Medikamentöse Langzeitbehandlung schizophrener Ersterkrankungen

Zusammenfassung

Antipsychotika haben sich in der Langzeitbehandlung schizophren erkrankter Patienten als sehr effektiv erwiesen. Dennoch bedarf es weiterer Forschung, um die medikamentöse Langzeitbehandlung, insbesondere bei ersterkrankten schizophrenen Patienten zu optimieren. Unter dieser Zielsetzung wurde eine multizentrische klinische Studie im Rahmen des Kompetenznetzes Schizophrenie durchgeführt, die zwei Hauptfragestellungen untersucht: Gibt es Unterschiede in der Rezidivrate a) der postakuten einjährigen Erhaltungsmedikation mit einem niedrigdosierten typischen versus atypischen Antipsychotikum und b) anschließendem Fortführen versus Absetzen der neuroleptischen Medikation, jeweils ergänzt durch prodromgestützte Frühintervention. Erste Ergebnisse der abgeschlossenen Studie sprechen für eine rezidivprophylaktische Effektivität beider Neuroleptika bei einer hohen Abbruchquote. Dies verweist auf einen Bedarf an speziellen Programmen, um (ersterkrankte) schizophrene Patienten in der effektiven Behandlung zu halten. Entsprechend werden in einer Transfer-Phase Informations-und Fortbildungsmaterialien entwickelt, die zu einer verbesserten Versorgung ersterkrankter Patienten beitragen sollen.

Summary

Antipsychotic drugs have proven their efficacy in long term treatment of patients with schizophrenia. Nonetheless, further research is needed to improve neuroleptic long term treatment especially in first-episode patients. In this respect a multicenter clinical study has been carried out in the scope of the German Research Network on Schizophrenia testing two main hypotheses: are there differences in relapse rates regarding a) one year maintenance treatment with low-dose typical versus atypical neuroleptic treatment and b) afterwards further maintenance treatment against drug discontinuation, both supplemented by prodrome based early intervention. First results of the just finished study suggest a relapse preventing efficacy for both neuroleptics, whereas treatment non-adherence is quite often. Accordingly, special programs need to be developed to enhance treatment adherence. Therefore, materials for information and education are provided in the commencing transfer period to enhance care of patients with first-episode schizophrenia in Germany.

Schlüsselwörter

Ersterkrankte schizophrene Patienten - typische vs. atypische Antipsychotika - Erhaltungstherapie - Intervalltherapie

Keywords

First-episode schizophrenia - typical and atypical antipsychotics - maintenance treatment - intermittent treatment

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