Optimierung der pharmakologischen Langzeitbehandlung ersterkrankter schizophrener Patienten

Zusammenfassung

In den letzten Jahrzehnten sind eine Reihe bio-psycho-sozialer Behandlungsstrategien entstanden, die eine effektive Langzeitbehandlung von Patienten mit schizophrenen Störungen ermöglichen und die es durch weitere Forschung zu optimieren gilt. Eine multizentrische Verbundstudie im Rahmen des Kompetenznetzes Schizophrenie versucht dies speziell für schizophrene Erstmanifestationen, indem u.a. zwei Hauptfragestellungen untersucht werden: Gibt es Unterschiede in der Rezidivrate a) der postakuten einjährigen Erhaltungsmedikation mit einem niedrigdosierten typischem vs. atypischen Neuroleptikum und b) anschließendem Fortführen vs. Absetzen der neuroleptischen Medikation, jeweils ergänzt durch prodromgestützte Frühintervention. Erste Ergebnisse der noch laufenden Studie sprechen für eine rezidivprophylaktische Effektivität beider Neuroleptika bei einer hohen Abbruchquote. Entsprechend gilt es spezielle Programme zu entwickeln, um (ersterkrankte) schizophrene Patienten in der effektiven Behandlung zu halten.

Summary

Over the last decades, a set of effective bio-psycho-social long-term treatment strategies for schizophrenia have been developed. In the scope of the German Research Network on Schizophrenia, a multicenter study is currently under way, to optimize long-term treatment in first episode patients by testing two main hypotheses: are there differences in relapse rates regarding a) one year maintenance treatment with low-dose typical vs. atypical neuroleptic treatment and b) afterwards further maintenance treatment vs. drug discontinuation, both supplemented by prodrome based early intervention. First results of the ongoing study suggest a relapse preventing efficacy for both neuroleptics, whereas treatment non-adherence is quite often. Accordingly, special programs need to be developed to enhance treatment adherence.

Key words

First episode schizophrenia - long-term treatment - typical and atypical neuroleptics - maintenance treatment - intermittent treatment

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