Zusammenfassung
Die bipolare Störung ist charakterisiert durch den Wechsel zwischen manischen und depressiven Episoden. Jugendliche zeigen häufigere Episodenwechsel pro Jahr als Erwachsene. Liegen keine abgrenzbaren Episoden mit eindeutigen Stimmungsänderungen oder Reizbarkeit und Veränderungen von Kognition und Verhalten vor, soll keine bipolare Störung diagnostiziert werden. Die korrekte Diagnosestellung wird oft nur durch die Längsschnittbetrachtung des Verlaufes möglich. Bei der Behandlung der Manie spielt die Pharmakotherapie eine zentrale Rolle bei der Stabilisierung von Stimmung und Antrieb und soll dem Auftreten weiterer Phasen vorbeugen (Phasenprophylaxe). Aripiprazol kann aufgrund seines Nutzen-Risiko-Profils als Medikation der 1. Wahl gelten; Olanzapin, Quetiapin und Risperidon sind Wirkstoffe der 2. Wahl. Ab der zweiten Episode soll zur Rückfallprävention phasenprophylaktisch behandelt werden. Bei nicht ausreichendem Ansprechen kann die Behandlung mit mehreren Wirkstoffen notwendig werden.
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Holtmann, M. (2022). Bipolare Störungen im Kindes- und Jugendalter. In: Fegert, J., et al. Psychiatrie und Psychotherapie des Kindes- und Jugendalters. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49289-5_102-1
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