Simplificando tratamiento, ganando en funcionalidad

Abstract

It is presented the case of a 50-year-old woman referred to a private psychiatrist for schizoaffective disorder of years of evolution, without psychopathological decompensation requiring hospital admission. She reports clinical stability with prescribed treatment: haloperidol 10 mg, risperidone 3 mg, olanzapine 5 mg, biperiden 2 mg, amitriptyline 75 mg and bromazepam 1.5 mg. Gradual treatment changes are proposed in order to simplify the treatment since three different antipsychotics are prescribed without having reached the maximum dose of any of them. These changes require one year to reach antipsychotic monotherapy and then other months to achieve the transition from oral risperidone to monthly injectable and then quarterly. After these changes, the patient expresses improvement of functionality in daily life, which was diminished as a consequence of the side effects of the previous treatment. Although the introduction of escitalopram and clotiapine was necessary due to affective changes when the treatment with paliperidone palmitate monotherapy was started, the current treatment is more simplified than the initial one, maintaining the patient's improvement in functionality and the absence of significant side effects.