Medikamentös-induzierte psychiatrische Nebenwirkungen

Gesunde psychische Funktionen beruhen wesentlich auf ungestörten synaptischen Prozessen im Gehirn. Medikamente, die potenziell die Synapsenbildung, den Neurotransmitterstoffwechsel oder Aktionspotenziale beeinflussen können, tragen ein Risiko, zu psychiatrischen Störungen zu führen. Insbesondere Liganden von Neurotransmitterrezeptoren sowie Hormone haben ein hohes psychiatrisches Nebenwirkungspotenzial.

Kernaussagen

• Psychiatrische Nebenwirkungen von Medikamenten können ein buntes Erscheinungsbild annehmen.

• Der Zusammenhang zwischen Medikamenteneinnahme und psychiatrischen Syndromen ist leicht bei akut auftretenden halluzinatorischen, deliranten oder serotonergen Syndromen innerhalb von Stunden bis Tagen nach Einnahmebeginn zu stellen.

• Bei sich langsamer entwickelnden depressiven Syndromen ist die Befundlage oft nicht so eindeutig.

• Der wichtigste Punkt ist allerdings, bereits bei der Erfassung des vorlaufenden Medikationsverlaufs auch an das Auftreten psychiatrischer Nebenwirkung von Medikamenten aus nichtpsychiatrischen Indikationsgruppen zu denken.

Schlüsselwörter

Neurotransmitter - Betablocker - Antihypertensiva - Antiarrhythmika - Hormone - Antiepileptika - Wirkstoffklassen - Blut-Hirn-Schranke - ZNS

Publication History

Article published online:
17 May 2022

• Literatur

• 1 Gil-Martins E, Barbosa DJ, Silva V. et al. Dysfunction of ABC transporters at the blood-brain barrier: Role in neurological disorders. Pharmacol Ther 2020; 213: 107554 DOI: 10.1016/j.pharmthera.2020.107554. (PMID: 32320731)
• 2 Näslund J, Hieronymus F, Lisinski A. et al. Effects of selective serotonin reuptake inhibitors on rating-scale-assessed suicidality in adults with depression. Br J Psychiatry 2018; 212: 148-154 DOI: 10.1192/bjp.2017.24. (PMID: 29436321)
• 3 Hengartner MP, Amendola S, Kaminski JA. et al. Suicide risk with selective serotonin reuptake inhibitors and other new-generation antidepressants in adults: a systematic review and meta-analysis of observational studies. J Epidemiol Community Health 2021; DOI: 10.1136/jech-2020-214611.
• 4 Schildkraut JJ. The catecholamine hypothesis of affective disorders: a review of supporting evidence. Am J Psychiatry 1965; 122: 509 DOI: 10.1176/ajp.122.5.509. (PMID: 5319766)
• 5 Riemer TG, Villagomez Fuentes LE, Algharably EAE. et al. Do β-blockers cause depression? Systematic review and meta-analysis of psychiatric adverse events during β-blocker therapy. Hypertension 2021; 77: 1539-1548 DOI: 10.1161/HYPERTENSIONAHA.120.16590. (PMID: 33719510)
• 6 Baumeister AA, Hawkins MF, Uzelac SM. The myth of reserpine-induced depression: role in the historical development of the monoamine hypothesis. J Hist Neurosci 2003; 12: 207-220 DOI: 10.1076/jhin.12.2.207.15535. (PMID: 12953623)
• 7 Zhu GH, Sun XP, Li J. et al. No association between low-dose reserpine use and depression in older hypertensive patient: result of a multicenter, cross-sectional study. J Geriatr Cardiol 2019; 16: 608-613 DOI: 10.11909/j.issn.1671-5411.2019.08.001. (PMID: 31555328)
• 8 Wiciński M, Malinowski B, Puk O. et al. Methyldopa as an inductor of postpartum depression and maternal blues: A review. Biomed Pharmacother 2020; 127: 110196 DOI: 10.1016/j.biopha.2020.110196. (PMID: 32413670)
• 9 Huffman JC, Stern TA. Neuropsychiatric consequences of cardiovascular medications. Dialogues Clin Neurosci 2007; 9: 29-45 (PMID: 17506224)
• 10 Celano CM, Freudenreich O, Fernandez-Robles C. et al. Depressogenic effects of medications: a review. Dialogues Clin Neurosci 2011; 13: 109-125 (PMID: 21485751)
• 11 Kenna HA, Poon AW, de los Angeles CP. et al. Psychiatric complications of treatment with corticosteroids: review with case report. Psychiatry Clin Neurosci 2011; 65: 549-560 DOI: 10.1111/j.1440-1819.2011.02260.x. (PMID: 22003987)
• 12 Gable M, Depry D. Sustained corticosteroid- induced mania and psychosis despite cessation: A case study and brief literature review. Int J Psychiatry 2015; 50: 398-404 DOI: 10.1177/0091217415612735. (PMID: 26644319)
• 13 Khoodoruth MAS, Khan AA. Anabolic steroids-induced delirium: A case report. Medicine (Baltimore) 2020; 14: 99 DOI: 10.1097/MD.0000000000021639. (PMID: 32872027)
• 14 Patten SB, Barbui C. Drug-induced depression: a systematic review to inform clinical practice. Psychother Psychosom 2004; 73: 207-215 DOI: 10.1159/000077739. (PMID: 15184715)
• 15 Bremner JD, Shearer KD, McCaffery PJ. Retinoic acid and affective disorders: the evidence for an association. J Clin Psychiatry 2012; 73: 37-50 DOI: 10.4088/JCP.10r05993. (PMID: 21903028)
• 16 Machado MO, Oriolo G, Bortolato B. et al. Biological mechanisms of depression following treatment with interferon for chronic hepatitis C: A critical systematic review. J Affect Disord 2017; 209: 235-245 DOI: 10.1016/j.jad.2016.11.039. (PMID: 27936453)
• 17 Schaefer M, Sarkar R, Knop V. et al. Escitalopram for the prevention of peginterferon-α2a-associated depression in hepatitis C virus-infected patients without previous psychiatric disease: a randomized trial. Ann Intern Med 2012; 157: 94-103 DOI: 10.7326/0003-4819-157-2-201207170-00006. (PMID: 22801672)
• 18 Walker LG, Walker MB, Heys SD. et al. The psychological and psychiatric effects of rIL-2 therapy: a controlled clinical trial. Psychooncology 1997; 6: 290-301 (PMID: 9451748)
• 19 Musselman D, Royster EB, Wang M. et al. The impact of escitalopram on IL-2-induced neuroendocrine, immune, and behavioral changes in patients with malignant melanoma: preliminary findings. Neuropsychopharmacology 2013; 38: 1921-1928 DOI: 10.1038/npp.2013.85. (PMID: 23575741)
• 20 Minnema LA, Giezen TJ, Souverein PC. et al. Exploring the association between monoclonal antibodies and depression and suicidal ideation and behavior: A VigiBase Study. Drug Saf 2019; 42: 887-895 DOI: 10.1007/s40264-018-00789-9. (PMID: 30617497)
• 21 https://www.pei.de/DE/newsroom/veroffentlichungen-arzneimittel/sicherheitsinformationen-human/2019/ablage2019/2019-03-28-rhb-benlysta-belimumab.html;jsessionid=51C753EFF3A24F3841342629DC1C172A.intranet211
• 22 Lebwohl M, Leonardi C, Armstrong A. et al. Three-year U.S. pharmacovigilance report of brodalumab. Dermatol Ther 2021; e15105 DOI: 10.1111/dth.15105. (PMID: 34418244)
• 23 Chen B, Choi H, Hirsch LJ. et al. Psychiatric and behavioral side effects of antiepileptic drugs in adults with epilepsy. Epilepsy Behav 2017; 76: 24-31 DOI: 10.1016/j.yebeh.2017.08.039. (PMID: 28931473)
• 24 Hansen CC, Ljung H, Brodtkorb E. et al. Mechanisms underlying aggressive behavior induced by antiepileptic drugs: Focus on topiramate, levetiracetam, and perampanel. Behav Neurol 2018; 2018: 2064027 DOI: 10.1155/2018/2064027. (PMID: 30581496)
• 25 Warstler A, Bean J. Antimicrobial-induced cognitive side effects. Ment Health Clin 2016; 6: 207-214 DOI: 10.9740/mhc.2016.07.207. (PMID: 29955472)
• 26 Gomes J, Durães D, Sousa A. et al. Isoniazid-induced acute psychosis in a patient with pleural tuberculosis. Case Rep Psychiatry 2019; 2019: 4272941 DOI: 10.1155/2019/4272941. (PMID: 30906613)
• 27 Nagano H, Miura T, Ueda T. Mania induced by isoniazid preventive therapy during steroid treatment for rheumatoid arthritis and organising pneumonia. BMJ Case Rep 2019; 12: e231919 DOI: 10.1136/bcr-2019-231919. (PMID: 31678927)
• 28 Odeh M, Kogan Y, Paz A. et al. Delirium induced by levofloxacin. J Clin Neurosci 2019; 66: 262-264 DOI: 10.1016/j.jocn.2019.05.055. (PMID: 31178301)
• 29 Bangert MK, Hasbun R. Neurological and psychiatric adverse effects of antimicrobials. CNS Drugs 2019; 33: 727-753 DOI: 10.1007/s40263-019-00649-9. (PMID: 31321707)
• 30 Doyno C, Sobieraj DM, Baker WL. Toxicity of chloroquine and hydroxychloroquine following therapeutic use or overdose. Clin Toxicol 2021; 59: 12-23 DOI: 10.1080/15563650.2020.1817479. (PMID: 32960100)
• 31 Allegra A, Innao V, Basile G. et al. Post-chemotherapy cognitive impairment in hematological patients: current understanding of chemobrain in hematology. Expert Rev Hematol 2020; 13: 393-404 DOI: 10.1080/17474086.2020.1738213. (PMID: 32129131)
• 32 Eide S, Feng ZP. Doxorubicin chemotherapy-induced “chemo-brain”: Meta-analysis. Eur J Pharmacol 2020; 881: 173078 DOI: 10.1016/j.ejphar.2020.173078. (PMID: 32505665)
• 33 Grall-Bronnec M, Victorri-Vigneau C, Donnio Y. et al. Dopamine agonists and impulse control disorders: A complex association. Drug Saf 2018; 41: 19-75 DOI: 10.1007/s40264-017-0590-6. (PMID: 28861870)
• 34 Kiesel EK, Hopf YM, Drey M. An anticholinergic burden score for German prescribers: score development. BMC Geriatrics 2018; DOI: 10.1186/s12877-018-0929-6.
• 35 Dunkley EJ, Isbister GK, Sibbritt D. et al. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. QJM 2003; 96: 635-642 DOI: 10.1093/qjmed/hcg109. (PMID: 12925718)
• 36 Francescangeli J, Karamchandani K, Powell M. et al. The Serotonin syndrome: from molecular mechanisms to clinical practice. Int J Molecular Sci 2019; 20: 2288 DOI: 10.3390/ijms20092288.