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Leitlinien neuroleptischer Therapie pp 97–120Cite as

Neuroleptische Langzeittherapie schizophrener Erkrankungen

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Zusammenfassung

Bei der neuroleptischen Langzeittherapie schizophrener Erkrankungen muß man grundsätzlich unterscheiden zwischen der prophylaktischen Langzeitmedikation zur Verhinderung von psychotischen Rezidiven und der symptomsuppressiven Langzeitmedikation zur Kupierung chronisch psychotischer Symptomatik. Diese theoretisch plausible Unterscheidung wirft aber in der Praxis erhebliche Probleme auf. Die Frage, ob eine nach der neuroleptischen Akutbehandlung durchgeführte Langzeitbehandlung mit Neuroleptika rezidivprophylaktisch oder symptomsuppressiv ist, läßt sich prinzipiell nämlich nur entscheiden, wenn nach dem Abklingen der psychotischen Symptomatik unter der Akutbehandlung die Neuroleptika abgesetzt werden und eine mehrwöchige neuroleptikafreie Phase eingeschoben wird, in der geprüft werden kann, ob es zu einem Wiederaufflackern der psychotischen Symptomatik kommt oder der Patient symptomfrei bleibt. Dieses Vorgehen ist aus verständlichen Gründen im klinischen Alltag schwer praktikabel, da dem Patienten in der Regel nicht zugemutet werden kann, daß er aus derartigen erkenntnistheoretischen Gründen ein Exazerbieren der Symptomatik in Kauf nehmen soll. Nur im Rahmen von Forschungsprojekten ist dieses Vorgehen anzustreben (Müller 1983) und aus methodischen Gründen zu rechtfertigen, allerdings wird es auch dort nur selten praktiziert. Im klinischen Alltag hingegen wird die neuroleptische Akutbehandlung in der Regel ohne neuroleptikafreies Intervall direkt in die Langzeitbehandlung übergeführt.

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  1. Psychiatrichen Klinik und Poliklinik, Universität Bonn, D-5300, Bonn 1 (Venusberg), Deutschland

    Prof. Dr. H.-J. Möller (Direktor)

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  1. Prof. Dr. H.-J. Möller
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  1. Psychiatrische Klinik, Rheinische Landesklinik, Heinrich-Heine-Universität, Bergische Landstr. 2, 4000, Düsseldorf 12, Deutschland

    Kurt Heinrich

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Möller, HJ. (1990). Neuroleptische Langzeittherapie schizophrener Erkrankungen. In: Heinrich, K. (eds) Leitlinien neuroleptischer Therapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-93466-7_6

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  • DOI: https://doi.org/10.1007/978-3-642-93466-7_6

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