Mortalidad en pacientes con demencia tratados con antipsicóticos atípicos (olanzapina, quetiapina y ziprasidona)

Servicio de Farmacia, Complexo Hospitalario de Pontevedra, Pontevedra, España
Farmacia Hospitalaria 07/2009; DOI: 10.1016/S1130-6343(09)72168-3
Source: OAI

ABSTRACT Introducción: Los antipsicóticos atípicos (AA) quetiapina, olanzapina y ziprasidona se utilizan para el tratamiento de trastornos conductuales asociados a demencia. Esta indicación no fi gura en su fi cha técnica. El objetivo de este estudio es analizar la relación de estos tratamientos con la mortalidad y otros factores. Método: Estudio retrospectivo desde marzo de 2005 hasta julio de 2007 de los tratamientos de AA solicitados como uso compasivo. Se registraron datos de mortalidad, edad, antecedentes de cardiopatía o de enfermedad cerebrovascular (ECV), duración y tratamiento por paciente. Resultados: Los pacientes estudiados fueron 289. La mortalidad fue del 31,1 %. Se constató mayor mortalidad en los pacientes con antecedentes de enfermedad cardiovascular y en los que usaron olanzapina. La quetiapina fue el antipsicótico más prescrito. Conclusiones: La utilización de AA en ancianos puede tener riesgos que superen los benefi cios. Cuando se prescriben en pacientes de riesgo deben considerarse las alertas sobre su seguridad y la individualidad de cada paciente. De acuerdo con nuestros datos, la olanzapina parece entrañar un mayor riesgo que la quetiapina y la ziprasidona.

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