Pharmakotherapie von psychiatrischen Akut- und Notfallsituationen

Allgemeine Prinzipien

Pharmacotherapy of psychiatric acute and emergency situations

General principles

Zusammenfassung

Die Pharmakotherapie psychiatrischer Notfallpatienten wird wesentlich von der Akuität, dem Notfallort, der diagnostischen Einschätzung und dem besonderen pharmakologischen Anforderungsprofil der eingesetzten Medikamente bestimmt. Da es keine spezifischen Medikamente gibt, erfolgt die Behandlung syndromal. Hierfür stehen vorrangig Antipsychotika und Benzodiazepine zur Verfügung. Der vorliegende Beitrag gibt einen Überblick über den aktuellen Stand der Behandlungsoptionen für die wichtigsten psychiatrischen Notfallsyndrome, nämlich Unruhezustände, Delir, Katatonie und Stupor, Angst und Panik sowie medikamentös-induzierte Notfälle.

Summary

The pharmacotherapy of psychiatric emergencies is essentially determined by the acuteness, the scene of the emergency, the diagnostic assessment and the special pharmacological profile of the drug used. As there are no specific drugs, syndromic treatment is carried out. For this, primarily antipsychotic drugs and benzodiazepines are available. This article gives an overview of the current state of treatment options for major psychiatric emergency syndromes, namely agitation, delirium, stupor and catatonia, anxiety and panic, as well as drug-induced emergencies.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Messer für das Jahr 2014: Vortragshonorare und finanzielle Unterstützung bei Kongressen: Lundbeck GmbH, Otsuka, Janssen-Cilag, Trommsdorff. F.-G. Pajonk hat in den letzten 3 Jahren die Fa. Trommsdorff beratend unterstützt und hat bezahlte Vorträge mit Unterstützung der Fa. Trommsdorff gehalten. M.J. Müller hat Reisekostenerstattungen für wissenschaftliche Tagungen, Kongresse oder Fortbildungsveranstaltungen von Servier, Lilly, Lundbeck, Janssen-Cilag und Merz Pharma erhalten, war in einem Advisory Board von Lundbeck, ist im Besitz von Aktien der Firma Novartis und hat Vortragshonorare von Servier und Janssen-Cilag erhalten.

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Messer, T., Pajonk, FG. & Müller, M. Pharmakotherapie von psychiatrischen Akut- und Notfallsituationen. Nervenarzt 86, 1097–1110 (2015). https://doi.org/10.1007/s00115-014-4148-x

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Schlüsselwörter

  • Notfallmedizin
  • Notfallpsychiatrie
  • Psychopharmaka
  • Verabreichung und Dosierung
  • Medikamentenbezogene Begleiterscheinungen und Nebenwirkungen

Keywords

  • Emergency medicine
  • Emergency psychiatry
  • Psychotropic drugs
  • Administration and dosage
  • Drug-related side effects and adverse reactions