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Eventos adversos psiquiátricos y neurocognitivos en usuarios jóvenes de óxido nitroso no médico
Margot Lestienne1, Alexandra Macgregor2, Laurie Surig3
1Department of Medical Pharmacology and Toxicology, Addictovigilance Center.
Journal of clinical psychopharmacology
|August 26, 2025
Resumen
El uso no médico del óxido nitroso (N2O) está relacionado con eventos neuropsiquiátricos graves en adultos jóvenes. La consideración temprana del abuso de N2O es crucial para el diagnóstico de trastornos psiquiátricos y cognitivos desconocidos.
Área de la Ciencia:
- La neurociencia
- La psiquiatría
- Toxicología
Sus antecedentes:
- Aumento del uso no médico del óxido nitroso (N2O) entre adolescentes y adultos jóvenes en Francia.
- Se observó una asociación entre el uso de N2O y los acontecimientos adversos graves.
Objetivo del estudio:
- Analizar los informes espontáneos de eventos adversos neuropsiquiátricos en los usuarios de N2O.
- Discutir los posibles mecanismos farmacológicos subyacentes a estos eventos.
Principales métodos:
- Análisis de 19 informes espontáneos graves (SR) del centro de vigilancia de la adicción de Montpellier (2022-junio de 2024).
- Evaluación de la demografía de los pacientes, los síntomas informados, el uso de sustancias asociadas y los marcadores bioquímicos (vitamina B12, homocisteína, ácido metilmalónico, vitamina B9).
- Revisión de los hallazgos de la neuroimagen (IRM) y las intervenciones de tratamiento.
Principales resultados:
- Los informes involucraron predominantemente a hombres jóvenes con trastornos psiquiátricos, neurocognitivos o combinados.
- Los síntomas comunes incluyen trastornos del comportamiento y el delirio, déficits de memoria y desorientación.
- Las anomalías bioquímicas (baja vitamina B12, aumento de la homocisteína/ ácido metilmalónico) y las anomalías de la sustancia blanca en la resonancia magnética fueron frecuentes.
- El N2O exhibe un potencial neurotóxico a través de mecanismos psicoactivos, bioquímicos (interrupción del metabolismo de la vitamina B12) y anóxicos.
Conclusiones:
- Los trastornos neuropsiquiátricos inducidos por N2O son significativos y distintos.
- Se debe sospechar el abuso de N2O en pacientes jóvenes que presentan trastornos psiquiátricos inexplicables, especialmente con síntomas cognitivos atípicos.
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