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Erhöhte Mortalität bei Schizophrenie und möglicher Einfluss der antipsychotischen Behandlung

  • Conference paper
Therapie mit Neuroleptika

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Zusammenfassung

Die Mortalitätsrate bei schizophrenen Patienten ist doppelt so hoch wie die der Gesamtbevölkerung. Zu den Ursachen zählen Suizide, Unfälle, Gewalthandlungen, Katatoniefälle, körperliche Erkrankungen und Alkohol- oder Drogenmissbrauch.

Neuroleptika werden im Allgemeinen als sichere Medikamente angesehen. In seltenen Einzelfällen kann es unter der neuroleptischen Behandlung jedoch zu ernsten und möglicherweise tödlichen Komplikationen kommen. Zu den gefährlichen Zwischenfällen bei Neuroleptikatherapie zählen epileptische Krampfanfälle, das maligne neuroleptische Syndrom, Agranulozytose, Herzstillstand, Myokarditis, Atemstillstand, Lungenembolie, Kreislaufkollaps und Hypothermie. Plötzliche, ungeklärte Todesfälle sind ebenfalls mit der neuroleptischen Behandlung in Verbindung gebracht worden. Allerdings scheint deren Inzidenz unter Neuroleptikabehandlung nicht höher zu sein als in der allgemeinen Bevölkerung. Folgende mögliche Ursachen dieser Todesfälle wurden vermutet: Asphyxie durch einen behinderten Schluckreflex, laryngeal-pharyngeale dystonische Spasmen, Herzstillstand aufgrund von Arrhythmie, maligne Hypotonie, epileptische Krampfanfälle oder eine exzessive vagale und adrenerge Stimulation unter Fixierungsmaß-nahmen. Im vorliegenden Artikel werden Vorsichtsmaßnahmen zur Verhinderung letaler Zwischenfälle unter der antipsychotischen Behandlung erläutert.

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Literatur

  1. Allebeck P (1989) Schizophrenia: a life-shortening disease. Schizophr Bull 15: 81–89

    PubMed  CAS  Google Scholar 

  2. Allebeck P, Varla A, Wistedt B (1986) Suicide and violent death among patients with schizophrenia. Acta Psychiatr Scand 74: 43–49

    Article  PubMed  CAS  Google Scholar 

  3. Alvir JM, Lieberman JA (1994) Agranulocytosis: incidence and risk factors. J Clin Psychiatry 55 (Suppl B): 137–138

    PubMed  Google Scholar 

  4. Aunsholt NA (1989) Prolonged Q-T interval and hypokalemia caused by haloperidol. Acta-Psychiatr-Scand 79: 411–412

    Article  PubMed  CAS  Google Scholar 

  5. Bandelow B, Müller P, Gaebel W et al. (1990) Depressive syndromes in schizophrenic patients after discharge from hospital. ANI Study Group Berlin, Dusseldorf, Gottingen, Munich. Eur Arch Psychiatry Clin Neurosci 240: 113–120

    Article  PubMed  CAS  Google Scholar 

  6. Bandelow B, Müller P, Frick U et al. (1992) Depressive syndromes in schizophrenic patients under neuroleptic therapy. ANI Study Group Berlin Düsseldorf Göttingen Munich, Federal Republic of Germany. Eur Arch Psychiatry Clin Neurosci 241: 291–295

    Article  PubMed  CAS  Google Scholar 

  7. Bandelow B, Degner D, Kreusch U, Rüther E (1995) Myocarditis under therapy with clozapine. Schizophr Res 17: 293–294

    Article  PubMed  CAS  Google Scholar 

  8. Bell LV (1849) On a form of disease resembling mania and fever. American Journal of Insanity 6: 97–127

    Google Scholar 

  9. Black DW, Fisher R (1992) Mortality in DSM-IIIR schizophrenia. Schizophr Res 7: 109–116

    Article  PubMed  CAS  Google Scholar 

  10. Black DW, Winokur G (1988) Age, mortality and chronic schizophrenia. Schizophr Res 1: 267–272

    Article  PubMed  CAS  Google Scholar 

  11. Bruce ML, Leaf PJ, Rozal GP, Florio L, Hoff RA (1994) Psychiatric status and 9-year mortality data in the New Haven Epidemiologic Catchment Area Study. Am J Psychiatry 151: 716–721

    PubMed  CAS  Google Scholar 

  12. Buckley NA, Whyte IM, Dawson AH (1995) Cardiotoxicity more common in thioridazine overdose than with other neuroleptics. J Toxicol Clin Toxicol 33: 199–204

    Article  PubMed  CAS  Google Scholar 

  13. Caroff SN (1980) The neuroleptic malignant syndrome. J Clin Psychiatry 41: 79–83

    PubMed  CAS  Google Scholar 

  14. Caroff SN, Mann SC (1993) Neuroleptic malignant syndrome. Med Clin North Am 77: 185–202

    PubMed  CAS  Google Scholar 

  15. Chatterton R, Cardy S, Schramm TM (1996) Neuroleptic malignant syndrome and clozapine monotherapy. Aust N Z J Psychiatry 30: 692–693

    Article  PubMed  CAS  Google Scholar 

  16. Coffey CE, Ross DR (1980) Treatment of lithium/neuroleptic neurotoxicity during lithium maintenance. Am J Psychiatry 137: 736–737

    PubMed  CAS  Google Scholar 

  17. Dalmau A, Bergman B, Brismar B (1997) Somatic morbidity in schizophrenia - a case control study. Public Health 111: 393–397

    PubMed  CAS  Google Scholar 

  18. Davies MJ (1992) Unexplained death in fit young people. Bmj 305: 538–539

    Article  PubMed  CAS  Google Scholar 

  19. Devinsky O, Honigfeld G, Patin J (1991) Clozapine-related seizures. Neurology 41: 369–371

    PubMed  CAS  Google Scholar 

  20. Faigel DO, Metz DC, Kochman ML (1995) Torsade de pointes complicating the treatment of bleeding esophageal varices: association with neuroleptics, vasopressin, and electrolyte imbalance. Am J Gastroenterol 90: 822–824

    PubMed  CAS  Google Scholar 

  21. Flaherty JA, Lahmeyer HW (1978) Laryngeal-pharyngeal dystonia as a possible cause of asphyxia with haloperidol treatment. Am J Psychiatry 135: 1414–1415

    PubMed  CAS  Google Scholar 

  22. Fritze J, Bandelow B (1999) The QT interval and the atypical antipsychotic, sertindole. International Journal of Psychiatry in Clinical Practice 2: 265–273

    Article  Google Scholar 

  23. Gausset MF, Casadebaig F, Guillaud Bataille JM, Quemada N, Terra JL (1992) Mortalité des malades mentaux. Revue de la littérature. Encéphale 18: 93–100

    PubMed  CAS  Google Scholar 

  24. Grohmann R, Rüther E (1994) Neuroleptika. In: Grohmann R, Rüther E, Schmidt LG (Hrsg) Unerwünschte Wirkungen von Psychopharmaka. Springer, Berlin

    Chapter  Google Scholar 

  25. Grohmann R, Rüther E, Sassim N, Schmidt LG (1989) Adverse effects of clozapine. Psychopharmacology Berl 99 (Suppl): 101–104

    Article  Google Scholar 

  26. Gullestad L, Kjekshus J (1992) Plutselig hjertedod. Betydning av betablokkere. Tidsskr Nor Laegeforen 112: 2843–2847

    Google Scholar 

  27. Guy JM, André-Fouet X, Porte J, Bertrand M, Lamaud M, Verneyre H (1991) Torsades de pointes e allongement de la ducrée de l’intervalle QT après injection de droperidol. Ann Cardiol Angeloi 40: 541–545

    CAS  Google Scholar 

  28. Hambrecht M, Hafner H (1996) Substance abuse and the onset of schizophrenia. Biol Psychiatry 40: 1155–1163

    Article  PubMed  CAS  Google Scholar 

  29. Harris EC, Barraclough B (1997) Suicide as an outcome for mental disorders. Br J Psychiatry 170: 205–228

    Article  PubMed  CAS  Google Scholar 

  30. Harry P (1997) Intoxications aiguës par les nouveaux psychotropes. Rev Prat 47: 731–735

    PubMed  CAS  Google Scholar 

  31. Jann MW, Saklad SR, Ereshefsky L, Richards AL, Harrington CA, Davis CM (1986) Effects of smoking on haloperidol and reduced haloperidol plasma concentrations and haloperidol clearance. Psychopharmacol 90: 468–470

    CAS  Google Scholar 

  32. Jensen VE, Gotzsche O (1994) Allergisk myocarditis ved klozapinbehandling. Ugeskr Laeger 156: 4151–4152

    PubMed  CAS  Google Scholar 

  33. Jeste DV, Gladsjo JA, Lindamer LA, Lacro JP (1996) Medical comorbidity in schizophrenia. Schizophr Bull 22: 413–430

    PubMed  CAS  Google Scholar 

  34. Jusic N, Lader M (1994) Post-mortem antipsychotic drug concentrations and unexplained deaths. Br J Psychiatry 165: 787–791

    Article  PubMed  CAS  Google Scholar 

  35. Kannel WB, Doyle JT, McNamara PM, Quickenton P, Gordon T (1975) Precursors of sudden coronary death. Factors related to the incidence of sudden death. Circulation 51: 606–613

    Google Scholar 

  36. König F, Loble M, Wolfersdorf M (1996) Depressiver Stupor, malignes neuroleptisches Syndrom, Serotoninsyndrom. Ein kasuistischer Beitrag zu einer schwierigen Differentialdiagnose. Nervenarzt 67: 407–412

    Google Scholar 

  37. Lawrence KR, Nasraway SA (1997) Conduction disturbances associated with administration of butyrophenone antipsychotics in the critically ill: a review of the literature. Pharmacotherapy 17: 531–537

    PubMed  CAS  Google Scholar 

  38. Leestma JE, Koenig KL (1968) Sudden death and phenothiazines. Arch Gen Psychiatry 18: 137–148

    Article  Google Scholar 

  39. Leestma JE, Annegers JF, Brodie MJ et al. (1997) Sudden unexplained death in epilepsy: observations from a large clinical development program. Epilepsia 38: 47–55

    Article  PubMed  CAS  Google Scholar 

  40. Lesage AD, Trapani V, Tansella M (1990) Excess mortality by natural causes of Italian schizophrenic patients. Eur Arch Psychiatry Neurol Sei 239: 361–365

    Article  CAS  Google Scholar 

  41. Martin TG (1996) Serotonin syndrome. Ann Emerg Med 28: 520–526

    Article  PubMed  CAS  Google Scholar 

  42. Meeker JE, Herrmann PW, Som CW, Reynolds PC (1992) Clozapine tissue concentrations following an apparent suicidal overdose of Clozaril. J Anal Toxicol 16: 54–56

    PubMed  CAS  Google Scholar 

  43. Meterissian GB (1996) Risperidone-induced neuroleptic malignant syndrome: a case report and review. Can J Psychiatry 41: 52–54

    PubMed  CAS  Google Scholar 

  44. Metzger E, Friedman R (1993) Prolongation of the corrected QT and torsades de pointes cardiac arrhythmia associated with intravenous haloperidol in the medically ill. J Clin Psychopharmacol 13: 128–132

    Article  PubMed  CAS  Google Scholar 

  45. Modestin J, Krapf R, Böker W (1983) A fatality during haloperidol treatment: Mechanism of sudden death. Am J Psychiatry 138: 1616–1617

    Google Scholar 

  46. Moen A, Sorheim S, Brun H, Handal M, Helgheim A, Teige B, Wethe G (1992) Dodsfall forarsaket av antidepressiva og neuroleptika. Risikogrupper belyst ved et rettsmedisinsk materiale. Tidsskr Nor Laegeforen 112: 612–615

    Google Scholar 

  47. Mortensen PB, Juel K (1990) Mortality and causes of death in schizophrenic patients in Denmark. Acta Psychiatr Scand 81: 372–377

    Article  PubMed  CAS  Google Scholar 

  48. Mortensen PB, Juel K (1993) Mortality and causes of death in first admitted schizophrenic patients. Br J Psychiatry 163: 183–189

    Article  PubMed  CAS  Google Scholar 

  49. Mueller CE, Frost GL, Elenbaas RM (1983) Haloperidol-overdose-induced torsade de pointes. Drug Intelligence and Clinical Pharmacy 17: 440

    Google Scholar 

  50. Newman SC, Bland RC (1991) Mortality in a cohort of patients with schizophrenia: a record linkage study. Can J Psychiatry 36: 239–245

    PubMed  CAS  Google Scholar 

  51. Peele R, von Loetzen IS (1973) Phenothiazine deaths: a critical review. Am J Psychiatry 130: 306–309

    PubMed  CAS  Google Scholar 

  52. Pisciotta AV (1969) Agranulocytosis induced by certain phenothiazine derivatives. Jama 208: 1862–1868

    Article  PubMed  CAS  Google Scholar 

  53. Risch SC, Groom GP, Janowsky DS (1982) The effects of psychotropic drugs on the cardiovascular system. J Clin Psychiatry 43: 16–31

    PubMed  CAS  Google Scholar 

  54. Royal College of Psychiatrists (1997) The association between antipsychotic drugs and sudden death. Report of the Work Group of The Royal College of Psychiatrists ’ Psycho- pharmacology Sub-Group Council Report CR 57

    Google Scholar 

  55. Saku M, Tokudome S, Ikeda M, et al. (1995) Mortality in psychiatric patients, with a specific focus on cancer mortality associated with schizophrenia. Int J Epidemiol 24: 366–372

    Article  PubMed  CAS  Google Scholar 

  56. Settle EC, Ayd FJ (1983) Haloperidol: a quarter century of experience. J Clin Psychiatry 44: 440–448

    PubMed  CAS  Google Scholar 

  57. Sharma R, Trappler B, Ng YK, Leeman CP (1996) Risperidone-induced neuroleptic malignant syndrome. Ann Pharmacother 30: 775–778

    PubMed  CAS  Google Scholar 

  58. Simpson GM, Davis J, Jefferson JW (1987) Sudden deaths in psychiatric patients: the role of neuroleptic drugs. American Psychiatric Association Task Force Report 27

    Google Scholar 

  59. Simpson JC, Tsuang MT (1996) Mortality among patients with schizophrenia. Schizophr Bull 22: 485–499

    PubMed  CAS  Google Scholar 

  60. Singerman B, Raheja R (1994) Malignant catatonia - a continuing reality. Ann Clin Psychiatry 6: 259–266

    Article  PubMed  CAS  Google Scholar 

  61. Smith J, Hucker S (1994) Schizophrenia and substance abuse. Br J Psychiatry 165: 13–21

    Article  PubMed  CAS  Google Scholar 

  62. Spiess-Kiefer C, Hippius H (1986) Malignes Neuroleptisches Syndrom und Maligne Hyperthermie ein Vergleich. Fortschr Neurol Psychiatr 54: 158–170

    Article  PubMed  CAS  Google Scholar 

  63. Tabbane K, Joober R, Spadone C, Poirier MF, Olie JP (1993) Mortalité et causes de décès dans la schizophrénie. Revue de la littérature. Encéphale 19: 23–28

    Google Scholar 

  64. Toth P, Frankenburg FR (1994) Clozapine and seizures: a review. Can J Psychiatry 39: 236–238

    PubMed  CAS  Google Scholar 

  65. Tracqui A, Mutter Schmidt C, Kintz P, Berton C, Mangin P (1995) Amisulpride poisoning: a report on two cases. Hum Exp Toxicol 14: 294–298

    Article  PubMed  CAS  Google Scholar 

  66. Tsuang MT, Woolson RF (1978) Excess mortality in schizophrenia and affective disorders. Do suicides and accidental deaths solely account for this excess? Arch Gen Psychiatry 35: 1181–1185

    Article  PubMed  CAS  Google Scholar 

  67. Tsuang MT, Woolson RF, Fleming JA (1980) Premature deaths in schizophrenia and affective disorders. An analysis of survival curves and variables affecting the shortened survival. Arch Gen Psychiatry 37: 979–983

    Google Scholar 

  68. Turbott J, Cairns FJ (1984) Sudden death and neuroleptic medication [letter]. Am-J-Psy- chiatry 141: 919–920

    CAS  Google Scholar 

  69. Ungvári G (1980) Neuroleptic-related sudden death (proven or a mere hypothesis?). Pharmakopsychiatr Neuropsychopharmakol 13: 29–33

    PubMed  Google Scholar 

  70. Ungvári G (1985) Sudden cardiac deaths among psychiatric patients receiving neuroleptics. Acta Méd Leg Soc Liège 35: 268–270

    PubMed  Google Scholar 

  71. Walker AM, Lanza LL, Arellano F, Rothman KJ (1997) Mortality in current and former users of clozapine. Epidemiology 8: 671–677

    PubMed  CAS  Google Scholar 

  72. Young DM (1996) Risk factors for hypothermia in psychiatric patients. Ann Clin Psychiatry 8: 93–97

    Article  PubMed  CAS  Google Scholar 

  73. Zaccara G, Muscas GC, Messori A (1990) Clinical features, pathogenesis and management of drug-induced seizures. Drug Saf 5: 109–151

    Article  PubMed  CAS  Google Scholar 

  74. Zee-Cheng CS, Mueller CE, Seifert CF, Gibbs HR (1985) Haloperidol and torsade de pointes. Ann Int Med 102: 418

    PubMed  CAS  Google Scholar 

  75. Ziedonis DM, George TP (1997) Schizophrenia and nicotine use: report of a pilot smoking cessation program and review of neurobiological and clinical issues. Schizophr Bull 23: 247–254

    PubMed  CAS  Google Scholar 

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Authors
  1. B. Bandelow
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  2. E. Rüther
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  1. Klinik und Poliklinik für Psychiatrie und Psychotherapie, Georg-August-Universität Göttingen, von-Siebold-Straße 5, D-37075, Göttingen, Deutschland

    Borwin Bandelow  & Eckart Rüther  & 

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Bandelow, B., Rüther, E. (2000). Erhöhte Mortalität bei Schizophrenie und möglicher Einfluss der antipsychotischen Behandlung. In: Bandelow, B., Rüther, E. (eds) Therapie mit Neuroleptika. Steinkopff. https://doi.org/10.1007/978-3-642-93714-9_10

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  • DOI: https://doi.org/10.1007/978-3-642-93714-9_10

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-7985-1257-3

  • Online ISBN: 978-3-642-93714-9

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