Zusammenfassung
Epidemiologische Studien zeigen, dass bei Alkoholabhängigen eine hohe Lebenszeitprävalenz
für psychiatrische Störungen, insbesondere für Angst-, phobische, depressive und schizophrene
Störungen besteht. Aufgrund der komplexen Zusammenhänge von erhöhtem Alkoholkonsum
und psychischem Befinden kommt es häufig zu diagnostischen Problemen und Schwierigkeiten
bei der Therapieplanung, insbesondere der Indikation zu einer medikamentösen Therapie.
In dieser Übersicht werden die Ergebnisse der Studien über eine medikamentöse Behandlung
von psychiatrischen Störungen bei Alkoholkranken referiert und anhand dieser Daten
Indikationen für eine medikamentöse Therapie erarbeitet. Nur in wenigen Studien konnte
auch ein Effekt auf das Trinkverhalten nachgewiesen werden. Zusammenfassend muss festgestellt
werden, dass die medikamentösen Behandlungsmöglichkeiten für Alkoholkranke mit einer
psychiatrischen Störung bisher nur unzureichend untersucht worden sind. Insbesondere
fehlen Studien über die Behandlungsmöglichkeiten von Schizophrenen mit Alkoholproblemen.
Medical Treatment of Psychiatric Comorbidity in Alcoholics
Purpose: Epidemiological studies show that alcoholics have a high life-time prevalence of
psychiatric illnesses, particularly of anxiety, depressive and schizophrenic disorders.
But the complex relationships between elevated alcohol consumption and psychiatric
symptomatology frequently Iead to problems in finding diagnosis and thereafter in
planning therapeutic strategies. Methods: In this article the results of the studies concerning the medical treatment of psychiatric
comorbidity of alcoholics are critically reviewed. Results: According to the available results a therapy with antidepressive drugs indicated
in alcoholics with depression lasting over 14 days. Anxiety disorders seem to have
little influence on the course of alcoholism. Thus, an anxiolytic medication has to
be considered carefully in view of the addiction potency of tranquilizers. There is
a paucity of data concerning drug treatment of schizophrenics with alcohol abuse.
Thus far only a few studies have shown an effect of a drug treatment of the psychiatric
comorbidity on the drinking behavior. Conclusion: There is a lack of studies on specific treatment strategies of psychiatric comorbid
alcoholics, particularly of schizophrenics with alcohol abuse.
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Prof. Dr. Dipl.-Chem. Tilman Wetterling
Klinik für Psychiatrie und Psychotherapie I der Johann Wolfgang Goethe-Universität
Heinrich-Hoffmann-Straße 10
60528 Frankfurt/Main
Email: wetterling@em.uni-frankfurt.de
