Psychiatrie und Psychotherapie up2date 2011; 5(4): 209-224
DOI: 10.1055/s-0031-1276834
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© Georg Thieme Verlag KG Stuttgart · New York

Akutbehandlung der Manie

Johannes  Rentzsch, Roland  Ricken, Mazda  Adli
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Publication History

Publication Date:
30 June 2011 (online)

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Kernaussagen

Es stehen insgesamt verschiedene medikamentöse orale und parenterale Strategien zur Behandlung der akuten Manie zur Verfügung, weitgehend mit ähnlicher Wirkstärke.

Empfohlen werden die Mood-Stabilizer Lithium und Valproat und verschiedene atypische Antipsychotika. Aufgrund des Nebenwirkungsprofils sind Aytpika teilweise den Mood-Stabilizern vorzuziehen.

Da jedes Medikament sein eigenes Nebenwirkungs-, Risiko- und Interaktionsprofil hat, sollte jeweils eine individuelle Therapieauswahl in Abhängigkeit bestehender Vorerfahrungen, Komorbidität und unter Beachtung bestehender weiterer Medikation mit dem Patienten erarbeitet werden.

Die meisten antimanischen Medikamente lassen sich untereinander gut kombinieren mit dadurch erhöhter Wirksamkeit. Ein Teil der Pharmaka kann auch in der Rezidivprophylaxe weitergeführt werden. In diesem Fall sollten Langzeitnebenwirkungen und der bisherige Krankheitsverlauf beachtet werden.

Asenapin steht seit Kurzem zur antimanischen Therapie zur Verfügung, muss sich im klinischen Alltag aber noch bewähren.

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Dr. med. Johannes Rentzsch

Klinik für Psychiatrie und Psychotherapie
Charité – Universitätsmedizin Berlin
Campus Charité Mitte

Charitéplatz 1

10117 Berlin

Email: johannes.rentzsch@charite.de