Publication: Uso de cocaína o estimulantes de tipo anfetamínico y riesgo de crisis convulsivas o de enfermedad cerebrovascular. Revisiones sistemáticas
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2018-04-17
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Universidad Complutense de Madrid
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Abstract
Los psicoestimulantes son un grupo de sustancias neurofarmacológicamente muy similares cuyo uso se encuentra muy extendido en todo el mundo. En este trabajo nos centramos en el uso de Cocaína y Estimulantes de Tipo Anfetamínico, que son los de consumo más frecuente y causantes desde los años 70 verdaderas epidemias de consumo problemático, conquistando regiones enteras y subgrupos de población. En los últimos años su consumo ha experimentado un importante aumento contribuyendo de manera significativa a la carga global de enfermedades y representa un reto para la salud pública en varias zonas del mundo. No se trata solo del incremento en el consumo de sustancias ilegales, determinadas variedades de estimulantes tipo anfetamínico son medicamentos recetables, lo cual comporta nuevas implicaciones. Entre las complicaciones médicas con las que se relaciona su uso, destacan las complicaciones neurológicas agudas, en concreto las crisis convulsivas y las enfermedades cerebrovasculares. No obstante, la mayoría de las publicaciones científicas que se refieren a la asociación entre el consumo de psicoestimulantes y la aparición de enfermedades cerebrovasculares o crisis convulsivas, se basan en evidencia procedente de estudios con diseños metodológicos poco adecuados o de muy baja calidad. Existen tantos estudios que se limitan a describir casos o series de casos como escasez de otros con metodologías adecuadas para establecer relaciones de causalidad. Por ese motivo es necesario conocer el estado de la situación de las complicaciones neurológicas agudas en relación al uso de psicoestimulantes siguiendo una metodología sistemática que permita llegar a conclusiones sobre el estado de la cuestión y poder marcar el camino para futuras investigaciones. Objetivos: En este trabajo se pretende compilar, revisar y resumir la evidencia científica disponible sobre la relación entre el uso de psicoestimulantes y la ocurrencia de complicaciones neurológicas agudas. Concretamente evaluar la evidencia científica disponible para las siguientes tres asociaciones: 1. En estudios clínico-epidemiológicos sobre la relación entre el consumo de cocaína y la ocurrencia de crisis convulsivas. 2. En estudios clínico-epidemiológicos sobre la relación entre el consumo de cocaína y la ocurrencia de enfermedad cerebrovascular. 3. En estudios clínico-epidemiológicos sobre la relación entre el consumo de ETA y la ocurrencia de enfermedad cerebrovascular...
Psychostimulants are a group of neuropharmacologically similar substances widely used across the world. In this work we focus on the use of Cocaine and Amphetamine-type Stimulants, which are the types most frequently used and the cause of important problem drug use epidemics since the 1970s. In recent years, its consumption has experienced a significant increase, spreading throughout entire regions and subgroups of population, contributing to a large extent to the global burden of diseases and representing a challenge for public health in several areas of the world. However this is not only about the consumption of illegal substances, some amphetamine-type stimulants are prescription drugs or performance enhancers, with all the new implications that this represents. Most of the medical literature that links psychostimulant use to the occurrence of acute neurological complications such as seizures and strokes, are based on evidence from poor quality studies with inadequate methodologies. Thus, there are many studies that limit their scope to the description of cases or series of cases but an important shortage of studies with an adequate methodology to establish causal relationships. For this reason it is necessary to describe the current situation of acute neurological complications in relation to the use of psychostimulants and to summarize the existing scientific evidence with a systematic approach in order to reach conclusions and to show the way for future investigations. Objectives: This piece of work aims to compile, review and summarize the available scientific evidence on the relationship between psychostimulant use and the occurrence of acute neurological complications. More precisely, we aim to evaluate scientific evidence for the following three associations: 1. In Clinical-epidemiological studies on the relationship between cocaine use and the occurrence of seizures. 2. In Clinical-epidemiological studies on the relationship between cocaine use and the occurrence of cerebrovascular disease. 3. In Clinical-epidemiological studies on the relationship between amphetamine tyoe stimulant use and the occurrence of cerebrovascular disease...
Psychostimulants are a group of neuropharmacologically similar substances widely used across the world. In this work we focus on the use of Cocaine and Amphetamine-type Stimulants, which are the types most frequently used and the cause of important problem drug use epidemics since the 1970s. In recent years, its consumption has experienced a significant increase, spreading throughout entire regions and subgroups of population, contributing to a large extent to the global burden of diseases and representing a challenge for public health in several areas of the world. However this is not only about the consumption of illegal substances, some amphetamine-type stimulants are prescription drugs or performance enhancers, with all the new implications that this represents. Most of the medical literature that links psychostimulant use to the occurrence of acute neurological complications such as seizures and strokes, are based on evidence from poor quality studies with inadequate methodologies. Thus, there are many studies that limit their scope to the description of cases or series of cases but an important shortage of studies with an adequate methodology to establish causal relationships. For this reason it is necessary to describe the current situation of acute neurological complications in relation to the use of psychostimulants and to summarize the existing scientific evidence with a systematic approach in order to reach conclusions and to show the way for future investigations. Objectives: This piece of work aims to compile, review and summarize the available scientific evidence on the relationship between psychostimulant use and the occurrence of acute neurological complications. More precisely, we aim to evaluate scientific evidence for the following three associations: 1. In Clinical-epidemiological studies on the relationship between cocaine use and the occurrence of seizures. 2. In Clinical-epidemiological studies on the relationship between cocaine use and the occurrence of cerebrovascular disease. 3. In Clinical-epidemiological studies on the relationship between amphetamine tyoe stimulant use and the occurrence of cerebrovascular disease...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina Preventiva, Salud Pública e Historia de la Ciencia, leída el 04/07/2017