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Reacciones agudas de distonía a la “calle Xanax”
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Reacciones agudas de distonía a la “calle Xanax”

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Reacciones agudas de distonía a la “calle Xanax”

N inglés J Med 2002; 346:175330 de mayo de 2002

Las reacciones de distonía aguda se han divulgado después de la ingestión de numerosas medicaciones que alteran  el tono dopaminergico en el ganglio basal o receptores antagonistas de la dopamina D2. En el departamento de emergencia de un hospital urbano de la comunidad, hemos tratado recientemente a seis pacientes que presentaban  distonía aguda. Todos los pacientes manifestaron  la ingestión de medicamentos (por vendedores de calle)  los que le habían asegurado que era Xanax (alprazolam). En cinco de estos pacientes, la droga injerida fue demostrada realmente ser haloperidol.

Tres muchachos adolescentes se presentaron en urgencia con los síntomas de tortícolis, crisis ocular, y opisthotonos. Cada uno divulgó la ingestión de “uno o dos” tabletas de “Xanax” de 12 a 16 horas antes de la admisión. Dos de estos pacientes describieron específicamente las tabletas azules que llevaban la inscripción “GG126,” y el tercero entregó  una píldora de las mismas marcas. Las drogas fueron identificadas como 10 tabletas del magnesio de la marca de fábrica de Ginebra del haloperidol genérico. Los tres pacientes tuvieron  resolución rápida de sus síntomas después de que se le administró  diphenhydramine intravenoso.

También tratamos a tres pacientes adicionales con presentaciones clínicas más sutiles. Un niño presentó sedación y contractura intermitente de la boca;  seguidos por la tortícolis y los movimientos involuntarios de la lengua. Una mujer  de 32 años de edad  presentó bruxism suave, intermitente. Y un muchacho  adolescente se presentó con una sensación de  debilidad y de espasmos en su parte posterior  y una sensación de hinchazón en su lengua, seguida por disartria, espasmo buco-lingual, y diaphoresis. En los tres de estos pacientes, los síntomas resueltos rápidamente después de la administración del diphenhydramine intravenoso. En el primer paciente, un análisis del suero  utilizando espectroscopia de la cromatografía-masa del gas identificó el haloperidol y no detectó ningún alprazolam. Las píldoras inusitadas del segundo paciente fueron identificadas como haloperidol. El tercer paciente divulgó que él había injerido una píldora que era idéntica en aspecto a la marca de fábrica de Ginebra del haloperidol genérico, aunque la persona que le proveyó la droga  insistió que la píldora era alprazolam genérico.

La substitución del haloperidol por el diazepan del benzodiazepine (“valium de la calle”) era común en la calle en los años 70 y los años 80. Ambas píldoras eran azules y tenían un agujero central.1,2 Los médicos hoy deben estar enterados que el haloperidol se está substituyendo por el alprazolam (“calle Xanax”), aun cuando las píldoras tienen diversas formas y colores. Roberto G. Hendrickson, M.D.; Anthony P. Marruecos, M.D.;

Michael I. Greenberg, M.D., Ph.D. Universidad médica de la universidad de Pennsylvania-Hahnemann, Philadelphia, PA 19129 ; Esta dirección electrónica esta protegida contra spam bots. Necesita activar JavaScript para visualizarla

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