Zusammenfassung
Atypische Antipsychotika werden in zunehmendem Ausmaß auch für die Behandlung älterer
Patienten eingesetzt. Es liegen bislang allerdings nur wenige Untersuchungen über
ihre Wirksamkeit und Nebenwirkungen bei dieser Patientengruppe vor. Es wird über einen
67-jährigen Patienten berichtet, bei dem es unter Behandlung mit Olanzapin in üblicher
Dosierung zu einem Anstieg des Serumspiegels weit über den therapeutischen Bereich
kam. Diese Olanzapinüberdosierung war begleitet von ausgeprägten Gedächtnisstörungen
für visuelles und verbales Material und von einer mittelschweren Allgemeinveränderung
im EEG. Beide Veränderungen lassen sich auf die anticholinerge Wirkung von Olanzapin
zurückführen und bildeten sich nach Dosisreduktion und Normalisierung des Olanzapinserumspiegels
rasch zurück.
Abstract
Atypical antipsychotics are increasingly used for the treatment of elderly patients.
However, there are only few studies on their efficacy and side effects in this patient
group. The case of a 67-year old patient is presented, in whom under treatment with
olanzapine in usual dosage, serum level increased into the toxic range. This olanzapine
overdosage was accompanied by severe impairments in visual and verbal memory and by
an increase of slow-frequency activity in the EEG. Both alterations may be attributed
to the anticholinergic effects of olanzapine and reversed rapidly after dose reduction
and normalization of the olanzapine serum level.
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Prof. Dr. Georg Adler
Altentagesklinik am Zentralinstitut für Seelische Gesundheit
J5
68159 Mannheim
Email: adler@zi-mannheim.de
