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Uso auxiliar de la reboxetina en la esquizofrenia

Published online by Cambridge University Press:  12 May 2020

Thomas J. Raedler
Affiliation:
Hospital Universitario de Hamburgo-Eppendorf, Departamento de Psiquiatría y Psicoterapia, Martini str. 52, 20246Hamburgo, Alemania
Holger Jahn
Affiliation:
Hospital Universitario de Hamburgo-Eppendorf, Departamento de Psiquiatría y Psicoterapia, Martini str. 52, 20246Hamburgo, Alemania
Josef Arlt
Affiliation:
Hospital Universitario de Hamburgo-Eppendorf, Departamento de Psiquiatría y Psicoterapia, Martini str. 52, 20246Hamburgo, Alemania
Falk Kiefer
Affiliation:
Hospital Universitario de Hamburgo-Eppendorf, Departamento de Psiquiatría y Psicoterapia, Martini str. 52, 20246Hamburgo, Alemania
Mildred Schick
Affiliation:
Hospital Universitario de Hamburgo-Eppendorf, Departamento de Psiquiatría y Psicoterapia, Martini str. 52, 20246Hamburgo, Alemania
Dieter Naber
Affiliation:
Hospital Universitario de Hamburgo-Eppendorf, Departamento de Psiquiatría y Psicoterapia, Martini str. 52, 20246Hamburgo, Alemania
Klaus Wiedemann
Affiliation:
Hospital Universitario de Hamburgo-Eppendorf, Departamento de Psiquiatría y Psicoterapia, Martini str. 52, 20246Hamburgo, Alemania
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Resumen

Antecedentes.

La esquizofrenia se complica con frecuencia por síntomas depresivos o negativos que responden sólo de manera moderada al tratamiento con los medicamentos antipsicóticos. La reboxetina es un antidepresivo nuevo que inhibe la recaptación de norepinefrina. Tratamos de estudiar la eficacia y tolerabilidad del uso auxiliar de la reboxetina en una cohorte de pacientes esquizofrénicos con síntomas depresivos o negativos prominentes.

Métodos.

Se seleccionó para este estudio a 16 pacientes esquizofrénicos hospitalizados. Todos los sujetos recibieron 4-8 mg/día de reboxetina mientras se continuaba la medicación antipsicótica (antipsicóticos típicos = 4; antipsicóticos atípicos = 12). Todos los sujetos pasaron una evaluación estandarizada que incluía la PANSS, la CGI, la HAMD y la CDSS antes y después del tratamiento con reboxetina (media: 26 ± 17 d).

Resultados.

Todos los sujetos toleraron el tratamiento con reboxetina. Los efectos adversos fueron leves y no requirieron la interrupción del fármaco. Todas las puntuaciones clínicas (PANSS: 93,1 frente a 63,1; CGI: 5,4 frente a 4,1; HAMD: 20,4 frente a 8,1, y CDSS: 12,5 frente a 4,6) mejoraron significativamente bajo el tratamiento auxiliar con reboxetina (todos P < 0,01).

Conclusión.

El uso auxiliar de reboxetina en los pacientes esquizofrénicos fue seguro y se toleró bien. Nuestros resultados indican que el uso auxiliar de reboxetina puede ser un tratamiento efectivo para los síntomas depresivos y negativos en la esquizofrenia.

Type
Artículos Originales
Copyright
Copyright © European Psychiatric Association 2005

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Footnotes

RedlerTJ. JahnH, ArltJ, KieferF, SchickM, NaberD, WiedemannK. Uso auxiliar de la reboxetina en la esquizofrenia. Eur Psychiatry2004; 19:366–369

References

Bibliografía

Addington, D, Addington, J, Schissel, B. A depression rating scale for schizophrenics. Schizophr Res 1990; 3: 247-51.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry 1997; 154(Suppl): 163.Google Scholar
Baynes, D, Mulholland, C, Cooper, SJ, Montgomery, RC, MacFlynn, G, Lynch, G, et al. Depressive symptoms in stable chronic schizophrenia: prevalence and relationship to psychopathology and treatment. Schizophr Res 2000; 45: 4756.CrossRefGoogle ScholarPubMed
Berk, M, Ichim, C, Brook, S. Effficacy of mirtazapine add on therapy to haloperidol in the treatment of the negative symptoms of schizophrenia: a double-blind randomized placebo-controlled study. Int Clin Psychopharmacol 2001; 16: 8792.Google Scholar
Bermanzohn, PC, Porto, L, Arlow, PB, Pollack, S, Stronger, R, Siris, SG. Hierarchical diagnosis in chronic schizophrenia: a clinical study of co-occuring syndromes. Schizophr Bull 2000; 26: 517-25.Google Scholar
Goff, DC, Midha, KK, Sarid-Segal, O, Hubbard, JW, Amico, E. A placebo-controlled trial of fluoxetine added to neuroleptic in patients with schizophrenia. Psychopharmacology (Bert) 1995; 117: 417-23.CrossRefGoogle ScholarPubMed
Green, MF. What are the functional consequences of neurocognitive déficits in schizophrenia? Am J Psychiatry 1996; 153: 321-30.Google Scholar
Guy, W. ECDEU Assessment Manual for Psychopharmacology, 338. Washington, DC: US Department of Health and Welfare; 1976. p. 534-7. [20]Google Scholar
Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960, 23: 5662.CrossRefGoogle ScholarPubMed
Heila, H, Isometsa, ET, Henriksson, MM, Heikkinen, ME, Marttunen, MJ, Lonnqvist, JK. Suicide and schizophrenia: a nation-wide psy-chological autopsy study on age-and sex-specific clinical characteristics of 92 suicide victims with schizophrenia. Am J Psychiatry 1997; 154: 1235-42. [22]Google Scholar
Hogarty, GE, McEvoy, JP, Ulrich, RF, DiBarry, AL, Bartone, P, Cooley, S, et al. Pharmacotherapy of impaired affect in recovering schizophrenic patients. Arch Gen Psychiatry 1995; 52: 2941.Google ScholarPubMed
Kay, SR, Opler, LA, Fiszbein, A. Positive and negative symptoms in schizophrenia: assessment and research. New York: Bruner Mazel; 1991.Google Scholar
Lancon, C, Auquier, P, Reine, G, Bernard, D, Addington, D. Relationships between depression and psychotic symptoms of schizophrenia during an acute episode and stable period. Schizophr Res 2001; 47: 135-40.Google ScholarPubMed
Levinson, DF, Umapathy, C, Musthaq, M. Treatment of schizoaffective disorder and schizophrenia with mood symptoms. Am J Psychiatry 1999; 156: 1138-48.Google ScholarPubMed
Linner, L, Endersz, H, Ohman, D, Bengtsson, F, Schalling, M, Svensson, TH. Reboxetine modulates the firing pattern of dopamine cells in the ventral tegmental area and selectively increases dopamine availability in the prefrontal cortex. J Pharmacol Exp Ther 2001; 297: 540-6.Google ScholarPubMed
Massana, J, Moller, HJ, Burrows, GD, Montenegro, RM. Reboxetine: a double-blind comparison with fluoxetine in major depressive disorder. Int Clin Psychopharmacol 1999; 14: 7380.CrossRefGoogle ScholarPubMed
Poyurovsky, M, Isaacs, I, Fuchs, C, Schneidman, M, Faragian, S, Weizman, R, et al. Attenuation of olanzapine-induced weight gain with reboxetine in patients with schizophrenia: a double-blind, placebo controlled study. Am J Psychiatry 2003; 160: 297302.Google ScholarPubMed
Sánds, JR, Harrow, M. Depression during the longitudinal course of schizophrenia. Schizophr Bull 1999; 25: 157-71.Google ScholarPubMed
Schulz, G, Berk, M. Reboxetine add on therapy to haloperidol in the treatment of schizophrenia: a preliminary double-blind randomized placebo-controlled study. Int Clin Psychopharmacol 2001; 16: 275-8.Google Scholar
Silver, H, Barash, I, Aharon, N, Kaplan, A, Poyurovsky, M. Fluvoxamine augmentation of antipsychotics improves negative symptoms in psychotic chronic schizophrenic patients: a placebo-controlled study. Int Clin Psychopharmacol 2000; 15: 257-61.CrossRefGoogle ScholarPubMed
Siris, SG, Masón, SE, Bermanzohn, PC, Alvir, JM, McCorry, TA. Adjunctive imipramine maintenance in postpsychotic depression/negative symptoms. Psychopharmacol Bull 1990; 26: 91-4.Google ScholarPubMed
Siris, SG. Depression in Schizophrenia. In: Hirsch, SR, Weinberger, DR, editors. Schizophrenia. Oxford: Blackwell Science Ltd; 1995. p. 128-6.Google Scholar
Siris, SG. Depression in schizophrenia: perspective in the era of “Atypical” antipsychotic agents. Am J Psychiatry 2000; 157: 1379-89.CrossRefGoogle ScholarPubMed
Taiminen, TJ, Syvalahti, E, Saarijarvi, S, Niemi, H, Lehto, H, Ahola, V, et al. Citalopram as an adjuvant in schizophrenia: further evidence for a serotonergic dimensión in schizophrenia. Int Clin Psychopharmacol 1997, 12: 31-5.Google Scholar
Thakore, JH, Berti, C, Dinan, TG. An open trial of adjunctive sertraline in the treatment of chronic schizophrenia. Acta Psychiatr Scand 1996; 94: 194-7.CrossRefGoogle ScholarPubMed
Tollefson, GD, Sanger, TM. Negative symptoms: a path analytic approach to a double-blind, placebo -and haloperidol-controlled clinical trial with olanzapine. Am J Psychiatry 1997; 154: 466-74.Google ScholarPubMed
Weickert, TW, Goldberg, TE, Gold, JM, Bigelow, LB, Egan, MF, Weinberger, DR. Cognitive impairments in patients with schizophrenia displaying preserved and compromised intellect. Arch Gen Psychiatry 2000; 57: 907-13.CrossRefGoogle ScholarPubMed
Wong, EH, Sonders, MS, Amara, SG, Tinholt, PM, Piercey, MF, Hoffmann, WP, et al. Reboxetine: a pharmacologically potent, selective, and specific norepinephrine reuptake inhibitor. Biol Psychiatry 2000; 47: 818-29.CrossRefGoogle ScholarPubMed
Zisook, S, McAdams, LA, Kuck, J, Harris, MJ, Bailey, A, Patterson, TL, et al. Depressive symptoms in schizophrenia. Am J Psychiatry 1999; 156: 1736-43.Google Scholar