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Estudio prospectivo de la incidencia de discinesia tardía en los ancianos
B L Saltz1, M G Woerner, J M Kane
1Department of Psychiatry, Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, NY 11004.
JAMA
|November 6, 1991
Resumen
La incidencia de discinesia tardía en pacientes de edad avanzada que comienzan a tomar antipsicóticos es del 31% después de 43 semanas. El diagnóstico psiquiátrico y los signos extrapiramidales tempranos aumentan el riesgo de este efecto secundario antipsicótico.
Área de la Ciencia:
- La psiquiatría geriátrica es la psiquiatría geriátrica.
- Farmacología clínica Farmacología clínica.
Sus antecedentes:
- La discinesia tardía (TD) es un posible efecto secundario de los medicamentos antipsicóticos.
- Las personas mayores pueden ser más susceptibles a la TD debido a los cambios relacionados con la edad.
Objetivo del estudio:
- Para determinar la incidencia de TD en pacientes de edad avanzada que inician el tratamiento antipsicótico.
- Para identificar los factores de riesgo asociados con el desarrollo de TD en esta población.
Principales métodos:
- Un estudio longitudinal de cohorte de pacientes naíves en neurolepticos mayores de 55 años.
- Los pacientes fueron evaluados al inicio y seguidos regularmente para detectar movimientos involuntarios anormales y signos extrapiramidales.
- El análisis de supervivencia se utilizó para calcular la incidencia de TD.
Principales resultados:
- La incidencia acumulada de discinesia inducida por neurolepticos fue del 31% a las 43 semanas de tratamiento.
- Un diagnóstico psiquiátrico y la presencia temprana de signos extrapiramidales se relacionaron con un mayor riesgo de TD.
- El estudio incluyó a 160 pacientes ancianos (edad media de 77 años, 72% mujeres).
Conclusiones:
- Los pacientes de edad avanzada que inician la terapia antipsicótica tienen un riesgo significativo de desarrollar discinesia tardía.
- El diagnóstico psiquiátrico y los signos extrapiramidales tempranos son factores de riesgo importantes para la TD en los ancianos.
- Estos hallazgos resaltan la necesidad de un monitoreo cuidadoso en esta población vulnerable.
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