Zusammenfassung
Das Neuroleptikum Pipamperon wird zur psychomotorischen Dämpfung eingesetzt. Seine Wirkung beruht auf der Blockade von Dopaminrezeptoren im mesolimbischen System, wodurch die der Erkrankung zugrunde liegende pathologisch gesteigerte Dopaminausschüttung gedrosselt wird. Dopamin ist aber auch Teil der Signaltransduktion des visuellen Systems. Visusminderung, abweichende Farbwahrnehmung, Skotome und elektrophysiologische Veränderungen wurden als unerwünschte Wirkung antidopaminerger Medikamente, bisher jedoch noch nicht nach Pipamperon-Therapie, beobachtet. Wir stellen den Fall einer jungen Patientin vor, die nach Pipamperon-Anwendung unter einer passageren, einseitigen Visusminderung litt.
Abstract
The butyrophenone derivative pipamperone is a neuroleptic agent administered to reduce psychomotor agitation and psychotic conditions in schizophrenic psychoses. Among other things it blocks D2 receptors in the dopamine pathways of the mesolimbic system and therefore reduces excess release of dopamine in the area thought to control psychotic experiences. Dopamine also takes part in signal transduction in the visual process. Loss of visual acuity, color vision, scotoma and electrophysiological alterations were observed under treatment with different groups of neuroleptics which interfere with dopamine metabolism but have not yet been observed after therapy with pipamperone. We present the case of a young women suffering from unilateral loss of visual acuity after treatment with pipamperone.
Literatur
Bartel P, Blom M, Robinson E et al (1990) The effects of levodopa and haloperidol on flash and pattern ERGs and VEPs in normal humans. Documenta Ophthalmologica 76, Number 1
Biousse V, Skibell BC, Watts RL et al (2004) Ophthalmologic features of Parkinson’s disease. Neurology 62(2):177–180
Ehinger B (1976) Biogenic monoamines as transmitters in the retina. Transmitters in the visual process. Pergamons Press, Oxford, S 145–163
Forano P, Calabria G, Corallo G, Picotti GB (2002) Pathogenesis of degenerative retinopathies induced by thioridazine and other antipsychotics: a dopamine hypothesis. Doc Ophthalmol 105(1):41–49
Inzelberg R, Ramirez JA, Nisipeanu P, Ophir A (2004) Retinal nerve fiber layer thinning in Parkinson disease. Vision Res 44(24):2793–2797
Masson G, Mestre D, Blin O (1993) Dopaminergic modulation of visual sensitivity in man. Fundam Clin Pharmacol 7(8):449–463
Nencini C, Barberi L, Runci FM, Micheli L (2008) Retinopathy induced by drugs and herbal medicines. Eur Rev Med Pharmacol Sci 12:293–298
Toler SM (2005) Fluphenazine augments retinal oxidative stress. J Ocul Pharmacol Ther 21(4):259–265
Witkovsky P (2004) Dopamine and retinal function. Doc Ophthalmol 108(1):17–40
Zarbin MA, Wamsley JK, Palacios JM, Kuhar MJ (1986) Autoradiographic localization of high affinity GABA, benzodiazepine, dopaminergic, adrenergic and muscarinic cholinergic receptors in the rat, monkey and human retina. Brain Res 374(1):75–92
Interessenkonflikt
Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Loos, D., Kook, P., Huber, J. et al. Visusminderung nach Pipamperon-Therapie. Ophthalmologe 108, 763–765 (2011). https://doi.org/10.1007/s00347-011-2349-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00347-011-2349-2