[Psychopharmacotherapy in somatic diseases -- treatment principles in daily medical routine]

Abstract

Up to 46.5% of general hospital inpatients suffer from clinically relevant psychiatric disorders. Appropriate psychopharmacotherapy of comorbid mental disorders in the medically ill can have positive effects on the course of somatic illness and can enhance quality of life in patients with medical or neurologic conditions. However, treating psychiatric disorders in this population can often be challenging, even for the most seasoned clinicians. An increasingly important issue in daily medical routine when prescribing medications is the possibility that a newly prescribed drug may interact with existing pharmacotherapy. Most often the concern is to avoid adverse consequences, such as undermining the effectiveness of previously stable drug therapy or precipitating the appearance of new adverse events. We have used the examples of Parkinson's disease, epilepsy and cardiovascular disease commonly associated with mental disorders to illustrate how these considerations affect the clinician's choice of a psychotropic drug in the medically ill.