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PSYCH up2date 2016; 10(04): 307-321
DOI: 10.1055/s-0042-100897
Affektive Störungen
© Georg Thieme Verlag KG Stuttgart · New York

Therapie der Manie

Johannes Petzold
,
Michael Bauer
,
Emanuel Severus
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Publication Date:
13 July 2016 (online)

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Kernaussagen

Die Therapie der Manie im Rahmen bipolarer Störungen umfasst verschiedene Behandlungsstadien mit unterschiedlichen Behandlungszielen. Hierbei sind bereits für die Akutbehandlung rezidivprophylaktische Optionen zu berücksichtigen, bei letzteren stellt Lithium weiterhin den Goldstandard dar. Generell sollte mit der Monotherapie einer für diese Indikation zugelassenen Substanz begonnen werden. In schweren Fällen kann eine Kombinationsbehandlung aus einem Stimmungsstabilisierer und einem Antipsychotikum (z. B. Lithium und Quetiapin) sinnvoll sein. Die Therapie ist soweit wie möglich zu individualisieren – in partizipativer Entscheidungsfindung. Clozapin sowie die Elektrokonvulsionstherapie stellen Therapieoptionen bei gegenüber zugelassenen medikamentösen Interventionen resistenten schweren manischen Episoden dar. Spätestens nach Remission der Akutsymptomatik sollte in der Erhaltungstherapie eine ausführliche Psychoedukation erfolgen.

 

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