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Tratamiento a largo plazo de la esquizofrenia crónica con risperidona: un estudio con concentraciones plasmáticas
Published online by Cambridge University Press: 12 May 2020
Resumen
Se trató a 24 pacientes ambulatorios esquizofrénicos crónicos con una edad media de 37,21 años ± 9,96 DT con risperidona (RSP) en una dosis de 2-9 mg/día (media = 4,46 mg/día ± 1,30 DT, media = 0,06 mg/kg ± 0,01 DT) durante un año.
La evaluación clínica se realizó con la Escala de Evaluación Psiquiátrica Breve (BPRS), la Escala de Síntomas Positivos y Negativos (PANSS), la Escala de Evaluación de los Efectos Secundarios Extrapiramidales (EPSE) y una lista para los Efectos Secundarios Anticolinérgicos (ACS) en T0 y luego después de 1 (TI), 2 (T2), 3 (T3), 6 (T6), 9 (T9) y 12 (TI2) meses. Se determinaron las concentraciones de RSP y 9-hidroxi-risperidona (9OH-RSP) en T12 por el método CLAR. Los valores medios de la BPRS y la PANSS mostraron una mejoría significativa durante el estudio. No resultó ninguna correlación entre la dosis de RSP (mg/kg) y las concentraciones plasmáticas de RSP, de 9OH-RSP o el grupo activo. Se observó una correlación positiva entre la edad y el gmpo activo y también entre las concentraciones plasmáticas de RSP y 9OH-RSP Se observó una relación curvilínea entre el grupo activo y la mejoría en la PANSS (%). Los pacientes con la mejora mayor en la PANSS mostraron concentraciones plasmáticas de RSP + 9OH-RSP de 15-30 ng/mL. La RSP parece ser un fármaco bastante efectivo. Sin embargo, parece difícil idear programas de dosis apropiados y la determinación de la concentración plasmática parece ser necesaria en algunos casos.
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