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Introdução: Os transtornos alimentares são caracterizados como distúrbios do comportamento alimentar, associados ao desequilíbrio nos pensamentos, ações e atitudes dos indivíduos resultando em prejuízos à saúde do indivíduo. Estas condições são cada vez mais comuns na sociedade atual e têm ganhado crescente atenção da comunidade científica. Objetivo: Analisar a procura pelo atendimento e farmacoterapia em mulheres com anorexia e bulimia nervosa atendidas em uma faculdade de medicina em 2018. Material e método: Realizou-se análise documental dos prontuários médicos. A procura pelo atendimento foi considerada não-espontânea quando a paciente foi encaminhada pela unidade de urgência/emergência ou compareceu acompanhada por responsável legal sem admitir necessidade de tratamento. Resultados: Identificou-se 14 pacientes, com idade média de 31,21 anos. 43% apresentaram procura não-espontânea pelo atendimento, sendo 83% destas encaminhadas por unidades de urgência/emergência. Foram prescritos 21 medicamentos diferentes, sendo a maioria antidepressivos. 52% dos fármacos prescritos não são disponibilizados pelo Sistema Único de Saúde. 29% dos pacientes apresentavam polifarmácia, 43% automedicação e 57% pensamento de morte. Houve associação entre o pensamento de morte e uso de 4 ou mais medicamentos. Conclusão: Uma parcela considerável das pacientes teve procura não-espontânea pelo atendimento. Os fármacos prescritos foram principalmente antidepressivos e a maioria não é disponibilizado no Sistema Único de Saúde, evidenciando a onerosidade econômica e social do tratamento(AU)

Introduction: Eating disorders are characterized as disorders of eating behavior, associated with imbalance in the thoughts, actions and attitudes of individuals resulting in harm to the health of the individual. These conditions are increasingly common in today's society and have gained increasing attention from the scientific community. Objective: To analyze the search for health services and pharmacotherapy in women with anorexia and bulimia nervosa attended at a medical school in 2018. Material and method: Documental analysis of medical records was performed. The search for care was considered non-spontaneous when the patient was referred by the emergency unit or accompanied by a legal guardian without admitting need for treatment. Results: We identified 14 patients with a mean age of 31.21 years. 43% showed non-spontaneous search for care, which 83% were referred by emergency units. 21 different drugs were prescribed, most of them antidepressants. 52% of the drugs prescribed are not available from Brazilian Unified Health System. 29% of the patients presented polypharmacy, 43% self-medication and 57% thought death. There was an association between the thought of death and the use of 4 or more medications. Conclusion: A considerable number of patients had non-spontaneous search for care. The drugs prescribed were mainly antidepressants and most are not available in the Brazilian Unified Health System , evidencing the economic and social onerosity of the treatment(AU)

Introducción: Los trastornos alimentarios se caracterizan como disturbios del comportamiento alimentario, asociados al desequilibrio en los pensamientos, acciones y actitudes de los individuos resultando en perjuicios a la salud del individuo. Estas condiciones son cada vez más comunes en la sociedad actual y han ganado creciente atención de la comunidad científica. Objetivo: Analizar búsqueda de atención médica y farmacoterapia en mujeres con anorexia y bulimia nerviosa atendidas en una Facultad de medicina en 2018. Material y método: se realizó análisis documental de registros médicos. La búsqueda de atención médica fue considerada no espontánea cuando la paciente fue remitida por urgencia/emergencia o acompañada por responsable legal sin admitir necesidad de tratamiento. Resultados: se identificaron 14 pacientes, edad media de 31,21 años. 43% presentaron búsqueda no espontánea, 83% de estas remitidas por unidades de urgencia/emergencia. Fueron prescritos 21 medicamentos diferentes, la mayoría antidepresivos. 52% de medicamentos prescritos no son proporcionados por el Sistema Único de Salud Brasileño. 29% de los pacientes presentan polifarmacia, 43% automedicación y 57% pensamiento de muerte. Hubo asociación entre pensamiento de muerte y uso de 4 o más medicamentos. Conclusión: Parte considerable de los pacientes tuvo búsqueda no espontánea de atención médica. Los medicamentos prescritos fueron principalmente antidepresivos, la mayoría no disponible en el Sistema Único de Salud Brasileño, evidenciando la onerosidad económica y social del tratamiento(AU)

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La prevalencia entre los adolescentes, de trastornos de la conducta alimentaria como anorexia nerviosa (AN), bulimia nerviosa (BN) y otro (obesidad, alimentación compulsiva, o no especificados), viene creciendo día a día de modo sostenido y a gran velocidad; y siendo la alimentación una necesidad básica, importante y vital para el crecimiento y desarrollo, debe entenderse que este acto ejerce una conducta poderosa influencia en la estructura y funcionamiento del organismo por lo tanto una conducta alimentaria adecuada hace posible que esto se desarrolle de manera adecuada y óptima. Cada sociedad tiene formas habituales de alimentarse según sus costumbres y características socioculturales y religiosas; cuando un individuo se aparta de los límites racionales presentando características anormales tanto en la calidad como en la cantidad o distribución de las comidas a esto se le llama ôTrastornos en la Conducta Alimentariaõ. El tratamiento de los trastornos en la conducta alimentaria representa todo un desafío de Salud Pública por su alta incidencia, gravedad y evolución clínica prolongada con propensión a la cronicidad y por el grupo etáreo afectado, por lo tanto, es indispensable buscar las herramientas que permitan una detección temprana y una intervención especializada con un equipo multidisciplinario que incluya médico, psicólogo, nutricionista, psiquiatría, de modo que el pronóstico de recuperación sea el mejor posible.

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OBJECTIVE: To evaluate the effects of antidepressant interventions for patients with Binge Eating Disorder (BED). METHOD: A systematic review and meta-analysis of available randomized controlled trials including a quality appraisal was conducted. Six databases: PUBMED, EMBASE, PSYINFO, LILACS, The Cochrane Collaboration Controlled Trials Register and The Cochrane Depression, Anxiety and Neurosis Group Database of Trials were searched using an electronic search strategy. Articles published during the period from January 1994 to December 2005 were included. RESULTS: From the 3357 articles initially identified, 19 full manuscripts were selected and analyzed and 7 studies fulfilled the inclusion criteria and were included in the final analysis. Data from the meta-analysis revealed that binge-eating remission rates were higher in patients receiving antidepressants when compared with placebo. No difference in body weight has been found as measured by short-term change in body mass index. Most studies were short-term trials (median duration: 8 weeks). The only 16-week duration study did not show superiority of antidepressants over placebo. CONCLUSION: Available data are not sufficient to formally recommend antidepressants as a single first line therapy for both short-term remission of binge-eating episodes and weight reduction in patients with BED. BED is a chronic condition and very short-term studies (8 weeks) may be of limited value.

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OBJECTIVE: To evaluate the efficacy and tolerability of adjunctive topiramate compared to placebo in reducing weight and binge eating in obese patients with binge-eating disorder (BED) receiving cognitive-behavior therapy (CBT). METHOD: A double-blind, randomized, placebo-controlled trial of 21 weeks' duration was conducted at 4 university centers. Participants were 73 obese (body mass index >or= 30 kg/m(2)) outpatients with BED (DSM-IV criteria), both genders, and aged from 18 to 60 years. After a 2- to 5-week run-in period, selected participants were treated with group CBT (19 sessions) and topiramate (target daily dose, 200 mg) or placebo (September 2003-April 2005). The main outcome measure was weight change, and secondary outcome measures were binge frequencies, binge remission, Binge Eating Scale (BES) scores, and Beck Depression Inventory (BDI) scores. RESULTS: Repeated-measures random regression analysis revealed a greater rate of weight reduction associated with topiramate over the course of treatment (p < .001), with patients taking topiramate attaining a clinically significant weight loss (-6.8 kg) compared to patients taking placebo (-0.9 kg). Although rates of reduction of binge frequencies, BES scores, and BDI scores did not differ between groups during treatment, a greater number of patients of the topiramate plus CBT group (31/37) attained binge remission compared to patients taking placebo (22/36) during the trial (p = .03). No difference between groups was found in completion rates; 1 patient (topiramate group) withdrew for adverse effect. Paresthesia and taste perversion were more frequent with topiramate, and insomnia was more frequent with placebo (p < .05). CONCLUSIONS: Topiramate added to CBT improved the efficacy of the later, increasing binge remission and weight loss in the short run. Topiramate was well tolerated, as shown by few adverse events during treatment. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov identifier NCT00307619.

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BACKGROUND: The objective of this study was to evaluate the effectiveness and safety of reboxetine, a selective noradrenaline reuptake inhibitor, in the treatment of obese patients with binge eating disorder (BED). METHOD: Nine outpatients with BED and obesity received reboxetine 8 mg/day for 12 weeks. The number of days with binge eating episodes per week was considered the primary outcome measure. Body weight, body mass index (BMI), Binge Eating Scale (BES), Clinical Global Impression Severity (CGI-S) and the World Health Organization Quality of Life Assessment Scale (WHOQOL-BREF) scores were used as secondary outcome measures. Paired t-test with the last observation carried forward was used to analyze changes from baseline to endpoint. RESULTS: Five patients completed the study and showed a complete remission of BED. The mean binge days per week was significantly reduced from 4.6+/-1.8 to 0.2+/-0.6, at the end of the study (p=0.0002). Mean BES scores were decreased from 32.3+/-6.3 to 9.3+/-6.8 (p=0.0003). There was also a statistically significant decrease in BMI (from 36.5+/-4.48 to 35.06+/-4.49; p=0.01), and in CGI-S (from 5.1+/-0.9 to 1.4+/-1.01; p=0.0002). Quality of life, assessed using the WHOQOL-BREF was significantly improved on overall quality of life and general health (p=0.02) and on psychological (p=0.03) domain. No serious adverse events were observed. CONCLUSION: Reboxetine may be an effective and well-tolerated agent in the treatment of BED in obese patients.

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