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01.09.2012 | Leitthema

Psychopharmakotherapeutische Ansätze bei somatoformen Störungen und funktionellen Körpersyndromen

verfasst von: Prof. Dr. Dr. H.P. Kapfhammer

Erschienen in: Der Nervenarzt | Ausgabe 9/2012

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Zusammenfassung

Somatoforme Störungen und funktionelle Körpersyndrome definieren eine große, aber diagnostisch sehr heterogene Gruppe von Patienten mit medizinisch unerklärten Körpersymptomen. In einem biopsychosozialen Modell lassen sich auch pharmakotherapeutische Ansätze begründen. Eine Übersicht über vorrangig randomisierte, doppelblinde und placebokontrollierte Studien zeigt, dass Antidepressiva statistisch bedeutsame und klinisch relevante Wirkungen auf somatoforme Symptome erzielen. Im Hinblick auf Schmerzsymptome scheinen dual wirksame Antidepressiva einen günstigeren Effekt zu besitzen als selektive serotonerge Substanzen. Für eine Reihe funktioneller Körpersyndrome wie Colon irritabile und Fibromyalgie kann ebenfalls ein primärer antinozizeptiver Effekt der Antidepressiva nachgewiesen werden, der weitgehend unabhängig von antidepressiven und/oder anxiolytischen Wirkungen ist. Bei der Fibromyalgie ist auch Pregabalin eine gute Therapieoption. Bisherige Studien konnten noch keine überzeugenden Wirkbelege von Psychopharmaka beim chronischen Müdigkeitssyndrom aufzeigen. Hypochondrische und körperdysmorphe Störungen unterstreichen aufgrund einer inhärenten Nähe zu Angst-, Zwangs- und depressiven Störungen ebenfalls den Stellenwert serotonerger Antidepressiva.

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Titel: Psychopharmakotherapeutische Ansätze bei somatoformen Störungen und funktionellen Körpersyndromen
verfasst von: Prof. Dr. Dr. H.P. Kapfhammer
Publikationsdatum: 01.09.2012
Verlag: Springer-Verlag
Erschienen in: Der Nervenarzt / Ausgabe 9/2012
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI: https://doi.org/10.1007/s00115-011-3446-9

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