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Antipsicóticos atípicos e comportamento suicida em pacientes esquizofrênicos ou esquizoafetivos Atypical antipsychotics and suicidal behavior in esquizophrenic or schizo-affective patients

By Felipe Filardi da Rocha, Nathália Bueno Alvarenga, Naira Vassalo Lage, Ana Luiza Lanna Trivelato, André Coelho Barros and Humberto Corrêa

Abstract

CONTEXTO: Os estudos a respeito da ação dos antipsicóticos atípicos no comportamento suicida são controversos e pouco explorados. OBJETIVOS: Análise discursiva da ação dos antipsicóticos atípicos no comportamento suicida de pacientes esquizofrênicos ou esquizoafetivos. MÉTODOS: Revisão de artigos nas bases de dados MEDLINE, LILACS e da Biblioteca Cochrane, entre o período de 1964 e 2009, usando as palavras-chave: "suicidal behavior" e/ou "suicide" e "atypical antipsychotics" e/ou "antipsychotics" e/ou "clozapine". RESULTADOS: As únicas evidências significativas positivas apontam para a clozapina, que apresenta uma relevância superior aos outros antipsicóticos de segunda geração na redução das taxas de autoextermínio. CONCLUSÕES: A clozapina é o único fármaco que pode alterar o comportamento suicida. Esse efeito não está associado à melhora clínica dos pacientes. Ela é a única droga aprovada pelo Food and Drug Administration (FDA) para prevenir suicídio em pacientes esquizofrênicos, mas os critérios para esse fim são incertos.<br>BACKGROUND: The literature concerning the net effect of atypical antipsychotic medication on suicidality is not consistent. OBJECTIVES: The empirical literature relating to the efficacy of pharmacological intervention with atypical antipsychotics in esquizophrenic or schizo-affective patients is comprehensively reviewed. METHODS: MEDLINE, LILACS and Cochrane Library were used to search for articles from 1964 to 2009 using these key-words: "suicidal behavior" e/ou "suicide" e "atypical antipsychotics" e/ou "antipsychotics" e/ou "clozapine". RESULTS: The strongest and perhaps unique evidence has been shown for clozapine, which seems to have a clinically relevant advantage over other second-generation antipsychotics for reducing suicidality temptation. DISCUSSION: Clozapine is the unique medication that modulates suicidal behavior. Its action is unknown but is not related do clinical improvement. It is the unique drug approved by Food and Drug Administration (FDA) to prevent suicide in esquizophrenic patients but the criteria for his use is uncertain

Topics: Antipsicóticos atípicos, clozapina, esquizofrenia, transtorno esquizoafetivo, suicídio, Atypical antipsychotic, clozapine, esquizophrenia, schizo-affective disorder, suicidality, Psychiatry, RC435-571, Neurology. Diseases of the nervous system, RC346-429, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Internal medicine, RC31-1245, Medicine, R, DOAJ:Psychiatry, DOAJ:Medicine (General), DOAJ:Health Sciences
Publisher: Universidade de São Paulo
Year: 2010
DOI identifier: 10.1590/S0101-60832010000500008
OAI identifier: oai:doaj.org/article:adb1a4f12c264f4e9b5ce8c0e5f9c540
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