Análise do conteúdo de propagandas de medicamentos psicoativos

O objetivo do estudo foi descrever as figuras humanas retratadas nas propagandas de medicamentos psicoativos quanto ao gênero, a idade, a etnia e o contexto social. Foi realizada análise de conteúdo de 86 impressos publicitários inéditos divulgados em Araraquara (SP) no ano de 2005. A associação entre as categorias foi analisada usando o teste exato de Fisher. Houve predomínio de mulheres (62,8%), sendo quatro vezes mais freqüentes que os homens em propagandas de antidepressivos e ansiolíticos. A maioria era constituída de jovens adultos (72%), de etnia branca (98,8%). As pessoas estavam em lazer (46,5%), em suas casas (29%) ou em contato com a natureza (16,2%). A mensagem transmitida foi que os medicamentos tratam sintomatologias subjetivas de desconforto do dia-a-dia, induzindo a um apelo irracional que pode refletir na prescrição medicamentosa.

Effect of chronic treatment with Clomipramine on food intake, macronutrient selection and body weight gain in rats

Long-term treatment with clomipramine (CMI), a tricyclic antidepressant, induces food craving and body weight gain in patients. The present study investigated the effects of chronic treatment with CMI on total food intake, macronutrient selection, and body weight gain in rats. Male Wistar rats were maintained on a dietary self-selection regime with separate sources of protein, fat and carbohydrate. Animals received i.p. injections of CMI (0, 3, 10, 30 mg/kg) during 27 consecutive days. Food consumption and body weight were recorded daily and results were calculated as average of three consecutive days, namely during pre-treatment (3 d before pharmacological treatment), treatment (7th-9th; l6th-l8th and 25th-27th days), and post-treatment (28th-33rd days). Results showed that CMI (30 mg/kg) significantly decreased energy intake during all treatment period, an effect that was related to a decrease in both carbohydrate-rich diet intake and body weight gain. At dose of 3 mg/kg CMI increased the total energy intake in the 16th-18th days, suggesting an apparent biphasic effect of chronic treatment with CMI on caloric intake. Chronic administration with CMI (27 d) did not alter protein-rich or fat-rich diet consumption. The main result of this study indicated that chronic treatment with CMI decreases rather than increase food consumption and body weight gain in rats exposed to a macronutrient self-selection procedure.

Contrasting effects of acute and chronic treatment with imipramine and fluoxetine on inhibitory avoidance and escape responses in mice exposed to the elevated T-maze

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Um caso de delirio de infestacao parasitaria tratado com clomipramina

The article describes a clinical case of primary delusional parasitosis responsive to clomipramine, that had not previously respond to neuroleptic treatment. Clinical similarities of this disorder with obsessive-compulsive disorder are discussed. In conclusion, the article suggests that serotonergic antidepressants may be usefull in the treatment of patients with somatic delusional disorder.

Um programa de saúde mental: A experiência do Projeto UNI de Botucatu

The aim of this paper was to assess the Projeto UNI (Kellogg Foundation) in one of the Mental Health Centers (ARE) of Botucatu, SP, Brazil. We analysed 20% of the charts and the number of patients seen by psychiatrists and other mental health professionals before and after. Our results showed that: 1) the service users were mainly of neurotic patients (anxious, dysthymiacs, ICD-9 V code), followed by psychotics (schizophrenics, affectives) and organics (epileptics, mental deficients, demented patients); 2) there were more treatment options after the Projeto UNI implementation and over 2,495 group consultations were made in one year (as opposed to 90 in the year prior the project); 3) medical and nurse students are evaluating the program favourably; 4) there is a clear necessity of reassessing and changing some prescription practices: 43% of the patients were taking drug associations, there was an excessive use of benzodiazepines (54%) and low use of mood stabilizers (5%). There is also a need for more availability of depot neuroleptics, other antidepressants and better quality psychotropic drugs, and 5) there is a necessity of improving quality and quantity of charts information.

Double-blind comparison of venlafaxine and amitriptyline in outpatients with major depression with or without melancholia

The purpose of this study was to compare the efficacy and tolerability of venlafaxine and amitriptyline in outpatients with major depression with or without melancholia. This was an 8-week, multicentre, randomized, double-blind, parallel-group comparison of venlafaxine and amitriptyline. Outpatients with DSM-IV major depression, a minimum score of 20 on the 21-item Hamilton Depression Rating Scale (HAM-D), and depressive symptoms for at least 1 month were eligible. Patients were randomly assigned to venlafaxine or amitriptyline, both drugs titrated to a maximum of 150 mg/day until study day 15. The primary efficacy variables were the final on-therapy scores on the HAM-D, Montgomery-Asberg Depression Rating Scale and Clinical Global Impression severity scales. Data were evaluated on an intent-to-treat basis using the LOCF method. One hundred and 16 patients were randomized, and 115 were evaluated for efficacy. Both drugs showed efficacy in the treatment of depression with or without melancholia. No significant differences were noted between treatments for any efficacy parameter. However, significantly (p < 0.05) more patients in the amitriptyline group had at least one adverse event. These results should support the efficacy and tolerability of venlafaxine in comparison with amitriptyline for treating major depression with or without melancholia.

Injeção subaracnóidea inadvertida de corticoíde em tratamento de dor crônica da coluna lombar. Relato de caso

BACKGROUND AND OBJECTIVES: Before epídural steroids were used in chronic lumbar pain, subarachnoid injection of these agents was the treatment of choice. Although still preconized by some authors, this technique may lead to severe complications with neurological sequelae. This report aimed at describing a case of accidental subarachnoid injection of steroid associated to local anesthetics during epidural puncture to treat lumbar pain. CASE REPORT: Male patient, 46 years old, followed byneuro-surgery for presenting right sciatic pain for 9 month, refractory to clinical treatment due to L 4-L 5 disk protrusion confirmed by CT scan, without neurological deficit. Epidural puncture for pain treatment was performed in L 4-L 5 with 17G needle and 10 mL solution were injected containing 4 mL of 0.25% bupivacaine, 80 mg methylprednisolone and 4 mL of 0.9% saline. Although there has not been CSF reflux, 5 minutes after injection there were sensory block in T 4 and motor block in T 6, associated to blood pressure and heart rate decrease. CONCLUSIONS: Accidental subarachnoid injections with the association of steroids for pain relief may cause adverse effects. There are several risks, varying from mild transient symptoms to nervous injuries, including spinal cord injuries. Our patient had no sequelae from the accidental subarachnoid injection, probably because it has been a single injection.

Citrus aurantium L. essential oil exhibits anxiolytic-like activity mediated by 5-HT1A-receptors and reduces cholesterol after repeated oral treatment

Background: The current treatments for anxiety disorders and depression have multiple adverse effects in addition to a delayed onset of action, which has prompted efforts to find new substances with potential activity in these disorders. Citrus aurantium was chosen based on ethnopharmacological data because traditional medicine refers to the Citrus genus as useful in diminishing the symptoms of anxiety or insomnia, and C. aurantium has more recently been proposed as an adjuvant for antidepressants. In the present work, we investigated the biological activity underlying the anxiolytic and antidepressant effects of C. aurantium essential oil (EO), the putative mechanism of the anxiolytic-like effect, and the neurochemical changes in specific brain structures of mice after acute treatment. We also monitored the mice for possible signs of toxicity after a 14-day treatment.Methods: The anxiolytic-like activity of the EO was investigated in a light/dark box, and the antidepressant activity was investigated in a forced swim test. Flumazenil, a competitive antagonist of benzodiazepine binding, and the selective 5-HT1A receptor antagonist WAY100635 were used in the experimental procedures to determine the mechanism of action of the EO. To exclude false positive results due to motor impairment, the mice were submitted to the rotarod test.Results: The data suggest that the anxiolytic-like activity observed in the light/dark box procedure after acute (5 mg/kg) or 14-day repeated (1 mg/kg/day) dosing was mediated by the serotonergic system (5-HT1A receptors). Acute treatment with the EO showed no activity in the forced swim test, which is sensitive to antidepressants. A neurochemical evaluation showed no alterations in neurotransmitter levels in the cortex, the striatum, the pons, and the hypothalamus. Furthermore, no locomotor impairment or signs of toxicity or biochemical changes, except a reduction in cholesterol levels, were observed after treatment with the EO.Conclusion: This work contributes to a better understanding of the biological activity of C. aurantium EO by characterizing the mechanism of action underlying its anxiolytic-like activity. © 2013 Costa et al; licensee BioMed Central Ltd.

Ethopharmacological analysis of the open elevated plus-maze in mice

Exposure of rodents to an open elevated plus-maze (oEPM) elicits antinociception and increases plasma corticosterone levels. However, no studies have yet assessed the defensive behaviour repertoire of animals in this modified test. In Experiment 1, factor analysis was employed to characterise the behavioural profile of mice exposed to the oEPM. Experiments 2 and 3 assessed the effects of acute alprazolam (0.5-1.5. mg/kg; diazepam 0.5-1.5. mg/kg), pentylenetetrazole (10.0-30.0. mg/kg), yohimbine (2.0-6.0. mg/kg), mCPP (0.3-3.0. mg/kg), and acute and chronic fluoxetine (10.0-30.0. mg/kg) and imipramine (1.0-15.0. mg/kg) on behaviours identified in Experiment 1. The factor analyses revealed that behaviour in the oEPM can largely (77% total variance) be accounted for in terms of 3 factors: factor 1 ('. depth exploration'; e.g. head-dipping on the arms), factor 2 ('. cautious exploration of arms'; e.g. flatback approach), and factor 3 ('. risk assessment'; stretched attend postures - SAP). Experiments 2 and 3 showed that, over the dose range used, alprazolam selectively attenuated all measures of defensiveness. Similar, though more modest, effects were seen with diazepam. Confirming the intensity of the emotional response to the oEPM (nociceptive, endocrine and behavioural), relatively few significant behavioural changes were seen in response to the anxiogenic compounds tested. Although acute fluoxetine or imipramine treatment failed to modify behaviour in the oEPM, chronic fluoxetine (but not chronic imipramine) attenuated total flat back approach and increased head dipping outside the central square. Together, the results indicate that the oEPM induces behavioural defensive responses that are sensitive to alprazolam and chronic fluoxetine. © 2013 Elsevier B.V.

Qualidade de vida em mulheres na pós-menopausa usuárias e não usuárias da terapia hormonal em unidade básica de saúde de Franca-SP

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Validação farmacológica da preferência claro-escuro em Danio rerio

A ansiedade é uma desordem complexa e com grande relevância clínica, cujo estudo com modelos animais é importante para pesquisar sobre seus mecanismos e drogas para o seu tratamento. O zebrafish figura como um potencial modelo animal para pesquisas farmacológicas da ansiedade. Um modelo de ansiedade é a preferência claro-escuro, que já foi validado comportamentalmente em zebrafish, contudo necessita de uma validação farmacológica. Objetiva-se descrever a sensibilidade da preferência claro-escuro em zebrafish adultos para as drogas mais utilizadas na clínica da ansiedade, foram administradas pela imersão do animal na solução: Benzodiazepínicos (Clonazepam); Agonistas parciais 5-HT1A (Buspirona); Antidepressivo tricíclico (Imipramina); Antidepressivo ISRS (Fluoxetina e Paroxetina); Antipsicóticos (Haloperidol e Risperidona); Psicostimulante (Dietilpropiona); Beta bloqueadores (Propranolol) e Depressores do SNC (Etanol). Os parâmetros analisados foram o tempo despendido pelo animal no ambiente escuro, o tempo da primeira latência e número de alternâncias. O clonazepam administrado por 300s aumentou o tempo no escuro na menor concentração e reduziu a atividade locomotora, a administração durante 600s da concentração intermediária diminuiu o tempo no escuro e da primeira latência, assim como aumentou a atividade locomotora, indicando efeito ansiolítico. A buspirona aumentou o tempo de permanência no escuro provavelmente devido a redução da atividade motora. A imipramina e a fluoxetina aumentaram o tempo no escuro e da primeira latência e diminuíram o número de alternâncias, indicando ação ansiogênica. A paroxetina não alterou o tempo no escuro, entretanto aumentou o tempo da primeira latência e diminuiu a atividade locomotora. O haloperidol diminuiu a ansiedade na menor concentração, curiosamente aumentou a atividade motora na maior concentração, ao contrário da risperidona que diminuiu a atividade na maior concentração. A dietilpropriona não modificou o tempo no escuro, mas aumentou o tempo da primeira latência e diminuiu a atividade motora apenas na menor concentração. O propranolol reduziu somente o tempo no escuro. O etanol foi efetivo na redução da ansiedade com a concentração intermediária e diminuiu a atividade locomotora em uma concentração menor Os dados corroboram com relatos da literatura em Danio rerio tanto neste modelo em administração intraperitoneal como em outros modelos por administração hídrica e em roedores, quando foi possível a comparação.

Genotoxicidade humana e fármacos antidepressivos: avaliação da duloxetina em culturas de linfócitos

Fármacos antidepressivos são largamente utilizados no tratamento sintomático do transtorno depressivo. Inúmeras pesquisas atuais sobre a depressão vêm contribuindo para o avanço da terapia farmacológica e para o surgimento de novos fármacos antidepressivos. Diretrizes atuais para testes de genotoxicidade de novos medicamentos sugerem a importante utilidade de ensaios que detectem danos ao DNA, ou seja, testes para avaliar a indução de quebras no DNA. Entretanto, o número escasso de dados sobre a genotoxicidade de fármacos faz com que seja reduzido o número de fármacos que realmente podem ser usados em segurança. Portanto, é de extrema importância estudos sobre a avaliação genotoxicológica de fármacos, principalmente, drogas utilizadas por um longo período de tempo como é o caso dos antidepressivos. A duloxetina é um antidepressivo novo, pertencente à classe dos inibidores seletivos da recaptação de serotonina e noradrenalina (ISRSN), utilizada no tratamento sintomático da depressão. Apesar da existência de trabalhos demonstrando que alguns fármacos antidepressivos são genotóxicos, não existe até hoje nenhum estudo sobre a possível genotoxicidade da duloxetina em células de origem humana. Assim, o presente estudo tem como objetivo explorar o possível potencial genotóxico in vitro da duloxetina em culturas primárias de linfócitos humanos através das técnicas de detecção de aberrações cromossômicas e micronúcleos. Culturas primárias de linfócitos sanguíneos de voluntários sadios foram expostas a diferentes concentrações de duloxetina (10-150 ng/ml) e ciclofosfamida (6 μg/ml) como controle positivo. Aberrações cromossômicas estruturais, índice mitótico, índice de divisão nuclear, índice de binucleação, número de células com um, dois, três e quatro micronúcleos e o número de células com pontes nucleoplasmáticas foram avaliadas. Todos os índices das culturas incubadas com duloxetina foram significativamente menores que aqueles dos grupos controles, indicando um certo grau de citotoxicidade da droga. Entretanto, só as concentrações de 100 e 150 ng/ml provocaram o aumento significativo da presença de aberrações cromossômicas e micronúcleos. Considerando que essas concentrações ficam perto do limite superior da faixa terapêutica da droga usada em humanos, nossos resultados alertam já sobre a necessidade de aprofundar no conhecimento da genotoxicidade humana da duloxetina.

Diferenças de gênero na apresentação fenomenológica do transtorno obsessivo-compulsivo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Uma análise dos efeitos do uso a longo prazo de antidepressivos

Pós-graduação em Psicologia - FCLAS

Morphological and biochemical alterations activated by antitumor clerodane diterpenes

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)