Pharmakotherapie der Kleptomanie - Literaturübersicht

Zusammenfassung

Die Kleptomanie wird entsprechend weit verbreiteter Klassifikationssysteme wie ICD-10 und DSM-IV zu den Impulskontrollstörungen gerechnet. Insbesondere unter Berücksichtigung der Komorbidität ergibt sich, dass die Kleptomanie zum Spektrum zwanghafter Störungen (obsessive-compulsive disorder-spectrum) und zum umfassenderen Spektrum affektiver Störungen assoziiert ist. Daraus leitet sich dann eine psychopharmakologische Interventionsmöglichkeit mit Antidepressiva oder stimmungsstabilisierenden Medikamenten ab, für welche keine Ergebnisse von Therapiestudien vorliegen, über deren erfolgreichen Einsatz jedoch kasuistische Mitteilungen gegeben wurden. Unter der Voraussetzung einer gestörten zentralen Serotonintransmission scheint sich dabei insbesondere der Einsatz von Serotoninwiederaufnahmehemmer (SSRI) zu bewähren. Eine Therapiealternative scheint jedoch in der Anwendung von Naltrexon zu bestehen.

Abstract

According to most diagnostic manuals such as ICD-10 and DSM-IV, kleptomania is classified as an impulse-control disorder. With regard to comorbidity, kleptomania is related to the obsessive- compulsive disorder spectrum and to the broarder spectrum of affective disorders. Accordingly a psychopharmalogical intervention with anti-depressant drugs or mood stabilizers may be possible, even though there are to date no known results from controlled therapy studies. Nevertheless the successful administration of such medication has been reported in several cases. Assuming a disturbed central serotonin reuptake, the use of selective serotonin reuptake inhibitors (SSRI) seems to be indicated. But also naltrexone could be of use in kleptomania.

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