Posibles alternativas terapéuticas farmacológicas al haloperidol para el Delirium: Revisión de tema
Palabras clave:
Haloperidol, Delirium, Farmacología, Agentes antipsicóticos, Eectos secundarios y reacciones adversas relacionados con los medicamentos, Sistema nervioso centralResumen
Introducción: El Delirium en un síndrome psiquiátrico con una alta incidencia en Colombia y el mundo, convirtiéndolo en una enfermedad de gran relevancia en el área de urgencias, hospitalización y cuidados intensivos (UCI), su tratamiento farmacológico de primera línea durante muchas décadas ha sido el haloperidol, el cual genera muchos efectos adversos a nivel de sistema nervioso central (SNC), por lo que es adecuado buscar un manejo alternativo. Objetivo: Describir las alternativas terapéuticas diferentes al haloperidol para el Delirium de acuerdo a la literatura actual publicada. Materiales y métodos: Se realizó una Revisión Narrativa de la literatura actual con artículos de investigación y reporte de casos de las bases de datos Medline y Scielo basados en el estudio de pacientes mayores de 18 años con delirium que consultaron a urgencias, estuvieron hospitalizados o en la unidad de cuidados intensivos (UCI) manejados con haloperidol o diferentes alternativas farmacológicas. Resultados: Se compararon los diferentes estudios sobre el delirium en diferentes áreas hospitalarias manejado con haloperidol y/o con otras alternativas farmacológicas y no farmacológicas, encontrando que aún faltan investigaciones más profundas y con muestras poblacionales mayores para determinar el nivel de seguridad del haloperidol y su alternativa farmacológica de uso en el futuro. Conclusiones: En la literatura actual se encuentran numerosos estudios aleatorizados y observacionales comparando el haloperidol con antipsicóticos de segunda generación, benzodiacepinas, al igual que con otros fármacos más recientes como el Suvorexant y Dexmedetomidina con resultados prometedores. En los metanálisis incluidos en las revisiones las conclusiones son similares: la mayoría de estudios realizados tienen sesgos metodológicos que imposibilitan hasta el día de hoy emitir un esquema farmacológico óptimo para el tratamiento del Delirium.
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