Sličnosti i razlike između dugodjelujućih i kratkodjelujućih antipsihotika

master's thesis

• Title (english): Similarities and differences between long-acting and short-acting antipsychotics
• Author: Petra Murković
• Mentor: Marina Šagud (mentor)
• Committee member: Martina Rojnić Kuzman (predsjednik povjerenstva)
• Committee member: Dražen Begić (član povjerenstva)
• Committee member: Marina Šagud (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Psychiatry and Psychological Medicine); Zagreb
• Defense date and country: 2024-09-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Psychiatry

Abstract

Uvođenje antipsihotika kod oboljelih od shizofrenije i srodnih poremećaja dovelo je do odgovarajuće kontrole pozitivnih simptoma i mogućnosti pretežito izvanbolničkog liječenja psihotičnih bolesnika čime se postigla bolja kvaliteta njihovih života, smanjilo opterećenje zdravstvenog sustava i potreba za dugotrajnom hospitalizacijom. Tipični antipsihotici su učinkoviti u eliminiranju pozitivnih simptoma, ali ne i kod perzistentnih negativnih simptoma te njihova primjena rezultira relativno čestim razvojem ekstrapiramidalnih nuspojava. Atipični antipsihotici pokazali su bolju podnošljivost i manju vjerojatnosti izazivanja ekstrapiramidalnih nuspojava te neki djelomično pokrivaju negativne simptome. Zbog manjka uvida u stanje kod oboljelih relativno čest problem kod oralne terapije je neadherencija koja povećava vjerojatnost recidiva, ponovne hospitalizacije, kasnije otežanog liječenja te dovodi do progresije kroničnog tijeka shizofrenije koja se očituje tvrdokornijim pozitivnim i negativnim simptomima, ali i kognitivnim deficitom i socijalnim nefunkcioniranjem. U novije vrijeme, dostupni su dugodjelujući intramuskularni antipsihotici koji su pokazali superiornost u odnosu na prvobitno razvijene oralne kratkodjelujuće antipsihotike u kontroli poremećaja iz shizofrenog spektra te smanjuju vjerojatnost neadherencije. Primjenom dugodjelujućih intramuskularnih antipsihotika postiže se stabilnija koncentracija aktivne komponente u krvi što se povezuje s manje čestim recidivima i hospitalizacijama te s poboljšanjem kognitivog i socijalnog funkcioniranja. Kratkodjelujući intramuskularni antipsihotici primjenjuju se kod akutnih agitiranih i delirantnih stanja.

Abstract (english)

The introduction of antipsychotics in patients with schizophrenia led to adequate control of positive symptoms and the possibility of mainly outpatient treatment of psychotic patients, who achieved a better quality of their lives, reduced the burden on the health system and the need for long-term hospitalization. Typical antipsychotics are effective in eliminating positive symptoms, but not in persistent negative symptoms, and their use results in the frequent development of extrapyramidal side effects. Atypical antipsychotics have shown better tolerability and lower possibility for extrapyramidal side effects, additionally some partially cover negative symptoms. Due to the lack of insight into the condition , a relatively common problem with oral therapy is non-adherence, which increases the likelihood of relapse, re-hospitalization, later difficult treatment and leads to the progression of the chronic course of schizophrenia, which is manifested with persistent positive and negative symptoms and also cognitive deficit and social dysfunction. More recently, long-acting intramuscular antipsychotics have become available, which have shown superiority over the originally developed oral short-acting antipsychotics in treatment disorders from the schizophrenic spectrum and in reducing the likelihood of non-adherence. With the use of long-acting intramuscular antipsychotics, a more stable concentration of the active component in the blood is achieved, which is associated with less frequent relapses, hospitalizations and with an improvement in cognitive and social functioning. Short-acting intramuscular antipsychotics are used in acutely agitated and delirious patient.

• Keywords: dugodjelujući antipsihotici; kratkodjelujući antipsihotici; neadherencija; shizofrenija
• Keywords (english): long-acting antipsychotics; short-acting antipsychotics; non-adherence; schizophrenia
• Language: croatian
• URN:NBN: urn:nbn:hr:105:323796
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-09-06 09:12:45