Trazodona: ¿Nuevo enfoque selectivo para el tratamiento de los sofocos generados por la deprivación androgénica en el carcinoma prostático?
Trazodone: A new selective approach to the treatment of hot flashes induced by androgen deprivation in prostate carcinoma?
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"tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "635" "paginaFinal" => "638" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Santiago Vilar González, Francesc Montañá Puig, Sebastiá Sabater Martí, Mª Victoria Villas Sánchez, Mª del Mar Sevillano Capellán, Manuel Aguayo Martos" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Santiago" "apellidos" => "Vilar González" "email" => array:1 [ 0 => "santiagov06@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Francesc" "apellidos" => "Montañá Puig" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Sebastiá" "apellidos" => "Sabater Martí" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Mª" "apellidos" => "Victoria Villas Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Mª" "apellidos" => "del Mar Sevillano Capellán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Manuel" "apellidos" => "Aguayo Martos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Complejo Hospitalario Universitario de Albacete (CHUA) Albacete" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Angelini-Farmaceútica. España" "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia autor: Dr. Santiago Vilar González Servicio de Radioterapia Complejo Hospitalario Universitario de Albacete (CHUA) Hnos. Falco, s/n - 02006 Albacete. Tef : 0034 96 75 97 523" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Trazodone: A new selective approach to the treatment of hot flashes induced by androgen deprivation in prostate carcinoma?" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-01-01" "fechaAceptado" => "2009-02-01" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec88998" "palabras" => array:7 [ 0 => "Carcinoma prostático" 1 => "Sofocos" 2 => "Deprivación hormonal" 3 => "Tratamiento" 4 => "Antidepresivos" 5 => "Trazodona" 6 => "Receptores 5-HT2A" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec88997" "palabras" => array:7 [ 0 => "Prostate carcinoma" 1 => "Hot flashes" 2 => "Hormone deprivation" 3 => "Treatment" 4 => "Antidepressants" 5 => "Trazodone" 6 => "5-HT2A receptors" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El protagonismo creciente del carcinoma prostático en las sociedades desarrolladas hace que tenga que ser muy tenido en cuenta el balance beneficio-perjuicio de los tratamientos prestados.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dado el enfoque terapéutico cada vez más complejo del carcinoma prostático, hoy en día se requiere de una suma de conocimientos extensos.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La deprivación androgénica juega un papel principal en esta patología. El tratamiento de la toxicidad derivada en forma de sofocos, síndrome metabólico, osteoporosis, trastornos cognitivos, etc., adquiere cada vez mayor interés.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El tratamiento farmacológico de los sofocos pasa por un manejo hormonal no exento de riesgo oncológico a la par que de una toxicidad nada despreciable. Dentro del tratamiento no hormonal de esta patología juegan un papel destacado los antidepresivos.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La trazodona, un antidepresivo SARI (inhibidores de la recaptación de serotonina/antagonista de la 2A), con un perfil de actuación más selectivo sobre los receptores implicados en los sofocos; podría ser de gran interés. Trazodona muestra una gran afinidad por los receptores 5-HT2A y una moderada afinidad por los receptores 5-HT1A.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Como es conocido los niveles de serotonina (5-hidroxitriptamina o 5-HT) en mujeres postmenopáusicas están disminuidos, normalizándose con las terapias sustitutivas. Todo ello sugiere que la deprivación abrupta de hormonas sexuales da lugar a una reducción en la circulación de serotonina, con el consiguiente aumento de sus receptores 5-HT2A hipotalámicos. Estos receptores estarían implicados en la patogénesis de los sofocos siendo su bloqueo una de las principales medidas terapéuticas.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El uso de trazodona elevando las concentraciones de serotonina y bloqueando a los receptores 5-HT2A y 5-HT1A podría plantearse como un nuevo enfoque más de acorde con la fisiopatología de los sofocos. Estudios comparativos bien dirigidos son necesarios para dar respuesta en cuanto a su efectividad. Otras cuestiones pendientes serían las dosis y el tiempo de tratamiento más eficaz para el control de los sofocos.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The growing relevance of prostate carcinoma in the developed world requires serious attention to focus on the risk-benefit relationships of the treatments used.</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Given the increasingly complex therapeutic approach to prostate carcinoma, an extensive range of knowledge is required.</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Androgen deprivation plays a central role in this disease. The management of androgen deprivation-derived toxicity in the form of hot flashes, metabolic syndrome, osteoporosis, cognitive disorders, etc., is of growing interest.</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">The drug treatment of hot flashes involves hormone management that is not without oncological risk and moreover generates considerable toxicity. Antidepressants in turn play an important role in the non-hormone treatment of this disorder.</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Trazodone, a serotonin reuptake inhibitor/5-HT2A receptor antagonist affording more selective action upon the receptors implicated in hot flashes, could be of great interest. Trazodone shows great affinity for the 5-HT2A receptors and moderate affinity for the 5-HT1A receptors.</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Serotonin (5-hydroxytryptamine, or 5-HT) levels are known to be lowered in postmenopausal women, and normalize when replacement therapy is provided. This suggests that abrupt sexual hormone deprivation gives rise to a reduction in blood serotonin – with a subsequent increase in its hypothalamic 5-HT2A receptors. These receptors would be implicated in the physiopathology of hot flashes; as a result, the blocking of such receptors is one of the principal therapeutic measures.</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">The use of trazodone, increasing the serotonin concentrations and blocking the 5-HT2A and 5-HT1A receptors, could be viewed as a novel management approach more in line with the physiopathology of hot flashes. Well designed comparative studies are needed to establish the efficacy of such treatment. Other issues pending clarification would be the most effective dose and duration of treatment for controlling hot flashes.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Androgen suppression and radiation vs radiation alone for prostate cancer: a randomized trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.V. D´Amico" 1 => "M.H. Chen" 2 => "A.A. Renshaw" 3 => "M. Loffredo" 4 => "P.W. 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| 2016 Agosto | 12 | 9 | 21 |
| 2016 Julio | 13 | 3 | 16 |
| 2016 Junio | 27 | 25 | 52 |
| 2016 Mayo | 15 | 33 | 48 |
| 2016 Abril | 13 | 21 | 34 |
| 2016 Marzo | 18 | 34 | 52 |
| 2016 Febrero | 15 | 28 | 43 |
| 2016 Enero | 14 | 33 | 47 |
| 2015 Diciembre | 20 | 38 | 58 |
| 2015 Noviembre | 10 | 35 | 45 |
| 2015 Octubre | 25 | 31 | 56 |
| 2015 Septiembre | 16 | 19 | 35 |
| 2015 Agosto | 11 | 10 | 21 |
| 2015 Julio | 10 | 12 | 22 |
| 2015 Junio | 5 | 11 | 16 |
| 2015 Mayo | 8 | 16 | 24 |
| 2015 Abril | 12 | 25 | 37 |
| 2015 Marzo | 14 | 26 | 40 |
| 2015 Febrero | 2 | 14 | 16 |
| 2015 Enero | 11 | 7 | 18 |
| 2014 Diciembre | 25 | 14 | 39 |
| 2014 Noviembre | 12 | 5 | 17 |
| 2014 Octubre | 14 | 7 | 21 |
| 2014 Septiembre | 19 | 4 | 23 |
| 2014 Agosto | 10 | 3 | 13 |
| 2014 Julio | 14 | 4 | 18 |
| 2014 Junio | 12 | 8 | 20 |
| 2014 Mayo | 7 | 5 | 12 |
| 2014 Abril | 3 | 5 | 8 |
| 2014 Marzo | 5 | 1 | 6 |
| 2014 Febrero | 5 | 3 | 8 |
| 2014 Enero | 5 | 4 | 9 |
| 2013 Diciembre | 4 | 2 | 6 |
| 2013 Noviembre | 6 | 2 | 8 |
| 2013 Octubre | 4 | 11 | 15 |
| 2013 Septiembre | 5 | 6 | 11 |
| 2013 Agosto | 2 | 15 | 17 |
| 2013 Julio | 1 | 4 | 5 |
| 2009 Mayo | 312 | 0 | 312 |
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