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Efectos clínicos y atencionales del tratamiento de nicotina agudo en el síndrome de la Tourette

Published online by Cambridge University Press:  12 May 2020

A. L. Howson ,
S. Batth ,
V. Ilivitsky ,
A. Boisjoli ,
M. Jaworski ,
C. Mahoney  and
V. J. Knott
A. L. Howson
Affiliation:
Clínica de Enfermedades Metabólicas Adultas, Hospital General de Vancouver, Autoridad Sanitaria Costera de Vancouver, Vancouver, BC, Canadá
S. Batth
Affiliation:
Departamento de Psiquiatría, Real Hospital de Otawa e Instituto de Investigación de la Salud Mental, Universidad de Ottawa, 1145Carling Avenue, Ottawa, Ont., Canadá K1A 7K4
V. Ilivitsky
Affiliation:
Departamento de Psiquiatría, Real Hospital de Otawa e Instituto de Investigación de la Salud Mental, Universidad de Ottawa, 1145Carling Avenue, Ottawa, Ont., Canadá K1A 7K4
A. Boisjoli
Affiliation:
Clínica del Síndrome de la Tourette, Hospital de Ottawa, Ottawa, Ont., Canadá
M. Jaworski
Affiliation:
Clínica del Síndrome de la Tourette, Hospital de Ottawa, Ottawa, Ont., Canadá
C. Mahoney
Affiliation:
Departamento de Psiquiatría, Real Hospital de Otawa e Instituto de Investigación de la Salud Mental, Universidad de Ottawa, 1145Carling Avenue, Ottawa, Ont., Canadá K1A 7K4
V. J. Knott
Affiliation:
Departamento de Psiquiatría, Real Hospital de Otawa e Instituto de Investigación de la Salud Mental, Universidad de Ottawa, 1145Carling Avenue, Ottawa, Ont., Canadá K1A 7K4
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Resumen

Los datos de investigaciones precl ínicas en organismos no humanos, ensayos clínicos al descubierto y un ensayo controlado individual encontraron que el tratamiento de nicotina agudo potenciaba hasta 4 semanas las reducciones inducidas por neurolépticos de los síntomas discinéticos que caracterizan al síndrome de la Tourette (ST). Dadas las perturbaciones de la atención asociadas con este síndrome, y las mejorías en los procesos atencionales comunicadas con la nicotina, este ensayo distribuido al azar doble ciego controlado con placebo exa- minó los efectos agudos (4 h) y sostenidos (2 semanas) de una dosis individual de nicotina transdérmica sobre los síntomas clínicos (es decir, los tics), atencionales (una tarea de ejecución continua, potenciales evocados cognitivos, los informes de los pacientes y los padres) y conductuales en 23 niños y adolescentes con ST que recibían tratamiento neuroléptico. En los 14 pacientes evaluables con datos de efi- cacia primarios completos, la nicotina (comparado con el placebo) no alteró los síntomas a las 4 h pero contrarrestó los signos de aten ción disminuida de la onda P300 de los potenciales evocados cognitivos (PEC) vistos 2 semanas después del tratamiento con placebo. Las medidas de eficacia secundarias, incluidos los autoinformes de los pacientes y las evaluaciones de los padres, encontraron que la nicoti na reducía los tics complejos y mejoraba las conductas relacionadas con el déficit de atención. Se requiere más trabajo con programas de dosis intermitentes para caracterizar los efectos clínicos y cognitivos óptimos con el tratamiento de nicotina.

Keywords

NicotinaSíndrome de la TouretteTicsAtenciónEjecuciónPotenciales evocados cognitivos
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 11 , Issue 5 , June 2004 , pp. 285 - 296
Copyright
Copyright © European Psychiatric Association 2004

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References

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