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Konsiliar- und Liaisonpsychiatrie

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Polypharmazie in der Behandlung psychischer Erkrankungen
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Zusammenfassung

Bis zu 46,5% aller Allgemeinkrankenhauspatienten leiden an klinisch bedeutsamen psychischen Störungen. Eine sachgerechte Psychopharmakotherapie der psychischen Begleiterkrankungen kann sowohl den Verlauf der zugrunde liegenden somatischen Erkrankung günstig beeinflussen als auch die Lebensqualität der Patienten mit internistischen oder neurologischen Erkrankungen erhöhen. Die Behandlung psychischer Störungen körperlich Kranker indes stellt selbst für den routinierten und erfahrenen Arzt oftmals eine besondere Herausforderung dar. Vor diesem Hintergrund wird dem Auftreten möglicher Arzneimittelinteraktionen bei der Neuverschreibung von Medikamenten respektive der Durchführung von Kombinationstherapien in der konsiliar- und liaisonpsychiatrischen Routineversorgung zunehmend ein hoher Stellenwert eingeräumt. In diesem Kontext gilt es in der Regel, unerwünschte Arzneimittelwirkungen bei Komedikation mit anderen Pharmaka, wie zum Beispiel den Wirkverlust eines zuvor in stabilen Erhaltungsdosen verabreichten Medikaments oder ein erhöhtes Risiko für die Entwicklung von Arzneimittelnebenwirkungen zu vermeiden. Überlegungen zur Wahl eines geeigneten Psychopharmakons bei körperlich Kranken in der konsiliar- und liaisonpsychiatrischen Routineversorgung werden exemplarisch anhand der häufig mit psychischen Störungen assoziierten Parkinsonerkrankung, Epilepsie und kardiovaskulären Erkrankung erörtert.

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Rothenhäusler, HB. (2016). Konsiliar- und Liaisonpsychiatrie. In: Messer, T., Schmauß, M. (eds) Polypharmazie in der Behandlung psychischer Erkrankungen. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1849-8_7

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