Franz Benninger
&
Andreas Karwautz aktualisierten  diese Seite letztmalig am 08.11.2010

Forschung - Publikationsliste

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Psychopharmakotherapie:
 

Neuropsychiatrie 2006 , 20: 135-136
Warnung der Arzneimittelbehörde zur Anwendung von Antidepressiva bei Kindern und Jugendlichen: Kommentar und Empfehlung aus kinder– und Jugendpsychiatrischer Sicht.
Klier CM, Karwautz A
 

Int J Neuropsychopharmacol. 2005 Sep;8(3):487-8.
Psychosis as a possible side-effect of treatment with glatiramer acetate.
Pjrek E, Winkler D, Dervic K, Aschauer H, Kasper S.

Multiple sclerosis (MS) is a common neurological disorder in younger adults. After an initial phase, which is characterized by complete or partial remission of neurological deficits (relapsing/remitting form), the illness enters a progressive phase with accumulation of neurological disability. Glatiramer acetate (GA, copolymer 1) is a new drug, which has recently been approved for the treatment of relapsing MS. GA is a synthetic mixture of relatively short polypeptides with a molecular weight between 4.7 and 10 kDa consisting of a random sequence of the four amino acids L-alanine, L-lysine, L-glutamic acid, and L-tyrosine. The substance is supposed to inhibit myelin-reactive T cells, to promote the induction of anti-inflammatory Th2 and CD8+ T cells, thus suppressing autoimmune responses in the CNS. Additional neuroprotective and repair mechanisms may be the result of local accumulation of GA-reactive T cells. In randomized, double-blind, placebo-controlled clinical trials the compound has been shown to reduce the relapse rate and to slow progression of disability in MS (Bornstein et al., 1991; Johnson et al., 2000). Side-effects of the drug were assessed, and GA was claimed as a well-tolerated drug (Johnson et al., 2001). Mild local injection site reactions occur in 90% of patients, while 15% of patients experience an immediate post-injection reaction with flushing, chest tightness, shortness of breath, palpitation and anxiety.

Neuropsychiatrie
Klier CM, Karwautz A
Warnung der Arzneimittelbehörde zur Anwendung von Antidepressiva bei Kindern und Jugendlichen: Kommentar und Empfehlung aus kinder– und Jugendpsychiatrischer Sicht.
 

World J Biol Psychiatry 2002 Jul;3(3):133-46 
Receptor and transporter imaging studies in schizophrenia, depression, bulimia
and Tourette's disorder--implications for psychopharmacology.
Kasper S, Tauscher J, Willeit M, Stamenkovic M, Neumeister A, Kufferle B, Barnas C, Stastny J, Praschak-Rieder N, Pezawas L, de Zwaan M, Quiner S, Pirker W, Asenbaum S, Podreka I, Brucke T

Considerable progress has been achieved over the past 15 years in uncovering the
biological basis of major psychiatric disorders. To determine patterns of brain
dysfunction and to uncover the mechanism of action of centrally active compounds
we used single photon emission computerized tomography (SPECT) as well as
positron emission tomography (PET) in patients diagnosed with schizophrenia,
depression, bulimia and Tourette's disorder. Striatal D2 and 5-HT1A receptors
were studied in schizophrenia and 5-HT transporters (5-HTT) in depression and
bulimia. Patients were either drug-naive or drug free, or we studied the
influence of specifically acting compounds on receptor/transporter occupancy. We
could demonstrate that atypical antipsychotics have a dose-dependent (with the
exception of clozapine and quetiapine) lower striatal D2 receptor occupancy rate
compared with typical neuroleptics, paralleling the more favourable
extrapyramidal side effects of atypical antipsychotics. However, no association
between striatal D2 receptor occupancy rates and antipsychotic efficacy has been
found. The measurement of 5-HT1A receptors in drug-naive schizophrenic patients
using the in vivo PET methodology revealed an increase of cortical 5-HT1A
receptor binding potential in schizophrenia. beta-CIT as a ligand for
measurement of 5-HT transporter densities (5-HTT) revealed lower rates in
depression compared to age- and sex-matching healthy controls, a measurement
that has also been obtained for bulimia. We also documented seasonal variations
in brain serotonergic function by our finding of reduced brain 5-HTT
availability in winter (compared to summer) in healthy controls. Furthermore,
displaceable [123I] beta-CIT binding in the area corresponding to the left
striatum (representing predominantly the density of dopamine transporters) was
significantly reduced in SAD patients compared to healthy controls. In
depression as well as in bulimia, selective serotonin reuptake inhibitors
significantly decreased the beta-CIT binding potential, however, no significant
dose relationship has been obtained in depression. Genotyping depressed patients
for the serotonin transporter promoter gene region (5-HTTLPR) did not provide
evidence for in vivo functional regulation of 5-HTT availability by 5-HTTLPR in
the thalamus-hypothalamus and mesencephalon-pons of healthy subjects. In
patients suffering from Tourette's disorder (TD) we were unable to detect
differences of dopamine transporter densities between psychotropic drug-naive TD
patients and controls. Furthermore, no difference could be found between
currently treated (with antipsychotics) and psychotropic drug-naive TD patients.
Our data provide insight into the pathophysiology of neuropsychiatric disorders
and may guide future psychopharmacological drug developments.


J Clin Psychopharmacol 2002 Feb;22(1):68-70 
The effect of orlistat on plasma levels of psychotropic drugs in patients with
long-term psychopharmacotherapy.
Hilger E, Quiner S, Ginzel I, Walter H, Saria L, Barnas C.

Weight gain induced by long-term psychopharmacotherapy has emerged as a relevant
clinical issue because it is a major problem affecting compliance and long-term
outcome. The novel antiobesity drug orlistat inhibits gastrointestinal lipases,
thus lowering the absorption of dietary fat and raising the possibility of
decreased absorption of fat-soluble vitamins and certain concomitantly
administered drugs in some individuals. We monitored plasma levels of several
psychotropic agents in eight psychiatric patients receiving orlistat to
determine the potential influence of orlistat on the bioavailability of these
drugs. We found no clinically relevant changes in plasma concentrations of
haloperidol, clozapine, clomipramine, desipramine, or carbamazepine over an
8-week period in orlistat recipients. We therefore consider orlistat to be
compatible with use during long-term pharmacotherapy. Our preliminary findings
suggest that orlistat may offer a pharmacological treatment option to support
dietary efforts in obese and overweight psychiatric patients. However, so far no
data about the potential influence of orlistat on pharmacokinetics of
psychotropics have been published; therefore, plasma level monitoring is
recommended.

Acta Med Austriaca 2001;28(2):56-9 
Prescription patterns and quality of information provided for consumers of
benzodiazepines
Gutierrez-Lobos K, Frohlich S, Quiner S, Haring C, Barnas C.

The long-time benzodiazepine use by a considerable part of the population and
its adverse consequences such as somatic and cognitive side effects,
interactions with other drugs and alcohol and its possible impairment of quality
of life has provoked a critical discussion about the practice of prescribing
benzodiazepine and the information provided by physicians. We therefore
investigated these issues in admitted patients of a general hospital. All
patients having been admitted to the department of Internal Medicine and taking
benzodiazepine were asked by means of a semi-structured interview, which was
repeated after 1 year. In 90% of later benzodiazepine discontinuers and in
almost 50% of benzodiazepine continuers, tranquilisers were first prescribed
during hospital admission. Only 2% of all patients estimated the information
provided by the prescribing physicians as satisfying and about 2/3 reported that
they did not get any information at all. 66% of all patients were informed about
dependency risks. This information was mainly provided by pharmacies, friends
and patient information leaflets; only about 20% of all patients were informed
by the prescribing physician. Guidelines for tranquiliser prescription only seem
to have a poor impact on the clinical practice. The education of physicians
about the risks of low-dose dependencies and especially about complementary
therapy methods needs to be improved.

Neuropsychobiology 2000;42(4):187-91 
A comparison of patterns of tranquiliser intake, anxiety and health locus of
control between short- and long-term benzodiazepine users.
Gutierrez-Lobos K, Frohlich S, Miller C, Whitworth AB, Quiner S, Barnas C.

This study investigates the impact of physical illness, health locus of control
and anxiety level on long- and short-term benzodiazepine (BZD) use in patients
of an internal medicine department. There was no significant difference observed
between the continuing and discontinuing group after hospital admission in terms
of average daily dose of BZD. However, the continuing patients rated the
condition of their somatic illness significantly higher than the discontinuing
group, although this difference was not confirmed by the objective assessment of
the treating physician. The non-continuing group displayed significantly higher
control over health- and sickness-related events. The somatic and physical
anxiety factor was significantly higher in the continuing group at initial
investigation as well as at follow-up. On the basis of these results, we
conclude that an increased focus on the psychosomatic element might reduce the
risk of long-term tranquiliser use in patients with physical illness. Copyright
2000 S. Karger AG, Basel.

Int Clin Psychopharmacol 2000 Jul;15(4):207-14 
Efficacy, cardiac safety and tolerability of sertindole: a drug surveillance.
Pezawas L, Quiner S, Moertl D, Tauscher J, Barnas C, Kufferle B, Wolf R, Kasper S.

Sertindole is a novel atypical antipsychotic, which has shown efficacy in the
treatment of positive and negative symptoms of schizophrenia in phase II and III
studies. Furthermore, these studies have demonstrated tolerability and a
favourable side-effect profile. In contrast to classical antipsychotics,
sertindole was not associated with extrapyramidal symptoms (EPS). We report drug
surveillance data in 34 comorbid and comedicated sertindole treated patients
suffering from different psychotic disorders. The drug surveillance consisted of
two distinct phases: inpatient treatment and outpatient follow-up. Clinical
global impression (severity and improvement of illness), psychotic symptoms,
side-effects, and blood parameters have been carefully documented. With special
respect to cardiac safety electrocardiograms (ECGs) have been recorded twice
(during sertindole treatment and during treatment with an antipsychotic
different from sertindole). Recommended ECG-parameters for assessment of the
proarrhythmic risk of a drug have been calculated (QTc-, QTc2-interval; QT-,
QTc-dispersion). The majority of patients (n = 29) have been treated previously
with several typical and/or atypical antipsychotics. We observed a clinical
response to sertindole treatment in 29 patients (85%). Both positive and
negative symptoms improved with sertindole and no severe side-effects have been
documented. EPS occurred at placebo level. A mean QTc-interval prolongation of
19.7 ms (4.7%) has been detected. None of the patients developed clinical or
electrocardiographic evidence of cardiac dysrhythmia during sertindole
treatment, or other clinical evidence of cardiac abnormalities. In summary,
sertindole did show efficacy for positive and negative symptoms together with a
favourable side-effect profile. No evidence for an increased proarrhythmic risk
has been found.

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