Extrapyramidale Nebenwirkungen bei neuroleptischer Therapie

  • J. Tegeler
Conference paper

Zusammenfassung

Der Nutzen einer neuroleptischen Therapie kann in erster Linie durch extrapyramidale Nebenwirkungen eingeschränkt werden, da diese das subjektive Erleben der Patienten beeinträchtigen können, häufig zu einem vorzeitigen Abbruch der Behandlung führen und therapeutisch nicht immer günstig zu beeinflussen sind. Im folgenden soll auf einige kontrovers diskutierte Aspekte extrapyramidaler Nebenwirkungen ausführlicher eingegangen werden, und es sollen Befunde eigener klinisch-experimenteller Studien vorgestellt werden.

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Literatur

  1. Adler L, Angrist E, Peselow E, Corvin J, Maslansky R, Rotrosen J (1986) A controlled assessment of propranolol in the treatment of neuroleptic-induced akathisia. Br J Psychiatry 149:42–45PubMedCrossRefGoogle Scholar
  2. Ayd FJ (1983) Early-onset neuroleptic-induced extrapyramidal reactions: a second survey 1961–1981. In: Coyle JT, Enna SJ (eds) Neuroleptics: neurochemical, behavioral and clinical perspectives. Raven, New YorkGoogle Scholar
  3. Baldessarini RJ, Davis JM (1980) What is the best maintenance dose of neuroleptics in schizophrenia? Psychiatry Res 3:115–122PubMedCrossRefGoogle Scholar
  4. Barnes TRE (1989) A rating scale for drug-induced akathisia. Br J Psychiatry 154:672–676PubMedCrossRefGoogle Scholar
  5. Barnes TRE, Braude WM (1985) Akathisia variants and tardive dyskinesia. Arch Gen Psychiatry 42:874–878PubMedCrossRefGoogle Scholar
  6. Barnes TRE, Kidger T, Gore SM (1983) Tardive dyskinesia: a 3-year follow-up study. Psychol Med 13:71–81PubMedCrossRefGoogle Scholar
  7. Branchey MC, Branchey LB, Richardson MA (1981) Effects of neuroleptic adjustment on clinical condition and tardive dyskinesia in schizophrenic patients. Am J Psychiatry 138:608–612PubMedGoogle Scholar
  8. Braude WM, Barnes TRE (1983) Late-onset akathisia — an indicant of covert dyskinesia: two case reports. Am J Psychiatry 140:611–612PubMedGoogle Scholar
  9. Braude WM, Barnes TRE, Gore SM (1983) Clinical characteristics of akathisia. A systematic investigation of acute psychiatric inpatient admissions. Br J Psychiatry 143:139–150PubMedCrossRefGoogle Scholar
  10. Casey DE (1985) Spontaneous and tardive dyskinesia: clinical and laboratory studies. J Clin Psychiatry 46:42–47PubMedGoogle Scholar
  11. Casey DE, Keepers GA (1988) Neuroleptic side effects: acute extrapyramidal syndromes and tardive dyskinesia. In: Casey DE, Christensen AV, Gerlach J (eds) Psychopharmacology: current trends. Psychopharmacology, series 5. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  12. Casey DE, Povlsen UJ, Meidahl B, Gerlach J (1986) Neuroleptic-induced tardive dyskinesia and parkinsonism: changes during several years of continuing treatment. Psychopharmacol Bull 22:250–253PubMedGoogle Scholar
  13. Chouinard G, Annable L, Ross-Chouinard A, Nostores JN (1979) Factors related to tardive dyskinesia. Am J Psychiatry 136:79–83PubMedGoogle Scholar
  14. Csernansky JG, Grabowski K, Cervantes J, Kaplan J, Yesavage JA (1981) Fluphenazine decanoate and tardive dyskinesia: a possible association. Am J Psychiatry 138:1362–1365PubMedGoogle Scholar
  15. Davis JM, Schaffer CM, Killian GA, Kinard C, Chan C (1980) Important issues in the drug treatment of schizophrenia. Schizophr Bull 6:70–87PubMedGoogle Scholar
  16. Dencker SJ (1984) The risk/benefit ratio of depot neuroleptics: a Scandinavian perspective. J Clin Psychiatry 45:22–27PubMedGoogle Scholar
  17. Drake RE, Ehrlich J (1985) Suicide attempts associated with akathisia. Am J Psychiatry 142:499–501PubMedGoogle Scholar
  18. Fleischhacker WW, Miller CH, Bergmann KJ (1989 a) Die neuroleptikainduzierte Akathisie. Nervenarzt 60:719–723PubMedGoogle Scholar
  19. Fleischhacker WW, Bergmann KJ, Perovich R, Pestreich LK, Borenstein M, Lieberman JA, Kane JM (1989 b) The Hillside Akathisia Scale: a new rating instrument for neuroleptic-induced akathisia. Psychopharmacol Bull 25:222–226PubMedGoogle Scholar
  20. Gelenberg AJ (1976) Computerized tomography in patients with tardive dyskinesia. Am J Psychiatry 133:578–579PubMedGoogle Scholar
  21. Gelenberg AJ, Doller JC, Schooler NR, Mieske M, Severe J, Mandel MR (1979) Acute extrapyramidal reactions with fluphenazine hydrochloride and fluphenazine decanoate. Am J Psychiatry 136:217–219PubMedGoogle Scholar
  22. Gibb WRG, Lees AJ (1986) The clinical phenomenon of akathisia. J Neurol Neurosurg Psychiatry 49:861–866PubMedCrossRefGoogle Scholar
  23. Gibson AC (1981) Incidence of tardive dyskinesia in patients receiving depot neuroleptic injection. Acta Psychiatr Scand [Suppl] 291:111–114CrossRefGoogle Scholar
  24. Glazer WM (1984) Depot fluphenazine: risk/benefit ratio. J Clin Psychiatry 45:28–35 (5 Sec 2)PubMedGoogle Scholar
  25. Goldberg SC, Shenoy RS, Julius D, Hamer RM, Ross B, Minton T, Spiro M (1982) Do long-acting injectable neuroleptics protect against tardive dyskinesia? Psychopharmacol Bull 18:177–179PubMedGoogle Scholar
  26. Greil W, Haag H, Rossnagl G, Rüther E (1984) Effect of anticholinergics on tardive dyskinesia. Br J Psychiatry 145:304–310PubMedCrossRefGoogle Scholar
  27. Haag H, Greil W, Rüther E (1987) Zusammenhang zwischen Spätdyskinesie und verschiedenen Variablen der neuroleptischen Behandlung. In: Heinrich K, Klieser E (Hrsg) Probleme der neuroleptischen Dosierung. Schattauer, Stuttgart New YorkGoogle Scholar
  28. Heinrich K (1988) Nebenwirkungsgeleitete Pharmakotherapie in der Psychiatrie. MMW 130:699–700Google Scholar
  29. Heinrich K, Lehmann E (1988) Fundamentals and results of controlled studies in neurolept-anxiolysis. Eur J Psychiatry 2:96–102Google Scholar
  30. Heinrich K, Wegener I, Bender HJ (1968) Späte extrapyramidale Hyperkinesen bei neuroleptischer Langzeittherapie. Pharmacopsychiatry 1:169–195CrossRefGoogle Scholar
  31. Heinrich K, Tegeler J, Wöller W, Quadbeck H, Arendt G, Klieser E, Lange H, Lehmann E (1985) GABA-ergic treatment of tardive dyskinesia. In: Pichot P, Berger P, Wolf R, Thau K (eds) Psychiatry. The state of art, vol 2. Higher nervous activity. Plenum Press, New York LondonGoogle Scholar
  32. Hermesh H, Shalev A, Munitz H (1985) Contribution of adverse drug reaction to admission rates in an acute psychiatric ward. Acta Psychiatr Scand 72:104–110PubMedCrossRefGoogle Scholar
  33. Hogarty GE (1984) Depot neuroleptics: the relevance of psychosocial factors. J Clin Psychiatry 45:34–42Google Scholar
  34. Hogarty GE, Schooler NR, Ulrich R, Mussare F, Ferro P, Herron E (1979) Fluphenazine and social therapy in the aftercare of schizophrenic patients. Relapse analyses of a two-year controlled study of fluphenazine decanoate and fluphenazine hydrochloride. Arch Gen Psychiatry 36:1283–1294PubMedCrossRefGoogle Scholar
  35. Jeste DV, Wyatt RJ (1981) Changing epidemiology of tardive dyskinesia: an overview. Am J Psychiatry 138:297–309PubMedCrossRefGoogle Scholar
  36. Jeste DV, Wyatt RJ (1982) Therapeutic strategies against tardive dyskinesia. Guilford, New YorkGoogle Scholar
  37. Jeste DV, Potkin SG, Sindha S, Feder S, Wyatt RJ (1979) Tardive dyskinesia: reversible and persistent. Arch Gen Psychiatry 36:585–590PubMedCrossRefGoogle Scholar
  38. Jeste DV, Wagner RL, Weinberger DR, Rieth KJ, Wyatt RJ (1980) Evaluation of CT scans in tardive dyskinesia. Am J Psychiatry 137:247–249PubMedGoogle Scholar
  39. Jeste DV, Karson CN, Lager AC, Bigelow LB, Wyatt RJ (1984) Association of abnormal involuntary movements and negative symptoms. Psychopharmacol Bull 20:380–381PubMedGoogle Scholar
  40. Jeste DV, Lohr JB, Clark K, Wyatt RJ (1988) Pharmacological treatments of tardive dyskinesia. J Clin Psychopharmacol 8:38–48CrossRefGoogle Scholar
  41. Johnson DAW (1984) Observations on the use of long-acting depot neuroleptic injections in the maintenance therapy of schizophrenia. J Clin Psychiatry 5:13–21Google Scholar
  42. Johnson DAW, Ludlow JM, Street K, Taylor RDW (1987) Double-blind comparison of half-dose and standard-dose flupenthixol decanoate in the maintenance treatment of stabilised outpatients with schizophrenia. Br J Psychiatry 151:634–638PubMedCrossRefGoogle Scholar
  43. Kane JM (1985) Antipsychotic drug side effects: their relationship to dose. J Clin Psychiatry 46:16–21PubMedGoogle Scholar
  44. Kane JM, Smith JM (1982) Tardive dyskinesia prevalence and risk factors, 1959 to 1979. Arch Gen Psychiatry 39:473–481PubMedCrossRefGoogle Scholar
  45. Kane JM, Woerner M, Weinhold P, Wegner J, Kinon B (1984) Incidence of tardive dyskinesia: five-year data from a prospective study. Psychopharmacol Bull 20:39–40PubMedGoogle Scholar
  46. Kane JM, Woerner M, Sarantakos S (1986) Depot neuroleptics: a comparative review of standard, intermediate, and low-dose regimens. J Clin Psychiatry 47:30–33PubMedGoogle Scholar
  47. Kane JM, Woerner M, Borenstein M, Wegner J, Lieberman J (1986) Integrating incidence and prevalence of tardive dyskinesia. Psychopharmacol Bull 22:254–258PubMedGoogle Scholar
  48. Kane JM, Woerner M, Lieberman J (1988) Tardive dyskinesia: prevalence, incidence, and risk factors. J Clin Psychopharmacol 8:52–56CrossRefGoogle Scholar
  49. Keepers GA, Clappison VJ, Casey DE (1983) Initial anticholinergic prophylaxis for neuroleptic-induced extrapyramidal syndromes. Arch Gen Psychiatry 40:1113–1117PubMedCrossRefGoogle Scholar
  50. Lehmann E (1987) Neuroleptanxiolyse: Neuroleptika in Tranquilizerindikation. In: Pichot P, Möller HJ (Hrsg) Neuroleptika-Rückschau 1952–1986. Springer, Berlin Heidelberg New York Tokyo, S 111–118Google Scholar
  51. Lehmann E, Quadbeck H, Tegeler J, Fararuni M, Heinrich K (1980) Wirkungsdifferenzen bei Hoch- und Standarddosierung von Fluphenazin-Decanoat in Abhängigkeit von Patienten-Merkmalen. Pharmacopsychiatry 13:117–120CrossRefGoogle Scholar
  52. Manos N, Lavrentiadis G, Gkiouzepas J (1986) Evaluation of the need for prophylactic antiparkinsonian medication in psychotic patients treated with neuroleptics. J Clin Psychiatry 47:114–116PubMedGoogle Scholar
  53. Marder SR, van Putten T, Mintz J, Lebell M, McKenzie J, May PRA (1987) Low- and conventional-dose maintenance therapy with fluphenazine decanoate. Two-year outcome. Arch Gen Psychiatry 44:518–521PubMedCrossRefGoogle Scholar
  54. Marsden CD (1985) Is tardive dyskinesia a unique disorder? In: Casey DE, Chase TN, Christensen AV, Gerlach J (eds) Dyskinesia research and treatment. Psychopharmacology [Suppl 2] Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  55. Morselli PL, Fournier V, Bossi L, Musch B (1985) Clinical activity of GABA agonists in neuroleptic- and L-dopa-induced dyskinesia. In: Casey DE, Chase TH, Christensen AV, Gerlach J (eds) Dyskinesia. Research and treatment. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  56. Munetz MR, Cornes CL (1982) Akathisia, pseudoakathisia and tardive dyskinesia: clinical examples. Compr Psychiatry 23:345–348PubMedCrossRefGoogle Scholar
  57. Owens DGC, Johnstone EC, Crow DJ, Frith CD, Jagon JR, Kreel L (1985) Lateral ventricular size in schizophrenia: relationship to the disease process and its clinical manifestations. Psychol Med 15:27–41PubMedCrossRefGoogle Scholar
  58. Pach J (1989) Tardive Dyskinesien nach Tranquilizerbehandlung mit einem niedrig dosierten Depot-Neuroleptikum (Fluspirilen 1,5 mg). Psycho 15:681–686Google Scholar
  59. Van Putten T, Marder SR (1986) Toward a more reliable diagnosis of akathisia. Arch Gen Psychiatry 43:1015–1016PubMedCrossRefGoogle Scholar
  60. Van Putten T, May PRA, Marder SR (1984) Akathisia with haloperidol and thiothixene. Psychopharmacol Bull 20:114–116PubMedGoogle Scholar
  61. Robinson ADT, McCreadie RG (1986) The nithsdale schizophrenia survey. V. Follow-up of tardive dyskinesia at 3 ½ years. Br J Psychiatry 149:621–623PubMedCrossRefGoogle Scholar
  62. Rüther E, Haag M, von Oefele K, Keppler E, Haag H (1987) Späte extrapyramidale Hyperkinesen (Spätdyskinesien): Risiko der Neurolepsie? In: Pichot P, Möller HJ (Hrsg) Neuroleptika, Rückschau 1952–1986. Künftige Entwicklungen. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  63. Schmidt LG (1989) Utilization and safety of fluspirilene in non-psychotic outpatients. Pharmacopsychiatry 22:188–191PubMedCrossRefGoogle Scholar
  64. Schmidt LG, Langscheid-Schmidt K (1987) Neuroleptika-bedingte Aufnahmen in einer psychiatrischen Universitätsklinik. Nervenarzt 58:379–382PubMedGoogle Scholar
  65. Siris SG (1985) Three cases of akathisia and „acting out“. J Clin Psychiatry 46:395–397PubMedGoogle Scholar
  66. Sovner R, DiMascio A (1978) Extrapyramidal syndromes and other neurological side effects of psychotropic drugs. In: Lipton MA, DiMascio A, Killam KF (eds) Psychopharmacology: a generation of progress. Raven, New YorkGoogle Scholar
  67. Struve FA, Willner AE (1983) Cognitive dysfunction and tardive dyskinesia. Br J Psychiatry 143:597–600PubMedCrossRefGoogle Scholar
  68. Tamminga CA, Gerlach J (1987) New neuroleptics and experimental antipsychotics in schizophrenia. In: Meltzer HY (ed) Psychopharmacology the third generation of progress. Raven, New YorkGoogle Scholar
  69. Tegeler J (1986) Depot-Neuroleptika und späte extrapyramidale Hyperkinesen. In: Heinrich K, Sieberns S (Hrsg) Internationales Fluanxol-Depot-Symposium, Das Ärztliche Gespräch 40. pmi, FrankfurtGoogle Scholar
  70. Tegeler J (1989) Klinik der Spätdyskinesien. In: Hippius H, Rüther E, Schmauss M (Hrsg) Katatone und dyskinetische Syndrome. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  71. Tegeler J, Wöller W (1983) Therapeutische Maßnahmen bei späten extrapyramidalen Hyperkinesen. Fortschr Neurol Psychiatr 51:203–226PubMedCrossRefGoogle Scholar
  72. Tegeler J, Wöller W (1986) Klinik und Therapie später extrapyramidaler Hyperkinesen. In: Laux G, Reimer F (Hrsg) Klinische Psychiatrie, Bd 2. Hippokrates, StuttgartGoogle Scholar
  73. Tegeler J, Klieser K (1988) Neue Neuroleptika zur Behandlung schizophrener Erkrankungen. MMW 130:567–571Google Scholar
  74. Tegeler J, Lehmann E, Quadbeck H, Klieser E, Wöller W (1982) Experimenteller Vergleich niedriger und hoher Haloperidol-Dosen in der Behandlung akut schizophrener Patienten. Arzneimittelforschung 32:887–888Google Scholar
  75. Tegeler J, Bogerts B, Wurthmann C (1988) CT-Untersuchungen an schizophrenen Patienten mit späten Hyperkinesen. In: Beckmann H, Laux D (Hrsg) Biologische Psychiatrie. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  76. Tegeler J, Strauss WH, Lüthcke H, Bertling R (1988) Cognitive functions in schizophrenic patients with tardive dyskinesia. Pharmacopsychiatry 21:308–309PubMedCrossRefGoogle Scholar
  77. Tegeler J, Lehmann E, Weiher A, Heinrich K (1989) Tolerability of long-term treatment with fluspirilene 1.5 mg per week. Pharmacopsychiatry 22:218Google Scholar
  78. Tegeler J, Lehmann E, Heinrich K (1990) Neuroleptanxiolyse. Fluspirilen in niedriger Dosierung. MMW 132Google Scholar
  79. Toenniessen LM, Casey DE, McFarland BH (1985) Tardive dyskinesia in the aged. Arch Gen Psychiatry 42:278–284PubMedCrossRefGoogle Scholar
  80. Waddington JL, Youssef HA, Molloy AG, OBoyle KM, Pugh MT (1985) Association of intellectual impairment, negative symptoms, and aging with tardive dyskinesia: clinical and animal studies. J Clin Psychiatry 46:29–33PubMedGoogle Scholar
  81. Wegner JT, Kane JM, Weinhold P, Woerner M, Kinon B, Liebermann J (1985) Cognitive impairment in tardive dyskinesia. Psychiatr Res 16:331–337CrossRefGoogle Scholar
  82. Williams AO, Reveley MA, Kolakowska T, Ardern M, Mandelbrote BM (1985) Schizophrenia with good and poor outcome 2: cerebral ventricular size and its clinical significance. Br J Psychiatry 146:239–246PubMedCrossRefGoogle Scholar
  83. Wöller W, Tegeler J (1983) Späte extrapyramidale Hyperkinesen. Klinik — Prävalenz — Pathophysiologic Fortschr Neurol Psychiatr 51:131–157CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • J. Tegeler
    • 1
  1. 1.Psychiatrische KlinikUniversität DüsseldorfBergische Landstraße 2Düsseldorf 11Deutschland

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