Patología dual en trastornos de ansiedad: recomendaciones en el tratamiento farmacológico

Pilar Alejandra Sáiz Martínez, Luis Jimenez Treviño, Eva Mª Díaz Mesa, Mª Paz García-Portilla González, Pedro Marina González, Susana Al-Halabí, Néstor Szerman, Julio Bobes García, Pedro Ruiz

Resumen


Los trastornos por uso de sustancias y los trastornos de ansiedad presentan una gran comorbilidad (entre el 18% y 37%), lo cual complica el tratamiento y empeora el pronóstico de los pacientes (incluido mayor riesgo de suicidio). Son pocos los trabajos de investigación terapéutica que hayan abordado de forma específica el tratamiento farmacológico de los trastornos de ansiedad en caso de patología dual. La mayor parte de los autores apuestan por el abordaje de ambos trastornos de forma integral y simultánea. Los datos procedentes de la revisión de la literatura indican que los fármacos recomendados habitualmente en el tratamiento para los trastornos de ansiedad también son eficaces en el tratamiento de la ansiedad dual. Los antidepresivos ISRS constituyen el tratamiento de primera línea en los trastornos de ansiedad duales, mientras que las benzodiacepinas son fármacos a evitar. En los últimos años se observa una gran tendencia a utilizar fármacos antiepilépticos de última generación, los cuales muestran resultados prometedores en estudios abiertos y series de casos, en especial la pregabalina en el trastorno de ansiedad generalizada.


Palabras clave


Trastornos de ansiedad; patología dual; comorbilidad; tratamiento; recomendaciones.

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Referencias


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