Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
CNS Drugs
Erschienen in: CNS Drugs 8/2011

01.08.2011 | Therapy in Practice

Antipsychotic Pharmacotherapy and Orthostatic Hypotension

Identification and Management

verfasst von: Dr James J. Gugger

Erschienen in: CNS Drugs | Ausgabe 8/2011

Einloggen, um Zugang zu erhalten

Abstract

Orthostatic hypotension is a common adverse effect of antipsychotics that may delay or prevent titration to a dose necessary to control psychotic symptoms. Complications of orthostatic hypotension include syncope, transient ischaemic attack, stroke, myocardial infarction and death. The risk of orthostatic hypotension associated with antipsychotic therapy is increased in patients with disorders of the autonomic nervous system, fluid imbalance and those taking concomitant drug therapy that affects haemodynamic tone. Prospective monitoring for changes in postural blood pressure is important because patients with psychotic disorders often do not articulate symptoms of orthostasis and the subjective report of dizziness does not correlate well with orthostatic blood pressure changes.
Nonpharmacological strategies and patient education, most notably, slowly rising from the supine position, are crucial first steps in the prevention and treatment of both symptomatic and asymptomatic orthostatic hypotension. Pharmacological treatment is only recommended when symptomatic orthostatic hypotension persists despite proper nonpharmacological therapy and there is a compelling indication for antipsychotic treatment. Fludrocortisone is a reasonable first choice for symptomatic orthostatic hypotension. Other agents including desmopressin and midodrine may be considered in patients who do not respond favourably to a trial of fludrocortisone, but safety concerns and lack of evidence limit the utility of these agents.
Literatur
1.
Michelsen JW, Meyer JM. Cardiovascular effects of antipsychotics. Expert Rev Neurother 2007; 7: 829–39PubMedCrossRef
2.
Drici MD, Priori S. Cardiovascular risks of atypical antipsychotic drug treatment. Pharmacoepidemiol Drug Saf 2007; 16: 882–90PubMedCrossRef
3.
Casey DE. The relationship of pharmacology to side effects. J Clin Psychiatry 1997; 58 Suppl. 10: 55–62
4.
Lieberman JA, Stroup TS, McEvoy JP, et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005; 353: 1209–23PubMedCrossRef
5.
Stroup TS, Lieberman JA, McEvoy JP, et al. Effectiveness of olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia after discontinuing perphenazine: a CATIE study. Am J Psychiatry 2007; 164: 415–27PubMedCrossRef
6.
Stroup TS, Lieberman JA, McEvoy JP, et al. Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic. Am J Psychiatry 2006; 163: 611–22PubMedCrossRef
7.
McEvoy JP, Lieberman JA, Stroup TS, et al. Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment. Am J Psychiatry 2006; 163: 600–10PubMedCrossRef
8.
Stroup TS, Lieberman JA, McEvoy JP, et al. Results of phase 3 of the CATIE schizophrenia trial. Schizophr Res 2009; 107: 1–12PubMedCrossRef
9.
Citrome L. Iloperidone for schizophrenia: a review of the efficacy and safety profile for this newly commercialised second-generation antipsychotic. Int J Clin Pract 2009; 63: 1237–48PubMedCrossRef
10.
11.
Citrome L. Asenapine for schizophrenia and bipolar disorder: a review of the efficacy and safety profile for this newly approved sublingually absorbed second-generation antipsychotic. Int J Clin Pract 2009; 63: 1762–84PubMedCrossRef
12.
Swett Jr C, Cole JO, Hartz SC, et al. Hypotension due to chlorpromazine: relation to cigarette smoking, blood pressure, and dosage. Arch Gen Psychiatry 1977; 34: 661–3PubMedCrossRef
13.
Timdahl K, Carlsson A, Stening G. An analysis of safety and tolerability data from controlled, comparative studies of quetiapine in patients with schizophrenia, focusing on extrapyramidal symptoms. Hum Psychopharmacol 2007; 22: 315–25PubMedCrossRef
14.
Bishop MP, Gallant DM. Loxapine: a controlled evaluation in chronic schizophrenic patients. Curr Ther Res Clin Exp 1970; 12: 594–7PubMed
15.
Gershon S, Hekimian LJ, Burdock EI, et al. Antipsychotic properties of loxapine succinate. Curr Ther Res Clin Exp 1970; 12: 280–5PubMed
16.
17.
Mackin P. Cardiac side effects of psychiatric drugs. Hum Psychopharmacol 2008; 23 Suppl. 1: 3–14CrossRef
18.
Simpson GM, Cuculic Z. A double-blind comparison of loxapine succinate and trifluoperazine in newly admitted schizophrenic patients. J Clin Pharmacol 1976; 16: 60–5PubMed
19.
Weiden PJ, Cutler AJ, Polymeropoulos MH, et al. Safety profile of iloperidone: a pooled analysis of 6-week acute-phase pivotal trials. J Clin Psychopharmacol 2008; 28(2 Suppl. 1): S12–9PubMedCrossRef
20.
21.
Curry SH. Chlorpromazine: concentrations in plasma, excretion in urine and duration of effect. Proc R Soc Med 1971; 64: 285–9PubMed
22.
Chandrasena R, Dvorakova D, Lee SI, et al. Intramuscular olanzapine vs. intramuscular short-acting antipsychotics: safety, tolerability and the switch to oral antipsychotic medication in patients with schizophrenia or acute mania. Int J Clin Pract 2009; 63: 1249–58PubMed
23.
24.
Ritter RM, Davidson DE, Robinson TA. Comparison of injectable haloperidol and chlorpromazine. Am J Psychiatry 1972; 129: 78–81PubMed
25.
Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy: the Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Neurology 1996; 46: 1470CrossRef
26.
Mets TF. Drug-induced orthostatic hypotension in older patients. Drugs Aging 1995; 6: 219–28PubMedCrossRef
27.
Scalco MZ, de Almeida OP, Hachul DT, et al. Comparison of risk of orthostatic hypotension in elderly depressed hypertensive women treated with nortriptyline and thiazides versus elderly depressed normotensive women treated with nortriptyline. Am J Cardiol 2000; 85: 1156–8, A9PubMedCrossRef
28.
Ensrud KE, Nevitt MC, Yunis C, et al. Postural hypotension and postural dizziness in elderly women: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. Arch Intern Med 1992; 152: 1058–64
29.
Kaplan NM. Hypotension as a complication of promazine therapy. AMA Arch Intern Med 1959; 103: 219–23PubMedCrossRef
30.
Jefferson JW. Atypical manifestations of postural hypotension. Arch Gen Psychiatry 1972; 27: 250–1PubMedCrossRef
31.
Rutan GH, Hermanson B, Bild DE, et al. Orthostatic hypotension in older adults: the Cardiovascular Health Study. CHS Collaborative Research Group. Hypertension 1992; 19: 508–19
32.
Rosati D. Hypotensive side effects of phenothiazine and their management. Dis Nerv Syst 1964; 25: 366–9PubMed
33.
Eigenbrodt ML, Rose KM, Couper DJ, et al. Orthostatic hypotension as a risk factor for stroke: the atherosclerosis risk in communities (ARIC) study, 1987–1996. Stroke 2000; 31: 2307–13PubMedCrossRef
34.
Masaki KH, Schatz IJ, Burchfiel CM, et al. Orthostatic hypotension predicts mortality in elderly men: the Honolulu Heart Program. Circulation 1998; 98: 2290–5PubMedCrossRef
35.
Rose KM, Eigenbrodt ML, Biga RL, et al. Orthostatic hypotension predicts mortality in middle-aged adults: the Atherosclerosis Risk In Communities (ARIC) Study. Circulation 2006; 114: 630–6PubMedCrossRef
36.
Ray WA, Chung CP, Murray KT, et al. Atypical antipsychotic drugs and the risk of sudden cardiac death. N Engl J Med 2009; 360: 225–35PubMedCrossRef
37.
Silver H, Kogan H, Zlotogorski D. Postural hypotension in chronically medicated schizophrenics. J Clin Psychiatry 1990; 51: 459–62PubMed
38.
Smith JJ, Porth CM, Erickson M. Hemodynamic response to the upright posture. J Clin Pharmacol 1994; 34: 375–86PubMed
39.
Westfall TC, Westfall DP. Neurotransmission: the autonomic and somatic motor nervous systems. In: Brunton LL, Lazo JS, Parker KL, editors. Goodman & Gilman’s the pharmacological basis of therapeutics. 11th ed. New York (NY): The McGraw-Hill Companies, Inc., 2006: 137–82
40.
Young CR, Bowers Jr MB, Mazure CM. Management ofthe adverse effects of clozapine. Schizophr Bull 1998; 24: 381–90PubMedCrossRef
41.
Tonkin AL, Wing LM. Effects of age and isolated systolic hypertension on cardiovascular reflexes. J Hypertens 1994; 12: 1083–8PubMedCrossRef
42.
Laitinen T, Niskanen L, Geelen G, et al. Age dependency of cardiovascular autonomic responses to head-up tilt in healthy subjects. J Appl Physiol 2004; 96: 2333–40PubMedCrossRef
43.
Bradley JG, Davis KA. Orthostatic hypotension. Am Fam Physician 2003; 68: 2393–8PubMed
44.
Figueroa JJ, Basford JR, Low PA. Preventing and treating orthostatic hypotension: as easy as A, B, C. Cleve Clin J Med 2010; 77: 298–306PubMedCrossRef
45.
Freeman R. Current pharmacologic treatment for orthostatic hypotension. Clin Auton Res 2008; 18 Suppl. 1: 14–8CrossRef
46.
Jordan J. Effect of water drinking on sympathetic nervous activity and blood pressure. Curr Hypertens Rep 2005; 7: 17–20PubMedCrossRef
47.
Jordan J, Shannon JR, Black BK, et al. The pressor response to water drinking in humans: a sympathetic reflex? Circulation 2000; 101: 504–9PubMedCrossRef
48.
Goldstein DS, Robertson D, Esler M, et al. Dysautonomias: clinical disorders of the autonomic nervous system. Ann Intern Med 2002; 137: 753–63PubMed
49.
LaWall JS. Treatment of psychotropic-caused orthostatic hypotension. Psychosomatics 1980; 21: 693–4PubMed
50.
Pirke KM. Central and peripheral noradrenalin regulation in eating disorders. Psychiatry Res 1996; 62: 43–9PubMedCrossRef
51.
Kaufmann H. Treatment of patients with orthostatic hypotension and syncope. Clin Neuropharmacol 2002; 25: 133–41PubMedCrossRef
52.
Friedman JH, Factor SA. Atypical antipsychotics in the treatment of drug-induced psychosis in Parkinson’s disease. Mov Disord 2000; 15: 201–11PubMedCrossRef
53.
Weber MA. Calcium channel antagonists in the treatment of hypertension. Am J Cardiovasc Drugs 2002; 2: 415–31PubMedCrossRef
54.
Kranzler HR, Cardoni A. Sodium chloride treatment of antidepressant-induced orthostatic hypotension. J Clin Psychiatry 1988; 49: 366–8PubMed
55.
Maskall DD, Lam RW. Midodrine for TCA-induced orthostatic hypotension. J Psychiatry Neurosci 1993; 18: 276–7PubMed
56.
Forster HS. Naproxen reversal of nortriptyline-induced orthostatic hypotension [letter]. J Clin Psychiatry 1989; 50: 356PubMed
57.
Poon IO, Braun U. High prevalence of orthostatic hypotension and its correlation with potentially causative medications among elderly veterans. J Clin Pharm Ther 2005; 30: 173–8PubMedCrossRef
58.
Campese VM. Minoxidil: a review of its pharmacological properties and therapeutic use. Drugs 1981; 22: 257–78PubMedCrossRef
59.
Slavachevsky I, Rachmani R, Levi Z, et al. Effect of enalapril and nifedipine on orthostatic hypotension in older hypertensive patients. J Am Geriatr Soc 2000; 48: 807–10PubMed
60.
Wong J, Patel RA, Kowey PR. The clinical use of angiotensin-converting enzyme inhibitors. Prog Cardiovasc Dis 2004; 47: 116–30PubMedCrossRef
61.
Thomas M, Malmcrona R, Fillmore S, et al. Haemodynamic effects of morphine in patients with acute myocardial infarction. Br Heart J 1965; 27: 863–75PubMedCrossRef
62.
Crawford ME, Moiniche S, Orbaek J, et al. Orthostatic hypotension during postoperative continuous thoracic epidural bupivacaine-morphine in patients undergoing abdominal surgery. Anesth Analg 1996; 83: 1028–32PubMed
63.
Chambers JA. The haemodynamic effects of morphine. Arch Emerg Med 1988; 5: 124–5PubMed
64.
Prisant LM. Phosphodiesterase-5 inhibitors and their hemodynamic effects. Curr Hypertens Rep 2006; 8: 345–51PubMedCrossRef
65.
Chaudhuri KR, Maule S, Thomaides T, et al. Alcohol ingestion lowers supine blood pressure, causes splanchnic vasodilatation and worsens postural hypotension in primary autonomic failure. J Neurol 1994; 241: 145–52PubMedCrossRef
66.
Narkiewicz K, Cooley RL, Somers VK. Alcohol potentiates orthostatic hypotension: implications for alcohol-related syncope. Circulation 2000; 101: 398–402PubMedCrossRef
67.
Fung HL. Biochemical mechanism of nitroglycerin action and tolerance: is this old mystery solved? Annu Rev Pharmacol Toxicol 2004; 44: 67–85PubMedCrossRef
68.
MacMillan LB, Hein L, Smith MS, et al. Central hypotensive effects of the alpha2a-adrenergic receptor subtype. Science 1996; 273: 801–3PubMedCrossRef
69.
Lindqvist A, Jalonen J, Laitinen LA, et al. The effects of midazolam and ephedrine on post-exercise autonomic chronotropic control of the heart in normal subjects. Clin Auton Res 1996; 6: 343–9PubMedCrossRef
70.
van den Berg F, Tulen JH, Boomsma F, et al. Effects of alprazolam and lorazepam on catecholaminergic and cardiovascular activity during supine rest, mental load and orthostatic challenge. Psychopharmacology (Berl) 1996; 128: 21–30CrossRef
71.
Durrieu G, Senard JM, Tran MA, et al. Effects of levodopa and bromocriptine on blood pressure and plasma catecholamines in parkinsonians. Clin Neuropharmacol 1991; 14: 84–90PubMedCrossRef
72.
Haapaniemi TH, Kallio MA, Korpelainen JT, et al. Levodopa, bromocriptine and selegiline modify cardiovascular responses in Parkinson’s disease. J Neurol 2000; 247: 868–74PubMedCrossRef
73.
Munjack DJ. The treatment of phenelzine-induced hypotension with salt tablets: case report. J Clin Psychiatry 1984; 45: 89–90PubMed
74.
Console AD. Controlling MAO inhibitor hypotension. Am J Psychiatry 1964; 120: 709–11PubMed
75.
Robie TR. Controlling monoamine oxidase inhibitor hypotension with 9-alpha-fluoro-hydrocortisone. Am J Psychiatry 1963; 120: 170–1PubMed
76.
Simonson M. Controlling MAO inhibitor hypotension. Am J Psychiatry 1964; 120: 1118–9PubMed
77.
Turkka J, Suominen K, Tolonen U, et al. Selegiline diminishes cardiovascular autonomic responses in Parkinson’s disease. Neurology 1997; 48: 662–7PubMedCrossRef
78.
Churchyard A, Mathias CJ, Boonkongchuen P, et al. Autonomic effects of selegiline: possible cardiovascular toxicity in Parkinson’s disease. J Neurol Neurosurg Psychiatry 1997; 63: 228–34PubMedCrossRef
79.
Aronow WS. Treating hypertension in older adults: safety considerations. Drug Saf 2009; 32: 111–8PubMedCrossRef
80.
Westfall TC, Westfall DP. Adrenergic agonists and antagonists. In: Brunton LL, Lazo JS, Parker KL, editors. Goodman & Gilman’s the pharmacological basis of therapeutics. 11th ed. New York (NY): The McGraw-Hill Companies, Inc., 2006: 237–96
81.
Alexander Jr HE, McCarty K, Giffen MB. Hypotension and cardiopulmonary arrest associated with concurrent haloperidol and propranolol therapy. JAMA 1984; 252: 87–8PubMedCrossRef
82.
Vestal RE, Kornhauser DM, Hollifield JW, et al. Inhibition of propranolol metabolism by chlorpromazine. Clin Pharmacol Ther 1979; 25: 19–24PubMed
83.
Seideman P, Grahnen A, Haglund K, et al. Prazosin first dose phenomenon during combined treatment with a beta-adrenoceptor blocker in hypertensive patients. Br J Clin Pharmacol 1982; 13: 865–70PubMedCrossRef
84.
Raj SR, Black BK, Biaggioni I, et al. Propranolol decreases tachycardia and improves symptoms in the postural tachycardia syndrome: less is more. Circulation 2009; 120: 725–34PubMedCrossRef
85.
Freitas J, Santos R, Azevedo E, et al. Clinical improvement in patients with orthostatic intolerance after treatment with bisoprolol and fludrocortisone. Clin Auton Res 2000; 10: 293–9PubMedCrossRef
86.
Fruncillo RJ, Gibbons WJ, Vlasses PH, et al. Severe hypotension associated with concurrent clonidine and antipsychotic medication [letter]. Am J Psychiatry 1985; 142: 274PubMed
87.
Cantrell MA, Bream-Rouwenhorst HR, Hemerson P, et al. Silodosin for benign prostatic hyperplasia. Ann Pharmacother 2010; 44: 302–10PubMedCrossRef
88.
Schwinn DA, Roehrborn CG. Alpha1-adrenoceptor subtypes and lower urinary tract symptoms. Int J Urol 2008; 15: 193–9PubMedCrossRef
89.
Aronowitz JS, Chakos MH, Safferman AZ, et al. Syncope associated with the combination of clozapine and enalapril. J Clin Psychopharmacol 1994; 14: 429–30PubMedCrossRef
90.
White WB. Hypotension with postural syncope secondary to the combination of chlorpromazine and captopril. Arch Intern Med 1986; 146: 1833–4PubMedCrossRef
91.
92.
Pae CU, Kim JJ, Lee CU, et al. Rapid versus conventional initiation of quetiapine in the treatment of schizophrenia: a randomized, parallel-group trial. J Clin Psychiatry 2007; 68: 399–405PubMedCrossRef
93.
Boidi G, Ferro M. Rapid dose initiation of quetiapine for the treatment of acute schizophrenia and schizoaffective disorder: a randomised, multicentre, parallel-group, open study. Hum Psychopharmacol 2007; 22: 299–306PubMedCrossRef
94.
Smith MA, McCoy R, Hamer-Maansson J, et al. Rapid dose escalation with quetiapine: a pilot study. J Clin Psychopharmacol 2005; 25: 331–5PubMedCrossRef
95.
Baker RW, Kinon BJ, Maguire GA, et al. Effectiveness of rapid initial dose escalation of up to forty milligrams per day of oral olanzapine in acute agitation. J Clin Psychopharmacol 2003; 23: 342–8PubMedCrossRef
96.
Karagianis JL, Dawe IC, Thakur A, et al. Rapid tranquilization with olanzapine in acute psychosis: a case series. J Clin Psychiatry 2001; 62 Suppl. 2: 12–6
97.
Feifel D, Moutier CY, Perry W. Safety and tolerability of a rapidly escalating dose-loading regimen for risperidone. J Clin Psychiatry 2000; 61: 909–11PubMedCrossRef
98.
Chengappa KN, Parepally H, Brar JS, et al. A randomassignment, double-blind, clinical trial of once- vs twice-daily administration of quetiapine fumarate in patients with schizophrenia or schizoaffective disorder: a pilot study. Can J Psychiatry 2003; 48: 187–94PubMed
99.
Figueroa C, Brecher M, Hamer-Maansson JE, et al. Pharmacokinetic profiles of extended release quetiapine fumarate compared with quetiapine immediate release. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33: 199–204PubMedCrossRef
100.
Testani Jr M. Clozapine-induced orthostatic hypotension treated with fludrocortisone. J Clin Psychiatry 1994; 55: 497–8PubMed
101.
Schimmer BP, Parker KL. Adrenocorticotropic hormone; adrenocortical steroids and their synthetic analogs; inhibitors of the synthesis and actions of adrenocortical hormones. In: Brunton LL, Lazo JS, Parker KL, editors. Goodman & Gilman’s the pharmacological basis of therapeutics. 11th ed. New York (NY): The McGraw-Hill Companies, Inc., 2006: 1587–612
102.
Mathias CJ, Fosbraey P, da Costa DF, et al. The effect of desmopressin on nocturnal polyuria, overnight weight loss, and morning postural hypotension in patients with autonomic failure. Br Med J (Clin Res Ed) 1986; 293: 353–4CrossRef
103.
Stumpf JL, Mitrzyk B. Management of orthostatic hypotension. Am J Hosp Pharm 1994; 51: 648–60; quiz 697-8PubMed
104.
Sarma S, Ward W, O’Brien J, et al. Severe hyponatraemia associated with desmopressin nasal spray to treat clozapine-induced nocturnal enuresis [letter]. Aust N Z J Psychiatry 2005; 39: 949PubMedCrossRef
105.
Castrioto A, Tambasco N, Rossi A, et al. Acute dystonia induced by the combination of midodrine and perphenazine. J Neurol 2008; 255: 767–8PubMedCrossRef
106.
Takahashi H. Acute dystonia induced by adding midodrine, a selective alpha 1 agonist, to risperidone in a patient with catatonic schizophrenia. J Neuropsychiatry Clin Neurosci 2000; 12: 285–6PubMedCrossRef
Metadaten
Titel
Antipsychotic Pharmacotherapy and Orthostatic Hypotension
Identification and Management
verfasst von
Dr James J. Gugger
Publikationsdatum
01.08.2011
Verlag
Springer International Publishing
Erschienen in
CNS Drugs / Ausgabe 8/2011
Print ISSN: 1172-7047
Elektronische ISSN: 1179-1934
DOI
https://doi.org/10.2165/11591710-000000000-00000

Weitere Artikel der Ausgabe 8/2011

CNS Drugs 8/2011 Zur Ausgabe

Leading Article

Vitamin D, Cognitive Dysfunction and Dementia in Older Adults

Adis Drug Evaluation

Rotigotine Transdermal Patch

Adis Drug Evaluation

Fingolimod

Leading Article

Implications of Gliotransmission for the Pharmacotherapy of CNS Disorders

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Viel Bewegung in der Parkinsonforschung

25.04.2024 Parkinson-Krankheit Nachrichten

Neue arznei- und zellbasierte Ansätze, Frühdiagnose mit Bewegungssensoren, Rückenmarkstimulation gegen Gehblockaden – in der Parkinsonforschung tut sich einiges. Auf dem Deutschen Parkinsonkongress ging es auch viel um technische Innovationen.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise