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Estudio meta-analítico de los beneficios y riesgos de tratar la esquizofrenia crónica con risperidona o neurolépticos convencionales

Published online by Cambridge University Press:  12 May 2020

P. Bech ,
J. C. J. R. Peuskens ,
S. R. Marder ,
G. Chouinard ,
O. J. Høyberg ,
M. O. Huttunen ,
O. Blin  and
A. Claus
P. Bech
Affiliation:
Unidad de Psiquiatría, Hospital General Frederiksborg, Hillerøo Sygehus, DK-3400, Hillerød, Dinamarca
J. C. J. R. Peuskens
Affiliation:
Centro Universitario St. Jozef, Kortenberg, Bélgica
S. R. Marder
Affiliation:
Centro Médico West Los Angeles VA, Los Angeles, CA, EE.UU.
G. Chouinard
Affiliation:
Hospital Louis-H. Lufontaine, Montreal, Quebec, Canadá
O. J. Høyberg
Affiliation:
Departamento de Psiquiatría, Hospital Molde, Molde, Noruega
M. O. Huttunen
Affiliation:
Departamento de Psiquiatría, Universidad de Helsinki, Finlandia
O. Blin
Affiliation:
Hospital de la Timone, Marseille, Francia
A. Claus
Affiliation:
Hospital Universitario Psiquiátrico St. Camillus, Birbeek, Bélgica
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Resumen

Se analizaron los datos de seis estudios comparativos controlados distribuidos al azar de risperidona y neuroleptics convencionales (haloperidol, zuclopentixol y perfenazina) en el tratamiento de 911 pacientes con esquizofrenia crónica para estimar los beneficios y riesgos del tratamiento. Se evaluó la eficacia y el riesgo del tratamiento por medio de la Escala del Síndrome Positivo y Negativo (PANSS) y la Escala de Evaluación de Síntomas Extrapiramidales (ESRS). A partir de las puntuaciones de la PANSS y la ESRS, se calculó la eficacia del efecto (la diferencia entre los tratamientos). La eficacia del efecto antipsicótica fue favorable a la risperidona (iba de 0,22 a 0,37 en las subescalas de la PANSS), y el nivel de la seguridad también (iba de 0,18 a 0,36 en la ESRS). Un análisis de la proporción de pacientes que precisaron medicación antiparkinsoniana produjo un nivel del efecto de 0,37 (precisaron medicación anti-Jarkinsoniana el 20% de los pacientes con risperidona y el 38% de los pacientes que recibían un neuroléptico convencional). Estos datos indican que la risperidona es un antipsicótico más efectivo que los agentes convencionales y causa síntomas extrapiramidales menos graves.

Keywords

meta-análisis de la esquizofreniarisperidonaeficaciatolerabilidad
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 6 , Issue 2 , March 1999 , pp. 100 - 105
Copyright
Copyright © European Psychiatric Association 1999

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References

Bibliografía

American Psychiatric Association. Diagnostic and statistical Manual of Mental Disorders 3rd ed rev (DSM-III-R). Washington: American Psychiatric Association; 1987.Google Scholar
Andreasen, NCOlsen, SA.Negative versus positive schizophrenia: definition and validation. Arch Gen Psychiatry 1982; 39: 789–94.CrossRefGoogle Scholar
Bech, PCialdella, P.Citalopram in depression: metaanalysis of intented and unintended effects. Int Clin Psychopharmacol 1992; 6 suppl 5: 45–54.CrossRefGoogle Scholar
Blin, OAzorin, JMBouhours, P.Antipsychotic and anxiolytic properties of risperidone, haloperidol, and levomepromazine in schizophrenic patients. J Clin Psychopharmacol 1996; 16: 38–44.CrossRefGoogle ScholarPubMed
Borison, RLPathiraja, APDiamond, BIMeibach, RC.Risperidone: clinical safety and efficacy in schizophrenia. Psychopharmacol Bull 1992; 28: 213–8.Google Scholar
Carman, JPeuskens, JVangeneugden, A.Risperidone in the treatment of negative symptoms of schizophrenia: a meta-analysis. Int Clin Psychopharmacol 1995; 10: 207–13.CrossRefGoogle ScholarPubMed
Chouinard, GRoss-Chouinard, AAnnable, LJones, BD.Extrapyramidal Symptom Rating Scale. Can J Neurol Sci 1980; 7; 233.Google Scholar
Chouinard, GJones, BRemington, GBloom, DAddington, DMacEwan, GW, et al.A Canadian mul-ticenter placebo-controlled study of fixed doses of risperidone and haloperidol in the treatment of chronic schizophrenic patients. J Clin Psychopharmacol 1993; 13: 25–40.CrossRefGoogle ScholarPubMed
Claus, ABollen, JDe Cuyper, HEneman, MMalfroid, MPeuskens, JHeylen, S.Risperidone versus haloperidol in the treatment of chronic schizophrenic in patients: a multicentre double-blind comparative study. Acta Psychiatr Scand 1992; 85: 295–305.CrossRefGoogle ScholarPubMed
Cohen, J.Statistical Power Analysis for the Behavioral Sciences. Orlando: Academic Press; 1977.Google Scholar
Davis, JMJanicak, PG.Risperidone: a new, novel (and better)? antipsychotic. Psychiatr Ann 1996; 26: 78–87.CrossRefGoogle Scholar
Glass, GV.Integrating findings: the meta-analysis of research. Rev Educ Res 1977; 5: 351–79.Google Scholar
Greenberg, RPBornstein, RFZborowski, MJFisher, SGreenberg, MD.A meta-analysis of fluoxetine out-come in the treatment of depression. J Nerv Ment Dis 1994; 192: 547–51.CrossRefGoogle Scholar
Guy, W.Early Clinical Drug Evaluation (ECDEU) Assessment Manual. Rockville: National Institute of Mental Health; 1976.Google Scholar
Høyyberg, OJFensbo, C.Remvig, JLingjaerde, OSloth-Nielsen, MSalvesen, I.Risperidone versus perphenazine in the treatment of chronic schizophrenic patients with acute exacerbation. Acta Psychiatr Scand 1993; 88: 395–402.CrossRefGoogle Scholar
Huttunen, MOPieponnen, TRantanen, HLarmo, INyholm, RRaitasuo, V.Risperidone versus zuclo-penthixol in the treatment of acute schizophrenic episodes: a double-blind parallel-group trial. Acta Psychiatr Scand 1995; 91: 271–7.CrossRefGoogle ScholarPubMed
Kane, JM.Risperidone. Am J Psychiatry 1994; 151: 802–3.Google ScholarPubMed
Kane, JHonigfeld, GSinger, JMeltzer, H.Clozaril Collaborative Study Group. Clozapine for the treat-ment-resistant schizophrenic: a double-blind comparison with haloperidol. Arch Gen Psychiatry 1988;, 45:789–96.CrossRefGoogle Scholar
Kay, SRFiszbein, AOpler, LA.The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull 1987; 13: 261–76.CrossRefGoogle Scholar
Leysen, JEGommeren, WEens, A.De Chaffoy de Courcelles, DStoof, JCJanssen, PAJ.The biochemical profile of risperidone, a new antipsychotic. J Pharmacol Exp Ther 1988; 247: 61–70.Google ScholarPubMed
Lieberman, JAJohns, CAKane, JMRai, K.Clozapine-induced agranulocytosis: on non-cross reactivity with other psychotropic drugs. J Clin Psychiatry 1988; 49:271–7.Google ScholarPubMed
Marder, SRMeibach, RC.Risperidone in the treatment of schizophrenia. Am J Psychiatry 1994; 151: 825–35.Google ScholarPubMed
Meltzer, HYMatsubara, SLee, JC.Classification of typical and atypical antipsychotic drugs on the basis of dopamine D-l, D-2, and serotonin 2 pKi values. J Pharmacol Exp Ther 1989; 251: 238–49.Google Scholar
Moller, HJMuller, HBorison, RLSchooler, NRChourard, G.A path-analytical approach to differentiate between direct and indirect drug effects on negative symptoms in schizophrenic patients: a re-evaluation of the North American risperidone study. Eur Arch Psychiatry Clin Neurosci 1995; 245: 45–9.CrossRefGoogle ScholarPubMed
Overall, JEGorham, DR.The Brief Psychiatric Rating Scale. Psychol Rep 1962; 10: 799–812.CrossRefGoogle Scholar
Peuskens, J, the Risperidone Study Group. Risperidone in the treatment of patients with chronic schizophrenia: a multinational, multi-centre, double-blind, parallel-group study versus haloperidol. Br J Psychiatry 1995; 166: 712–26.CrossRefGoogle Scholar