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Inicio Psiquiatría Biológica Caso Clínico : Ciclación rápida en un paciente adulto mayor con trastorno bip...
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Vol. 22. Issue S2.
Antipsicóticos y trastorno bipolar. Tolerabilidad y aspectos clínicos
Pages 43-44 (July 2015)
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Vol. 22. Issue S2.
Antipsicóticos y trastorno bipolar. Tolerabilidad y aspectos clínicos
Pages 43-44 (July 2015)
Caso Clínico : Ciclación rápida en un paciente adulto mayor con trastorno bipolar tipo II y factores de riesgo cardiovascular
Rapid cycle in elderly patient with bipolar disorder type II and cardiovascular risk factors
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Diego Hidalgo-Mazzei
Unidad de Trastornos Bipolares, Instituto de Neurociencias, Hospital Clínic, Universidad de Barcelona, IDIBAPS, CIBERSAM, Barcelona, España.
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Resumen

Un paciente con una importante comorbilidad cardiovascular se presenta a su consulta con una historia de trastorno bipolar tipo II de inicio tardío de 2 años de evolución. A pesar del tratamiento instaurado para el trastorno bipolar con duloxetina y ácido valproico, el paciente continúa presentando episodios hipomaníacos y depresivos alternados aproximadamente cada 15 días, con una importante disminución de su calidad de vida y de la funcionalidad global. Ante este patrón se plantean alternativas terapéuticas basadas en la evidencia aportada por los estudios observacionales que pudieran mejorar la sintomatología y funcionalidad del paciente.

Palabras clave:
Antidepresivos
Antipsicóticos
Ciclación rápida
Estudios observacionales
Trastorno bipolar tipo II
Abstract

A patient with a major cardiovascular comorbidity is referred for consultation with a history of late-onset bipolar II disorder of two years of evolution. Despite receiving duloxetine and valproic acid for the treatment of bipolar disorder, the patient continues to present with hypomanic and depressive episodes, alternating approximately every 15 days, with a significant decline in quality of life and overall functionality. Given this pattern, alternative therapies were suggested on the basis of evidence from observational studies and could improve the patient's functionality and symptoms.

Keywords:
Antidepressants
Antipsychotics
Rapid cycle
Observational studies
Bipolar II disorder

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