Authors' objectives The main objectives were to assess the clinical effectiveness, safety and cost-effectiveness of 'atypical' antipsychotic drugs in schizophrenia in comparison with conventional antipsychotic drugs, placebo and other atypical antipsychotic drugs. The secondary objectives of the review were to investigate response in those with treatment-resistant schizophrenia, with predominantly negative symptoms or experiencing their first episode of schizophrenia.

http://www.senon-online.com/Documentation/telechargement/guidelines/Schizo%20APS%20new/mon713.pdf

A systematic review of atypical antipsychotic drugs in schizophrenia.

Since the era of modern pharmacologic treatment of psychiatric disorders began in the mid-1950s, much progress has been made in techniques to assess the efficacy of proposed therapeutic agents. This has come about for a variety of reasons including the amendment to the U.S. Food, Drug, and Cosmetics Law in 1962 that requires proof of efficacy before marketing of prescription medications is permitted. Assessment or proof of safety prior to marketing had been a requirement for many years.

Ascertainment of Side Effects in Psychopharmacologic Clinical Trials

Der Einsatz von Antidepressiva bei Alterspatienten wurde idealerweise die zugrundelegenden biologischen Veranderungen der jeweils zu behandelnden Erkrankungen voraussetzen. Der heutige Kenntnisstand erlaubt jedoch allenfalls Arbeitshypothesen uber Stoffwechselveranderungen, die der Depression generell, dem Altersprozes und der Demenz gemeinsam sein konnten. So last sich grob vereinfachend zusammenfassen, das die adrenerge und serotonerge Funktion bei allen 3 Zustanden erniedrigt und andererseits die Aktivitat der Monoaminoxidase (MAO) erhoht sein kann (Veith u. Raskin 1988; Fanchamps u. Basle 1990), wahrend das cholinerge System in differenter Form involviert zu sein scheint: Wenn auch kontrovers diskutiert, so gibt es gewisse Hinweise, das die cholinerge Aktivitat bei der Depression eher erhoht, beim Altersprozes unverandert oder vermindert ist und bei der Demenz eine dramatische Reduktion erfahrt. Die Auswahl eines geeigneten Antidepressivums bei Depression im Alter mit oder ohne Demenz ist daher nicht durch das postulierte adrenerge, serotonerge oder MAO-hemmende Wirkprofil limitiert, sondern durch das Nebenwirkungsprofil des applizierten Antidepressivums (Gerson et al. 1988), wobei der anticholinergen Komponente eine besondere Rolle zukommt. Entsprechend dem Titel dieses Symposiums, sollen die vorliegenden Ausfuhrungen schwerpunktmasig die Probleme einer antidepressiven Therapie darstellen.

Antidepressiva in der Psychogeriatrie

Publikationen und Dissertationen aus der AMÜP-Studie

Six years of drug surveillance in psychiatric inpatients

In 1979 a study for drug surveillance in psychiatric patients (Arzneimitteluberwachung in der Psychiatrie, AMUP) was initiated by the Arbeitsgemeinschaft fur Neuropsychopharmakologie und Pharmakopsychiatrie, financed by the Federal Health Agency (Bundesgesundheitsamt) of the Federal Republic of Germany. The main aim of the study was to assess data on adverse drug reactions (ADRs) under conditions of everyday clinical practice. Data on type and frequency of ADRs for various psychotropic drugs are available from clinical trials, however in everyday clinical practice patients of all age groups, including the elderly, are treated; some patients have concomitant physical diseases, and frequently drug combinations are used, as polypharmacy is a common practice in psychiatry worldwide (Clark and Holden 1987; Grohmann et al. 1986; Schmidt et al. 1987; Swett 1979). As the need for additional information on the occurence of ADR under these treatment conditions had not previously been met by any large-scale drug surveillance study, the AMUP study was undertaken.

L. G. Schmidt

Papers

Six years of drug surveillance in psychiatric inpatients

Drug Surveillance in Psychiatric Patients in the Federal Republic of Germany