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Schizophrenie pp 149-184 | Cite as

Ein pharmakodynamisches und pathophysiologisches Modell der medikamentösen antipsychotischen Therapie der Schizophrenie

  • L. Ereshefsky
Conference paper

Zusammenfassung

Die ursprüngliche Bezeichnung für Antipsychotika, Neuroleptika, vom französischen neuroleptique, was soviel bedeutet wie „das Neuron ergreifen“, basierte auf der Beobachtung, daß diese Substanzen die neuronale Funktion blockieren, erkennbar an Sedation und dem Auftreten von extrapyramidalmotorischen Symptomen (EPS). Typische Antipsychotika (Neuroleptika) wirken nicht „antischizophren“, wenn sie auch einige der klinischen Symptome dieser Erkrankung mildern. Der Begriff „typische Neuroleptika“ bezeichnet Pharmaka, die neben dem therapeutischen Effekt auch EPS bewirken. Die therapeutische Wirksamkeit aller typischen Antipsychotika in der Behandlung von Psychosen beruht auf einer gemeinsamen pharmakologischen Eigenschaft, der zentralen Blockade dopaminerger Rezeptoren im limbischen System. Die Wirkung von Standard-oder „typischen“ Antipsychotika hängt mit Dopaminrezeptoren vom Typ 2 (D2-Rezeptoren) zusammen. Alle marktgeführten typischen Antipsychotika sind durch ihre relative Affinität zu diesem Rezeptor gekennzeichnet. Es gibt jedoch mehrere Arten von Dopaminrezeptoren im ZNS sowie neue „atypische“ Antipsychotika, die diese pharmakologische Eigenschaft typischer Antipsychotika nicht unbedingt teilen (Clark et al. 1987; Ereshefsky et al. 1990a; van Tol et al. 1991; Wolff et al. 1993). Darüber hinaus scheinen auch Serotonin, Glutaminsäure, Gamma-Aminobuttersäure, Noradrenalin, Peptide und Acetylcholin für die Expression der verhaltensbezogenen Charakteristika der Schizophrenie, ihre Behandlung, wie auch für die unerwünschten Wirkungen der Antipsychotika von Bedeutung zu sein (Ereshefsky 1995; Meltzer et al. 1989).

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Copyright information

© Springer-Verlag Berlin Heidelberg 1995

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  • L. Ereshefsky

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