{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:30:56Z","timestamp":1787023856744,"version":"build-2736575974"},"reference-count":0,"publisher":"Socidrogalcohol","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Adicciones"],"abstract":"<jats:p>Esta revisi\u00f3n resume las intervenciones farmacol\u00f3gicos y psicosociales que se han realizado en trastorno bipolar (TB) y un diagn\u00f3stico com\u00f3rbido de trastorno por uso de sustancias (TUS) y adem\u00e1s proporciona recomendaciones cl\u00ednicas respecto de cu\u00e1les elementos de intervenci\u00f3n son \u00fatiles para hacer frente a los s\u00edntomas del uso de sustancias versus los s\u00edntomas de estado de \u00e1nimo en pacientes con estas afecciones concurrentes. Se utiliz\u00f3 la mejor evidencia de ensayos controlados aleatorizados para evaluar las opciones de tratamiento. La fuerza de las recomendaciones se describi\u00f3 mediante el enfoque GRADE. Muy pocos de los ensayos aleatorizados realizados hasta la fecha han proporcionado evidencia consistente para el manejo tanto de los s\u00edntomas de estado de \u00e1nimo como del uso de sustancias en pacientes con TB. No hay disponibilidad de ensayos cl\u00ednicos para pacientes con TB que utilizan el cannabis. Algunos tratamientos han mostrado beneficios para los s\u00edntomas de estado de \u00e1nimo sin beneficios para el uso de alcohol o sustancias il\u00edcitas. Nuestros resultados sugieren que 1) podemos (d\u00e9bilmente) recomendar el uso de \u00e1cido valproico o naltrexona adyuvante para aliviar los s\u00edntomas del trastorno por consumo de alcohol; 2) el tratamiento complementario con lamotrigina parece reducir los s\u00edntomas relacionados con la coca\u00edna y, por tanto, es recomendable (fuerza moderada); y 3) la vareniclina es recomendable (d\u00e9bilmente) para mejorar la abstinencia de la nicotina. La terapia grupal integrada es el enfoque con m\u00e1s validaci\u00f3n y eficacia sobre los resultados en el uso de sustancias cuando este uso es abordado durante la fase inicial de tratamiento.<\/jats:p>","DOI":"10.20882\/adicciones.1528","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T06:45:21Z","timestamp":1623739521000},"page":"142-156","source":"Crossref","is-referenced-by-count":5,"title":["Gu\u00eda de pr\u00e1ctica cl\u00ednica para el tratamiento farmacol\u00f3gico y psicol\u00f3gico de los pacientes adultos con trastorno bipolar y un diagn\u00f3stico com\u00f3rbido de trastorno por uso de sustancias"],"prefix":"10.20882","volume":"34","author":[{"given":"Ana","family":"Gonz\u00e1lez-Pinto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Manuel","family":"Goikolea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u00f1aki","family":"Zorrilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miquel","family":"Bernardo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Arrojo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Cunill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavi","family":"Castell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisardo","family":"Beco\u00f1a Iglesias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Torrens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Tirado-Mu\u00f1oz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francina","family":"Fonseca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bel\u00e9n","family":"Arranz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Garriga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar A.","family":"S\u00e1iz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo","family":"Fl\u00f3rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"San","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"8502","published-online":{"date-parts":[[2021,6,14]]},"container-title":["Adicciones"],"original-title":[],"link":[{"URL":"https:\/\/adicciones.es\/index.php\/adicciones\/article\/download\/1528\/1237","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/adicciones.es\/index.php\/adicciones\/article\/download\/1528\/1236","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T07:03:40Z","timestamp":1740035020000},"score":1,"resource":{"primary":{"URL":"https:\/\/adicciones.es\/index.php\/adicciones\/article\/view\/1528"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,14]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,5,5]]}},"URL":"https:\/\/doi.org\/10.20882\/adicciones.1528","relation":{},"ISSN":["0214-4840"],"issn-type":[{"value":"0214-4840","type":"print"}],"subject":[],"published":{"date-parts":[[2021,6,14]]}}}