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PSYCH up2date 2018; 12(05): 363-374
DOI: 10.1055/a-0525-5277
Abhängigkeitserkrankungen

Therapie der Benzodiazepinabhängigkeit

Michael Soyka
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Langzeitverordnungen von Benzodiazepinen entfallen vor allem auf ältere und weibliche Patienten. Entzugsbehandlungen sollten schrittweise über einen mehrwöchigen Zeitraum erfolgen. Begleitende Schlaf- und depresssive Störungen im Benzodiazepinentzug kann man am ehesten mit sedierenden Antidepressiva behandeln. Die spärliche Studienlage deutet auf eine gewisse Effizienz von Psychoedukation, motivationalen Strategien und kognitiver Verhaltenstherapie.
Kernaussagen

  • Benzodiazepine sind klinisch sehr sichere Substanzen mit hoher therapeutischer Breite.

  • Trotz sinkender Verschreibungszahlen ist die Zahl der Patienten mit Benzodiazepinabhängigkeit immer noch sehr hoch.

  • Langzeitverschreibungen sind gerade bei älteren Patienten sehr häufig.

  • Risikogruppen für Benzodiazepinabhängigkeit sind Frauen, Ältere, Menschen mit psychischen Störungen, Schlafstörungen, chronischen Schmerzen, Angst oder mit Suchterkrankungen.

  • Medikamentenabhängige vom Typ Benzodiazepine werden vom klassischen Suchthilfesystem kaum gesehen und selten in Suchtfachkliniken behandelt.

  • Typische Entzugssymptome sind Angst, Unruhe, Schlafstörungen und Perzeptionsstörungen. Bei zu raschem Absetzen besteht die Gefahr von epileptischen Anfällen, Delir oder Entzugspsychosen.

  • Der Entzug soll in jedem Falle schrittweise über mehrere Wochen erfolgen.

  • Im Benzodiazepinentzug kann z. B. kognitive Verhaltenstherapie eingesetzt werden; Antidepressiva werden symptomatisch zur Behandlung depressiver Störungen, aber auch Schlafstörungen eingesetzt.

Schlüsselwörter

Benzodiazepine - Abhängigkeit - Entzug - Therapie


Publication History

Publication Date:
11 September 2018 (online)

Georg Thieme Verlag KG
Stuttgart · New York

 

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