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Abstract(s)
Atualmente, as benzodiazepinas sĂŁo essenciais em Medicina nomeadamente nas ĂĄreas da Psiquiatria, EmergĂȘncia, Anestesia, Neurologia, etc. Quando surgiram, na dĂ©cada de 60, como alternativa aos barbitĂșricos foram muito bem recebidas e passaram a ser facilmente prescritas. No entanto, rapidamente se evidenciaram os seus inĂșmeros efeitos secundĂĄrios bem como sinais de dependĂȘncia dos utentes. Em Portugal Ă© a classe de psicofĂĄrmacos mais consumida hĂĄ mais de 12 anos.
AlteraçÔes cognitivas, risco acrescido de acidentes de viação e de fraturas da anca, dificuldades a nĂvel da concentração e atĂ© mesmo comportamentos de risco para si e para terceiros, sĂŁo vĂĄrios os efeitos secundĂĄrios que estes fĂĄrmacos podem apresentar.
Com dados a referir que menos de um terço das prescriçÔes sĂŁo adequadas, a prescrição errĂłnea e prolongada por tempos indefinidos Ă© uma caracterĂstica nefasta que aumenta o risco do desenvolvimento de dependĂȘncia e consequentemente uma possĂvel sĂndrome de abstinĂȘncia caracterizada tambĂ©m por uma sintomatologia variada.
Esta dissertação tem como objetivo alertar para o quadro de dependĂȘncia, o estado da arte acerca do seu tratamento e portanto a interrupção adequada do consumo do fĂĄrmaco, as falhas na investigação e quais as ĂĄreas com prioridade futura. PorĂ©m o objetivo central Ă© alertar para uma problemĂĄtica muitas vezes negligenciada podendo levar a graves consequĂȘncias na saĂșde e qualidade de vida das pessoas.
Para a elaboração desta dissertação recorreu-se a artigos cientĂficos da base de dados PubMed complementada com informaçÔes do Infarmed e textos de referĂȘncia acerca da temĂĄtica.
A estratégia principal defendida na maioria dos artigos passa por uma redução gradual da dose sendo o esquema mais utilizado o de 4 a 10 semanas com reduçÔes semanais na ordem dos 10 a 25% mas sem existirem normas ou recomendaçÔes com informaçÔes unùnimes e adequadas.
A psicoterapia poderĂĄ ter valor terapĂȘutico bem como alguns fĂĄrmacos em estudo nomeadamente o flumazenil e a pregabalina que jĂĄ revelaram resultados promissores.
O tratamento da dependĂȘncia de benzodiazepinas Ă© possĂvel e com resultados de cessação total a longo prazo na ordem dos 60%.
Conclui-se no entanto que são necessårias guidelines oficiais que permitam uma recomendação médica permitindo assim uma uniformização das medidas bem como uma capacitação dos médicos que ainda se mostram receosos em descontinuar este tipo de tratamentos principalmente por falta de informação adequada.
Currently, benzodiazepines are essential in Medicine in areas such as Psychiatry, Emergency, Anesthesia, Neurology, etc. When they emerged in the 1960s as an alternative to barbiturates they were very well received and easily prescribed, however, their innumerable side effects as well as signs of dependence in the users were quickly evident. In Portugal theyâre the most consumed psychotropic drugs for more than 12 years. Cognitive disorders, increased risk of road accidents and hip fractures, inability to focus attention and even risk behaviors for themselves and to the others, are several of the side effects that these drugs may present. With references indicating that less than a third of the prescriptions are adequate, an erroneous and prolonged prescription for indefinite times is an ominous characteristic that increases the risk of dependency development and consequently, a possible syndrome also characterized by a vast symptomatology. The objective of this dissertation is to alert to the dependency syndrome, the state of the art about its treatment and, therefore, an adequate interruption of the drug consumption, as well as the investigation failures and the investigation areas with future priority. But the main objective is to alert to a problem often neglected and which can lead to serious consequences on health and quality of life. Scientific articles from PubMed database, supplemented by information from the Infarmed and reference texts on the subject were used for the elaboration of this dissertation. The main strategy defended in the majority of the articles is a gradual reduction of the dose. The most used scheme is 4 to 10 weeks with weekly reductions of about 10 to 25% but without norms or recommendations with unanimous and appropriate information. Psychotherapy might have therapeutic value as well as some drugs currently in investigation, such as flumazenil and pregabalin, which already have shown promising results. Treatment of benzodiazepine dependence is possible and with long-term total cessation results around 60%. However, there is a need of official guidelines that allow a medical recommendation, thus allowing a standardization of the measures as well as a qualification of the doctors who still have apprehension in discontinuing this type of treatments mainly due to a lack of adequate information.
Currently, benzodiazepines are essential in Medicine in areas such as Psychiatry, Emergency, Anesthesia, Neurology, etc. When they emerged in the 1960s as an alternative to barbiturates they were very well received and easily prescribed, however, their innumerable side effects as well as signs of dependence in the users were quickly evident. In Portugal theyâre the most consumed psychotropic drugs for more than 12 years. Cognitive disorders, increased risk of road accidents and hip fractures, inability to focus attention and even risk behaviors for themselves and to the others, are several of the side effects that these drugs may present. With references indicating that less than a third of the prescriptions are adequate, an erroneous and prolonged prescription for indefinite times is an ominous characteristic that increases the risk of dependency development and consequently, a possible syndrome also characterized by a vast symptomatology. The objective of this dissertation is to alert to the dependency syndrome, the state of the art about its treatment and, therefore, an adequate interruption of the drug consumption, as well as the investigation failures and the investigation areas with future priority. But the main objective is to alert to a problem often neglected and which can lead to serious consequences on health and quality of life. Scientific articles from PubMed database, supplemented by information from the Infarmed and reference texts on the subject were used for the elaboration of this dissertation. The main strategy defended in the majority of the articles is a gradual reduction of the dose. The most used scheme is 4 to 10 weeks with weekly reductions of about 10 to 25% but without norms or recommendations with unanimous and appropriate information. Psychotherapy might have therapeutic value as well as some drugs currently in investigation, such as flumazenil and pregabalin, which already have shown promising results. Treatment of benzodiazepine dependence is possible and with long-term total cessation results around 60%. However, there is a need of official guidelines that allow a medical recommendation, thus allowing a standardization of the measures as well as a qualification of the doctors who still have apprehension in discontinuing this type of treatments mainly due to a lack of adequate information.
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Keywords
Ansiedade Benzodiazepinas DependĂȘncia Desmame InsĂłnia