EFECTOS SECUNDARIOS DE LOS MEDICAMENTOS EN NIÑOS Y ADOLESCENTES CON SÍNDROME ANSIOSO DEPRESIVO: REVISIÓN NARRATIVA CON BÚSQUEDA SISTEMATIZADA
A narrative review with systematic search of side effects of medications in children and adolescents with anxiety-depression syndrome
DOI:
https://doi.org/10.47187/cssn.Vol16.Iss2.452Palabras clave:
Antidepresivos, Toxicidad de Medicamentos, Trastorno Depresivo, Trastornos de Ansiedad, AdolescenteResumen
Introducción: El uso creciente de antidepresivos en población pediátrica obliga a comprender su perfil de seguridad para equilibrar beneficios y riesgos del tratamiento. Objetivo: Determinar la frecuencia y gravedad de los efectos adversos asociados al tratamiento farmacológico del síndrome ansioso-depresivo en niños y adolescentes. Métodos: Revisión narrativa con búsqueda sistemática de artículos en inglés y español, sin restricción de fecha, identificados en PubMed, ScienceDirect, Scopus, EBSCO, Research4Life, SciELO, Digitalia y Redalyc (búsqueda: 14–15 agosto 2023). Dos revisores seleccionaron y extrajeron datos de forma independiente y un tercero resolvió discrepancias. Se describieron fármacos utilizados, tipo de estudio y eventos adversos reportados. Resultados: De 68 referencias identificadas, 12 cumplieron los criterios de inclusión. Los inhibidores selectivos de la recaptación de serotonina (ISRS), especialmente la fluoxetina, fueron los fármacos más estudiados y utilizados. Los efectos adversos más frecuentes fueron cefalea y alteraciones gastrointestinales (náuseas, dolor abdominal, vómito, hiporexia [disminución del apetito] y diarrea), observados principalmente durante los tres primeros meses de tratamiento. Se notificaron efectos adversos poco frecuentes, pero clínicamente relevantes, como tics motores graves y episodios de manía/hipomanía. Conclusiones: En niños y adolescentes con síndrome ansioso-depresivo, los ISRS mantienen una relación favorable entre eficacia y seguridad, aunque los efectos adversos son comunes y requieren monitorización clínica estrecha al inicio del tratamiento. La identificación temprana de eventos raros y potencialmente graves refuerza la necesidad de vigilancia farmacológica pediátrica y de estudios multicéntricos que incluyan poblaciones latinoamericanas para mejorar la toma de decisiones clínicas.
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