Eficacia de la terapia electroconvulsiva vs Olanzapina en pacientes con esquizofrenia refractaria

Abstract

Introduction: Schizophrenia affects 1% of the world population and constitutes a therapeutic challenge when a subgroup of patients does not respond to antipsychotics, known as treatment-resistant schizophrenia. Around one-third of patients experience this phenomenon, limiting treatment options to electroconvulsive therapy (ECT) and olanzapine. Objective: To describe the efficacy of ECT vs. olanzapine in treating treatment-resistant schizophrenia through a literature review. Methodology: This study reviewed treatment efficacy by examining several sources and databases such as Scopus, Science, SciELO, Elsevier, PubMed, and PsycINFO, using information managers like Web of Science, SciELO, and Google Scholar. Studies without language and time restrictions were included, excluding those unrelated or with inadequate methodologies. Results: ECT and olanzapine show promise in treating treatment-resistant schizophrenia. ECT reduces symptoms in the medium term, especially in cases resistant to conventional treatments, according to scales like BPRS and PANSS. Olanzapine, more effective when combined with repetitive transcranial magnetic stimulation and amisulpride, is safe and tolerable but requires warning due to potential side effects, especially at high doses. The choice between ECT and olanzapine should be individualized, considering each patient's specific needs and circumstances. Conclusions: The literature review indicates that ECT and olanzapine offer short and medium-term benefits. However, the scarcity of long-term studies underscores the need for additional research to obtain more conclusive data on their efficacy.