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Los fármacos antipsicóticos frente al placebo para la prevención de recaídas en la esquizofrenia: una revisión
Stefan Leucht1, Magdolna Tardy, Katja Komossa
1Department of Psychiatry and Psychotherapy, Technische Universität München, Klinikum rechts der Isar, Munich, Germany. stefan.leucht@lrz.tum.de
Lancet (London, England)
|May 8, 2012
Resumen
Los medicamentos antipsicóticos reducen significativamente la recaída y la readmisión hospitalaria en pacientes con esquizofrenia en comparación con el placebo. Sin embargo, estos beneficios deben equilibrarse con los posibles efectos secundarios como el aumento de peso y los trastornos del movimiento.
Área de la Ciencia:
- La psiquiatría es la psiquiatría.
- Farmacología Farmacología.
Sus antecedentes:
- Las revisiones sistemáticas sobre la eficacia de los medicamentos antipsicóticos para la prevención de la recaída de la esquizofrenia son insuficientes.
- Las investigaciones anteriores no han resuelto completamente las controversias con respecto a estos tratamientos.
Objetivo del estudio:
- Evaluar la asociación entre los fármacos antipsicóticos y varios resultados en pacientes con esquizofrenia.
- Para resolver cuestiones controvertidas en el tratamiento de la esquizofrenia.
Principales métodos:
- Buscaron en varias bases de datos (Cochrane, PubMed, Embase) y se pusieron en contacto con compañías farmacéuticas.
- Se incluyeron ensayos aleatorizados comparando regímenes de medicamentos antipsicóticos versus placebo en pacientes estabilizados con esquizofrenia.
- El resultado primario fue la recaída entre 7 y 12 meses; también se examinaron los resultados de seguridad y funcionales.
Principales resultados:
- Los fármacos antipsicóticos redujeron significativamente las tasas de recaída (27% vs 64%) y las readmisiones hospitalarias (10% vs 26%) en 1 año.
- La evidencia limitada sugiere una mejor calidad de vida y una menor agresividad con los medicamentos antipsicóticos.
- Se observó un aumento en el aumento de peso, trastornos del movimiento y sedación con medicamentos antipsicóticos en comparación con el placebo.
Conclusiones:
- El mantenimiento del tratamiento con fármacos antipsicóticos beneficia a los pacientes con esquizofrenia.
- Las ventajas de los medicamentos antipsicóticos deben sopesarse frente a sus efectos secundarios.
- La investigación futura debería investigar los resultados de la participación social y la morbilidad/mortalidad a largo plazo.
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