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Geschlechterunterschiede in der neuropsychiatrischen Pharmakotherapie

Gender differences in psychopharmacology

  • Arzneimitteltherapie
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Zusammenfassung

Mindestens die Hälfte aller psychisch kranken Menschen sind Frauen. Bei depressiven Erkrankungen sind Frauen sogar doppelt so häufig betroffen wie Männer. Die geschlechtsspezifischen Aspekte der Psychopharmakotherapie finden jedoch meistens zu geringe Beachtung. Dabei weiß man, dass Frauen besser auf Substanzen mit serotoninmodulierender Wirkung ansprechen als Männer, dass sich dieser Effekt aber postmenopausal umkehrt. Ferner entwickeln Frauen unter bestimmten Psychopharmaka gynäkologische Komplikationen, die den Einsatz dieser Substanzen in Frage stellen. Nebenwirkungen wie Gewichtszunahme, Hyperglykämie, Herzrhythmusstörungen und sexuelle Dysfunktionen treten bei Frauen ebenfalls häufiger auf als bei Männern. Die Schwangerschaft ist ein besonders sensibler Aspekt. Hier muss das Risiko der psychisch kranken Mutter, bei Absetzen eines Psychopharmakons erneut einen Rückfall zu erleiden, gegen das Risiko für das Kind, Fehlbildungen zu erleiden oder pränatale Komplikationen zu entwickeln, abgewogen werden.

Abstract

At least half of all patients with psychiatric disorders are female. Depressive disorders occur twice as often in women than in men. Despite the need for a gender-specific approach in treating psychiatric disorders, little is known about gender issues in psychopharmacology. It has been recognized that women respond better than men to serotonin-modulating substances but that this effect is reversed after menopause. Furthermore, women develop gynecological complications under medication with certain psychopharmacological agents which calls the use of these drugs into question. Side effects such as weight gain, hyperglycemia, cardiac arrhythmias, and sexual dysfunction also occur more frequently in women than in men. Pregnancy is a particularly sensitive aspect. The risk that a mother with a psychiatric disorder could relapse if the drug is discontinued has to be weighed against the risk of the child being born with an anomaly or developing prenatal complications.

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Authors and Affiliations

  1. Berliner Institut für Geschlechterforschung in der Medizin (GiM) und CCR, Charité, Berlin, Deutschland

    V. Regitz-Zagrosek & C. Schubert

  2. Klinik für Psychiatrie und Psychotherapie, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland

    S. Krüger

Authors
  1. V. Regitz-Zagrosek
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  2. C. Schubert
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  3. S. Krüger
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Correspondence to S. Krüger.

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Regitz-Zagrosek, V., Schubert, C. & Krüger, S. Geschlechterunterschiede in der neuropsychiatrischen Pharmakotherapie. Internist 49, 1516–1523 (2008). https://doi.org/10.1007/s00108-008-2233-6

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