Peraire Marc, Gimeno-Vergara Rita, Pick-Martin Jennifer, Boscá Mireia, Echeverria Iván
TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón de la Plana, Spain.
Department of Mental Health, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain.
Front Mol Neurosci. 2024 Oct 16;17:1412855. doi: 10.3389/fnmol.2024.1412855. eCollection 2024.
Ziconotide is a non-opioid analgesic that acts on N-type voltage-gated calcium channels. Despite its proven effectiveness in pain treatment, it can induce neuropsychiatric symptoms. The aim of this article is to present a case of psychosis secondary to ziconotide and to explore the variety of neuropsychiatric symptoms it produces, exploring the relationship between these symptoms and the mechanism of action of ziconotide. For this purpose, a clinical case is presented as well as a scoping review of other cases published in the scientific literature. A search on Web of Science, Pubmed and Embase databases was performed on December 11, 2023, following the criteria of the PRISMA-ScR Statement. The clinical case presented shows the variety of neuropsychiatric symptomatology that ziconotide can cause in the same patient. On the other hand, 13 papers were retrieved from the scoping review (9 case reports, 4 case series), which included 21 cases of patients treated with ziconotide who presented adverse effects ranging from psychotic symptoms to delirium. In conclusion, the variety of neuropsychiatric symptoms derived from ziconotide could be related to the blockade of N-type voltage-gated calcium channels in glutamatergic and GABAergic neurons, in turn affecting dopaminergic pathways.
齐考诺肽是一种作用于N型电压门控钙通道的非阿片类镇痛药。尽管其在疼痛治疗中的有效性已得到证实，但它可诱发神经精神症状。本文的目的是介绍一例继发于齐考诺肽的精神病病例，并探讨其产生的各种神经精神症状，探究这些症状与齐考诺肽作用机制之间的关系。为此，本文介绍了一个临床病例，并对科学文献中发表的其他病例进行了范围综述。按照PRISMA-ScR声明的标准，于2023年12月11日在科学网、PubMed和Embase数据库上进行了检索。所呈现的临床病例显示了齐考诺肽可在同一患者中引起的各种神经精神症状。另一方面，从范围综述中检索到13篇论文（9篇病例报告，4篇病例系列），其中包括21例接受齐考诺肽治疗的患者，这些患者出现了从精神症状到谵妄等不良反应。总之，齐考诺肽引起的各种神经精神症状可能与谷氨酸能和γ-氨基丁酸能神经元中N型电压门控钙通道的阻断有关，进而影响多巴胺能通路。
