Die Einführung moderner, gut wirksamer und verträglicher Psychopharmaka in den vergangenen
Jahren brachte große Fortschritte in den Therapiemöglichkeiten für die psychischen
Erkrankungen des höheren Lebensalters. Diese Medikamente sind zwar erheblich besser
verträglich als die älteren Psychopharmaka, jedoch nicht völlig neben- und wechselwirkungsfrei.
Im Folgenden werden einige allgemeine Gesichtspunkte der Psychopharmakotherapie im
Alter erörtert und für die wichtigsten Klassen von Psychopharmaka die häufigsten und
gefährlichsten Neben- und Wechselwirkungen dargestellt.
In recent years, psychopharmacotherapy in the elderly has been advanced by the introduction
of newly developed drugs with high effectiveness and good tolerability. However, these
drugs have indeed a much better tolerability than the older psychotropics, but are
not free of side effects and interactions. In this article, general aspects of psychopharmacotherapy
in the elderly will be briefly summarized. Special aspects of the treatment with antidepressants,
antipsychotics, benzodiazepines, phase prophylactics and antidementives will be discussed
in detail and recommendations for treatment will be given.
Key Words
elderly - antidepressant - antipsychotic - benzodiazepine - antidementiva
Literatur
- 1
Adler G, Jajcevic A, Chwalek K, Dieterle D.
Wirksamkeit und Verträglichkeit von Mirtazapin-Lösung bei der Behandlung der Altersdepression.
Psychopharmakotherapie.
2006;
13
24-26
- 2
Alexopoulos GS, Silver J, Kahn D.
Management of the behavioural manifestation of dementia.
Postgrad Med.
1998;
1
1-88
- 3
Deyn PP De, Rabheru K, Rasmussen A. et al. .
A randomized trial of risperidone, placebo, and haloperidol for behavioral symptoms
of dementia.
Neurology.
1999;
53
946-955
- 4
Herrmann N, Bremner KE, Naranjo CA.
Pharmacotherapy of late life mood disorders.
Clin Neurosci.
1997;
4
41-47
- 5
Katona C, Livingston G.
Safety and efficacy of antidepressants in older people.
Europ Neuropsychopharmacol.
2001;
11
144-145
- 6 Lohr JB, Jeste DV, Harns MJ. Treatment of disordered behavior. In: Salzman C (ed).
Clinical geriatric psychopharmacology. Baltimore: Williams & Wilkins 1992: 79-113
- 7
McDonald ET, McDonald JB, Phoenix M.
Improving drug compliance after hospital discharge.
BMJ.
1977;
2
618
- 8
McGleenon BM, Dynan KB, Passmore AP.
Acetylcholinesterase inhibitors in Alzheimer's disease.
J Clin Pharmacol.
1999;
48
471-480
- 9
Nair NP, Amin M, Holm P. et al. .
Moclobemide and nortriptyline in elderly depressed patients. A randomized, multicentre
trial against placebo.
J Affect Disord.
1995;
33
1-9
- 10
Pollock BG.
Adverse reactions of antidepressants in elderly patients.
J Clin Psychiatry.
1999;
60
4-8
- 11
Preskorn SH.
Recent pharmacologic advances in antidepressant therapy for the elderly.
Am J Med.
1993;
94
2-12
- 12
Ray WA, Griffin MR, Schaffner W. et al. .
Psychotropic drug use and the risk of hip fracture.
N Engl J Med.
1987;
316
363-369
- 13
Ray WA, Griffin MR, Downey W.
Benzodiazepines of long and short elimination half-life and the risk of hip fracture.
J Am Med Assoc.
1989;
262
3303-3307
- 14
Stoudemire A, Hill CD, Lewison BJ. et al. .
Lithium intolerance in a medical-psychiatric population.
Gen Hosp Psychiat.
1998;
20
85-90
- 15
Volz HP, Möller HJ.
Antidepressant drug therapy in the elderly - a critical review of the controlled trials
conducted since 1980.
Pharmacopsychiatry.
1994;
27
93-100
Korrespondenzadresse:
Prof. Georg Adler
Institut für Studien zur Psychischen Gesundheit (ISPG)
Friedrichsplatz 12
68165 Mannheim
Email: www.ispg-mannheim.de
