Envíe este artículo por correo electrónico Fumar en las psicosis afectivas: revisión sobre el consumo de nicotina en el trastorno bipolar y esquizoafectivo
Resumen
Las psicosis afectivas incluyen aquellos trastornos con síntomas psicóticos y afectivos descritos en el DSM-IV-TR. En ellas, la prevalencia de la dependencia de nicotina es muy elevada. El objetivo es revisar la relación entre el consumo de nicotina y las psicosis afectivas a nivel epidemiológico, clínico, pronóstico, y de tratamiento. Se revisan los artículos publicados en la base PubMed que incluyen las palabras fumar, tabaco, nicotina y trastorno esquizoafectivo o bipolar. La comorbilidad del trastorno bipolar y el trastorno esquizoafectivo con el consumo de nicotina es de 66-82,5% y del 67% respectivamente. Tras esta revisión se puede concluir que el hábito tabáquico determina un peor pronóstico y mayor gravedad clínica del trastorno bipolar y esquizoafectivo. El consumo de otras sustancias, el diagnóstico, el consumo de cafeína y la gravedad clínica son factores de riesgo para el consumo de nicotina. El tratamiento más efectivo es el farmacológico en combinación con el psicológico. Los medicamentos de primera línea para la desintoxicación y deshabituación tabáquica son la terapia sustitutiva (parches transdérmicos, aerosoles, tabletas sublinguales, comprimidos para chupar o chicles de nicotina), la vareniclina y el bupropion. El tratamiento indicado para los síntomas psicóticos son los antipsicóticos atípicos por su mejor perfil de tolerabilidad y mejores resultados para el abandono del hábito tabáquico.
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DOI: https://doi.org/10.20882/adicciones.168
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