Download PDF
Nervenheilkunde 2006; 25(03): 170-176
DOI: 10.1055/s-0038-1626447
Original- und Übersichtsarbeiten - Original and Review Articles
Schattauer GmbH

Verträglichkeit von modernen Antipsychotika

Tolerability of modern antipsychotics
E. Rüther
1   Abteilung Psychiatrie und Psychotherapie Bereich Humanmedizin, Georg-August-Universität Göttingen
› Author Affiliations
Further Information

Publication History

Publication Date:
19 January 2018 (online)

    Permissions and Reprints

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.
    CrossrefPubMedGoogle Scholar
  • 2 Allison DB, Mentore JL, Heo M. et al. Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry 1999; 156: 1686-96.
    PubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 5 Association AP. Practice guidelines for the treatment of patients with schizophrenia. Am J Psychiatry 1997; 154 (Suppl. 04) 1-63.
    PubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 8 Bergmann RN, Ader M. Atypical antipsychotics and glucose homeostasis. J Clin Psychiatry 2005; 66: 505-14.
    Google Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 10 Buckley NA, Sanders P. Cardiovascular adverse effects of antipsychotic drugs. Drug Saf 2000; 23: 215-28.
    CrossrefPubMedGoogle Scholar
  • 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.
    Google Scholar
  • 12 Casey DE. The relationship of pharmacology side effects. J Clin Psychiatry 1997; 58 (Suppl. 10) 55-62.
    PubMedGoogle Scholar
  • 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.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 15 Hong X, Wang X. Agranulocytosis and neutropenia with typical and atypical neuroleptics. Am J Psychiatry 2001; 158: 1736-7.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 17 Jody D, Saha A, Iwamoto T. et al. Meta-analysis of weight effects with aripiprazole. Int J Neuropsychopharmacol 2004; 05 (Suppl. 01) S186.
    Google Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 19 Kapur S. A new framework for investigating antipsychotic action in humans: lessons from PET imaging. Mol Psychiatry 1998; 03: 135-40.
    CrossrefPubMedGoogle Scholar
  • 20 Kapur S, Remington G. Atypical antipsychotics: new directions and new challenges in the treatment of schizophrenia. Annu Rev Med 2001; 52: 503-17.
    CrossrefPubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 22 Karow A, Naber D. Subjective well-being and quality of life under atypical antipsychotic treatment. Psychopharmacol (Berl) 2002; 162: 3-10.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 24 Kasper S, Muller-Spahn F. Review of quetiapine and its clinical applications in schizophrenia. Expert Opin Pharmacother 2000; 01: 783-801.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 27 Kurzthaler I, Fleischhacker WW. The clinical implications of weight gain in schizophrenia. J Clin Psychiatry 2001; 62 (Suppl. 07) 32-7.
    PubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 29 Masand PS. Side effects of antipsychotics in the elderly. J Clin Psychiatry 2000; 61 (Suppl. 08) 43-9.
    PubMedGoogle Scholar
  • 30 McIntyre RS, McCann SM, Kennedy SH. Antipsychotic metabolic effects: weight gain, diabetes mellitus, and lipid abnormalities. Can J Psychiatry 2001; 46: 273-81.
    CrossrefPubMedGoogle Scholar
  • 31 Meyer JM. Novel antipsychotics and severe hyperlipidemia. J Clin Psychopharmacol 2001; 21: 369-74.
    CrossrefPubMedGoogle Scholar
  • 32 Müller WE. Partieller D2-Agonismus und dopaminerge Stabilisierung durch Aripiprazol. Psychopharmakotherapie 2002; 09: 120-7.
    Google Scholar
  • 33 Naber D. Atypische Neuroleptika in der Behandlung schizophrener Patienten. Bremen: Uni-med Verlag; 2000
    Google Scholar
  • 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
    Google Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 37 Ruppert A. et al. Antipsychotika-induzierte Hyperlipidämie, Gewichtszunahme und Diabetesrisiko. In: DGPPN, 19.-22.11.2003. Berlin.:
    Google Scholar
  • 38 Smith SM, O’Keane V, Murray R. Sexual dysfunction in patients taking conventional antipsychotic medication. Br J Psychiatry 2002; 181: 49-55.
    CrossrefPubMedGoogle Scholar
  • 39 Stock E, Soha AR, Brunell R, Achibald DG. Metaanalysis of the cardiac safety with aripiprazole. Int J Neuropsychopharmacol 2002; 05 (Suppl. 01) S186.
    Google Scholar
  • 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.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 46 Worrel JA, Marken PA, Beckman SE, Ruehter VL. Atypical antipsychotic agents: a critical review. Am J Health Syst Pharm 2000; 57: 238-55.
    PubMedGoogle Scholar
  • 47 Yang CR. Targeting prefrontal cortical dopamine D1 and N-methyl-D-aspartate receptor interactions in schizophrenia treatment. Neuroscientist 2005; 11: 452-70.
    CrossrefPubMedGoogle Scholar
  • 48 Zoler ML. Antipsychotics linked to weight gain and diabetes. Clin Psychiatr News 1999; 27: 20.
    Google Scholar