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Fortschr Neurol Psychiatr 2002; 70(3): 139-144
DOI: 10.1055/s-2002-20501
Originalarbeit
Georg Thieme Verlag Stuttgart · New York

Atypische Neuroleptika in der Behandlung von Aggressivität und Feindseligkeit bei schizophrenen Patienten

Atypical Neuroleptics in the Treatment of Aggression and Hostility in Schizophrenic PatientsP.  Briken1 , E.  Nika1 , M.  Krausz1 , D.  Naber1
  • 1Zentrum für psychosoziale Medizin, Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf (Direktor: Prof. Dr. D. Naber)
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Publication History

Publication Date:
04 March 2002 (online)

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Zusammenfassung

Die Behandlung aggressiver Symptome bei schizophrenen Patienten ist sowohl ein klinisches als auch gesellschaftlich relevantes Problem. Der vorliegende systematische Literaturüberblick stellt nach einer Darstellung allgemeiner methodischer Probleme die bisher existierenden Untersuchungen zu der Wirksamkeit atypischer Neuroleptika vor dem Hintergrund von Akut- und Langzeittherapie und der Verfügbarkeit verschiedener Applikationsformen der Medikamente dar. In der Akuttherapie aggressiver Symptome werden die klassischen Neuroleptika immer noch als Mittel der ersten Wahl angesehen, obwohl Risperidon und Olanzapin mögliche Alternativen darstellen. Insbesondere bei persistierender oder wiederkehrender aggressiver Symptomatik scheint aber für Clozapin bisher die beste, spezifisch antiaggressive Wirksamkeit bei geringeren Nebenwirkungen nachgewiesen. Bei medikamentöser Noncompliance muss auf klassische Depotpräperate zurückgegriffen werden.

Abstract

The treatment of aggressive symptoms in schizophrenic patients is a relevant clinical problem. We systematically review the efficacy of the different atypical neuroleptics on acute or persistent aggressive symptoms also regarding methodological problems. Currently typical neuroleptics are still first choice in treating acute aggressive symptoms, while risperidone and olanzapine could be alternatives. In persistent aggression clozapin shows the best specific results. Typical depot neuroleptics should be considered in cases when medication compliance is a problem.

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Dr. med. P. Briken

Abteilung für Sexualforschung und Forensische Psychiatrie
Zentrum für psychosoziale Medizin, Psychiatrie und Psychotherapie des Universitätsklinikum Hamburg-Eppendorf

Martinistr. 52

20246 Hamburg

Email: briken@uke.uni-hamburg.de