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Polypharmazie in der Behandlung psychischer Erkrankungen pp 41–83Cite as

Behandlung der Schizophrenie

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Zusammenfassung

Polypharmazie in der Behandlung der Schizophrenie ist – wie häufig auch in der Behandlung anderer psychischer Störungen – das Resultat einer Therapieresistenz. Bis zu 70% der schizophrenen Patienten erreichen keine Vollremission, mindestens 30% der Betroffenen sprechen auf zwei oder mehr Monotherapien mit modernen Antipsychotika nicht an.

Nach wie vor ist die Frage, ob eine Polypharmazie in der Behandlung der Schizophrenie Vorteile gegenüber einer Monotherapie hat, nicht eindeutig geklärt. Die klinische Praxis zeigt jedoch, dass entgegen wiederholt formulierter, plausibler Empfehlungen, z. B. in den Leitlinien von Fachgesellschaften, eine Monotherapie mit Antipsychotika zu verordnen, auch weiterhin häufig und regional sogar mit steigender Tendenz Kombinationstherapien durchgeführt werden. Obwohl bereits vor mehr als 10 Jahren das Fehlen kontrollierter Studien zur Polypharmazie und die daraus resultierende geringe wissenschaftliche Evidenz für eine weltweit in großem Umfang angewandte Praxis als „a dirty little secret“ kritisiert wurde, stellt Polypharmazie weiterhin eher die Regel als die Ausnahme dar und wird umso häufiger angewandt, je schwerer und je länger der Patient erkrankt ist.

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  1. Danuviusklinik GmbH, Krankenhausstraße 68, 85276, Pfaffenhofen, Deutschland

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    Dr. med. Cordula Tiltscher

  3. Bezirkskrankenhaus Augsburg, Bezirkskliniken Schwaben, Dr. Mack Straße 1, 86156, Augsburg, Deutschland

    Prof. Dr. Max Schmauß

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Messer, T., Tiltscher, C., Schmauß, M. (2016). Behandlung der Schizophrenie. In: Messer, T., Schmauß, M. (eds) Polypharmazie in der Behandlung psychischer Erkrankungen. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1849-8_2

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