title: [Maintenance Treatment With Antipsychotics for Adult Patients Diagnosed With Schizophrenia].
abstract: OBJECTIVE
  To determine the effectiveness and security of the antipsychotics available for the management of adult patients with schizophrenia in the maintenance phase. To develop recommendations of treatment for the maintenance phase of the disease.
  
  
  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. The evidence of NICE guide 82 was adopted and updated. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced.
  
  
  RESULTS
  18 studies were included to evaluate the effectiveness and / or safety of different antipsychotic drugs first and second generation. Overall, antipsychotics (AP) showed superiority over placebo in relapse rate over 12 months (RR 0.59 95% CI 0.42, 0.82) and hospitalization rate over 24 months of follow-up (RR 0.38 95% 0.27, 0.55); its use is associated with increased risk of treatment dropout (RR 0.53 95% CI 0.46, 0.61) and adverse events such as weight gain, dystonia, extrapyramidal symptoms and sedation. There was no difference in the outcome of re hospitalizations, comparisons on quality of life, negative symptoms or weight gain between AP first and second generation. Continuous or standard dose regimens appear to be superior to intermittent or low doses in reducing the risk of abandonment of treatment regimes.
  
  
  CONCLUSIONS
  Adult patients diagnosed with schizophrenia should receive maintenance treatment with antipsychotics. The medication of choice will depend on the management of the acute phase, the patient's tolerance to it and the presentation of adverse events.
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, Colombia. Electronic address: cgomez@javeriana.edu.co.
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, Colombia.
authors.forename: Adriana Patricia
authors.initials: AP
authors.lastname: Bohórquez Peñaranda
authors.affiliation: Médica, magístra en Epidemiología Clínica. Profesora del Departamento de Epidemiología Clínica y Bioestadística. Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Ana María
authors.initials: AM
authors.lastname: de la Hoz Bradford
authors.affiliation: Médica, candidata a magístra en Epidemiología Clínica. Asistente de investigación del Departamento de Epidemiología Clínica y Bioestadística. Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Tamayo Martínez
authors.affiliation: Médica psiquiatra, doctora en Epidemiología Clínica. Profesora titular del Departamento de Psiquiatría, Facultad de Medicina. Universidad de Antioquia, Medellín, Antioquia, Colombia.
authors.forename: Jenny
authors.initials: J
authors.lastname: García Valencia
authors.affiliation: Médico psiquiatra, Master en Farmacología. Profesor Universidad Nacional de Colombia, Bogotá, Colombia.
authors.forename: Luis Eduardo
authors.initials: LE
authors.lastname: Jaramillo González
keywords: Antipsicóticos; Antipsychotics; Clinical Practice Guidelines; Esquizofrenia; Follow-up; Guía de práctica clínica; Maintenance; Mantenimiento; Schizophrenia; Seguimiento