Complicaciones psicopatológicas asociadas al consumo de drogas recreativas Psychopathological complications associated to recreational drug consumption

Autores/as

  • Pilar Alejandra Sáiz Martínez Profesor Titular de Psicología Médica.
  • Paz García-Portilla González Profesor Titular de Psicología Médica.
  • Sara Martínez Barrondo Doctorando Area Psiquiatría.
  • Mª Teresa Bascarán Fernández Doctorando Area Psiquiatría.
  • Manuel Bousoño García Profesor Titular de Psicología Médica.
  • Julio Bobes García Catedrático de Psiquiatría Area de Psiquiatría. Facultad de Medicina. Universidad de Oviedo. Enviar correspondencia: Julio Bobes García. Área de Psiquiatría. Facultad de Medicina. Julián Clavería 6 – 3º. 33006 Oviedo (Asturias). Tfno/FAX: +34 985 10 3553

DOI:

https://doi.org/10.20882/adicciones.463

Palabras clave:

MDMA, éxtasis, deterioro cognitivo, trastornos mentales, serotonina MDMA, ecstasy, cognitive impairment, mental disorders, serotonin

Resumen

Esta revisión pretende evaluar las evidencias empíricas existentes en relación a las secuelas psicológicas persistentes asociadas al uso recreativo de MDMA. Numerosos casos clínicos sugieren que el uso regular de MDMA puede asociarse con trastornos psiquiátricos crónicos (psicosis, crisis de pánico, despersonalización, depresión, flashbacks) que persisten tras el cese del consumo. Es difícil determinar si el consumo de MDMA es el responsable directo de estos cuadros o es una asociación casual. Estudios comparativos entre usuarios regulares de MDMA y controles sugieren que la MDMA puede generar alteración selectiva de la memoria episódica, memoria de trabajo, y de la atención. Evidencias preclínicas apoyan dichos hallazgos: depleción serotoninérgica en usuarios importantes de MDMA, relación dosis-respuesta entre consumo de MDMA y gravedad del deterioro cognitivo. Hay que ser cautos al establecer relaciones de causalidad entre consumo de MDMA y trastornos mentales, usando datos procedentes de estudios transversales, ya que el uso de MDMA se asocia a patrón de policonsumo y, además, el comienzo del trastorno mental podría en muchas ocasiones preceder al uso de la sustancia.
The aim of this review is to evaluate recent empirical evidence concerning the persistent psychological sequelae of recreational MDMA use. Clinical case reports suggest that regular MDMA use can be associated with chronic psychiatric disorders (psychosis, panic attacks, despersonalisation, depression, flashbacks) which persist after the cessation of drug use. However, it is difficult to determine whether MDMA use is directly responsible or is incidental. Neuropsychological comparisons of regular MDMA users and controls suggest that MDMA may be associated with selective impairment of episodic memory, working memory, and attention. Preclinical evidence supports these data: depletion of serotonin in heavy MDMA users, dose-response relationships between the extent of exposure to MDMA and the severity of cognitive impairment. Care should be taken in cross sectional studies in interpreting mental disorders merely as a consequence of MDMA use, as MDMA use might be associated with the use of multiple substances, and the onset of mental disorder might precede rather than follow the use of MDMA

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2003-12-15

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Vol. 15 (2003): Especial

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