Spezielle psychopharmakologische Therapie und Prophylaxe

U. Lewitzka; R. Haussmann; M. Bauer; J. Conell

doi:10.1055/s-0038-1627006

Nervenheilkunde, Table of Contents

Nervenheilkunde 2017; 36(04): 239-243
DOI: 10.1055/s-0038-1627006

Suizid

Schattauer GmbH

Spezielle psychopharmakologische Therapie und Prophylaxe

Psychopharmacological treatment and prevention of suicidality in patients with affective or schizophrenic disorders.

Authors

U. Lewitzka

Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
R. Haussmann

Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
M. Bauer

Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
J. Conell

Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden

Abstract

Zusammenfassung

Suizidales Verhalten stellt ein häufiges Phänomen bei psychiatrischen Erkrankungen dar. Insbesondere Patienten mit affektiven Störungen haben ein erhöhtes Suizidrisiko. Die leitliniengerechte Versorgung affektiver Störungen ist für Ärzte, Pfleger, Psychologen und andere Berufsgruppen im Gesundheitswesen hochanspruchsvoll und bedarf pharmakotherapeutischer, psychotherapeutischer und pflegerischer Expertise sowie eines hohen Maßes an Empathie. Generell verfügen wir über pharmakologische Behandlungsmöglichkeiten, die effektiv in der Behandlung von psychiatrischen Erkrankungen eingesetzt werden können, mindestens genauso bedeutsam sind auch psychotherapeutische und soziotherapeutische Behandlungsansätze. In den letzten Jahren konnte eine andauernde Debatte über den potenziellen Einfluss antidepressiver Medikation auf Suizidalität verfolgt werden. Hierbei zeigte sich eine mangelnde Evidenz für die suizidprotektive Wirkung von Antidepressiva. Mögliche Gründe dafür liegen in methodischen Schwierigkeiten, dies zu untersuchen. Seit den frühen 1970er-Jahren haben eine große Anzahl von Studien einen suizidprotektiven Effekt von Lithium nachgewiesen. Für die Behandlung von schizophrenen Erkrankungen konnte ein solcher Effekt für Clozapin aufgezeigt werden. Der folgende Artikel gibt einen Überblick über den aktuellen Wissenstand bezüglich psychopharmakologischer Behandlungsmöglichkeiten von suizidalen Patienten.

Summary

Suicidal behavior represents a frequent phenomenon in patients with psychiatric disorders. Especially patients with affective disorders have an increased suicide risk. The management and treatment of those patients is one of the most challenging tasks for health care professionals. In general several pharmacological strategies are known to be effective in the treatment of psychiatric diseases, however psychotherapeutic and sociotherapeutic strategies play also an important role.

There is an ongoing debate whether or not antidepressant and neuroleptic drugs have a suicide-preventing effect. There is still a lack of evidence due to methodical study limitations and ethical concerns. Since the early 1970s, several national and international studies confirmed the anti-suicidal effect of lithium in the treatment of patients with affective disorders. Only clozapine has shown to have some anti-suicidal properties in the treatment of schizophrenic patients. The following article provides an overview about the current knowledge of psychopharmacological treatment options for patients with suicidal behavior.

Schlüsselwörter

Suizidalität - affektive Störungen - Lithium - Prävention

Keywords

Suicidality - lithium - prevention - affective disorders

Full Text

References

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