Comparación de la eficacia y seguridad de la olanzapina y el aripiprazol en el tratamiento de Esquizofrenia. Revisión sistemática.

Abstract

Background: Schizophrenia is a chronic mental disorder that affects patients' quality of life; therefore, having effective and safe treatments is a clinical priority. Objective: To compare the efficacy and safety profile of Olanzapine and Aripiprazole in patients with schizophrenia through a systematic review. Methodology: A search was conducted in PubMed, ScienceDirect, SciELO, and the Cochrane Library for studies published between 2015 and 2024. Randomized, double-blind clinical trials comparing both antipsychotics in patients diagnosed with schizophrenia were included. Literature reviews, editorials, and animal studies were excluded. Of the 850 records identified, 30 studies met the inclusion criteria after evaluation of their methodological quality. Results: More than 80% of the studies presented a low risk of bias. Both Olanzapine and Aripiprazole reduced symptoms assessed using the PANSS scale, with no differences in treatment discontinuation rates. Aripiprazole showed a favorable relative risk (RR = 1.91; 95% CI) and a better tolerability profile, whereas Olanzapine demonstrated greater efficacy in patients with severe cases, although it was associated with a higher risk of metabolic adverse effects. Conclusions: Both antipsychotics are effective in the treatment of schizophrenia. Olanzapine offers greater clinical efficacy in severe cases, whereas Aripiprazole has a favorable safety profile. The therapeutic choice should be individualized according to severity, patient characteristics, the risk of adverse effects, and the need to promote treatment adherence and improve quality of life. Keywords: schizophrenia, olanzapine, aripiprazole, efficacy, safety