title: [Prevention and Treatment of Common Acute Adverse Effects With Antipsychotic Use in Adults With Schizophrenia Diagnosis].
abstract: OBJECTIVE
  To determine the most adequate strategies for the prevention and treatment of the acute adverse effects of the use of antipsychotics.
  
  
  METHODS
  A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. A systematic literature search was carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced.
  
  
  RESULTS
  The non-pharmacological interventions such as nutritional counseling by a nutritionist, exercise and psychotherapy are effective in preventing weight gain with the use of antipsychotics. (Kg Weight reduction in DM of -3.05 (-4.16, -1.94)). The antipsychotic change from olanzapine to aripiprazole showed weight loss and decreased BMI (decreased weight in KG DM -3.21 (-9.03, -2.61). The use of beta blockers was ineffective in reducing akathisia induced by antipsychotic; using as outcome the 50% reduction of symptoms of akathisia comparing beta-blockers with placebo RR was 1.4 (0.59, 1.83).
  
  
  CONCLUSIONS
  It is recommended to make psychotherapeutic accompaniment and nutrition management of overweight for patients with weight gain. If these alternatives are ineffective is suggested to change the antipsychotic or consider starting metformin. For the management of drug-induced akathisia it is recommended to decrease the dose of the drug and the addition of lorazepam. It is recommended using 5mg biperiden IM or trihexyphenidyl 5mg orally in case of secondary acute dystonia and for the treatment of antipsychotic-induced parkinsonism to decrease the dose of antipsychotic or consider using 2 - 4mg/day of biperiden or diphenhydramine 50mg once daily.
authors.affiliation: Médico psiquiatra, Magíster en Epidemiología Clínica. Profesor del departamento de Psiquiatría y Salud Mental. Pontificia Universidad Javeriana. Director científico, Clínica La Inmaculada, Bogotá, D.C., Colombia. Electronic address: alarenasb@hotmail.com.
authors.forename: Álvaro Enrique
authors.initials: ÁE
authors.lastname: Arenas Borrero
authors.affiliation: Médico psiquiatra, psicoanalista, psiquiatra de enlace, magíster en Epidemiología Clínica. Profesor titular y Director del Departamento de Epidemiología Clínica y Bioestadística. Pontificia Universidad Javeriana. Hospital Universitario San Ignacio, Bogotá, D.C., Colombia.
authors.forename: Carlos
authors.initials: C
authors.lastname: Gómez Restrepo
authors.affiliation: Médica psiquiatra, magístra en Epidemiología Clínica. Profesora asistente del departamento de Psiquiatría y Salud Mental. Pontificia Universidad Javeriana, Bogotá, D.C., Colombia.
authors.forename: Adriana Patricia
authors.initials: AP
authors.lastname: Bohórquez Peñaranda
authors.affiliation: Médica psiquiatra. Bogotá D.C. Delegada Asociación Colombiana de Psiquiatría.
authors.forename: Ángela
authors.initials: Á
authors.lastname: Vélez Traslaviña
authors.affiliation: Médico cirujano, Residente de Psiquiatría. Pontificia Universidad Javeriana, Bogotá, D.C., Colombia.
authors.forename: Sergio Mario
authors.initials: SM
authors.lastname: Castro Díaz
authors.affiliation: Médico psiquiatra, Master en Farmacología. Profesor Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
authors.forename: Luis Eduardo
authors.initials: LE
authors.lastname: Jaramillo González
authors.affiliation: Médica psiquiatra, Doctora en Epidemiología Clínica. Profesora asociada del Departamento de Psiquiatría, Universidad de Antioquia, Medellín, Antioquia, Colombia.
authors.forename: Jenny
authors.initials: J
authors.lastname: García Valencia
keywords: Adverse effects; Antipsicóticos; Antipsychotics; Clinical Practice Guidelines; Efectos adversos; Esquizofrenia; Follow-up; Guías de práctica clínica; Schizophrenia; Seguimiento