Zusammenfassung
Bis vor einigen Jahren hat sich die medikamentöse Behandlung zur Verhinderung von Rückfällen bei bipolaren Erkrankungen in erster Linie auf Lithium beschränkt, das sich vor allem bei den typischen, klassischen Verläufen der bipolaren Störungen mit seiner stimmungsstabilisierenden Wirkung und antisuizidalem Effekt günstig auf den Krankheitsverlauf auswirkt. Bei atypischen Symptomen oder schnellem Phasenwechsel jedoch scheint die Effektivität eingeschränkt, mit der Konsequenz, dass weitere Therapieoptionen, v. a. Antiepileptika wie Carbamazepin, Valproat oder Lamotrigin auch in der Indikation der prophylaktischen Anwendung untersucht wurden. Auch atypische Neuroleptika, Schilddrüsenhormone und Omega-Fettsäuren wurden in Langzeitstudien bezüglich stimmungsstabilisierender Effekte untersucht. Der vorliegende Artikel fasst den gegenwärtigen Stand zur Wirksamkeit der verschiedenen Therapieoptionen in der Langzeittherapie zusammen.
Abstract
Until recently, the psychopharmacological treatment alternatives for bipolar maintenance treatment were limited to lithium, which seems of special usefulness in a classical manifestation of the illness with mood-stabilising and anti-suicidal properties. With atypical features like psychotic symptoms or rapid cycling, lithium seems to be less useful. This led to further research into alternative options as carbamazepine, valproate or lamotrigine as well as atypical neuroleptics, thyroid hormones or innovative substances like omega fatty acids. This article summarises the current state of knowledge on treatment options for maintenance therapy.
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Dr. med. Heinz Grunze
Psychiatrische Klinik der LMU
Nussbaumstraße 7
80336 München
Email: Heinz.Grunze@med.uni-muenchen.de
