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Erschienen in: neuropsychiatrie 1/2015

01.03.2015 | übersicht

Parkinson-Krankheit und Psychosen

verfasst von: Jacopo Vittoriano Bizzarri, Giancarlo Giupponi, Ignazio Maniscalco, Patrizia Schroffenegger, Andreas Conca, Hans Peter Kapfhammer

Erschienen in: neuropsychiatrie | Ausgabe 1/2015

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Zusammenfassung

Psychotische Symptome stehen bei der Parkinson-Krankheit (PD) in Zusammenhang mit erhöhter Beeinträchtigung, einer Verschlechterung der Lebensqualität und einen schlechteren Langzeitprognose. In diesem Artikel wird über klinische Merkmale, Hypothesen über die Pathogenese, und aktuelle Strategien für die Behandlung der Parkinson-Krankheit Psychose (PDP) berichtet. Nach epidemiologischen Studien liegt die Prävalenz von PDP zwischen 20 bis 40 %. Komplexe visuelle Halluzinationen sind die häufigsten psychotischen Symptome und bei 17 bis 72 % der Patienten vorhanden. Andere sensorische Störungen umfassen taktile Halluzinationen, das Gefühl der Präsenz und visuelle Illusionen. Halluzinationen sind häufig von Wahnvorstellungen, deren häufigsten Themen Verfolgung und Eifersucht sind, begleitet. Die Pathophysiologie der PDP bleibt unklar. Verschiedene Faktoren sind beteiligt, darunter Levo-Dopa und Dopamin-Medikamente, Neurotransmitter Ungleichgewichte, neuroanatomische Veränderungen, abnormale visuell-räumliche Prozesse und genetische Veranlagung. Der erste Schritt bei der Behandlung von anhaltenden und problematischen PDP ist die Reduktion der Anti-PD-Medikamente. Die Therapiewahl fällt auf Antipsychotika der zweiten Generation, wobei sich Clozapin als effektivstes und verträglichstes Medikament bei Parkinson-Patienten erwiesen hat.
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Metadaten
Titel
Parkinson-Krankheit und Psychosen
verfasst von
Jacopo Vittoriano Bizzarri
Giancarlo Giupponi
Ignazio Maniscalco
Patrizia Schroffenegger
Andreas Conca
Hans Peter Kapfhammer
Publikationsdatum
01.03.2015
Verlag
Springer Vienna
Erschienen in
neuropsychiatrie / Ausgabe 1/2015
Print ISSN: 0948-6259
Elektronische ISSN: 2194-1327
DOI
https://doi.org/10.1007/s40211-014-0132-8

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