Schizophrenie. Nervenarzt 77, S77–S98 (2006). https://doi.org/10.1007/s00115-006-2194-8

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Schlüsselwörter

  • Schizophrenie
  • Pharmakotherapie
  • Wirksamkeit
  • Verträglichkeit
  • Langzeitmanagement
  • Akutmanagement

Keywords

  • Acute management
  • Effectiveness
  • Long-term management
  • Pharmacotherapy
  • Schizophrenia
  • Tolerability
  • Treatment