Hipersexualidad y parafilias asociadas a la terapia de reemplazo de dopamina en el tratamiento de la enfermedad de Parkinson
Resumen
La enfermedad de Parkinson es una afección neurológica crónica que se caracteriza por la presencia de anormalidades en el movimiento, tales como bradicinesia, rigidez, temblor, inestabilidad postural y trastornos de la marcha y del habla. En lo que respecta al tratamiento, por años ha sido aceptado que la terapia de reemplazo de dopamina es la opción a seguir rumbo a la disminución de los síntomas, lo cual implica la administración de fármacos como la levodopa y otros agonistas dopaminérgicos. El tratamiento crónico con levodopa o con agonistas dopaminérgicos se encuentra asociado con una diversidad de complicaciones motoras y no motoras secundarias, entre las que se suele añadir a la categoría amplia de desorden del control de impulsos. Dentro de ésta, la denominada conducta sexual compulsiva, que incluye a la hipersexualidad y las parafilias, encuentra un incremento del riesgo de desarrollo, con importantes características ansiogénicas para los pacientes o sus familiares y con especial importancia dadas las dificultades legales y daños a terceros que podría suscitar. Por lo anterior, en esta revisión abordaremos brevemente las características de tales perturbaciones conductuales y su relación con la terapia de remplazo de dopamina en la enfermedad de Parkinson.
Abstract
Parkinson's disease is a chronic neurological disease characterized by the presence of movement abnormalities such as bradykinesia, rigidity, tremor, postural instability, gait, and speech disorders. In terms of treatment, for years, it has been accepted that dopamine replacement therapy is the option to follow in order to reduce its symptoms, which includes the administration of drugs such as levodopa and other dopamine agonists. Chronic treatment with levodopa or dopamine agonists is associated with various secondary motor and non-motor complications, among which the broad category of impulse control disorder is often added. Within this, the so-called compulsive sexual behavior, which includes hypersexuality and paraphilias, finds an increased risk of development, with important anxiogenic characteristics for patients or their families and with special importance given the legal difficulties and damages to third parties that could arise. Therefore, in this review, we will briefly address the characteristics of such behavioral disturbances and their relationship with dopamine replacement therapy in Parkinson's disease.
Keywords: Hypersexuality; paraphilias; Parkinson's disease; dopamine replacement therapy.
Palabras clave
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DOI: https://doi.org/10.25009/eb.v14i36.2625
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