Update – Lithium in der Phasenprophylaxe Bipolarer Störungen

Zusammenfassung

Lithium ist der Goldstandard in der Phasenprophylaxe Bipolarer Störungen und das einzige Medikament für das es eine überzeugende suizidpräventive Wirkung bei affektiven Erkrankungen gibt. Unter Berücksichtigung eines regelmäßigen Monitorings ist Lithium eine zumeist gut verträgliche und sichere Phasenprophylaxe, die nach sorgfältiger Risiko-Nutzen-Abwägung auch eine off-label Therapieoption in Schwangerschaft und Stillzeit darstellt. Darüber hinaus gibt es Hinweise, dass Lithium neuroprotektiv wirken mag und möglicherweise das Risiko für eine Alzheimer-Demenz und Schlaganfälle senken kann. Perspektivisch könnten Biomarker zur Verfügung stehen, mit denen man das Ansprechen auf Lithium voraussagen kann und damit personalisiertere Therapien entwickeln könnte.

Abstract

Lithium is the gold standard in the long-term treatment of bipolar disorders and the only substance with a convincing antisuicidal effect in affective disorders. Under regular monitoring, lithium represents mostly a well-tolerated and safe medication. Balancing risk and benefits shows that lithium can also be an off-label therapeutic option during pregnancy and breast feeding. Lithium may exhibit neuroprotective effects and has been linked to a reduced risk of Alzheimer’s disease and stroke. In the future, biomarkers of lithium response may be available that enable development of more personalized therapies.

Schlüsselwörter

Lithium - Bipolare Störungen - Phasenprophylaxe - Schwangerschaft und Stillzeit - Nebenwirkungen

Key words

lithium - bipolar disorders - long-term treatment - pregnancy and breast feeding - side effects

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