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Allgemeinmedizin up2date 2023; 04(04): 319-334
DOI: 10.1055/a-2114-8209
DOI: 10.1055/a-2114-8209
Spezifische Patientengruppen
Antipsychotika: Was der Allgemeinmediziner wissen sollte
Antipsychotika (AP) wurden ursprünglich entwickelt, um Symptome der Schizophrenie zu behandeln – heute werden sie auch häufig bei geriatrischen Patienten, v.a. an Demenz Erkrankten eingesetzt. Dieser Beitrag erläutert den Einsatz von AP bei Schizophrenie und Verhaltensauffälligkeiten bei Demenz gemäß den jeweiligen Behandlungsleitlinien. Auch die unerwünschten Wirkungen häufig verwendeter AP und ihre Behandlungsmöglichkeiten werden vorgestellt.
Schlüsselwörter
Antipsychotika - Demenz - Schizophrenie - Leitlinie - unerwünschte ArzneimittelwirkungPublication History
Article published online:
21 November 2023
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Literatur
- 1 Braslow JT, Marder SR. History of Psychopharmacology. Annu Rev Clin Psychol 2019; 15: 25-50
- 2 Leucht S, Corves C, Arbter D. et al. Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet 2009; 373: 31-41
- 3 Krause M, Zhu Y, Huhn M. et al. Antipsychotic drugs for patients with schizophrenia and predominant or prominent negative symptoms: a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 2018; 268: 625-639
- 4 Lohse MJ, Seifert J, Bleich S. Psychopharmaka. In: Arzneiverordnungs-Report 2021. Springer; 2021: 689-725
- 5 Hessmann P, Dodel R, Baum E. et al. Antipsychotic treatment of community-dwelling and institutionalised patients with dementia in Germany. Int J Psychiatry Clin Pract 2018; 22: 232-239
- 6 Lenzer J. FDA warns about using antipsychotic drugs for dementia. BMJ 2005; 330: 922
- 7 Kiss N, Giezendanner S, Zeller A. Geriatric Psychiatry in Nursing Homes in the Canton Basel-Stadt - The View of General Practitioners. Praxis (Bern 1994) 2021; 110: 257-261
- 8 Siafis S, Tzachanis D, Samara M. et al. Antipsychotic Drugs: From Receptor-binding Profiles to Metabolic Side Effects. Curr Neuropharmacol 2018; 16: 1210-1223
- 9 Kim SA. 5-HT1A and 5-HT2A Signaling, Desensitization, and Downregulation: Serotonergic Dysfunction and Abnormal Receptor Density in Schizophrenia and the Prodrome. Cureus 2021; 13: e15811
- 10 Seifert R. Basiswissen Pharmakologie. Heidelberg: Springer; 2021
- 11 Benkert O, Hippius H. Kompendium der Psychiatrischen Pharmakotherapie. Berlin: Springer; 2021
- 12 Bleich S, Dabbert D, Kropp S. et al. Handbuch Psychopharmaka – Deutsche Bearbeitung der englischsprachigen Version von Ric M. Procyshyn, Kalyna Z. Bezchlibnyk-Butler und J. Joel Jeffries. Göttingen: Hogrefe; 2022.
- 13 Gaebel W, Hasan A, Falkai P. S3-Leitlinie Schizophrenie. Heidelberg: Springer; 2019
- 14 Ostuzzi G, Vita G, Bertolini F. et al. Continuing, reducing, switching, or stopping antipsychotics in individuals with schizophrenia-spectrum disorders who are clinically stable: a systematic review and network meta-analysis. Lancet Psychiatry 2022; 9: 614-624
- 15 Siskind D, Orr S, Sinha S. et al. Rates of treatment-resistant schizophrenia from first-episode cohorts: systematic review and meta-analysis. Br J Psychiatry 2022; 220: 115-120
- 16 Kishi T, Ikuta T, Matsui Y. et al. Effect of discontinuation v. maintenance of antipsychotic medication on relapse rates in patients with remitted/stable first-episode psychosis: a meta-analysis. Psychol Med 2019; 49: 772-779
- 17 Seibert M, Mühlbauer V, Holbrook J. et al. Efficacy and safety of pharmacotherapy for Alzheimer's disease and for behavioural and psychological symptoms of dementia in older patients with moderate and severe functional impairments: a systematic review of controlled trials. Alzheimers Res Ther 2021; 13: 131
- 18 Huang Y-Y, Teng T, Shen X-N. et al. Pharmacological treatments for psychotic symptoms in dementia: A systematic review with pairwise and network meta-analysis. Ageing Res Rev 2022; 75: 101568
- 19 Tampi RR, Tampi DJ, Balachandran S. et al. Antipsychotic use in dementia: a systematic review of benefits and risks from meta-analyses. Ther Adv Chronic Dis 2016; 7: 229-245
- 20 Watt JA, Goodarzi Z, Veroniki AA. et al. Safety of pharmacologic interventions for neuropsychiatric symptoms in dementia: a systematic review and network meta-analysis. BMC Geriatr 2020; 20: 212
- 21 Yeh TC, Tzeng NS, Li JC. et al. Mortality Risk of Atypical Antipsychotics for Behavioral and Psychological Symptoms of Dementia: A Meta-Analysis, Meta-Regression, and Trial Sequential Analysis of Randomized Controlled Trials. J Clin Psychopharmacol 2019; 39: 472-478
- 22 Seppala LJ, Wermelink A, de Vries M. et al. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: II. Psychotropics. J Am Med Dir Assoc 2018; 19: 371.e311-371.e317
- 23 Deuschl G, Maier W. Deutsche Gesellschaft für Neurologie. S3-Leitlinie Demenzen. Leitlinien für Diagnostik und Therapie in der Neurologie 2016. AWMF-Register-Nr.: 038–013.
- 24 Mann NK, Mathes T, Sönnichsen A. et al. Potentially Inadequate Medications in the Elderly: PRISCUS 2.0—First Update of the PRISCUS List. Dtsch Arztebl Int 2023; 120: 3-10
- 25 Van Leeuwen E, Petrovic M, van Driel ML. et al. Withdrawal versus continuation of long-term antipsychotic drug use for behavioural and psychological symptoms in older people with dementia. Cochrane Database Syst Rev 2018; 3: CD007726
- 26 Dabbert D, Toto S, Seifert J. Clozapin aus Sicht des Projekts „Arzneimittelsicherheit in der Psychiatrie". InFo Neurologie + Psychiatrie 2022; 24: 40-51