Efectividad y seguridad de la quetiapina en la disminución de los síntomas depresivos, en pacientes con esquizofrenia
Mera Fernandez, Luz Angela
Introduction: Depression is frequent in patients with Schizophrenia at different phases from this psychotic disorder, and difficult to identify due to its similarities with other symptoms that belong to schizophrenia itself or to side effects from de neuroleptic drugs. The aim of the present study is to determinate the efficacy and security of the Quetiapine (Seroquel®) for the control and treatment of depressive symptoms compared with other second generation antipsychotic or no pharmacology treatment, in patients with schizophrenia. Methods: a systematic review of literature was performed in six databases (MEDLINE, EMBASE, COCHRANE, PsycNET, OpenGrey, LILACS), according with the PRISMA methodology, including efficacy and safety of quetiapine use in schizophrenic patients with depression. Primary Outcomes were: remission of depressive symptoms, reduction of suicide attempts , and adverse effects to treatment. Results: Two studies were included. The Di Fiorino trial reports efficacy of quetiapine for the treatment of patients con schizophrenia and depression with a difference between the least squares means score reduction in the CDSS score of 2.2 with IC 95% (0.8 – 3.7) compared to risperidone, and a decrease in HAM-D of 3.3 (p<0.0001) compared to risperidone. The more common side effects with quetiapine were: drowsiness dry mouth and hypotension. Discussion: Quetiapine is effective for the treatment of depressive symptoms in patients with schizophrenia when compared to risperidone employing CDSS in this population. Quality of evidence is moderated with important risk of bias. More high-quality clinical trials are necessary to elucidate quetiapine efficacy and its security profile in this population.