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1.
Rev. psiquiatr. Urug ; 85(1): 28-42, oct. 2021. graf, tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1343130

ABSTRACT

El tratamiento farmacológico de demostrada eficacia en la esquizofrenia es el antipsicótico. Sin embargo, en muchas ocasiones se requiere medicación concomitante que depende de comorbilidades y efectos adversos. Se realizó un estudio cuantitativo, longitudinal, retrospectivo, considerando el año 2006 y 2016, en una población de usuarios con esquizofrenia de la Policlínica del Hospital Vilardebó, analizando los tratamientos con psicofármacos. Se diferenciaron los tratamientos según monoterapia antipsicótica y polifarmacia con 2 antipsicóticos, y polifarmacia con más de 2 antipsicóticos, antidepresivos, estabilizantes del humor, benzodiacepinas y anticolinérgicos. La población inicial en 2006 fue de 621 pacientes y 398 pacientes continuaban en tratamiento en 2016. Mantuvieron el trata-miento con antipsicóticos 377 pacientes; 184 mantuvieron benzodiacepinas; 59 se mantuvieron con anticolinérgicos; 49, con estabilizantes del humor y 47, con antidepresivos. La monoterapia antipsicótica se presentó en torno al 50 % de la población estudiada. Se deberían revisar aquellas prácticas que se infieren a partir de este estudio, como el uso prolongado de anticolinérgicos, benzodiacepinas, y polifarmacia con más de 2 antipsicóticos, que está extendida en los usuarios con esquizofrenia. El tratamiento con clozapina fue el más estable y no parece aumentar la mortalidad en estos pacientes


Antipsychotics are the proved effective therapy for schizophrenia. However, on many occasions, associated drugs are required depending on comorbidities and side effects. A retrospective longitudinal quantitative study of drug prescription for 2006 and 2016 in patients with schizophrenia diagnosis was carried out in an outpatient clinic at Hospital Vilardebó. Treatments were classified as antipsychotic monotherapy, two antipsychotic drugs polypharmacy and polypharmacy with two antipsychotic drugs, antidepressants, mood stabilizers, benzodiazepines and anticholinergic drugs. Initial population in 2006 included 621 patients, 398 were still being treated in 2016. Antipsychotic drugs were still being received in 377 patients, benzodiazepines in 184, anticholinergic drugs in 59, mood stabilizers in 49, and anti-depressants in 47. Antipsychotic monotherapy was 50% of the population. Those practices that can be inferred from this study, with lengthy use of anticholinergic drugs, benzodiazepines, and the use of more than 2 antipsychotic drugs in patients with schizophrenia diagnosis should be revised. Clozapine therapy was the most stable and does not seem to increase mortality.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Schizophrenia/drug therapy , Antipsychotic Agents/therapeutic use , Drug Therapy/statistics & numerical data , Phenothiazines/therapeutic use , Chlorpromazine/therapeutic use , Epidemiology, Descriptive , Retrospective Studies , Cohort Studies , Clozapine/therapeutic use , Risperidone/therapeutic use , Polypharmacy , Age and Sex Distribution , Tiapride Hydrochloride/therapeutic use , Quetiapine Fumarate/therapeutic use , Aripiprazole/therapeutic use , Olanzapine/therapeutic use , Haloperidol/therapeutic use , Methotrimeprazine/therapeutic use
3.
SMAD, Rev. eletrônica saúde mental alcool drog ; 17(1): 39-47, jan.-mar. 2021. ilus
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1280639

ABSTRACT

OBJETIVO: caracterizar os idosos atendidos em um Serviço de Urgência e Emergência Psiquiátrica quanto ao perfil sociodemográfico, diagnóstico psiquiátrico, prescrição de medicamentos e conduta médica e avaliar suas associações com o sexo. MÉTODO: estudo transversal, quantitativo, em que os dados foram obtidos a partir dos prontuários de pacientes atendidos no referido serviço, entre julho/2015 e junho/2016. A variável independente foi o sexo e as dependentes foram: idade; procedência; informante; tratamento psiquiátrico anterior; diagnóstico; medicamentos prescritos e conduta. RESULTADOS: nos 152 prontuários analisados, observam-se idade prevalente entre 60 a 69 anos, maioria de mulheres, procedência do município local e comparecimento com acompanhante. Os diagnósticos prevalentes são a esquizofrenia e os transtornos mentais e comportamentais decorrentes do uso de substâncias psicoativas. As medicações prescritas com maior frequência são da classe dos antipsicóticos e anti-histamínicos, seguidas dos ansiolíticos/sedativos. O critério de Beers considera a prescrição de medicamentos do grupo dos benzodiazepínicos, antipsicóticos e anti-histamínicos inapropriada para idosos. A principal conduta foi a alta, sem encaminhamento a outro serviço. CONCLUSÃO: embora haja incentivo do Ministério da Saúde, com a criação de novas políticas de saúde mental, muitos profissionais mantêm o modelo de atendimento baseado na queixa e conduta, dificultando a reabilitação psicossocial dos pacientes.


OBJECTIVE: characterize the elderly treated in a Psychiatric Emergency and Urgency Service regarding their sociodemographic profile, psychiatric diagnosis, prescription of medication and medical conduct and evaluate their associations with sex. METHOD: a cross-sectional, quantitative study in which data was obtained from the medical records of patients seen in the referred service, between July/2015 and June/2016. The independent variable was gender and dependents were: age; origin; informant; previous psychiatric treatment; diagnosis; prescribed drugs and conduct. RESULTS: in the 152 medical records analyzed, the prevailing age is between 60 and 69 years old, most of them women, coming from the local municipality and attending with a companion. The prevalent diagnoses are schizophrenia and mental and behavioral disorders resulting from the use of psychoactive substances. The most frequently prescribed medications are in the class of antipsychotics and antihistamines, followed by anxiolytics/sedatives. Beers' criteria consider the prescription of benzodiazepine, antipsychotic and antihistamine medications inappropriate for the elderly. The main conduct was discharge, without referral to another service. CONCLUSION: although there is encouragement from the Ministry of Health, with the creation of new mental health policies, many professionals maintain the model of care based on complaint and conduct, hindering the psychosocial rehabilitation of patients.


OBJETIVO: caracterizar a los ancianos atendidos en un servicio psiquiátrico de emergencia y urgencia en relación con el perfil sociodemográfico, el diagnóstico psiquiátrico, la prescripción de medicamentos y la conducta médica; y evaluar sus asociaciones con el sexo. MÉTODO: un estudio cuantitativo y transversal en el que se obtuvieron datos de los registros médicos de los pacientes tratados en el citado servicio, del 2015 al 2016 de julio. La variable independiente era el sexo y los dependientes eran: edad, procedencia, informante, tratamiento psiquiátrico previo, diagnóstico, medicamentos recetados y conducta. RESULTADOS: de los 152 registros médicos analizados, se observa que: la edad predominante es de 60 a 69 años, la mayoría de ellos son mujeres, desde el municipio local y atendido a la atención de un acompañante. Los diagnósticos prevalentes son la esquizofrenia y los trastornos mentales y conductuales resultantes del uso de sustancias psicoactivas. Los medicamentos recetados con mayor frecuencia son la clase antipsicótica y anti-histamina, seguida de ansiolíticos/sedantes. El criterio de Beers considera que la prescripción de fármacos del grupo de benzodiazepinas, antipsicóticos y antihistaminas, es inadecuada para los ancianos. La conducta principal era alta, sin remisión a otro servicio. CONCLUSIÓN: aunque hay aliento del Ministerio de salud con la creación de nuevas políticas de salud mental, muchos profesionales mantienen el modelo de cuidado basado en la queja y la conducta, obstaculizando la rehabilitación psicosocial de los pacientes.


Subject(s)
Humans , Male , Female , Aged , Anxiety Disorders/drug therapy , Schizophrenia/therapy , Antipsychotic Agents/therapeutic use , Anti-Anxiety Agents/therapeutic use , Mentally Ill Persons , Psychiatric Rehabilitation , Mental Disorders/therapy
4.
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, CONASS, SES-GO | ID: biblio-1344538

ABSTRACT

Tecnologia: Aripiprazol, antipsicóticos atípicos disponíveis no Sistema Único de Saúde, outras classes de potencializadores de tratamento depressivo. Indicação: Depressão refratária. Pergunta: Há diferenças de eficácia e segurança entre o Aripiprazol, Ziprasidona, Olanzapina, Quetiapina e Risperidona como agente potencializador do tratamento de depressão refratária? Há diferenças de eficácia e segurança entre as principais classes de drogas potencializadoras do tratamento de depressão refratária? Métodos: Levantamento bibliográfico foi realizado na base de dados PUBMED, seguindo estratégias de buscas predefinidas. Foi feita a avaliação da qualidade metodológica das revisões sistemáticas com a ferramenta Assessing the Methodological Quality of Systematic Reviews version 2. Resultados: Foram selecionadas 3 revisões sistemáticas, que atendiam aos critérios de inclusão. Conclusão: Na potencialização do tratamento antidepressivo, o Aripiprazol, em dose padrão ou dose diária reduzida, não é superior à Quetiapina, Olanzapina/Fluoxetina ou Risperidona em desfechos de eficácia ou segurança para casos de depressão refratária com pelo menos uma falha terapêutica prévia. As diferentes classes de potencializadores de antidepressivos não diferem entre si nos desfechos de eficácia para casos de depressão refratária com duas ou mais falhas terapêuticas prévias. Ziprasidona e Quetiapina se mostraram mais eficazes que o placebo e seguros para promover remissão sintomática da depressão refratária


Technology: Aripiprazole, atypical antipsychotics available in the Brazilian Public Health System, other classes of augmentative antidepressant agent. Indication: Treatment-resistant depression (TRD). Question: Are there differences in efficacy and safety between Aripiprazole, Ziprasidone, Olanzapine, Quetiapine, and Risperidone as augmentative agent in the treatment of TRD? Are there differences in efficacy and safety between the main classes of augmentative drugs that enhance the treatment of TRD? Methods: A bibliographic survey was carried out in the PUBMED database, following predefined search strategies. The methodological quality of systematic reviews was assessed using the Assessing the Methodological Quality of Systematic Reviews version 2 tool. Results: 3 systematic reviews were selected that met the inclusion criteria. Conclusion: In potentiating antidepressant treatment, Aripiprazole, in standard dose or reduced daily dose, is not superior to Quetiapine, Olanzapine/fluoxetine or Risperidone in efficacy or safety outcomes for cases of TRD with at least one previous therapeutic failure. The different classes of antidepressant enhancers do not differ in efficacy outcomes for cases of TRD with two or more prior therapeutic failures. Ziprasidone and Quetiapine were more effective than placebo and safer for the outcome of symptomatic remission of TRD


Subject(s)
Humans , Antipsychotic Agents/therapeutic use , Depressive Disorder, Treatment-Resistant/drug therapy , Aripiprazole/therapeutic use , Efficacy , Risperidone/therapeutic use , Quetiapine Fumarate/therapeutic use , Olanzapine/therapeutic use
5.
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, CONASS, SES-GO | ID: biblio-1121615

ABSTRACT

Tecnologia: Aripiprazol, medicamento antipsicótico de segunda geração. Indicação: tratamento da esquizofrenia. Objetivos: Apresentar evidências de análise econômicas em saúde, no cenário do SUS e contextos internacionais, do tratamento com Aripiprazol para esquizofrenia, comparado a outros antipsicóticos de uso oral de primeira e segunda geração utilizados no SUS. Realizar uma análise de impacto orçamentário para o contexto do SUS em Goiás e estimar uma projeção de gastos diretos com aquisição de Aripiprazol pela Secretaria de Saúde de Goiás, em cenário de incorporação do Aripiprazol para tratamento de esquizofrenia, no período de 2021 a 2025. Materiais e Métodos: Levantamentos bibliográficos nas bases de dados PUBMED e Biblioteca Virtual em Saúde, no mês de junho de 2020. Realizada avaliação da qualidade metodológica das revisões sistemáticas e dos estudos econômicos com as ferramentas Assessing the Methodological Quality of Systematic Reviews (AMSTAR), e Quality of Health Economic Studies (QHES) checklist, respectivamente. Foi calculado o impacto orçamentário, seguindo diretrizes do Ministério da Saúde, e projeção de gastos para a Secretaria de Saúde de Goiás. Resultados: Foram selecionadas e incluídas 1 revisão sistemática e 1 estudo econômico brasileiro no estudo de revisão rápida de evidências. Conclusão: No contexto brasileiro, o Aripiprazol é custo-efetivo, quando comparado a Clorpromazina, Haloperidol, Quetiapina e Ziprasidona. Porém, é menos custo-efetivo que Risperidona e Olanzapina. Caso seja padronizado pela Secretaria de Saúde de Goiás, promoverá economia anual para o SUS de R$ 250.042,05 a R$ 407.418,41, em sua máxima difusão. A projeção de gastos diretos é estimada em R$1.582.115,24 a R$27.960.108,08


Technology: Aripiprazole, second generation antipsychotic medication. Indication: treatment of schizophrenia. Objectives: To show evidence of health economic analysis in the scenario of Brazilian Public Health System (BPHS) and international contexts, for schizophrenia treatment with Aripiprazole, compared to other oral antipsychotics used in BPHS. To make a budget impact analysis for the Goias Public Health System perspective and estimate direct expenditures for the acquisition of Aripiprazole by State Department of Health of Goias, in a scenario of technology incorporation of Aripiprazole for the treatment of schizophrenia, in the period from 2021 to 2025. Materials and Methods: Bibliographical searches were done in the PUBMED and Virtual Health Library databases, in 2020 June. An evaluation of the methodological quality of systematic reviews and economic studies was done using the tools AMSTAR (Assessing the Methodological Quality of Systematic Reviews), and QHES (Quality of Health Economic Studies) checklist, respectively. Calculation of budget impact, following guidelines of the Brazilian Health Ministry, and projection of expenditures for the State Department of Health of Goias. Results: 1 systematic review and 1 Brazilian economic study were selected and included in the study of rapid evidence review. Conclusion: In the Brazilian context, Aripiprazole is cost-effective when compared to Chlorpromazine, Haloperidol, Quetiapine and Ziprasidone. However, it is less cost-effective than Risperidone and Olanzapine. If it is standardized by State Department of Health of Goias, it will promote anual savings for BPHS from R$ 250,042.05 to R$ 407,418.41, in its maximum dissemination. The direct expenses are estimated at R$ 1,582,115.24 to R $ 27,960,108.08


Subject(s)
Humans , Schizophrenia/drug therapy , Antipsychotic Agents/therapeutic use , Aripiprazole/therapeutic use , Analysis of the Budgetary Impact of Therapeutic Advances , Antipsychotic Agents/economics , Unified Health System/economics , Aripiprazole/economics
6.
Washington; Organización Panamericana de la Salud; ago 25, 2020. 28 p.
Non-conventional in Spanish | LILACS | ID: biblio-1117908

ABSTRACT

En el transcurso de la pandemia de COVID-19, numerosos países, de ingresos bajos, medianos y alto, han visto agotadas sus reservas de medicamentos esenciales necesarios para el manejo de los pacientes con COVID-19 en las unidades de cuidados intensivos (UCI). El plan de preparación para emergencias sanitarias de los países requiere incluir una lista de medicamentos esenciales y otros dispositivos médicos necesarios en las UCI para afrontar emergencias sanitarias. La lista de medicamentos esenciales para el manejo de pacientes que ingresan a unidades de cuidados intensivos con sospecha o diagnóstico confirmado de COVID-19 es un documento de orientación fundamental que ayuda a los sistemas de salud de los países a priorizar los medicamentos esenciales que deben estar ampliamente disponibles y ser asequibles para manejar los pacientes en las UCI durante las situaciones de emergencia sanitaria, en este caso con sospecha o diagnóstico confirmado de COVID-19. Está dirigida a las autoridades sanitaras y a los encargados del manejo del sistema de salud de los países. Esta lista incluye fundamentalmente los medicamentos considerados esenciales para el manejo de los cuadros clínicos que con se observan con mayor frecuencia en pacientes hospitalizados en UCI a causa de una infección por SARS-CoV-2. No se incluyen la mayoría de los medicamentos que comúnmente se encuentran en las UCI para el manejo de otras patologías, comorbilidades o la estabilización del paciente (p. ej., insulina o antihipertensivos), salvo aquellos que pueden requerirse para el tratamiento o apoyo (p. ej., bloqueantes neuromusculares o anestésicos) de las dolencias generadas por la infección. Tampoco se incluyen medicamentos específicos para el tratamiento de la infección por SARS-CoV-2, puesto que no existe, por el momento, evidencia científica de alta calidad que avale su uso, salvo en el contexto de ensayos clínicos controlados. Un equipo de expertos en el tema realizó una búsqueda de información sobre la atención de pacientes en UCI durante la pandemia de COVID-19, en Medline (a través de PubMed), Cochrane, Tripdatabase, Epistemonikos y en buscadores generales de internet (Google). Se identificaron también revisiones o guías generadas por ministerios de Salud de varios países de la Región de las Américas, la Organización Mundial de la Salud (OMS), la Organización Panamericana de la Salud (OPS), el Instituto Nacional de Salud y Excelencia Clínica (NICE) de Reino Unido, los Centros para el Control y la Prevención de Enfermedades (CDC) de Estados Unidos y los Institutos Nacionales de Salud (NIH) de Estados Unidos.


Subject(s)
Humans , Child , Adult , Pneumonia, Viral/drug therapy , Succinylcholine/therapeutic use , Antipsychotic Agents/therapeutic use , Benzodiazepines/therapeutic use , Patient Care Management/organization & administration , Dexamethasone/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Coronavirus Infections/drug therapy , Drugs, Essential/supply & distribution , Dexmedetomidine/therapeutic use , Severe Acute Respiratory Syndrome/drug therapy , Antipyretics/therapeutic use , Pandemics/prevention & control , Betacoronavirus/drug effects , Haloperidol/therapeutic use , Analgesics, Opioid/therapeutic use , Intensive Care Units/organization & administration , Anti-Infective Agents/therapeutic use , Pneumonia, Viral/prevention & control , Respiration, Artificial/nursing , Shock, Septic/prevention & control , Thromboembolism/prevention & control , Coronavirus Infections/prevention & control , Evidence-Based Medicine , Intubation/nursing , Hypoxia/drug therapy
7.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 22-26, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1055359

ABSTRACT

Objective: German psychiatrist Kurt Schneider proposed the concept of first-rank symptoms (FRS) of schizophrenia in 1959. However, their relevance for diagnosis and prediction of treatment response are still unclear. Most studies have investigated FRS in chronic or medicated patients. The present study sought to evaluate whether FRS predict remission, response, or improvement in functionality in antipsychotic-naive first-episode psychosis. Methods: Follow-up study of 100 patients at first episode of psychosis (FEP), with no previous treatment, assessed at baseline and after 2 months of treatment. The participants were evaluated with the standardized Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF) and for presence of FRS. Results: Logistic regression analysis showed that, in this sample, up to three individual FRS predicted remission: voices arguing, voices commenting on one's actions, and thought broadcasting. Conclusion: Specific FRS may predict remission after treatment in FEP patients. This finding could give new importance to Kurt Schneider's classic work by contributing to future updates of diagnostic protocols and improving estimation of prognosis.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Psychotic Disorders/diagnosis , Psychotic Disorders/drug therapy , Schizophrenia/diagnosis , Schizophrenia/drug therapy , Antipsychotic Agents/therapeutic use , Psychiatric Status Rating Scales , Reference Values , Remission Induction , Logistic Models , Predictive Value of Tests , Follow-Up Studies , Treatment Outcome
8.
Rev. ANACEM (Impresa) ; 14(1): 58-67, 2020. graf, tab
Article in Spanish | LILACS | ID: biblio-1123594

ABSTRACT

Cuando la esquizofrenia no responde satisfactoriamente a tratamiento farmacológico, alcanzar una terapia efectiva para el paciente es una tarea bastante frustrante para el médico psiquiatra. Es en este contexto que la terapia electroconvulsiva y la estimulación magnética transcraneal repetitiva han tomado fuerza en la investigación clínica, a pesar de los grandes cuestionamientos sobre su efectividad y mala reputación. Se realizó una revisión sistemática de la literatura en las principales bases de datos disponibles. Concluyendo que ambas terapias demuestran ser herramientas útiles en el tratamiento de la esquizofrenia resistente a tratamiento farmacológico, así como también complementarias a los antipsicóticos


When schizophrenia does not respond satisfactorily to pharmacological treatment, achieving effective therapy for the patient is quite a frustrating task for the psychiatrist. It is in this context that electroconvulsive therapy and repetitive transcranial magnetic stimulation have gained strength in clinical research, despite huge questions about its success and bad reputation. A systematic review of the literature was conducted in the main available databases. Concluding that both specific therapies will be useful tools in the treatment of schizophrenia resistant to pharmacological treatment, as well as complementary to antipsychotics.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Schizophrenia/therapy , Electroconvulsive Therapy/statistics & numerical data , Transcranial Magnetic Stimulation , Schizophrenia/drug therapy , Antipsychotic Agents/adverse effects , Antipsychotic Agents/therapeutic use , Randomized Controlled Trial
9.
Article in English | WPRIM | ID: wpr-880607

ABSTRACT

Antipsychotic medication is the primary treatment for schizophrenia, which is effective on ameliorating positive symptoms and can reduce the risk of recurrence, but it has limited efficacy for negative symptoms and cognitive dysfunction. The negative symptoms and cognitive dysfunction seriously affects the life quality and social function for the patients with schizophrenia. Currently, there is plenty evidence that antipsychotic drugs combined with adjuvant therapy drugs can effectively improve the negative symptoms and cognitive dysfunction. These drugs include anti-oxidants, nicotinic acetylcholine receptors and neuro-inflammatory drugs (anti-inflammatory drugs, minocycline), which show potential clinical effects.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , Antipsychotic Agents/therapeutic use , Cognitive Dysfunction/etiology , Humans , Minocycline/therapeutic use , Schizophrenia/drug therapy
10.
Article in Chinese | WPRIM | ID: wpr-879792

ABSTRACT

OBJECTIVE@#To study the changes in metabolic markers and clinical outcome after treatment with different drug regimens in children with bipolar affective disorder.@*METHODS@#A retrospective analysis was performed on the medical data of 220 children with bipolar affective disorder who attended the hospital from January 2017 to January 2020. According to the treatment method, 112 children treated with atypical antipsychotic drugs alone were enrolled as the control group, and 108 children treated with atypical antipsychotic drugs combined with mood stabilizer were enrolled as the study group. The two groups were compared in terms of baseline data, changes in related metabolic markers[fasting insulin (FIN), glycosylated hemoglobin (HbAlc), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)] after treatment, incidence rate of metabolic syndrome, and clinical outcome.@*RESULTS@#There were no significant differences in the baseline data including age, sex, and course of disease between the two groups (@*CONCLUSIONS@#Atypical antipsychotic drugs combined with mood stabilizer in the treatment of bipolar disorder in children have little effect on the level of metabolic markers, and the curative effect is significant.


Subject(s)
Antipsychotic Agents/therapeutic use , Biomarkers/blood , Bipolar Disorder/drug therapy , Child , Cholesterol, HDL , Humans , Mood Disorders , Retrospective Studies , Triglycerides
11.
Arch. Clin. Psychiatry (Impr.) ; 46(6): 165-168, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054913

ABSTRACT

Abstract Objective Schizophrenia is a complex and chronic psychiatric disorder. In recent years, studies have found glutamatergic system participation in its etiopathogenesis, especially through aberrant NMDA receptors functioning. Thus, drugs that modulate this activity, as amantadine and memantine, could theoretically be used in its treatment. To perform a systematic literature review about memantine and amantadine use as adjunct in schizophrenia treatment. Methods A systematic review of papers published in English indexed in the electronic database PubMed ® using the terms "memantine", "amantadine" and "schizophrenia" published until October 2016. Results We found 144 studies, 8 selected for analysis due to meet the objectives of this review. Some of these have shown benefits from such drug use, especially in symptoms measured by PANSS and its subdivisions, while others do not. Discussion: The data in the literature about these drugs use for schizophrenia treatment is still limited and have great heterogeneity. Thus, assay with greater robustness are needed to assess real benefits of these drugs as adjuvant therapy.


Subject(s)
Humans , Schizophrenia/drug therapy , Amantadine/therapeutic use , Memantine/therapeutic use , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Placebos , Psychiatric Status Rating Scales , Antipsychotic Agents/therapeutic use , Amantadine/adverse effects , Memantine/adverse effects , Double-Blind Method , Treatment Outcome , PubMed , Adjuvants, Anesthesia/therapeutic use
14.
Rev. gaúch. enferm ; 40: e20180084, 2019.
Article in Portuguese | LILACS, BDENF | ID: biblio-1004089

ABSTRACT

Resumo OBJETIVO Compreender, sob a perspectiva ética de Freire, o cuidado de enfermagem às pessoas com transtorno de personalidade borderline. MÉTODOS Pesquisa qualitativa cuja produção das informações foi realizada de maio a junho de 2016, em duas unidades de internação psiquiátrica. Foram entrevistados sete enfermeiros e oito técnicos de enfermagem. As informações foram analisadas à luz do referencial de Paulo Freire. RESULTADOS Emergiram as categorias: 1) Acolhimento e relacionamento terapêutico como instrumentos para fortalecimento de vínculo; e 2) Terapia medicamentosa e contenção: interface entre proteção, estabelecimento de limites e outros desafios para o cuidado. CONCLUSÕES Os cuidados de enfermagem envolveram tecnologias relacionais, administração de medicamentos e contenção mecânica. Foram referidas dificuldades para lidar com pessoas com esse transtorno. A maneira de cuidar da enfermagem, embora ainda permeada por alguns preconceitos, passa por ideários contidos nos pressupostos éticos que operam à luz da obra de Freire.


Resumen OBJETIVO Comprender, bajo la perspectiva ética de Freire, la atención de enfermería a personas con trastorno límite de la personalidad. MÉTODOS Investigación cualitativa, cuya producción de información se realizó de mayo a junio de 2016, en dos unidades de internación psiquiátrica. Se entrevistaron a siete enfermeras y ocho técnicos de enfermería. Se analizó la información a la luz del marco referencial de Paulo Freire. RESULTADOS Surgieron las categorías: 1) Acogida y relación terapéutica como instrumentos para el fortalecimiento del vínculo; y 2) Terapia medicamentosa y contención: interfaz entre protección, establecimiento de límites y otros desafíos para la atención. CONCLUSIONES La atención de enfermería incluyó tecnologías relacionales, administración de fármacos y contención física. Hubo dificultades para tratar con personas con este trastorno. La forma de cuidar de la enfermería, aunque esté aún impregnada por algunos prejuicios, pasa por ideologías contenidas en los supuestos éticos que operan a la luz de la obra de Freire.


Abstract OBJECTIVE To understand, from the ethical perspective of Freire's, the nursing care for people with borderline personality disorder. METHODS This is a qualitative research whose production of information was conducted from May to June 2016 in two psychiatric admission units. We have interviewed seven nurses and eight nursing technicians. The information was analyzed in the light of Paulo Freire's referential framework. RESULTS The following categories have come up: 1) Welcoming and therapeutic relationship as instruments to strengthen linkage; and 2) Drug therapy and restraint: interface between protection, establishment of limits and other challenges for care". CONCLUSIONS Nursing care involved technologies related, medicine administration and physical restraint. There were difficulties in dealing with this disorder. The way to care for nursing, although still permeated by some prejudices, runs through ideologies contained in the ethical assumptions that operate in the light of Freire's work.


Subject(s)
Humans , Male , Female , Adult , Aged , Young Adult , Borderline Personality Disorder/nursing , Prejudice , Antipsychotic Agents/therapeutic use , Restraint, Physical , Qualitative Research , Ethics, Nursing , Middle Aged , Nurse-Patient Relations
16.
Psiquiatr. salud ment ; 35(3/4): 257-261, jul.-dic. 2018.
Article in Spanish | LILACS | ID: biblio-1005051

ABSTRACT

Paciente de 47 años, casada, con 3 hijos. Antecedentes de patología psiquiátrica en madre y hermano. Sin antecedentes psiquiátricos previos. Ingresa hace 4 años al Servicio. Con síntomas polimorfos, varios diagnósticos desde el ingreso, pero con respuesta al tratamiento y con periodos de estabilidad psicopatológica demás de un año. Conocida en varios dispositivos del servicio. Diagnósticos: Trastorno Delirante, Obs. Trastorno Afectivo Bipolar, Trastorno Esquizoafectivo


Patient 47 years old, married, with 3 children. History of psychiatric pathology in mother and brother. No previous psychiatric history. Enter the Service 4 years ago. With polymorphic symptoms, several diagnoses from admission, but with response to treatment and with periods of psychopathological stability over a year. Known in several service devices. Diagnoses: Delusional Disorder, Obs. Bipolar Affective Disorder, Schizoaffective Disorder


Subject(s)
Humans , Female , Middle Aged , Psychotic Disorders/diagnosis , Schizophrenia, Paranoid/diagnosis , Bipolar Disorder/diagnosis , Psychotherapy , Psychotic Disorders/therapy , Schizophrenia, Paranoid/therapy , Signs and Symptoms , Syndrome , Antipsychotic Agents/therapeutic use , Bipolar Disorder/therapy , Occupational Therapy
17.
Psiquiatr. salud ment ; 35(3/4): 262-267, jul.-dic. 2018.
Article in Spanish | LILACS | ID: biblio-1005052

ABSTRACT

Caso Clínico: Mujer, 23 años. Discapacidad intelectual. Asiste a colegio especial (no lee ni escribe). Institucionalizada. Motivo de ingreso: Paciente ingresa en octubre del 2017 traída por carabineros por ser encontrada en la calle bajo el efecto de múltiples sustancias, con ideación suicida. Días antes fue expulsada del hogar por agresión a cuidadoras. Diagnósticos de ingreso: Discapacidad intelectual moderado. Síndrome suicidal, Trastorno por dependencia a drogas. ¿Esquizofrenia hebefrénica? Evolución: Mantiene desajustes conductuales severos fluctuantes, con serias dificultades para manejar la rabia, lo que la lleva a tener conductas hetero y autoagresivas. Plan de tratamiento: Farmacológico (clozapina), Psicológico (TCC), Social (dispositivo adecuado post-alta). Clozapina para trastornos psicóticos en adultos con discapacidad intelectual. El principal riesgo de atribuir alguno de estos comportamientos a una supuesta "psicosis", es el de "medicalizar" y tratar de forma poco acertada. Es importante descartar factores ambientales y del aprendizaje (hábitos y conductas aprendidas, institucionalización, reacciones ante el estrés agudo.) La prevalencia de abuso y dependencia de sustancias en población con DI va desde el 0,5% al 2,6%. Lo cual es menor que la población general. Pacientes con DI y dependencia a drogas se asocia a otras enfermedades psiquiátricas (42-54%). Se ha informado que las personas con discapacidad intelectual en América Latina a menudo están institucionalizadas y escondidas de la sociedad en instalaciones deficientes y superpobladas.


Clinical Case: Female, 23 years old. Intellectual disability. He attends a special school (she does not read or write). Institutionalized. Reason for admission: Patient enters in October 2017 brought by police officers to be found in the street under the effect of multiple substances, with suicidal ideation. Days before she was expelled from the home because of assaulting caregivers. Admission diagnoses: Moderate intellectual disability. Suicidal syndrome, Disorder due to drug dependence. Hebephrenic schizophrenia? Evolution: Maintains fluctuating severe behavioral imbalances, with serious difficulties in managing rage, which leads to hetero and self-aggressive behaviors. Treatment plan: pharmacological (clozapine), Psychological (CBT), Social (adequate post-hospitalization discharge device). Clozapine for psychotic disorders in adults with intellectual disabilities. The main risk of attributing some of these behaviors to a supposed "psychosis" is that of "medicalizing" and dealing inappropriately. It is important to rule out environmental and learning factors (habits and behaviors learned, institutionalization, reactions to acute stress. The prevalence of substance abuse and dependence in the population with ID ranges from 0.5% to 2.6%. Which is less than the general population. Patients with ID and drug dependence are associated with other psychiatric illnesses (42-54%). It is reported that people with intellectual disabilty in Latin America are often institutionalized and hidden from society in poor and overcrowded facilities.


Subject(s)
Humans , Female , Young Adult , Substance-Related Disorders/diagnosis , Intellectual Disability/diagnosis , Intellectual Disability/therapy , Psychotherapy , Psychotic Disorders , Antipsychotic Agents/therapeutic use , Clozapine/therapeutic use , Substance-Related Disorders/complications , Substance-Related Disorders/therapy , Suicidal Ideation , Intellectual Disability/classification , Intellectual Disability/complications , Intellectual Disability/etiology
18.
Rev. bras. psiquiatr ; 40(3): 233-237, July-Sept. 2018. tab
Article in English | LILACS | ID: biblio-959242

ABSTRACT

Objective: To evaluate how well symptom rating scales differentiate bipolar disorder (BD) episode types. Methods: One hundred and six patients with BD were followed for 13 years. At each visit, the following clinical scales were administered: Young Mania Rating Scale (YMRS), Hamilton Depression Scale (HAM-D) and Clinical Global Impressions scale for use in bipolar illness (CGI-BP). To perform a comparison between the affective states of BP, three time points in each patient's follow-up period were chosen for evaluation: the most severe manic episode, the most severe depressive episode, and the euthymic period with least symptoms. Canonical discriminant analyses (CDA) were performed to identify which symptoms best discriminated episodes. Results: CDA revealed HAM-D was worse than YMRS and CGI-BP to discriminate mood states. The items evaluating increased motor activity in YMRS (2, increased motor activity/energy) and HAM-D (9, agitation) were the best to distinguish mania, depression, and euthymia. In contrast, HAM-D item 8 (retardation) and the HAM-D and YMRS items related to mood symptoms were less important and precise. Conclusion: Higher levels of energy or activity should be considered a core symptom of mania. However, our results do not confirm the association between a decrease in energy or activity and depression. HAM-D probably does not assess motor activity adequately.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Psychiatric Status Rating Scales , Bipolar Disorder/psychology , Depressive Disorder/psychology , Motor Activity/physiology , Antipsychotic Agents/therapeutic use , Bipolar Disorder/diagnosis , Discriminant Analysis , Follow-Up Studies , Depressive Disorder/drug therapy , Ambulatory Care Facilities
20.
Psiquiatr. salud ment ; 35(1/2): 93-100, ene.-jun. 2018.
Article in Spanish | LILACS | ID: biblio-998490

ABSTRACT

La Enfermedad de Parkinson se inicia generalmente en las personas entre los 50 y 60 años, La mayoría de los pacientes de Parkinson se encuentran en situación de doble vulnerabilidad: vejez y discapacidad. El objetivo del tratamiento es reducir la velocidad de progresión de la enfermedad, controlar los síntomas y los efectos secundarios derivados de los fármacos que se usan para tratarla. La presentación de las alteraciones psiquiátricas se caracteriza por episodios de alucinaciones, trastornos confusionales, trastornos del control de los impulsos, hipersexualidad o Parasomnias, siendo de presentación habitualmente vespertina. Estos pueden evolucionar llegando a cuadros de psicosis, estados confusionales crónicos, ideas delirantes en forma permanente, con alto contenido paranoide, existiendo un gran riesgo de intentos suicidas.


Parkinson's disease usually begins in people between the ages of 50 and 60. Most Parkinson's patients are in a situation of double vulnerability: old age and disability. The goal of treatment is to reduce the rate of progression of the disease, control of the symptoms and side effects derived from the drugs used to treat it. The presentation of the psychiatric alterations is characterized by episodes of hallucinations, confusional disorders, disorders of the control of the impulses, hypersexuality or Parasomnias, being usually of evening presentation. These can evolve into psychosis, chronic confusional states, persistent delusional ideas, with high paranoid content, and there is a high risk of suicide attempts.


Subject(s)
Humans , Male , Middle Aged , Parkinson Disease/complications , Mental Disorders/complications , Mental Disorders/diagnosis , Mental Disorders/drug therapy , Psychotic Disorders/complications , Psychotic Disorders/diagnosis , Psychotic Disorders/drug therapy , Suicide, Attempted , Antipsychotic Agents/therapeutic use , Medical History Taking , Mental Disorders/classification
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