Tratamiento farmacológico: la desintoxicación

P.A. Soler, M. Guasch

Resumen


El síndrome de abstinencia alcohólico se produce por la disminución brusca de la alcoholemia en individuos con neuroadaptación al alcohol. La deprivación comporta alteraciones en diversos sistemas de neurotransmisores, provocando una hiperactivación noradrenérgica, un incremento de la sensibilidad del receptor NMDA y una inhibición del GABA. El síndrome de abstinencia alcohólica puede objetivarse mediante diversas escalas (Ciwa, Soler Insa), que permiten valorar la intensidad de la abstinencia. Las pautas de tratamiento más contrastadas se ajustan en función de la severidad del cuadro. Asimismo, se exponen las pautas fijas, también utilizadas y publicadas, pero para los autores menos aconsejables. El clometiazol, el tetrabamato y las benzodiacepinas son los fármacos más utilizados y sobre los que existen más datos de eficacia y seguridad , pero también se detallan algunos estudios con otros fármacos como la carbamazepina y otros anticonvulsivantes, los beta-bloqueadores, los antagonistas alfa2, los antagonistas del calcio y otros. Finalmente se dan recomendaciones terapéuticas para casos especiales como el delirium tremens, las convulsiones durante la abstinencia o los casos de la mujer embarazada, el anciano o el paciente postquirúrgico.


Palabras clave


abstinencia del alcohol; valoración; intensidad; tratamiento; farmacoterapia

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Referencias


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DOI: https://doi.org/10.20882/adicciones.536

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