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Tratamiento antipsicótico en la esquizofrenia: las opciones atípicas y la guía NICE

Published online by Cambridge University Press:  12 May 2020

A.M. Mortimer
A.M. Mortimer*
Affiliation:
Departamento de Psiquiatría, Universidad de Hull, East Riding Campus Willerby, Hull HU10 6NS, Reino Unido
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Resumen

Después de la reintroducción de la clozapina, se han comercializado varios antipsicóticos atípicos para el tratamiento de la esquizofrenia. Estos fármacos son al menos tan efectivos como el tratamiento convencional. Aunque cada uno tiene un patrón de afinidades individual, los nuevos trabajos indican que el sello de la atipicidad es la disociación rápida en el receptor de dopamina D2. Se están desarrollando numerosos fármacos nuevos, pero no está claro cómo se ajustan a esta teoría del efecto terapéutico. Los antipsicóticos atípicos causan menos efectos secundarios extrapiramidales que el tratamiento convencional, pero otros efectos como la hiperprolactinemia, el aumento de peso, la disrregulación de la glucosa y la prolongación del intervalo QTc son problemáticos para algunos. La práctica actual de prescripción de antipsicóticos está lejos del ideal: la guía NICE hace hincapié en que se deben considerar los tratamientos atípicos a menos que los síntomas estén bien controlados y los efectos secundarios sean aceptables, o esté indicada la formulación depot. Hay un énfasis oportuno en el tratamiento farmacológico como parte de un paquete integrado de asistencia negociado con los pacientes y sus cuidadores.

Keywords

Antipsicótico atípicoEsquizofreniaDescubrimiento de nuevos fármacosEfectos secundariosGuía NICE
Type
Artículo Original
Information
European Psychiatry (Ed. Española) , Volume 10 , Issue 8 , November 2003 , pp. 502 - 516
Copyright
Copyright © European Psychiatric Association 2003

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