Zusammenfassung
In der Behandlung manischer Episoden bei bipolaren Störungen werden häufig Neuroleptika
eingesetzt, entweder als Monotherapie, als Komedikation zu einem Stimmungsstabilisierer
oder bei Patienten, die sich als therapieresistent in der Therapie mit Lithium oder
einem anderen Stimmungsstabilisierer erweisen. Die Studiendaten mit konventionellen
Neuroleptika zeigen jedoch, dass ihr Nebenwirkungsprofil sowie eine mögliche Induktion
depressiver Symptome ihren Einsatz - insbesondere in der Langzeittherapie und Phasenprophylaxe
bipolarer Störungen - limitiert. Atypische Neuroleptika sind im Vergleich zu konventionellen
Neuroleptika nebenwirkungsärmer und weisen im Gegensatz zu der Behandlung mit konventionellen
Neuroleptika eine signifikant bessere extrapyramidalmotorische Verträglichkeit auf.
Das atypische Neuroleptikum Risperidon konnte in klinischen Studien seine Wirksamkeit
und Verträglichkeit in der Behandlung manischer Episoden bei bipolaren Störungen nachweisen.
Dies gilt sowohl in der Akut- als auch in der Erhaltungstherapie. Die bisherigen Daten
zu Risperidon zeigen, dass es als wirksames und verträgliches Therapeutikum in der
Kombination mit einem Stimmungsstabilisierer oder auch als Alternative zu stimmungsstabilisierenden
Substanzen eingesetzt werden kann. Die vorliegende Übersicht fasst die bisherigen
Studiendaten zu Risperidon in der Behandlung bipolarer Störungen zusammen.
Abstract
In patients with bipolar disorder antipsychotics are frequently used for the treatment
of acute manic episodes, either in monotherapy, in addition to a mood stabilizer or
in patients refractory to lithium or other mood stabilizers. However, a number of
studies demonstrated that the use of conventional neuroleptics is restricted - particularly
for long-term treatment and relapse prevention in bipolar disorder - due to their
side effect profile and their potential to induce or worsen depressive symptoms. In
contrast, atypical antipsychotics have a better tolerability profile and fewer extrapyramidal
side effects. A number of clinical studies showed that the atypical antipsychotic
risperidone was effective and well tolerated in the treatment of bipolar mania. This
was reported both for the treatment of acute episodes and for the maintenance therapy.
Recent data suggest that risperidone can be used effectively either in addition to
or even instead of a mood stabilizer. This review summarizes the available literature
on risperidone in the treatment of bipolar disorders.
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Dr. med. Andreas Schreiner
Leiter Medizinischer Fachbereich ZNS & Schmerz · Janssen-Cilag GmbH
Raiffeisenstraße 8
41470 Neuss
Email: aschrein@jacde.jnj.com
