Extrapyramidal Side-Effects: Avoidance, Diagnosis and TreatmentW. Wolfgang Fleischhacker1
, Christian Widschwendter1
1Abteilung für Biologische Psychiatrie Universitätsklinik für Psychiatrie Innsbruck, Medizinische Universität Innsbruck
Die Autoren bedanken sich ausdrücklich bei Frau Silvia Brandl, Dr. Albert Putzhammer und Prof. Dr. Göran Hajak, die die Transkription eines von Wort gehaltenen Vortrages erstellt haben.Prof. Fleischhacker hat finanzielle Forschungsunterstützung und Honorare von folgenden Firmen erhalten: Astra Zeneca, Bristol Myers Squibb, Eli Lilly, Janssen, Novartis, Organon, Otsuka, Pfizer, Sanofi-Synthelabo
Akute extrapyramidalmotorische Störungen (EPMS) stellen eine häufige Nebenwirkung bei antipsychotischer Behandlung dar. EPMS führen zu reduzierter Lebensqualität und zu verminderter Compliance der Patienten. Dieser Artikel gibt einen Überblick über die unterschiedlichen Formen von EPMS, stellt die Vermeidung dieser Nebenwirkungen kurz dar, zeigt Diagnose- und Behandlungsprobleme auf, und weist auf die Bedeutung von prophylaktischen Maßnahmen hin. Die Antipsychotika der neueren Generation führen im Vergleich zu klassischen Antipsychotika deutlich seltener zu EPMS, wie zahlreiche Studien zeigen. Dennoch gibt es widersprüchliche Arbeiten zu diesem Thema. Dieser Artikel diskutiert einige dieser Ergebnisse und beleuchtet auch Probleme betreffend die Methodik der Erhebung von Nebenwirkungen.
Abstract
Acute extrapyramidal side-effects (EPS) are a common phenomenon of treatment with antipsychotics. They are associated with a substantial reduction of the patient's quality of life and of compliance with the treatment. This article gives an overview of the different forms of EPS. It outlines strategies to avoid these side-effects and discusses problems in diagnosis and treatment. In comparison to conventional compounds, the clearest advantage of new generation antipsychotics is a reduced risk of the occurrence of extrapyramidal side-effects (EPS). Many studies have found that newer antipsychotics have a lesser propensity to causes EPS. Nevertheless, there are some conflicting results on this topic. This article discusses some of these results and sheds light on methodological problems in the evaluation of side-effects of antipsychotic treatment.
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