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Wissenschaftliche Grundlagen der EKT

  • Smesny
  • Sauer
  • Folkerts
  • Scharfetter
  • Frey
  • Kasper
  • Meisenzahl
  • Frodl
  • Padberg
  • Zinka
  • Ella
  • Möller
  • Zwanzger

Zusammenfassung

Wie bereits dargelegt, ist die Elektrokonvulsionstherapie (Elektrokrampftherapie, EKT) für die Behandlung schizophrener Psychosen entwickelt worden. Nach Einführung des Verfahrens in die klinische Psychiatrie wurde jedoch sehr bald deutlich, dass der größere therapeutische Gewinn auf dem Gebiet der affektiven Psychosen, insbesondere bei der Depression lag. Sehr rasch hatte sich bei dieser Indikation die EKT zur Therapie der ersten Wahl entwickelt. Als in den 50er Jahren die trizyklischen Antidepressiva eingeführt worden waren, wurde eine Vielzahl von Vergleichsuntersuchungen zwischen EKT und den Pharmaka durchgeführt, die sich teilweise durch sehr große Fallzahlen auszeichneten. Auf dem Gebiet der Schizophrenie sind nach Einführung der Neuroleptika ebenfalls etliche vergleichende Studien durchgeführt worden, allerdings in weitaus geringerer Zahl. Diese früheren Studien werden im folgenden Kapitel aufgrund der hohen Fallzahl unverändert berücksichtigt, wenngleich die methodischen Anforderungen an einen Wirksamkeitsnachweis in den vergangenen Jahrzehnten erheblich gestiegen sind, so dass die Ergebnisse nur noch unter Vorbehalt betrachtet werden können. Über die Arbeiten zur Depression und Schizophrenie hinaus sollen noch die Ergebnisse bezüglich der Manie dargestellt werden, die im deutschsprachigen Raum bisher zu wenig beachtet wurden. Ferner werden die sogenannten Doppelblindstudien dargestellt, die der Aufklärung des Wirksamkeitsmechanismus dienen, aber seinerzeit auch die wissenschaftliche Antwort auf eine ideologisch geführte öffentliche Diskussion darstellten. Schließlich sollen die derzeit aktuellen Forschungsthemen erörtert werden, die die Fragen der kombinierten elektrokonvulsiven und medikamentösen Behandlung betreffen, den Einsatz der EKT bei Therapieresistenz und die Erarbeitung von Behandlungsstrategien, die zur Stabilisierung desTherapieeffektes über die Dauer der EKT-Serie hinaus beitragen.

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Copyright information

© Springer-Verlag Wien 2004

Authors and Affiliations

  • Smesny
    • 1
  • Sauer
    • 1
  • Folkerts
    • 2
  • Scharfetter
    • 3
  • Frey
    • 3
  • Kasper
    • 3
  • Meisenzahl
    • 4
  • Frodl
    • 4
  • Padberg
    • 4
  • Zinka
    • 4
  • Ella
    • 4
  • Möller
    • 4
  • Zwanzger
    • 4
  1. 1.JenaDeutschland
  2. 2.WilhelmshavenDeutschland
  3. 3.WienÖsterreich
  4. 4.MünchenDeutschland

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