Behandlung manischer Episoden bei bipolaren Störungen mit Risperidon

 

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Zusammenfassung

In der Behandlung manischer Episoden bei bipolaren Störungen werden häufig Neuroleptika eingesetzt, entweder als Monotherapie, als Komedikation zu einem Stimmungsstabilisierer oder bei Patienten, die sich als therapieresistent in der Therapie mit Lithium oder einem anderen Stimmungsstabilisierer erweisen. Die Studiendaten mit konventionellen Neuroleptika zeigen jedoch, dass ihr Nebenwirkungsprofil sowie eine mögliche Induktion depressiver Symptome ihren Einsatz - insbesondere in der Langzeittherapie und Phasenprophylaxe bipolarer Störungen - limitiert. Atypische Neuroleptika sind im Vergleich zu konventionellen Neuroleptika nebenwirkungsärmer und weisen im Gegensatz zu der Behandlung mit konventionellen Neuroleptika eine signifikant bessere extrapyramidalmotorische Verträglichkeit auf. Das atypische Neuroleptikum Risperidon konnte in klinischen Studien seine Wirksamkeit und Verträglichkeit in der Behandlung manischer Episoden bei bipolaren Störungen nachweisen. Dies gilt sowohl in der Akut- als auch in der Erhaltungstherapie. Die bisherigen Daten zu Risperidon zeigen, dass es als wirksames und verträgliches Therapeutikum in der Kombination mit einem Stimmungsstabilisierer oder auch als Alternative zu stimmungsstabilisierenden Substanzen eingesetzt werden kann. Die vorliegende Übersicht fasst die bisherigen Studiendaten zu Risperidon in der Behandlung bipolarer Störungen zusammen.

Abstract

In patients with bipolar disorder antipsychotics are frequently used for the treatment of acute manic episodes, either in monotherapy, in addition to a mood stabilizer or in patients refractory to lithium or other mood stabilizers. However, a number of studies demonstrated that the use of conventional neuroleptics is restricted - particularly for long-term treatment and relapse prevention in bipolar disorder - due to their side effect profile and their potential to induce or worsen depressive symptoms. In contrast, atypical antipsychotics have a better tolerability profile and fewer extrapyramidal side effects. A number of clinical studies showed that the atypical antipsychotic risperidone was effective and well tolerated in the treatment of bipolar mania. This was reported both for the treatment of acute episodes and for the maintenance therapy. Recent data suggest that risperidone can be used effectively either in addition to or even instead of a mood stabilizer. This review summarizes the available literature on risperidone in the treatment of bipolar disorders.

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