Zusammenfassung
Benzodiazepine gehören trotz ihres Abhängigkeitspotenzials zu den am meisten verordneten
Medikamenten. Wir berichten über eine Patientin mit Alprazolamabhängigkeit, die wegen
schwerer Entzugssymptomatik mit Carbamazepin behandelt wurde. Unter dieser Behandlung
traten Leberenzymerhöhungen auf, sodass wir das Antikonvulsivum Gabapentin einsetzten.
Hierunter zeigte sich eine dramatische Besserung der Entzugssymptomatik und der während
des Entzuges aufgetretenen Panikattacken. Wegen ihrer guten Verträglichkeit und Wirksamkeit
könnten neuere Antikonvulsiva wie Gabapentin sowohl als Medikament zum Entzug von
Benzodiazepinen als auch als Alternative zur Benzodiazepinbehandlung bei Panikstörung
in Erwägung gezogen werden.
Abstract
Despite their addictive potential, benzodiazepines belong to the most often prescribed
drugs. We report on a patient with alprazolam dependence, who initially was treated
with carbamazepine because of severe withdrawal symptoms. Due to liver enzyme elevation
related to carbamazepine, we had to stop this treatment and instead of that started
gabapentin treatment. Under this new therapy, the patient showed a dramatic relief
of withdrawal symptoms and of the panic attacks reoccurring during withdrawal. Hence,
due to their effectiveness and tolerability, newer anticonvulsants could be considered
as medication for benzodiazepine withdrawal and as an alternative for benzodiazepine
treatment in panic disorders.
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Dr. med. Hubertus Himmerich
Max-Planck-Institut für Psychiatrie
Kraepelinstraße 10
80804 München
Email: himmerich@mpipsykl.mpg.de