Antipsicóticos injetáveis típicos e atípicos de ação rápida em pacientes esquizofrênicos em uso de atípicos orais: um relato do Brasil

Abstract

Introduction: Combining antipsychotics in schizophrenic patients is not a rare practice. Most of the time, doctors prescribe typical and atypical associated antipsychotics. To show the magnitude this problem, a research was developed at the Public Hospital Galba Velloso in the city of Belo Horizonte. Objective: to estimate the frequency and dosage of typical and atypical injectable antipsychotics in a sample of 1171 schizophrenic patients hospitalized between 2010-2013, intended to be treated only with atypicals. Method: Based on the prescriptions of interned schizophrenic patients, we selected the 105 patients who used atypical antipsychotics with conventional antipsychotics. Results: Of the selected patients, 59 used risperidone, 27 olanzapine, 11 clozapine, 5 quetiapine and 3 ziprasidone. Seventeen subjects received at least one quick-acting injectable haloperidol vial after the onset of the atypical antipsychotic, 10 received olanzapine IM and none received chlorpromazine. Injection Haloperidol was generally given in combination with promethazine. Aggregated results indicate that olanzapine and ziprasidone IM were more effective than haloperidol and promethazine IM in reducing agitation and aggressive behavior in the first 2 hours, with a lower risk of shortterm extrapyramidal side effects. Conclusion: The use of fast-acting injectable haloperidol for patients using exclusively atypical oral was more frequent than olanzapine IM, but did not result in an increased need for anticholinergic use.