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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
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.

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 1999

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