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Mejora gradual del tratamiento con agentes antipsicóticos desde los neurolépticos orales tradicionales hasta el primer depot atípico

Published online by Cambridge University Press:  12 May 2020

H.-J. Möller
H.-J. Möller*
Affiliation:
Departamento de Psiquiatría, Universidad Ludwig Maximilians, Nussbaum Strasse 7, 80336, Munich, Alemania
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Resumen

La recaída es uno de los factores clave en la evolución a largo plazo de la esquizofrenia. Las consecuencias de la recaída son diversas y a menudo impredecibles, y el tiempo hasta la recuperación y el grado de ésta empeoran con cada recaída sucesiva. Hoy en día hay datos abrumadores de que los avances en el tratamiento con fármacos antipsicóticos han llevado a reducciones significativas en la tasa de recaídas. Esta revisión traza el derrotero de los avances que han tenido lugar en la terapia antipsicótica desde la introducción de las formulaciones depot, pasando por los agentes atípicos, hasta el desarrollo del primer antipsicótico atípico de acción prolongada. Las formulaciones depot de antipsicóticos convencionales se desarrollaron en la década de 1960 y llevaron a un número de recaídas y episodios de hospitalización menor, comparado con los equivalentes orales. El meta-análisis ha confirmado que los pacientes que reciben antipsicóticos depot experimentan una mejoría global significativamente mayor que los que reciben los agentes orales respectivos. Sin embargo, los antipsicóticos convencionales se asocian con diversos acontecimientos adversos potencialmente importantes. Los antipsicóticos atípicos se introdujeron en la década de 1990 y tienen ventajas significativas sobre los agentes convencionales con respecto a los síntomas positivos y negativos. Hay datos también de que los agentes atípicos pueden reducir el riesgo de recaída. Es importante que los antipsicóticos atípicos tengan un perfil de seguridad mejor comparado con los agentes anteriores, en particular con respecto a los síntomas extrapiramidales. Una desventaja de los agentes atípicos ha sido que están disponibles únicamente en forma oral. El desarrollo reciente de una formulación inyectable de acción prolongada de risperidona significa que los médicos disponen de una nueva opción de tratamiento.

Keywords

EsquizofreniaAntipsicóticos atípicosAntipsicóticos convencionalesFormulación inyectable de acción prolongadaRecaída
Type
Revisión
Information
European Psychiatry (Ed. Española) , Volume 13 , Issue 2 , March 2006 , pp. 63 - 69
Copyright
Copyright © European Psychiatric Association 2006

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References

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