Verträglichkeit von modernen Antipsychotika

Zusammenfassung

Mit den Antipsychotika der zweiten Generation wurden die Möglichkeiten einer Therapie der Schizophrenie maßgeblich erweitert: Die modernen Substanzen zeichnen sich im Vergleich zu den konventionellen Antipsychotika insbesondere durch günstigere Effekte auf die negativen und depressiven Symptome aus und weisen zudem ein geringeres Risiko für extrapyramidalmotorische Symptome auf. Auf Grund ihres Einflusses auf verschiedene Neurotransmittersysteme können unter den modernen Antipsychotika aber, je nach Wirkstoff, unterschiedliche unerwünschte Arzneimittelwirkungen und Verträglichkeitsprobleme relevant werden. Dies erfordert eine sorgfältige Auswahl und ein engmaschiges Monitoring einer adäquaten Antipsychotikatherapie bei Patienten mit Schizophrenie.

Summary

With the second generation antipsychotics the options for treating schizophrenia were broadened considerably: in comparison to the conventional antipsychotics the modern substances show particularly more favourable effects on the negative and depressive symptoms and have, in addition, a lower risk of extrapyramidal side effects. However, because of the different influences on the various neurotransmitter systems other undesired drug effects and tolerance problems can, depending on the substance, become more relevant. Therefore, the appropriate treatment with modern antipsychotics has to be selected carefully for each patient and a close meshed monitoring of antipsychotic therapy has to be established.

Schlüsselwörter

Atypische Antipsychotika - Schizophrenie - Verträglichkeit - Sicherheit - Nebenwirkungen

Keywords

Atypical antipsychotics - schizophrenia - tolerability - safety - side effects

• Literatur

• 1 Allison DB, Fontaine KR, Heo M. et al. The distribution of body mass index among individuals with and without schizophrenia. J Clin Psychiatry 1999; 60: 215-20.
• 2 Allison DB, Mentore JL, Heo M. et al. Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry 1999; 156: 1686-96.
• 3 American Diabetes Association, American Psychiatric Association American Association of Clinical Endocrinologists, North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care 2004; 27: 596-601.
• 4 Arato M, O’Connor R, Meltzer HY. A 1-year, double-blind, placebo-controlled trial of ziprasidone 40, 80 and 160 mg/day in chronic schizophrenia: the Ziprasidone Extended Use in Schizophrenia (ZEUS) study. Int Clin Psychopharmacol 2002; 17: 207-15.
• 5 Association AP. Practice guidelines for the treatment of patients with schizophrenia. Am J Psychiatry 1997; 154 (Suppl. 04) 1-63.
• 6 Beasley CM, Dellva MA, Tamura RN. et al. Randomised double-blind comparison of the incidence of tardive dyskinesia in patients with schizophrenia during long-term treatment with olanzapine or haloperidol. BrJ Psychiatry 1999; 174: 23-30.
• 7 Bender S, Grohmann R, Engel RR, Degner D, Dittmann-Balcar A, Rüther E. Severe adverse drug reactions in psychiatric inpatients treated with neuroleptics. Pharmacopsychiatry 2004; 37 (Suppl. 01) S46-S53.
• 8 Bergmann RN, Ader M. Atypical antipsychotics and glucose homeostasis. J Clin Psychiatry 2005; 66: 505-14.
• 9 Bobes J, Garcia-Portilla MP, Rejas J. et al. Frequency of sexual dysfunction and other reproductive side-effects in patients with schizophrenia treated with risperidone, olanzapine, quetiapine, or haloperidol: the results of the EIRE study. J Sex Marital Ther 2003; 29: 125-47.
• 10 Buckley NA, Sanders P. Cardiovascular adverse effects of antipsychotic drugs. Drug Saf 2000; 23: 215-28.
• 11 Carson WH, Pigott TA, Saha AR. et al. Aripiprazole vs. placebo in the treatment of chronic schizophrenia. Int J Neuropsychopharmacol 2002; 05 (Suppl. 01) S187.
• 12 Casey DE. The relationship of pharmacology side effects. J Clin Psychiatry 1997; 58 (Suppl. 10) 55-62.
• 13 Grohmann R, Hippius H, Helmchen H, Rüther E, Schmidt LG. The AMÜP study for drug surveillance in psychiatry–a summary of inpatient data. Pharmacopsychiatry 2004; 37 (Suppl. 01) S16-S26.
• 14 Hirose T, Uwahodo Y, Yamada S. et al. Mechanism of action of aripiprazole predicts clinical efficacy and a favourable side-effect profile. J Psychopharmacol 2004; 18: 375-83.
• 15 Hong X, Wang X. Agranulocytosis and neutropenia with typical and atypical neuroleptics. Am J Psychiatry 2001; 158: 1736-7.
• 16 Jeste DV, Okamoto A, Napolitano J, Kane JM, Martinez RA. Low incidence of persistent tardive dyskinesia in elderly patients with dementia treated with risperidone. Am J Psychiatry 2000; 157: 1150-5.
• 17 Jody D, Saha A, Iwamoto T. et al. Meta-analysis of weight effects with aripiprazole. Int J Neuropsychopharmacol 2004; 05 (Suppl. 01) S186.
• 18 Kane JM, Carson WH, Saha AR. et al. Efficacy and safety of aripiprazole and haloperidol versus placebo in patients with schizophrenia and schizoaffective disorder. J Clin Psychiatry 2002; 63: 763-71.
• 19 Kapur S. A new framework for investigating antipsychotic action in humans: lessons from PET imaging. Mol Psychiatry 1998; 03: 135-40.
• 20 Kapur S, Remington G. Atypical antipsychotics: new directions and new challenges in the treatment of schizophrenia. Annu Rev Med 2001; 52: 503-17.
• 21 Kapur S, Zipursky RB, Remington G. Clinical and theoretical implications of 5-HT2 and D2 receptor occupancy of clozapine, risperidone, and olanzapine in schizophrenia. Am J Psychiatry 1999; 156: 286-93.
• 22 Karow A, Naber D. Subjective well-being and quality of life under atypical antipsychotic treatment. Psychopharmacol (Berl) 2002; 162: 3-10.
• 23 Kasper S, Lerman MN, McQuade RD. et al. Efficacy and safety of aripiprazole vs. haloperidol for long-term maintenance treatment following acute relapse of schizophrenia. Int J Neuropsychopharmacol 2003; 06: 325-37.
• 24 Kasper S, Muller-Spahn F. Review of quetiapine and its clinical applications in schizophrenia. Expert Opin Pharmacother 2000; 01: 783-801.
• 25 Koro CE, Fedder DO, L’Italien GJ. et al. An assessment of the independent effects of olanzapine and risperidone exposure on the risk of hyperlipidemia in schizophrenic patients. Arch Gen Psychiatry 2002; 59: 1021-6.
• 26 Koro CE, Fedder DO, L’Italien GJ. et al. An assessment of the independent effect of olanzapine and risperidone on the risk of diabetes among schizophrenia patients in the United Kingdom: a population-based nested case-control study using the General Practice Research Database. BMJ 2002; 325: 243.
• 27 Kurzthaler I, Fleischhacker WW. The clinical implications of weight gain in schizophrenia. J Clin Psychiatry 2001; 62 (Suppl. 07) 32-7.
• 28 Martinot JL, Paillere-Martinot ML, Poirier MF, Dao-Castellana MH, Loc’h C, Maziere B. In vivo characteristics of dopamine D2 receptor occupancy by amisulpride in schizophrenia. Psychopharmacology (Berl) 1996; 124: 154-8.
• 29 Masand PS. Side effects of antipsychotics in the elderly. J Clin Psychiatry 2000; 61 (Suppl. 08) 43-9.
• 30 McIntyre RS, McCann SM, Kennedy SH. Antipsychotic metabolic effects: weight gain, diabetes mellitus, and lipid abnormalities. Can J Psychiatry 2001; 46: 273-81.
• 31 Meyer JM. Novel antipsychotics and severe hyperlipidemia. J Clin Psychopharmacol 2001; 21: 369-74.
• 32 Müller WE. Partieller D2-Agonismus und dopaminerge Stabilisierung durch Aripiprazol. Psychopharmakotherapie 2002; 09: 120-7.
• 33 Naber D. Atypische Neuroleptika in der Behandlung schizophrener Patienten. Bremen: Uni-med Verlag; 2000
• 34 National Institute for Clinical Exellence. Guidance on the use of newer (atypical) antipsychotic drugs for the treatment of schizophrenia. In. London: NICE June; 2002
• 35 Potkin SG, Saha AR, Kujawa MJ. et al. Aripiprazole, an antipsychotic with a novel mechanism of action, and risperidone vs. placebo in patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry 2003; 60: 681-90.
• 36 Rao ML, Hiemke C, Grasmäder K, Baumann P. für die TDM Arbeitsgruppe der AGNP. Olanzapin: Pharmakologie, Pharmakokinetik und Therapeutisches Drug Monitoring. Fortschr Neurol Psychiatr 2001; 69: 510-7.
• 37 Ruppert A. et al. Antipsychotika-induzierte Hyperlipidämie, Gewichtszunahme und Diabetesrisiko. In: DGPPN, 19.-22.11.2003. Berlin.:
• 38 Smith SM, O’Keane V, Murray R. Sexual dysfunction in patients taking conventional antipsychotic medication. Br J Psychiatry 2002; 181: 49-55.
• 39 Stock E, Soha AR, Brunell R, Achibald DG. Metaanalysis of the cardiac safety with aripiprazole. Int J Neuropsychopharmacol 2002; 05 (Suppl. 01) S186.
• 40 Stübner S, Rustenbeck E, Grohmann R. et al. Severe and uncommon involuntary movement disorders due to psychotropic drugs. Pharmacopsychiatry 2004; 37 (Suppl. 01) S54-64.
• 41 Tauscher J, Hussain T, Agid O. et al. Equivalent occupancy of dopamine D1 and D2 receptors with clozapine: differentiation from other atypical antipsychotics. Am J Psychiatry 2004; 161: 1620-5.
• 42 Tauscher J, Kufferle B, Asenbaum S, Tauscher-Wisniewski S, Kasper S. Striatal dopamine-2 receptor occupancy as measured with [123I]iodobenzamide and SPECT predicted the occurrence of EPS in patients treated with atypical antipsychotics and haloperidol. Psychopharmacology (Berl) 2002; 162: 42-9.
• 43 Weiden PJ, Miller AL. Which side effects really matter? Screening for common and distressing side effects of antipsychotic medications. J Psychiatr Pract 2001; 07: 41-7.
• 44 Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998; 97: 1837-47.
• 45 Wirshing DA, Boyd JA, Meng LR, Ballon JS, Marder SR, Wirshing WC. The effect of novel antipsychotics on glucose and lipid levels. J Clin Psychiatry 2002; 63: 856-65.
• 46 Worrel JA, Marken PA, Beckman SE, Ruehter VL. Atypical antipsychotic agents: a critical review. Am J Health Syst Pharm 2000; 57: 238-55.
• 47 Yang CR. Targeting prefrontal cortical dopamine D1 and N-methyl-D-aspartate receptor interactions in schizophrenia treatment. Neuroscientist 2005; 11: 452-70.
• 48 Zoler ML. Antipsychotics linked to weight gain and diabetes. Clin Psychiatr News 1999; 27: 20.