Manifestações psiquiátricas da terapêutica analgésica opióde no doente oncológico - Reflexões a partir de um caso clínico

Paula Garrido, Emília Albuquerque

Resumo


A desregulação do sistema mesolímbico tem sido implicada na fisiopatologia das perturbações do humor induzidas pelos fármacos opióides. Os autores descrevem a ocorrência de um quadro clínico de mania num doente jovem, portador de carcinoma da nasofaringe, alguns dias após início de terapêutica analgésica opióide com fentanilo. Com base no caso clínico apresentado propõem-se fazer uma revisão do tema, com recurso à literatura recente sobre a fisiopatologia e formas de intervenção na mania induzida por opióides. Secundariamente, são abordados alguns aspetos acerca dos efeitos cognitivos da terapêutica opióide, pela sua frequência e relevância clínica no contexto oncológico.

 

The mesolimbic system dysregulation has been implicated in the pathophysiology of mood disorders induced by opioid drugs. The authors describe a clinical case of mania in a young male patient with nasopharyngeal cancer, few days after the initiation of therapy with opioid analgesic fentanyl. Based on this clinical case, we propose to review the topic, using the recent literature on the pathophysiology and management of opioid-induced mania. Secondly, the authors discuss some aspects about the cognitive effects of opioid therapy, due its frequency and clinical relevance in the oncology setting.


Palavras-chave


episódio maníaco; episódio hipomaníaco; efeitos cognitivos; opióides; fentanilo

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Referências


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