Use of Quetiapine as a Coadjuvant to Benzodiazepines in General Anxiety Disorder in Patients Aged Over 20 Years at Hospital Naval Guayaquil

Abstract

Generalized anxiety disorder is the most prevalent mental disorder worldwide. The use of quetiapine + benzodiazepines has been shown to reduce symptoms in patients with generalized anxiety disorder who do not respond adequately to the exclusive use of benzodiazepines. Despite the benefits shown in Ecuador, there are no published studies about its effectiveness. This is a prevalent, retrospective, cross-sectional, descriptive, and analytical study carried out at the Hospital Naval de Guayaquil, in patients aged over 20 years diagnosed with generalized anxiety disorder and had undergone treatment with quetiapine, benzodiazepines, or both during the years 2017–2020. The average age of diagnosis of generalized anxiety disorder is 45.12 years. It prevails in married male patients diagnosed at 39.95 years. Benzodiazepine is the drug that produces clinical improvement in 38% of patients. However, it does not present great variation before quetiapine + benzodiazepine, which produced an improvement in 27% of patients. The treatment time according to the type of drug used is shorter with quetiapine, lasting 4.32 months. However, the Kruskal-Wallis test established that the treatment time is shorter using the combination of quetiapine as a coadjuvant to benzodiazepine with a significance of >0.05. The improvement of the sleep disorder stood out with the use of benzodiazepine in 38.57%. The benzodiazepine produces clinical improvement in 38% and in turn improves the sleep disorder in 38.57%. The use of quetiapine as a coadjuvant to benzodiazepines decreases the treatment time.


Keywords: Ecuador, anxiety disorder, benzodiazepines, quetiapine.


Resumen


El trastorno de ansiedad generalizada es el desorden mental más prevalente a nivel mundial. El uso de quetiapina + benzodiacepinas, ha demostrado disminuir la sintomatología en pacientes sin mejoría con el uso exclusivo de benzodiacepinas. Sin embargo, pese al beneficio demostrado en Ecuador, no existen estudios publicados sobre su efectividad. Materiales y métodos. Estudio de prevalencia, retrospectivo, transversal, descriptivo y analítico realizado en el Hospital Naval de Guayaquil, en pacientes mayores de 20 años que acudieron con diagnóstico de trastorno de ansiedad generalizada y que fueron sometidos a tratamiento con quetiapina , benzodiacepinas o ambas durante los años 2017-2020. Resultados. El trastorno de ansiedad generalizada se diagnostica a la edad promedio 45,12 años. Prevalece en los pacientes casados de sexo masculino diagnosticados a los 39,95 años. La benzodiacepina es el fármaco que produce mejoría clínica en un 38% de los pacientes. Sin embargo, no presenta gran variación ante la quetiapina + benzodiacepina que produjo la mejoría de 27% de los pacientes. El tiempo de tratamiento de acuerdo al tipo de fármaco utilizado es menor con quetiapina durando 4,32 meses. Sin embargo, el test de Kruskal-Wallis estableció que el tiempo de tratamiento es menor utilizando la combinacion de quetiapina mas benzodiacepina con una significacia menor que 0.05. La mejoría del trastorno del sueño destacó con el uso de benzodiacepina en 38,57%. Conclusión. La benzodiacepina produce mejoría clínica en un 38%, mejorando además el trastorno del sueño en un 38,57%. El uso de quetiapina más benzodiacepina disminye el tiempo de tratamiento.


Palabras Clave: Ecuador,trastorno de ansiedad, benzodiacepinas, quetiapina.

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