RESUMEN
Los neurolépticos son un grupo de medicamentos ampliamente empleados en el tratamiento de cuadros psicóticos, entre sus efectos adversos cabe destacar la posibilidad de desencadenar un síndrome neuroléptico maligno (SNM). El diagnóstico del SNM se determina por exclusión y su manejo terapéutico inicial será la retirada de los neurolépticos junto a la administración de benzodiacepinas y terapia electroconvulsiva (TEC). La TEC representa una efectiva opción terapéutica en estos pacientes así como en aquellos casos que se obtenga una respuesta escasa al manejo con medicamentos antipsicóticos. Revisamos las alternativas terapéuticas y las implicaciones anestésicas que conlleva manejar un paciente programado para TEC, diagnosticado de esquizofrenia paranoide, en el contexto de SNM (AU)
Neuroleptics are a group of drugs widely used in the treatment of psychotic symptoms. Among their adverse effects is the ability to trigger a neuroleptic malignant syndrome (NMS). The diagnosis of NMS is determined by exclusion, and its initial therapeutic management should be the withdrawal of neuroleptics, the administration of benzodiazepines, and electroconvulsive therapy (ECT). ECT is an effective treatment in these patients, and in those cases with a poor response to treatment with antipsychotic drugs. A review is presented on the treatment options and anaesthetic implications of ECT used to handle a patient diagnosed with paranoid schizophrenia in the context of NMS (AU)
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Síndrome Neuroléptico Maligno/complicaciones , Síndrome Neuroléptico Maligno/tratamiento farmacológico , Terapia Electroconvulsiva/métodos , Terapia Electroconvulsiva , Succinilcolina/uso terapéutico , Receptores de GABA-A/uso terapéutico , Antipsicóticos/uso terapéutico , Antipiréticos/uso terapéutico , Electrocardiografía , Propofol/uso terapéutico , Bloqueantes Neuromusculares/metabolismo , Bloqueantes Neuromusculares/farmacología , Fármacos Neuromusculares no Despolarizantes/uso terapéuticoRESUMEN
Neuroleptics are a group of drugs widely used in the treatment of psychotic symptoms. Among their adverse effects is the ability to trigger a neuroleptic malignant syndrome (NMS). The diagnosis of NMS is determined by exclusion, and its initial therapeutic management should be the withdrawal of neuroleptics, the administration of benzodiazepines, and electroconvulsive therapy (ECT). ECT is an effective treatment in these patients, and in those cases with a poor response to treatment with antipsychotic drugs. A review is presented on the treatment options and anaesthetic implications of ECT used to handle a patient diagnosed with paranoid schizophrenia in the context of NMS.