Tabaquismo y trastorno mental graveconceptualización, abordaje teórico y estudios de intervención

  1. Sendra Gutiérrez, Juan Manuel
  2. Casanova Peña, Bernardo
  3. Vargas Aragón, Martín L.
Revista:
Revista de la Asociación Española de Neuropsiquiatría

ISSN: 0211-5735

Año de publicación: 2012

Volumen: 32

Número: 116

Páginas: 707-722

Tipo: Artículo

DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Revista de la Asociación Española de Neuropsiquiatría

Resumen

El hábito tabáquico es un grave problema de salud en los pacientes con trastorno mental grave. Este trabajo realiza una revisión actualizada de sus bases neurofisiológicas y abordaje terapéutico. Existe una vinculación conocida entre neurotransmisión nicotínica y esquizofrenia sin una propuesta de modelo etiológico. El abordaje terapéutico del tabaquismo en enfermos psiquiátricos requiere formación específica y unidades de tabaquismo o servicios de salud mental preparados. La asociación con consumo de sustancias tóxicas, psicofármacos, comorbilidad psiquiátrica y falta de motivación profesional constituyen factores limitantes. La intervención breve aprovecha el contacto sanitario para explorar la presencia de tabaquismo y valorar la predisposición del paciente a dejar de fumar. El tratamiento utiliza terapia sustitutiva con nicotina, antidepresivos, agonistas del receptor nicotínico y/o intervenciones psicosociales. El tratamiento con bupropion es el más efectivo y seguro, mientras la terapia sustitutiva con nicotina y la vareniclina son también útiles. En la práctica clínica la utilización de farmacoterapia y psicoterapia puede ser la opción más razonable

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