A associação do ganho de peso com o uso de quetiapina ou risperidona em pacientes com esquizofrenia: uma revisão sistemática

Abstract

Introduction: Schizophrenia is a complex mental disorder that has a certain chronicity and varying levels of incapability. From the epidemiological point of view schizophrenia is a disorder that affects 1% of the world population. Despite its pathophysiology still not be well understood, the control of its symptoms have improving in recent decades with the use of antipsychotics. However, one of the major side effects of these medicines is the significant weight gain. These neuroleptics are divided into two classes representing the first and second generation, being the second generation antipsychotics the most commonly used nowadays. Among them, risperidone and quetiapine, have proven to be effictive in the treatment of schizophrenic patients, with an intermediate risk for weight gain.Objective: To identify through systematic review of the medical literature publications about the use of quetiapine or risperidone in patients with schizophrenia and to analyse weight gain resulting from the terapeutic treatment. Methodology: This systematic review was based on a search of the scientific literature on the electronic data base PubMed/Medline. The articles were analyzed regarding their quality by the Critical Appraisal Skills Programme (CASP) and the descriptors used were "Schizophrenia," "Risperidone" "Quetiapine" and "Weight gain"; published in English, Portuguese or Spanish, in the last five years; restricted to randomised controlled trials and performed in humans. Results: It were found 6 articles which attended the inclusion criteria. All studies identified clinically significant weight gain (increase of 7% or more on body weight) in their sample population, with variations in incidence due to methodological differences such as: medicine used in the treatment (risperidone or quetiapine), route of administration, follow-up time per patient and dosage administered. In addition, it was shown the number of patients who had adverse events, for example the extrapyramidal symptoms, resulting from the treatment. Conclusion: Patients with the diagnosis of schizophrenia had higher weight gain with the use of neuroleptic antipsychotic risperidone compared to quetiapine. However, a more secure comparability between these two drugs was undermined by the lack of methodological homogeneity. Therefore, further studies are required to diminish potential biases of these differences.