EFICÁCIA E SEGURANÇA DA CLOZAPINA E DA OLANZAPINA NA ESQUIZOFRENIA RESISTENTE AO TRATAMENTO: UMA REVISÃO INTEGRATIVA
DOI:
https://doi.org/10.71248/q8tk7462Keywords:
Antipsychotic Agents, Clozapine, Drug Resistence, Electroconvulsive Therapy, Olanzepine, SchizophreniaAbstract
A esquizofrenia resistente ao tratamento representa um desafio clínico e de saúde pública, especialmente pela persistência dos sintomas após falha terapêutica com pelo menos dois antipsicóticos. Objetivo: analisar a literatura acerca da eficácia, segurança, efeitos adversos e custo-benefício da clozapina e da olanzapina no tratamento da esquizofrenia resistente. Métodos: realizou-se uma revisão com busca sistematizada na base Epistemonikos, utilizando a estratégia treatment AND schizophrenia AND clozapina OR olanzapina. Foram encontrados 419 resultados iniciais e, após aplicação de filtros, 29 artigos foram selecionados para análise. Resultados e discussão: os estudos indicam que a clozapina permanece como padrão-ouro para a esquizofrenia resistente, apresentando superioridade clínica e redução de internações hospitalares. Entretanto, exige monitoramento rigoroso devido a efeitos adversos como hipersonolência, constipação, taquicardia e risco de toxicidade em infecções. A olanzapina mostrou eficácia em quadros agudos, porém com importante limitação por efeitos metabólicos. Estratégias como metformina, topiramato e eletroconvulsoterapia podem auxiliar em casos específicos. Conclusão: a clozapina é a principal alternativa terapêutica para a esquizofrenia resistente, desde que acompanhada de vigilância clínica, manejo de efeitos adversos e suporte estruturado nos serviços de saúde.
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