Zum optimalen Umgang mit Nebenwirkungen von Neuroleptika: Auswertung einer Klientenerfahrung

J. Sin; C. Gamble

doi:10.1055/s-2005-858584

PPH 2005; 11(5): 268-274
DOI: 10.1055/s-2005-858584

Fallbeispiel

Zum optimalen Umgang mit Nebenwirkungen von Neuroleptika: Auswertung einer Klientenerfahrung

J. Sin, C. GambleDer Artikel erschien zuerst in der Zeitschrift „Journal of Psychiatric and Mental Health Nursing” 2003; 10: 147 - 153. Der Abdruck erfolgt mit freundlicher Genehmigung des Verlages Blackwell Science Ltd. Übersetzung aus dem Englischen: Susan Smeaton.

Abstract

Trotz der in letzter Zeit aufkommenden psychosozialen Interventionen und anderer Behandlungsmethoden bleibt die medikamentöse Behandlung mit Neuroleptika der Eckpfeiler bei schizophrenen Erkrankungen, da diese die Rückfallquote anerkanntermaßen wirksam reduzieren. Gleichzeitig erschweren aber die Nebenwirkungen das Einhalten des gemeinsam erarbeiteten Behandlungsplans durch die Patienten. Bis vor kurzem haben psychiatrische Pflegekräfte wenig zur konsequenten Dokumentation bzw. zum Umgang mit diesen Symptomen beigesteuert. Der vorliegende Bericht zeigt, wie das Einfließen von pharmakologischem Hintergrundwissen und praktischer Erfahrung die Abstimmung bei einem Klienten optimieren kann. Beschrieben wird Herrn M.s Erfahrung mit seinen Medikamenten und welche Rolle psychiatrische Pflegekräfte innerhalb des Medikamentenmanagements unter interdisziplinärer Herangehensweise einnehmen können: Einschätzen von Wirkungen, Erfassen von und den Umgang mit Nebenwirkungen.

Full Text

References

Literatur

1 Baguley I, Baguley C. Psychosocial interventions in the treatment of psychosis. Mental Health Care. 1999; 21 334-337
2 Bebbington P E, Wilkins S, Jones P. et al . Life event and psychosis. Initial results from the Camberwell collaborative psychosis study. British Journal of Psychiatry. 1993; 162 72-79
3 Bennett J, Done J, Harrison-Read P. et al .A rating scale/checklist for the assessment of the side-effects of antipsychotic drugs. Brooker C, White E Community Psychiatric Nursing: a Research Perspective. Vol. 3 London; Chapman & Hall 1995: 1-19
4 Bennett J, Done J, Hunt B. Assessing the side-effects of antipsychotic drugs: a survey of CPN practice. Journal of Psychiatric and Mental Health Nursing. 1995; 2 177-182
5 Birchwood M, Tarrier N. Innovations in the Psychological Management of Schizophrenia: Assessment, Treatment and Services. Chichester; Wiley 1992
6 Buchanan R W. Clozapine: efficacy and safety. Schizophrenia Bulletin. 1995; 21 579-593
7 Burnett S. A new lease on life. Nursing Times. 1994; 90 (30) 57
8 Clozapine Study Group . The safety and efficacy of clozapine in severe treatment-resistant schizophrenic clients in the U.K. British Journal of Psychiatry. 1993; 163 150-154
9 Clozaril-Novartis .Summary of Product Characteristics - UK Specific. Surrey; Novartis 1999
10 Corrigan P W, Liberman R P, Engel J D. From non-compliance to collaboration in the treatment of schizophrenia. Hospital Community Psychiatry. 1990; 41 1203-1211
11 Day J C, Wood G, Dcwey M. et al . A self-rating scale for measuring neuroleptic side-effects. British Journal of Psychiatry. 1995; 166 650-653
12 Dev V J, Krupp P. Adverse event profile and safety of clozapine. Review of Contemporary Pharmacotherapy. 1995; 6 197-208
13 Finn S E, Bailey J M, Schultz R T. et al . Subjective utility ratings of neuroleptics in treating schizophrenia. Psychological Medicine. 1990; 20 843-848
14 Fowler D, Garcty P, Kuipers E. Cognitive Behavioural Therapy for Psychosis. Chichester; Wiley 1995
15 Gardner B, Owen L, Thompson S. Compliance: the need for a fresh approach. Mental Health Nursing. 1999; 19 18-22
16 Gray R. Medication Management Handout Pack. London; Institute of Psychiatry 1999
17 Howard A, Reveley A. Review of compliance in schizophrenia. Schizophrenia Monitor. 2000; 10 1-3
18 Kane J M. Clinical efficacy of clozapine in treatment-refractory schizophrenia: an overview. British Journal of Psychiatry. 1992; 160 (Suppl 17) 41-45
19 Kane J, Honigfeld G, Singer J. et al . Clozapine for the treatment-resistant schizophrenic (a double-blind comparison with chlorpromazine). Archives of General Psychiatry. 1988; 45 789-796
20 Kemp R, Hayward P, Applewhaite G. et al . Compliance therapy in psychotic clients: randomised controlled trial. British Medical Journal. 1996; 312 345-349
21 King D. Seminars in Clinical Psychopharmacology. London; Royal College of Psychiatrists 1995
22 Krawiecka M, Goldberg D, Vaughn M. A standardised psychiatric assessment scale for rating chronic psychotic clients. Acta Psychiatrica Scandinavica. 1977; 55 299-308
23 Lieberman J A, Safferman A Z. Clinical profile of clozapine: adverse reactions and agranulocytosis. Psychiatry Quarterly. 1992; 62 51-70
24 Lieberman J A, Safferman A Z, Pollack S. et al . Clinical effects of clozapine in chronic schizophrenia: response to treatment and predictors of outcome. American Journal of Psychiatry. 1994; 151 1744-1752
25 Lindstrom L H. The effect of long-term treatment with clozapine in schizophrenia: a retrospective study in 96 clients treated with clozapine for up to 13 years. Acta Psychiatrica Scandinavica Supplementum. 1988; 77 524-529
26 Marland G. Partnerships encourage clients to comply with treatment. Nursing Times. 1998; 94 58-59
27 Marland G, Sharkey V. Depot neuroleptics, schizophrenia and the role of the nurse: is practice evidence based? A review of literature. Journal of Advanced Nursing. 1999; 30 1255-1262
28 Meltzer H Y. The importance of scroronin-dopaminc interactions in the action of clozapine. British Journal of Psychiatry. 1992; 160 (Suppl 17) 22-29
29 Meltzer H Y. Clozapine: is another view valid?. American Journal of Psychiatry. 1995; 152 821-825
30 Meltzer H Y, Burnett D, Bastani B. et al . Effects oi six months of clozapine treatment on the quality of life of chronic schizophrenic clients. Hospital Community Psychiatry. 1990; 41 892-897
31 National Schizophrenia Fellowship .National Schizophrenia Fellowship Fact Sheet I. 3rd ed. London; NSF 1996
32 Shiloh R, Zemishlany Z, Aizenberg M. et al . Sulpiride augmentation in people with schizophrenia partially responsive to clozapine (a double-blind, placebo-controlled study). British Journal of Psychiatry. 1997; 171 569-573
33 Sin J. One step at a time: negative symptoms. Mental Health Care. 2000; A 97-101
34 Sullivan G, Wells K B, Leake B. Clinical factors associated with better quality of life in a seriously mentally ill population. Hospital and Community Psychiatry. 1992; 43 794-799
35 Taylor D, Hardy S. Psychopharmacology. Thomas B, Hardy S, Cutting P Stuart and Sundeen’s Mental Health Nursing Principles and Practice St Louis; Mosby 1997

Jacqueline Sin

Compass Place Battle Hospital, Oxford Road, Reading

Berkshire RG 30 1AG

Großbritannien