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Eficacia de la monoterapia de clozapina, olanzapina, quetiapina, risperidona y haloperidol en la reducción del comportamiento hostil y agresivo en pacientes ambulatorios tratados por esquizofrenia: un estudio naturalista prospectivo (IC-SOHO)

Published online by Cambridge University Press:  12 May 2020

Istvan Bitter ,
Pal Czobor ,
Martin Dossenbach  and
Jan Volavka
Istvan Bitter
Affiliation:
Departamento de Psiquiatría y Psicoterapia, Universidad Semmelweis, Balassa u 6, 1083 , Budapest, Hungría
Pal Czobor
Affiliation:
Instituto Nathan S. Kline para la Investigación Psiquiátrica, Orangeburg, NY, EE. UU Universidad de Nueva York, Nueva York, NY, EE. UU DOV Pharmaceutical, Inc., Hackensack, NJ, EE. UU
Martin Dossenbach
Affiliation:
Eli Lilly Ges.m.b.H., Viena, Austria
Jan Volavka
Affiliation:
Instituto Nathan S. Kline para la Investigación Psiquiátrica, Orangeburg, NY, EE. UU Universidad de Nueva York, Nueva York, NY, EE. UU
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Resumen

Objetivo

Los medicamentos antipsicóticos pueden reducir el comportamiento hostil y agresivo en la esquizofrenia. Este estudio comparó la eficacia de los antipsicóticos en el tratamiento de la agresión.

Método

El estudio Evolución Sanitaria Ambulatoria Intercontinental de la Esquizofrenia (IC-SOHO) compara la eficacia de los tratamientos antipsicóticos en el entorno de la consulta. En este estudio observacional sin intervención preventivo se proporciona seguimiento durante un periodo de hasta 3 años a pacientes ambulatorios de esquizofrenia que iniciaron un nuevo antipsicótico o cambiaron a él, disponiéndose ahora de los datos a los 6 meses sobre la cohorte entera (N = 7.655). Se evaluó retrospectivamente la presencia o ausencia de hostilidad/agresión verbal o física para el periodo de 6 meses antes de la inscripción, y prospectivamente en el periodo de 6 meses posterior a ella (el periodo de tratamiento del estudio). En la línea de base, se prescribió a los pacientes en cinco grupos de tratamiento en monoterapia (N combinado = 3.135) uno de los tratamientos: clozapina, olanzapina, quetiapina, risperidona o haloperidol, y se recogió los datos completos.

Resultados

El comportamiento hostil/agresivo se redujo durante el periodo de tratamiento. La olanzapina y la risperidona fueron significativamente superiores al haloperidol y la clozapina a este respecto. Estos resultados permanecieron esencialmente igual al ajustar los desequilibrios de línea de base en la edad, el género, la edad de comienzo y el abuso de sustancias.

Conclusiones

Como monoterapia, tanto la olanzapina como la risperidona fueron superiores al haloperidol y la clozapina en la reducción de la agresión. La falta relativa de eficacia de la clozapina puede ser específica a esta población de estudio.

Keywords

EsquizofreniaAgresiónAntipsicóticos
Type
Artículo Original
Information
European Psychiatry (Ed. Española) , Volume 13 , Issue 2 , March 2006 , pp. 70 - 76
Copyright
Copyright © European Psychiatric Association 2006

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References

Bibliografía

[1]Bitter, I, Basson, BR, Dossenbach, MRAntipsychotic treatment and sexual functioning in first-time neuroleptic-treated schizophrenic patients. Int Clin Psychopharmacol 2005;20(1): 19–21.CrossRefGoogle ScholarPubMed
[2]Buckley, P, Bartell, J, Donenwirth, K, Lee, S, Torigoe, F, Schulz, SCViolence and schizophrenia: clozapine as a specific antiaggressive agent. Bull Am Acad Psychiatry Law 1995;23:607-11.Google ScholarPubMed
[3]Chengappa, KN, Goldstein, JM, Greenwood, M, John, V, Levine, JA post hoc analysis of the impact on hostility and agitation of quetiapine and haloperidol among patients with schizophrenia. Clin Ther 2003;25(2):530-ll.CrossRefGoogle ScholarPubMed
[4]Chiles, JA, Davidson, P, McBride, DEffects of clozapine on use of seclusion and restraint at a State hospital. Hosp Community Psychiatry 1994;45:269-71.Google ScholarPubMed
[5]Citrome, L, Volavka, J, Czobor, P, Sheitman, B, Lindenmayer, J-P, McEvoy, J et al. Effects of clozapine, olanzapine, risperidone, and haloperidol on hostility in treatment-resistant patients with schizophrenia and schizoaffective disorder. Psychiatr Serv 2001;52:1510-4.CrossRefGoogle Scholar
[6]Czobor, P, Volavka, J, Meibach, RCEffect of risperidone on hostility in schizophrenia. J Clin Psychopharmacol 1995;15:243-9.CrossRefGoogle Scholar
[7]Dossenbach, M, Erol, A, el Mahfoud, KM, Shaheen, MO, Sunbol, MM, Boland, J et al. Effectiveness of antipsychotic treatments for schizophrenia: interim 6-month analysis from a prospective observational study (IC-SOHO) comparing olanzapine, quetiapine, risperidone, and haloperidol. J Clin Psychiatry 2004;65(3):312-21.CrossRefGoogle ScholarPubMed
[8]Ebrahim, GM, Gibler, B, Gacono, CB, Hayes, GPatient response to clozapine in a forensic psychiatric hospital. Hosp Community Psychiatry 1994;45:271-3.Google Scholar
[9]Guy, WECDEU Assessment Manual for Psychopharmacology. Rockville: National Institute of Mental Health; 1976.Google Scholar
[10]Haro, JM, Kamath, SA, Ochoa, S, Novick, D, Rele, K, Fargas, A et al. The Clinical Global Impression-Schizophrenia scale: a simple instrument to measure the diversity of symptoms present in schizophrenia. Acta Psychiatr Scand 2003;416(Suppl):16–23.CrossRefGoogle Scholar
[11]Kinon, BJ, Roychowdhury, SM, Milton, DR, Hill, ALEffective resolution with olanzapine of acute presentation of behavioral agitation and positive psychotic symptoms in schizophrenia. J Clin Psychiatry 2001;62(Suppl 2):17–21.Google Scholar
[12]Korb, FA, Trzebiatowska, I, Janikova, E, Winkler-Skaza, V, Ilies, D, Peciukaitiene, D et al. The Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study: Baseline clinical and functional characteristics and antipsychotic use of patterns in the Central and Eastern Europe (CEE) region. Psychiatria Danubina 2003;15:163-74.Google ScholarPubMed
[13]Korb, FA, Yenilmez, C, Belaid, A, Ghazi, M, Ornar, A-E, Bitter, IThe intercontinental schizophrenia outpatient health outcomes (ic-soho) study: baseline clinical and functional characteristics and antipsychotic use patterns in the North Africa and Middle Eastern (amea) region. South African Psychiatry Review 2004;7:27–34.Google Scholar
[14]Maier, GJThe impact of clozapine on 25 forensic patients. Bull Am Acad Psychiatry Law 1992;20:297–307.Google ScholarPubMed
[15]Mallya, AR, Roos, PD, Roebuck-Colgan, K.Restraint, seclusion, and clozapine. J Clin Psychiatry 1992;53:395-7.Google ScholarPubMed
[16]Ratey, JJ, Leveroni, C, Kilmer, D, Gutheil, C, Swartz, BThe effects of clozapine on severely aggressive psychiatric inpatients in a State hospital. J Clin Psychiatry 1993;54:219-23.Google ScholarPubMed
[17]Spivak, B, Roitman, S, Vered, Y, Mester, R, Graff, E, Talmon, Y et al. Diminished suicidal and aggressive behavior, high plasma norepinephrine levels, and serum triglyceride levels in chronic neurolepticresistant schizophrenic patients maintained on clozapine. Clin Neuropharmacol 1998;21(4):245-50.Google ScholarPubMed
[18]Swanson, JW, Swartz, MS, Elbogen, EB, Van Dorn, RAReducing violence risk in persons with schizophrenia: olanzapine versus risperidone. J Clin Psychiatry 2004;65(12):1666-73.CrossRefGoogle ScholarPubMed
[19]Treuer, T, Dossenbach, M, Meder, J, Herman, E, Pecenak, J, Tavar, R et al. Observational study of schizophrenia outpatients in Central and Eastern Europe: 3- and 6 -month efficacy and safety results. Socialna Psihijatria 2004;32:49–57.Google Scholar
[20]Volavka, JNeurobiology of Violence. 2 ed. Washington, DC; American Psychiatric Publishing, Inc.; 2002.Google Scholar
[21]Volavka, J, Laska, E, Baker, S, Meisner, M, Czobor, P, Krivelevich, IHistory of violent behaviour and schizophrenia in different cultures. Analyses based on the WHO study on determinants of outcome of severe mental disorders. Br J Psychiatry 1997;171:9–14.CrossRefGoogle Scholar
[22]Volavka, J, Zito, JM, Vitra, J, Czobor, RClozapine effects on hostilit; and aggression in schizophrenia. J Clin Psychopharmacol 1993;13:287-9.CrossRefGoogle Scholar
[23]Wilson, WH, Claussen, AM18-month outcome of clozapine treatment for 100 patients in a State psychiatric hospital. Psychiatr Sen 1995;46:386-9.Google Scholar