ABSTRACT
Generalmente, se cree que la cleptomanía es un cuadro clínico infrecuente, y caracterizado por el fracaso reiterado para intentar resistir el impulso de robar varios objetos no necesarios para el uso personal o por su valor monetario. En la actualidad, hay muchos investigadores que proponen subdividir a los pacientes con cleptomanía según la comorbilidad psiquiátrica, la respuesta a los psicofármacos y la posible etiología. Estos grupos son: 1) trastornos del control de los impulsos; 2) espectro obsesivo compulsivo; 3) espectro afectivo; 4) una conducta adictiva. Los inhibidores de la recaptación selectiva de serotonina (IRSS) son el grupo de sustancias más utilizadas para el tratamiento de esta enfermedad. La naltrexona (NTX), un antagonista opioide empleado en el tratamiento de la dependencia alcohólica, también resultaría eficaz en el tratamiento de la cleptomanía. De todas maneras, al programar la estrategia terapéutica hay que considerar las condiciones comórbidas del paciente, especialmente los trastornos del ánimo y el abuso de fármacos. También, es importante evaluar los problemas maritales, laborales y legales en estos individuos.
Subject(s)
Disruptive, Impulse Control, and Conduct Disorders/classification , Disruptive, Impulse Control, and Conduct Disorders/etiology , Disruptive, Impulse Control, and Conduct Disorders/drug therapy , Disruptive, Impulse Control, and Conduct Disorders/therapyABSTRACT
Background: Central reninangiotensin system modulates alcohol intake and inhibition of angiotensin converting enzyme reduces ethanol consumption in rats, and may be potentially useful in the treatment of alcoholism. Aim: To study the effect of captopríl on alcohol intake, both in humans and animals . Material and methods: In a double-blind, placebo-controlled clinical study, 15 alcoholics who met DSM-IV criíteria were randomized to receive captopril 100 mg/day or placebo for 12 weeks. In the experimental study, daily consumption of ethanol (10 percent v/v), water and solid food was assessed in 12 male Wistar rats before and after the intraperítoneal administration of captopríl 50 mg/kg/day. Results: In alcoholics, mean weekly standard alcoholic drínk consumption was not different during captopríl treatment or placebo. However, both groups had a signiñcantly lower intake than duríng baseline. Days of abstinence increased and days of drunkeness decreased in the group receiving captopril, when compared with baseline but not with placebo. Craving was significantly reduced by captopríl when compared with placebo. In rats, captopríl reduced not only alcohol consumption but also water and food intake. Conclusions: Captopríl decreases alcohol intake in rats and this effect is not speciñc for ethanol. Captopril did not alter alcohol consumption in alcoholics when compared with placebo but reduced craving.
Subject(s)
Adult , Animals , Humans , Male , Middle Aged , Rats , Alcohol Drinking/drug therapy , Alcoholism/drug therapy , Angiotensin II/biosynthesis , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Captopril/therapeutic use , Alcohol Drinking/psychology , Alcoholism/psychology , Double-Blind Method , Drinking/drug effects , Eating/drug effects , Ethanol/administration & dosage , Disruptive, Impulse Control, and Conduct Disorders/drug therapy , Placebo Effect , Rats, Wistar , TemperanceABSTRACT
Os autores descrevem e comentam o caso de uma paciente com Distúrbio de Humor Bipolar e Cleptomania (DSM-III-R) que apresentou remissäo de seu quadro compulsivo após instituiçäo de litioterapia. Discutem a possibilidade de tratamento medicamentoso para este distúrbio e apontam para a necessidade de estudos que estabeleçam a eventual relaçäo entre cleptomania, distúrbios do humor e litioterapia