Fluoxetina ou Hypericum perforatum no tratamento de pacientes portadores de transtorno depressivo maior leve a moderado? Uma revisão

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Publicado: dez 20, 2011
DOI: https://doi.org/10.7322/abcs.v36i3.57
Palavras-chave:
transtorno depressivo maior, medicamentos sob prescrição, Hypericum perforatum, erva-de-são-joão, fluoxetina, terapêutica

Conteúdo do artigo principal

Renato Davino Chiovatto
Disciplina de Farmacologia da Faculdade de Medicina do ABC (FMABC) – Santo André, (SP) Brasil.
Ellen Yukie Fukuda
Disciplina de Farmacologia da Faculdade de Medicina do ABC (FMABC) – Santo André, (SP) Brasil.
David Feder
Disciplina de Farmacologia da Faculdade de Medicina do ABC (FMABC) – Santo André, (SP) Brasil.
Cristina de Zotti Nassis
Disciplina de Farmacologia da Faculdade de Medicina do ABC (FMABC) – Santo André, (SP) Brasil.

Resumo

Conhecidos há mais de 2.500 anos, os transtornos afetivos continuam a dominar os interesses da saúde pública, com destaque ao transtorno depressivo maior (TDM). Diversos antidepressivos foram desenvolvidos destacando-se os Inibidores Seletivos da Recaptura de Serotonina (ISRS), entre eles, a fluoxetina medicamento de primeira escolha no manejo do TDM. Em contrapartida, os extratos do Hypericum perforatum (HP) vêm tomando destaque, representando os antidepressivos mais prescritos em vários países europeus. Essa revisão teve por objetivo analisar a eficácia e a aceitação das formas mais prevalentes de terapias medicamentosas do TDM leve a moderado: fluoxetina e HP, por meio de estudos avaliados, a partir de 2005, identificados nas bases de dados MEDLINE, Ovid, ScienceDirect, além de referências bibliográficas. Dentre os estudos avaliados, três consideraram o HP mais eficaz que fluoxetina, um o considerou menos eficaz e um não demonstrou diferença. Os trabalhos que avaliaram a aceitação foram unânimes quanto à superioridade do HP. Os trabalhos analisados são controversos quanto à eficácia do HP no manejo do TDM. Todos os estudos utilizaram doses de 900 mg de HP administrados uma a três vezes ao dia, contra 20 mg de fluoxetina uma vez ao dia. O tempo de tratamento realizado variou de 4 a 12 semanas, analisando o tratamento em depressão leve a moderada e apenas um estudo avaliou depressão com parâmetros vegetativos invertidos. Há, portanto, necessidade de mais estudos com tratamento em longo prazo, variando as doses das medicações a fim de avaliar se o HP consiste em mais uma arma contra o TDM leve a moderado.

Detalhes do artigo

Edição
v. 36 n. 3 (2011)
Seção
Artigos de Revisão

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