Tratamiento farmacológico antidepresivo en adultos mayores: Guía basada en síntesis de la evidencia

La depresión del adulto mayor es una patología con una alta prevalencia y complicaciones, en un grupo poblacional en constante crecimiento, que conlleva múltiples desafíos por la influencia de diferentes factores biopsicosociales que no están presentes en otros grupos poblacionales. Se asocia a un p...

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Autores:
Porras Angarita, Henry Alberto
Tipo de recurso:
Fecha de publicación:
2021
Institución:
Universidad Autónoma de Bucaramanga - UNAB
Repositorio:
Repositorio UNAB
Idioma:
spa
OAI Identifier:
oai:repository.unab.edu.co:20.500.12749/13787
Acceso en línea:
http://hdl.handle.net/20.500.12749/13787
Palabra clave:
Medical sciences
Health sciences
Elderly
Antidepressants
Evidence-based guidance
Depression
Pharmacology
Psychotropic drugs
Pathology
Ciencias médicas
Farmacología
Drogas psicotrópicas
Patología
Ciencias de la salud
Adulto mayor
Antidepresivos
Guía basada en evidencia
Depresión
Rights
openAccess
License
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
id UNAB2_66a8570b68cf98b4f2367e8086ad479a
oai_identifier_str oai:repository.unab.edu.co:20.500.12749/13787
network_acronym_str UNAB2
network_name_str Repositorio UNAB
repository_id_str
dc.title.spa.fl_str_mv Tratamiento farmacológico antidepresivo en adultos mayores: Guía basada en síntesis de la evidencia
dc.title.translated.spa.fl_str_mv Antidepressant drug treatment in older adults: Guidance based on evidence synthesis
title Tratamiento farmacológico antidepresivo en adultos mayores: Guía basada en síntesis de la evidencia
spellingShingle Tratamiento farmacológico antidepresivo en adultos mayores: Guía basada en síntesis de la evidencia
Medical sciences
Health sciences
Elderly
Antidepressants
Evidence-based guidance
Depression
Pharmacology
Psychotropic drugs
Pathology
Ciencias médicas
Farmacología
Drogas psicotrópicas
Patología
Ciencias de la salud
Adulto mayor
Antidepresivos
Guía basada en evidencia
Depresión
title_short Tratamiento farmacológico antidepresivo en adultos mayores: Guía basada en síntesis de la evidencia
title_full Tratamiento farmacológico antidepresivo en adultos mayores: Guía basada en síntesis de la evidencia
title_fullStr Tratamiento farmacológico antidepresivo en adultos mayores: Guía basada en síntesis de la evidencia
title_full_unstemmed Tratamiento farmacológico antidepresivo en adultos mayores: Guía basada en síntesis de la evidencia
title_sort Tratamiento farmacológico antidepresivo en adultos mayores: Guía basada en síntesis de la evidencia
dc.creator.fl_str_mv Porras Angarita, Henry Alberto
dc.contributor.advisor.none.fl_str_mv Villar Centeno, Juan Carlos
Santacruz, José Manuel
dc.contributor.author.none.fl_str_mv Porras Angarita, Henry Alberto
dc.contributor.cvlac.spa.fl_str_mv Villar Centeno, Juan Carlos [0000068519]
dc.contributor.orcid.spa.fl_str_mv Villar Centeno, Juan Carlos [0000-0002-7047-7299]
dc.contributor.researchgate.spa.fl_str_mv Villar Centeno, Juan Carlos [Juan-Carlos-Villar-Centeno-2168464015]
dc.subject.keywords.spa.fl_str_mv Medical sciences
Health sciences
Elderly
Antidepressants
Evidence-based guidance
Depression
Pharmacology
Psychotropic drugs
Pathology
topic Medical sciences
Health sciences
Elderly
Antidepressants
Evidence-based guidance
Depression
Pharmacology
Psychotropic drugs
Pathology
Ciencias médicas
Farmacología
Drogas psicotrópicas
Patología
Ciencias de la salud
Adulto mayor
Antidepresivos
Guía basada en evidencia
Depresión
dc.subject.lemb.spa.fl_str_mv Ciencias médicas
Farmacología
Drogas psicotrópicas
Patología
dc.subject.proposal.spa.fl_str_mv Ciencias de la salud
Adulto mayor
Antidepresivos
Guía basada en evidencia
Depresión
description La depresión del adulto mayor es una patología con una alta prevalencia y complicaciones, en un grupo poblacional en constante crecimiento, que conlleva múltiples desafíos por la influencia de diferentes factores biopsicosociales que no están presentes en otros grupos poblacionales. Se asocia a un peor pronóstico, curso crónico, menor respuesta antidepresiva y mayor riesgo de recaída o recurrencia. El uso de fármacos antidepresivos en ancianos se ha correlacionado con efectos adversos importantes que podrían poner en riesgo la vida y que deben ser tenidos en cuenta a la hora de pautar el tratamiento. La información que actualmente existe en guías sobre el tratamiento farmacológico antidepresivo está centrada en la población general, no están basadas en evidencia o no están sintetizadas. Estas guías permiten transmitir la información de manera clara, sintetizada, y lleva a que los profesionales de la salud puedan tomar decisiones terapéuticas de manera más rápida, evitar complicaciones, prevenir un uso inapropiado de fármacos y mejorar las pautas de tratamiento en beneficio del adulto mayor.
publishDate 2021
dc.date.accessioned.none.fl_str_mv 2021-08-12T13:36:29Z
dc.date.available.none.fl_str_mv 2021-08-12T13:36:29Z
dc.date.issued.none.fl_str_mv 2021
dc.type.eng.fl_str_mv Thesis
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.local.spa.fl_str_mv Tesis
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/TM
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/20.500.12749/13787
dc.identifier.instname.spa.fl_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional UNAB
dc.identifier.repourl.spa.fl_str_mv repourl:https://repository.unab.edu.co
url http://hdl.handle.net/20.500.12749/13787
identifier_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
reponame:Repositorio Institucional UNAB
repourl:https://repository.unab.edu.co
dc.language.iso.spa.fl_str_mv spa
language spa
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repository.name.fl_str_mv Repositorio Institucional | Universidad Autónoma de Bucaramanga - UNAB
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spelling Villar Centeno, Juan CarlosSantacruz, José ManuelPorras Angarita, Henry AlbertoVillar Centeno, Juan Carlos [0000068519]Villar Centeno, Juan Carlos [0000-0002-7047-7299]Villar Centeno, Juan Carlos [Juan-Carlos-Villar-Centeno-2168464015]Colombia2021-08-12T13:36:29Z2021-08-12T13:36:29Z2021http://hdl.handle.net/20.500.12749/13787instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.coLa depresión del adulto mayor es una patología con una alta prevalencia y complicaciones, en un grupo poblacional en constante crecimiento, que conlleva múltiples desafíos por la influencia de diferentes factores biopsicosociales que no están presentes en otros grupos poblacionales. Se asocia a un peor pronóstico, curso crónico, menor respuesta antidepresiva y mayor riesgo de recaída o recurrencia. El uso de fármacos antidepresivos en ancianos se ha correlacionado con efectos adversos importantes que podrían poner en riesgo la vida y que deben ser tenidos en cuenta a la hora de pautar el tratamiento. La información que actualmente existe en guías sobre el tratamiento farmacológico antidepresivo está centrada en la población general, no están basadas en evidencia o no están sintetizadas. Estas guías permiten transmitir la información de manera clara, sintetizada, y lleva a que los profesionales de la salud puedan tomar decisiones terapéuticas de manera más rápida, evitar complicaciones, prevenir un uso inapropiado de fármacos y mejorar las pautas de tratamiento en beneficio del adulto mayor.1. TÍTULO DEL PROYECTO 10 2. RESUMEN 10 3. DESCRIPCIÓN DEL PROYECTO 14 3.1. PLANTEAMIENTO DEL PROBLEMA DE INVESTIGACIÓN Y SU JUSTIFICACIÓN EN TÉRMINOS DE NECESIDADES Y PERTINENCIA 14 3.2. MARCO TEORICO 18 3.3. ESTADO DEL ARTE 20 3.4. OBJETIVO GENERAL 21 OBJETIVOS ESPECÍFICOS 21 3.5. METODOLOGIA PROPUESTA 21 Búsqueda de la literatura 22 Selección de los estudios 22 3.6. PREGUNTAS DE INVESTIGACIÓN 22 ¿Cuál es la eficacia y riesgo de los antidepresivos (NO ADT) para el manejo de la depresión del adulto mayor en comparación con placebo? 22 ¿La eficacia y riesgo del uso de los antidepresivos en la población adulta mayor difiere según su mecanismo de acción? 23 ¿Cuáles son los factores que influyen en la presencia de efectos adversos graves al administrar un tratamiento antidepresivo en un adulto mayor con depresión? 23 ¿Existen diferencias en el tiempo de respuesta o remisión antidepresiva entre la población adulta mayor y población adulta joven con depresión mayor? 24 ¿En pacientes adultos mayores con depresión mayor usando antidepresivos, cuales son los factores que influyen en una recaída o recurrencia de la enfermedad? 24 4. RESULTADOS 25 4.1. ¿Cuál es la eficacia y riesgo de los antidepresivos (NO ADT) para el manejo de la depresión del adulto mayor en comparación con placebo? 25 Metodología para la búsqueda de la literatura 25 Gráfica Flujograma PRISMA 28 Resultados de la búsqueda 29 4.1.3.1. Pacientes sin deterioro cognitivo 29 Respuesta y remisión antidepresiva 29 Recaída depresión en adultos mayores sin deterioro cognitivo 30 Fractura 31 Sangrado Gastrointestinal 32 Hiponatremia 33 Suicidio 34 Muerte 35 Tabla Resumen GRADE 38 Discusión 39 Recomendaciones 40 4.1.3.2. Subgrupo: Pacientes con deterioro cognitivo 45 Respuesta y remisión antidepresiva 45 Recaída 45 Efectos adversos 46 Fractura 47 Suicidio 48 Muerte 49 Tabla Resumen GRADE 51 Discusión 51 Recomendaciones 52 4.2. ¿La eficacia y riesgo del uso de los antidepresivos en la población adulta mayor difiere según su mecanismo de acción? 57 Metodología para la búsqueda de la literatura 57 Gráfica Flujograma PRISMA 58 Resultados de la búsqueda 58 4.2.3.1. Pacientes sin deterioro cognitivo 58 Respuesta y remisión antidepresiva 58 Recaída depresión en adultos mayores sin deterioro cognitivo 60 Efectos adversos 60 Fractura 61 Muerte 61 Hiponatremia 63 Sangrado Gastro intestinal 64 Tablas de resumen GRADE 66 Discusión 70 Recomendación 71 4.2.3.2. Subgrupo: Pacientes con deterioro cognitivo 71 Tabla Resumen GRADE 72 Discusión 72 Recomendaciones 73 4.3. ¿Cuáles son los factores que influyen en la presencia de efectos adversos graves al administrar un tratamiento antidepresivo en un adulto mayor con depresión? 73 Metodología para la búsqueda de la literatura 73 Gráfica Flujograma PRISMA 74 Resultados 74 Fracturas 74 Sangrado Gastrointestinal 77 Hiponatremia 78 Suicidio 79 Muerte 81 Tabla resumen GRADE 83 Discusión 83 Recomendación 85 4.4. ¿Existen diferencias en el tiempo de respuesta o remisión antidepresiva entre la población adulta mayor y población adulta joven con depresión mayor? 86 Metodología para la búsqueda de la literatura 86 Grafica flujograma PRISMA 88 Resultados de la búsqueda 88 Discusión 89 Recomendación 90 4.5. ¿En pacientes adultos mayores con depresión mayor usando antidepresivos, cuales son los factores que influyen en una recaída o recurrencia de la enfermedad? 90 Metodología para la búsqueda de la literatura 90 Grafica flujograma PRISMA 91 Resultados de la búsqueda 91 Discusión 92 Recomendación 93 5. LIMITACIONES 94 6. MODIFICACIONES AL PROTOCOLO 95 7. APÉNDICE 96 8. BIBLIOGRAFÍA 97MaestríaDepression in the elderly is a pathology with high prevalence and complications in a population group in constant growth which entails multiple challenges due to the influence of various biopsychosocial factors that are not present in other population groups. It is associated with a worse prognosis, chronic course, lower antidepressant response and higher risk of relapse or recurrence. The use of antidepressant drugs in the elderly has been correlated with significant adverse effects that could be life-threatening and that must be taken into account when planning treatment. The information that currently exists in guidelines on antidepressant drug treatment is focused on the general population, is not based on evidence or is not synthesized. These present guidelines allow information to be transmitted in a clear, synthesized way, thus health professionals are able to make therapeutic decisions more quickly, avoid complications, prevent inappropriate use of drugs, and improve treatment guidelines for the benefit of the elderly.application/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Atribución-NoComercial-SinDerivadas 2.5 ColombiaTratamiento farmacológico antidepresivo en adultos mayores: Guía basada en síntesis de la evidenciaAntidepressant drug treatment in older adults: Guidance based on evidence synthesisThesisinfo:eu-repo/semantics/masterThesisTesishttp://purl.org/redcol/resource_type/TMMagíster en Métodos para la Producción y Aplicación de Conocimiento Científico en SaludUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludMaestría en Métodos para la Producción y Aplicación de Conocimiento Científico en SaludMedical sciencesHealth sciencesElderlyAntidepressantsEvidence-based guidanceDepressionPharmacologyPsychotropic drugsPathologyCiencias médicasFarmacologíaDrogas psicotrópicasPatologíaCiencias de la saludAdulto mayorAntidepresivosGuía basada en evidenciaDepresiónAgüera-Ortiz, L., Claver-Martín, M. 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