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Lithiumtherapie zur Behandlung affektiver Störungen im höheren Lebensalter

Lithium treatment for affective disorders in old age

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Zusammenfassung

Hintergrund

Lithium (Li) gilt als der Goldstandard in der Behandlung der bipolaren affektiven Störung zur Rezidivprophylaxe manischer und depressiver Episoden sowie in der Augmentationsbehandlung bei unipolaren schweren depressiven Episoden. Die Indikationen zur Li-Behandlung unterscheiden sich für ältere oder jüngere Patienten nicht. Dennoch gibt es bei der Gruppe der älteren Patienten im Hinblick auf die Arzneimittelsicherheit einige Besonderheiten zu beachten.

Ziele der Arbeit

Ziel war es, einen Überblick über die aktuelle Literatur zur Li-Therapie im höheren Lebensalter zu geben und daraus Handlungsempfehlungen abzuleiten.

Material und Methoden

Es wurde eine selektive Literaturübersicht zur Li-Behandlung im höheren Lebensalter durchgeführt, um Fragen zu Arzneimittelsicherheit, Monitoring (insbesondere im Hinblick auf Komorbiditäten) und Alternativen von Li zu beantworten.

Ergebnisse und Diskussion

Lithium ist auch bei älteren Menschen ein wirksames und bei richtiger Anwendung sicheres Medikament. Allerdings ist im Hinblick auf die mit dem Alter zunehmenden somatischen Komorbiditäten besondere Vorsicht bei der Anwendung geboten, um eine Nephropathie und eine Li-Intoxikation zu verhindern.

Abstract

Background

Lithium is considered the gold standard for the treatment of bipolar affective disorder for the prevention of recurrence of manic and depressive episodes and for augmentation treatment in unipolar severe depressive episodes. The indications for treatment with lithium do not differ for older or younger patients. Nevertheless, there are a number of aspects to be considered with respect to drug safety in the group of old patients.

Objective

The aim was to give an overview of the current literature on lithium treatment in old age and from this to derive recommendations for action.

Material and methods

A selective literature review on lithium treatment in old age was conducted to answer questions on drug safety, monitoring (particularly with respect to comorbidities) and potential alternatives to lithium.

Results and discussion

Lithium is an effective and, if used correctly, safe drug also in old people; however, with respect to somatic comorbidities that increase with age, special caution is required when using lithium in order to prevent nephropathy and intoxication.

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Authors and Affiliations

  1. Abteilung Gerontopsychiatrie, LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität Düsseldorf, Bergische Landstr. 2, 40629, Düsseldorf, Deutschland

    Julia Christl & Tillmann Supprian

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Correspondence to Julia Christl.

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J. Christl und T. Supprian geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Christl, J., Supprian, T. Lithiumtherapie zur Behandlung affektiver Störungen im höheren Lebensalter. Z Gerontol Geriat 56, 113–117 (2023). https://doi.org/10.1007/s00391-023-02164-5

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