Psychopharmakologische Behandlung von nicht suizidalem selbstverletzendem Verhalten

Zusammenfassung

Neben verschiedenen Behandlungsoptionen für nicht suizidales selbstverletzendes Verhalten (NSSV), stellt sich in der Praxis die Frage nach der Ergänzung durch psychopharmakologische Komponenten. Diese Arbeit will einen Überblick über Studien zur pharmakologischen Behandlung von NSSV bieten und den Kliniker darüber informieren, wann eine solche Option gerechtfertigt erscheint und welche Substanzen dafür in Betracht kommen. Im Rahmen einer systematischen Literaturrecherche der vergangenen 20 Jahre konnten 21 Studien identifiziert werden. Insgesamt ist die Evidenz für die pharmakologische Behandlung von NSSV sehr begrenzt. Je nach begleitendem Symptomcluster finden sich Hinweise für die Wirksamkeit von Sselektiven Serotoninwiederaufnahmehemmern, atypischen Antipsychotika oder Opioidantagonisten. Eine solche Behandlung soll nur in Kombination mit Psychotherapie erfolgen und nicht als Einzeltherapie.

Summary

Among different treatment modalities for non-suicidal self-injury (NSSI), the practitioner might consider adding a psychopharmacologic agent. This review summarizes studies dealing with pharmacologic treatment of NSSI and intends to inform the clinician about when such a treatment trial might be warranted and which substances should be considered. We conducted a systematic literature research of the past 20 years and were able to identify 21 studies. The evidence for pharmacological interventions in NSSI is very limited. According to the accompanying symptom clusters efficacy has been reported for selective serotonin reuptake inhibitors, atypical antipsychotics and opioid antagonists. To date the evidence for pharmacologic treatment options for NSSI is very limited. Medication should only be used in combination with psychotherapeutic treatment and not as monotherapy

Schlüsselwörter

Nicht suizidales selbstverletzendes Verhalten - Psychopharmakologie - Suizidalität - atypische Antipsychotika - selektive Serotoninwiederaufnahmehemmer

Keywords

Non-suicidal self-injury - psychopharmacology - suicidality - atypical antipsychotics - selective serotonin reuptake inhibitors

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