A systematic review of the treatment of schizophrenia: monotherapy vs antipsychotics combination

Detalhes bibliográficos
Autor(a) principal: Bertoni, Rafaela Albuquerque
Data de Publicação: 2023
Outros Autores: Leal, Fellipe Miranda
Tipo de documento: Artigo
Idioma: por
Título da fonte: Debates em Psiquiatria (Online)
Texto Completo: https://revistardp.org.br/revista/article/view/414
Resumo: Introduction: The pharmacological treatment of schizophrenia with the association of antipsychotics is a very common practice, although there is no consolidated scientific evidence to support this practice, not even some guidance regard to the clinical treatment guidelines. Objective: To evaluate the effectiveness and risks of using the combination of antipsychotics comparing to using antipsychotics in monotherapy in the treatment of schizophrenia. Method: A literature review was carried out in search for scientific studies which compared the use of antipsychotics in monotherapy with the use of antipsychotics in association for the treatment of schizophrenia. Results: Most studies showed no differences in symptom control between the groups. However, there was a lower frequency of relapse of symptoms and a decrease in hospitalizations in patients treated with antipsychotic monotherapy. In addition, there were fewer adverse effects in patients with this therapeutic option. Adherence was lower when switching from antipsychotic combination treatment to antipsychotic monotherapy. However, the change was well tolerated and in almost all patients favorable results were observed. Conclusions: The treatment of schizophrenia and schizoaffective disorder with antipsychotic monotherapy presents a symptom control like the treatment with combination of antipsychotics. However, in monotherapy the occurrence of side effects, relapses and hospitalization is lower. Therefore, this review emphasizes that in clinical practice the pharmacological treatment of schizophrenia, as well as schizoaffective disorder, should prioritize the use of antipsychotics in monotherapy.
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spelling A systematic review of the treatment of schizophrenia: monotherapy vs antipsychotics combinationUna revisión sistemática del tratamiento de la esquizofrenia: monoterapia versus combinación de antipsicóticosUma revisão do tratamento da esquizofrenia: monoterapia vs associação de antipsicóticosesquizofreniapolicombinaçãoprognósticoschizophreniapolypharmacyprognosisesquizofreniapolifarmaciapronósticoIntroduction: The pharmacological treatment of schizophrenia with the association of antipsychotics is a very common practice, although there is no consolidated scientific evidence to support this practice, not even some guidance regard to the clinical treatment guidelines. Objective: To evaluate the effectiveness and risks of using the combination of antipsychotics comparing to using antipsychotics in monotherapy in the treatment of schizophrenia. Method: A literature review was carried out in search for scientific studies which compared the use of antipsychotics in monotherapy with the use of antipsychotics in association for the treatment of schizophrenia. Results: Most studies showed no differences in symptom control between the groups. However, there was a lower frequency of relapse of symptoms and a decrease in hospitalizations in patients treated with antipsychotic monotherapy. In addition, there were fewer adverse effects in patients with this therapeutic option. Adherence was lower when switching from antipsychotic combination treatment to antipsychotic monotherapy. However, the change was well tolerated and in almost all patients favorable results were observed. Conclusions: The treatment of schizophrenia and schizoaffective disorder with antipsychotic monotherapy presents a symptom control like the treatment with combination of antipsychotics. However, in monotherapy the occurrence of side effects, relapses and hospitalization is lower. Therefore, this review emphasizes that in clinical practice the pharmacological treatment of schizophrenia, as well as schizoaffective disorder, should prioritize the use of antipsychotics in monotherapy.Introducción: El tratamiento farmacológico de la esquizofrenia con la asociación de antipsicóticos es una práctica muy común, aunque no existe evidencia científica consolidada que avale esta práctica, ni existen orientaciones al respecto en guías clínicas de tratamiento. Objetivo: Evaluar la eficacia y los riesgos del uso de la combinación de antipsicóticos frente al uso de antipsicóticos en monoterapia para el tratamiento de la esquizofrenia y el trastorno esquizoafectivo. Método: Se realizó una revisión bibliográfica en busca de estudios científicos que compararan el uso de antipsicóticos en monoterapia con el uso de antipsicóticos en asociación para el tratamiento de la esquizofrenia y el trastorno esquizoafectivo. Resultados: En la mayoría de los estudios no hubo diferencias en el control de los síntomas entre los grupos. Sin embargo, hubo una menor frecuencia de reagravación de los síntomas y una reducción de las hospitalizaciones en pacientes tratados con monoterapia antipsicótica. Además, hubo menos efectos adversos en los pacientes con esta opción terapéutica. En cuanto a la adherencia, fue menor con el cambio de tratamiento en asociación con antipsicóticos a antipsicóticos en monoterapia. Sin embargo, el cambio fue bien tolerado y en casi todos los pacientes se observaron resultados favorables. Conclusiones: El tratamiento de la esquizofrenia y el trastorno esquizoafectivo con monoterapia antipsicótica presenta control de los síntomas, similar al tratamiento con combinación de antipsicóticos. Sin embargo, en monoterapia, la ocurrencia de efectos secundarios, recaídas y hospitalizaciones es menor. Por tanto, esta revisión refuerza que, en la práctica clínica, el tratamiento farmacológico de la esquizofrenia, así como del trastorno esquizoafectivo, debe priorizar el uso de antipsicóticos en monoterapia.Introdução: O tratamento farmacológico da esquizofrenia com a associação de antipsicóticos é uma prática bastante comum, ainda que não haja evidências científicas consolidadas que a fundamentem, tampouco haja orientação nesse sentido, nas diretrizes de tratamento clínico. Objetivo: Avaliar os benefícios e os riscos do uso da associação de antipsicóticos em comparação ao uso de antipsicótico em monoterapia para o tratamento de esquizofrenia. Metodologia: Foi realizada uma revisão na literatura em busca de estudos científicos que comparassem o uso de antipsicóticos em monoterapia com a associação de antipsicóticos para o tratamento da esquizofrenia. Resultados: Na maioria dos estudos não houve diferenças no controle de sintomas entre os grupos. No entanto, observou-se menor frequência de reagudizações de sintomas e redução das hospitalizações nos pacientes em tratamento com antipsicótico em monoterapia. Além disso, houve menos efeitos adversos em pacientes com essa opção terapêutica. A adesão foi menor com a troca do tratamento com associação de antipsicóticos para antipsicótico em monoterapia. Porém a mudança foi bem tolerada, sendo que, em quase todos os pacientes, foram observados resultados favoráveis. Conclusões: O tratamento da esquizofrenia e do transtorno esquizoafetivo com antipsicótico em monoterapia apresenta um controle de sintomas semelhante ao tratamento com associação de antipsicóticos. Entretanto, em monoterapia é menor a ocorrência de efeitos colaterais, reagudizações e hospitalizações. Portanto, esta revisão reforça que, na prática clínica, o tratamento farmacológico da esquizofrenia, assim como do transtorno esquizoafetivo, deve priorizar uso de antipsicóticos em monoterapia.Associação Brasileira de Psiquiatria2023-02-03info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionPeer-ReviewedRevisado por ParesAvaliado Pelos Paresapplication/pdfhttps://revistardp.org.br/revista/article/view/41410.25118/2763-9037.2023.v13.414Debates in Psychiatry; Vol. 13 (2023); 1-20Debates em Psiquiatria; Vol. 13 (2023); 1-20Debates em Psiquiatria; v. 13 (2023); 1-202763-90372236-918Xreponame:Debates em Psiquiatria (Online)instname:Associação Brasileira de Psiquiatria (ABP)instacron:ABPporhttps://revistardp.org.br/revista/article/view/414/388Copyright (c) 2023 Rafaela Albuquerque Bertoni, Fellipe Miranda Lealhttps://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccessBertoni, Rafaela AlbuquerqueLeal, Fellipe Miranda2024-01-21T09:29:07Zoai:ojs.emnuvens.com.br:article/414Revistahttps://revistardp.org.br/revista/oaiPUBhttps://revistardp.org.br/revista/oairdp@abp.org.br2763-90372236-918Xopendoar:2024-01-21T09:29:07Debates em Psiquiatria (Online) - Associação Brasileira de Psiquiatria (ABP)false
dc.title.none.fl_str_mv A systematic review of the treatment of schizophrenia: monotherapy vs antipsychotics combination
Una revisión sistemática del tratamiento de la esquizofrenia: monoterapia versus combinación de antipsicóticos
Uma revisão do tratamento da esquizofrenia: monoterapia vs associação de antipsicóticos
title A systematic review of the treatment of schizophrenia: monotherapy vs antipsychotics combination
spellingShingle A systematic review of the treatment of schizophrenia: monotherapy vs antipsychotics combination
Bertoni, Rafaela Albuquerque
esquizofrenia
policombinação
prognóstico
schizophrenia
polypharmacy
prognosis
esquizofrenia
polifarmacia
pronóstico
title_short A systematic review of the treatment of schizophrenia: monotherapy vs antipsychotics combination
title_full A systematic review of the treatment of schizophrenia: monotherapy vs antipsychotics combination
title_fullStr A systematic review of the treatment of schizophrenia: monotherapy vs antipsychotics combination
title_full_unstemmed A systematic review of the treatment of schizophrenia: monotherapy vs antipsychotics combination
title_sort A systematic review of the treatment of schizophrenia: monotherapy vs antipsychotics combination
author Bertoni, Rafaela Albuquerque
author_facet Bertoni, Rafaela Albuquerque
Leal, Fellipe Miranda
author_role author
author2 Leal, Fellipe Miranda
author2_role author
dc.contributor.author.fl_str_mv Bertoni, Rafaela Albuquerque
Leal, Fellipe Miranda
dc.subject.por.fl_str_mv esquizofrenia
policombinação
prognóstico
schizophrenia
polypharmacy
prognosis
esquizofrenia
polifarmacia
pronóstico
topic esquizofrenia
policombinação
prognóstico
schizophrenia
polypharmacy
prognosis
esquizofrenia
polifarmacia
pronóstico
description Introduction: The pharmacological treatment of schizophrenia with the association of antipsychotics is a very common practice, although there is no consolidated scientific evidence to support this practice, not even some guidance regard to the clinical treatment guidelines. Objective: To evaluate the effectiveness and risks of using the combination of antipsychotics comparing to using antipsychotics in monotherapy in the treatment of schizophrenia. Method: A literature review was carried out in search for scientific studies which compared the use of antipsychotics in monotherapy with the use of antipsychotics in association for the treatment of schizophrenia. Results: Most studies showed no differences in symptom control between the groups. However, there was a lower frequency of relapse of symptoms and a decrease in hospitalizations in patients treated with antipsychotic monotherapy. In addition, there were fewer adverse effects in patients with this therapeutic option. Adherence was lower when switching from antipsychotic combination treatment to antipsychotic monotherapy. However, the change was well tolerated and in almost all patients favorable results were observed. Conclusions: The treatment of schizophrenia and schizoaffective disorder with antipsychotic monotherapy presents a symptom control like the treatment with combination of antipsychotics. However, in monotherapy the occurrence of side effects, relapses and hospitalization is lower. Therefore, this review emphasizes that in clinical practice the pharmacological treatment of schizophrenia, as well as schizoaffective disorder, should prioritize the use of antipsychotics in monotherapy.
publishDate 2023
dc.date.none.fl_str_mv 2023-02-03
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Peer-Reviewed
Revisado por Pares
Avaliado Pelos Pares
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://revistardp.org.br/revista/article/view/414
10.25118/2763-9037.2023.v13.414
url https://revistardp.org.br/revista/article/view/414
identifier_str_mv 10.25118/2763-9037.2023.v13.414
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://revistardp.org.br/revista/article/view/414/388
dc.rights.driver.fl_str_mv Copyright (c) 2023 Rafaela Albuquerque Bertoni, Fellipe Miranda Leal
https://creativecommons.org/licenses/by-nc/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2023 Rafaela Albuquerque Bertoni, Fellipe Miranda Leal
https://creativecommons.org/licenses/by-nc/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Associação Brasileira de Psiquiatria
publisher.none.fl_str_mv Associação Brasileira de Psiquiatria
dc.source.none.fl_str_mv Debates in Psychiatry; Vol. 13 (2023); 1-20
Debates em Psiquiatria; Vol. 13 (2023); 1-20
Debates em Psiquiatria; v. 13 (2023); 1-20
2763-9037
2236-918X
reponame:Debates em Psiquiatria (Online)
instname:Associação Brasileira de Psiquiatria (ABP)
instacron:ABP
instname_str Associação Brasileira de Psiquiatria (ABP)
instacron_str ABP
institution ABP
reponame_str Debates em Psiquiatria (Online)
collection Debates em Psiquiatria (Online)
repository.name.fl_str_mv Debates em Psiquiatria (Online) - Associação Brasileira de Psiquiatria (ABP)
repository.mail.fl_str_mv rdp@abp.org.br
_version_ 1796798365344727040

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