CATIE: Die Auswahl von Antipsychotika bei Schizophrenie

Zusammenfassung

Das Projekt CATIE des NIMH hat nur für das atypische Neuroleptikum Olanzapin, nicht aber für Risperidon, Quetiapin und Ziprasidon, begrenzte Überlegenheit gegenüber dem typischen Neuroleptikum Perphenazin gezeigt. Hauptzielvariable waren die Abbruchraten. Ziel der Therapie sind aber symptomatische Besserung, einschließlich kognitiver Störungen und Lebensqualität, die CATIE nicht erfasst hat, bei Vermeiden motorischer Nebenwirkungen, insbesondere von Spätdyskinesien, die unter atypischen Neuroleptika seltener sind. Das kann CATIE wegen eines methodischen Mangels nicht widerlegen. Entscheidend ist individualisierte Therapieanpassung.

Summary

The CATIE project of the NIMH has revealed moderately superior effectiveness of atypical neuroleptics only for olanzapine, but not risperidone, quetiapine and ziprasidone, compared to the typical perphenazine. Primary outcome measure was the discontinuation for any cause. The aim of routine treatment, however, is symptomatic improvement including cognitive functioning and quality of life which were not assessed in CATIE, and the avoidance of motor side effects, especially tardive dyskinesia which occurs less frequently under atypical neuroleptics. Due to a methodological flaw CATIE cannot disprove this. Individualized adaption of treatment is decisive.

Key words

CATIE - atypical neuroleptics - schizophrenia

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