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Der Schmerz
Erschienen in: Der Schmerz 4/2022

13.07.2022 | Opioide | CME

Unerwünschte Wirkungen von Opioiden, Antidepressiva und Antikonvulsiva auf Sexualhormone

Häufig unbeachtet, aber klinisch relevant

verfasst von: PD Dr. med. Stefan Wirz, Dr. med. Michael Schenk, Dr. med. Kristin Kieselbach

Erschienen in: Der Schmerz | Ausgabe 4/2022

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Zusammenfassung

Eine Androgeninsuffizienz unter Therapie mit Opioiden, Antidepressiva und Antikonvulsiva bei chronischer Schmerzerkrankung ist eine Nebenwirkung mit hoher Prävalenz. Sie kann zu klinisch-metabolischen Veränderungen, Adynamie, Stressintoleranz, Anämie oder Osteoporose führen und hat erhebliche Auswirkungen auf die Lebensqualität. Opioide, Antidepressiva und Antikonvulsiva beeinträchtigen die Hypothalamus-Hypophysen-Gonaden-Achse von Sexualhormonen. Frühzeitig ist eine Urolog*in, Androlog*in bzw. Endokrinolog*in in die Behandlung zu involvieren. Die Empfehlung einer differenzialtherapeutischen Auswahl bestimmter Substanzen hat lediglich Hinweischarakter und entspricht nicht Evidenzkriterien. Die Indikation einer Androgensubstitution erfolgt individuell und in Abwägung von Nutzen und Risiken. Die Aufmerksamkeit für diese Nebenwirkung bei ansonsten lege artis durchgeführter medikamentöser Schmertherapie muss geschärft werden und zwingend in die Differenzialdiagnostik einbezogen werden.
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Metadaten
Titel
Unerwünschte Wirkungen von Opioiden, Antidepressiva und Antikonvulsiva auf Sexualhormone
Häufig unbeachtet, aber klinisch relevant
verfasst von
PD Dr. med. Stefan Wirz
Dr. med. Michael Schenk
Dr. med. Kristin Kieselbach
Publikationsdatum
13.07.2022
Verlag
Springer Medizin
Erschienen in
Der Schmerz / Ausgabe 4/2022
Print ISSN: 0932-433X
Elektronische ISSN: 1432-2129
DOI
https://doi.org/10.1007/s00482-022-00655-9

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