Update zur Behandlung schizophrener Erkrankungen

Zusammenfassung

Einführung: Trotz moderner Therapieverfahren ist der Verlauf schizophrener Erkrankungen in nur etwa einem Drittel der Fälle durch eine gute, dauerhafte Remission gekennzeichnet. Die Entwicklung von Behandlungsleitlinien geben evidenzbasierte Hinweise zur Optimierung der Behandlung. Sie unterliegen einer andauernden Diskussion um Therapiestrategien und deren Einführung in die Routine-versorgung. Methoden: Im vorliegenden narrativen Review werden leitlinienorientierte Behandlungsstrategien vorgestellt und aktuelle Entwicklungen diskutiert. Neben der Pharmakotherapie wird auf moderne Versorgungsmodelle und deren Rolle in der Behand-lung eingegangen. Ergebnisse: Neuere Studienergebnissen relativieren die Empfehlungen von Behandlungsleitlinien im Bezug auf den Vorteil von Antipsychotika der zweiten Generation. Dabei wird unter Aufhebung des gene-rellen Klasseneffektes auf ein individuelles Therapieregime unter Abwägung des individuellen Risiko-Nutzen-Verhältnisses verwiesen. Depotpräparate sind in der klinischen Praxis gegenüber dem potenziellen Nutzen in der Rückfallprophylaxe möglicherweise unterbewertet.

Summary

Introduction: Despite novel aspects of treatment, the course of schizophrenia disorders includes an enduring remission only in a third of its cases. The development of guidelines offers evidence based advice to optimize treatment. However they are continuous subject of debate when considering new findings in literature and putting their content to clinical practice. Methods: The following narrative review displays guideline strategies of treatment with respect to novel discussions. Along with pharmaceutical treatment, current development in health care science and its aspects fort the impact of treatment are presented. Results: New guidelines stress the fact that preferring second generation antipsychotics has to be questioned. Modern treatment focuses on individual aspects of therapy indication and risk management rather than relying on general aspects of class distinction between antipsychotics. Despite their potential benefits for long term treatment depot formulations may be underrepresented in clinical practice.

Schlüsselwörter

Schizophrenie - Antipsychotika - Depotpräparate - Versorgung

Keywords

Schizophrenia - antipsychotics - depot formulations - health care services

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