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corresponde a uma dose de 15 mg/dia. Pacientes<br />
com depressão não-endógena, entretanto, obtiveram<br />
remissão mesmo com níveis de 15 a 25<br />
μmol/L. Não foi observada uma relação entre níveis<br />
séricos e a ocorrência de efeitos colaterais.<br />
PRECAUÇÕES<br />
1. Evitar a associação com IMAOs.<br />
2. Reduzir as doses em pacientes com insuficiência<br />
renal ou hepática graves.<br />
3. Ficar atento para sintomas de hiponatremia<br />
(confusão, letargia, mal-estar, podendo ocorrer<br />
inclusive convulsões), particularmente em<br />
pacientes idosos.<br />
REFERÊNCIAS BIBLIOGRÁFICAS<br />
1. Milne RJ, Goa K. Citalopram – a review of its pharmacodynamic<br />
and pharmacokinetic properties and therapeutic<br />
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2. Preskorn SH. Clinically relevant pharmacology of selective<br />
serotonin reuptake inhibitors. An overview with enphasis<br />
on pharmacokinetics and effects on oxidative metabolism.<br />
Clin Pharmacokin 1997; 32: (suppl.1):1-21.<br />
3. Rosenberg C, Damsbo N, Fuglum E, Jacobsen LV, Horsgard<br />
S.Citalopram and imipramine in the treatment of depressive<br />
patients in general practice. A Nordic multicentre clinical<br />
study.Int Clin Psychopharmacol 1994 ;9 (Suppl 1):41-8<br />
4. Feighner JP, Overo K. Multicenter, placebo-controlled,<br />
fixed-dose study of citalopram in moderate-to-severe<br />
depression. J Clin Psychiatry 1999; 60(12):824-30.<br />
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Mahnert FA, Rouillon F, Wade AG, Andersen M, Pedersen<br />
SF, Swart JC, Nil R. Prophylactic effect of citalopram in<br />
unipolar, recurrent depression: placebo-controlled study of<br />
maintenance therapy. Br J Psychiatry 2001;178:304-10.<br />
6. Perna G, Bertani A, Caldirola D, Smeraldi E, Bellodi L.A<br />
comparison of citalopram and paroxetine in the treatment<br />
of panic disorder: a randomized, single-blind study.<br />
Pharmacopsychiatry 2001; 34(3):85-90.<br />
7. Lepola UM, Wade AG, Leinonen EV, Koponen HJ, Frazer J,<br />
Sjodin I, Penttinen JT, Pedersen T, Lehto HJ.A controlled,<br />
prospective, 1-year trial of citalopram in the treatment of<br />
panic disorder. J Clin Psychiatry 1998; 59(10):528-34.<br />
8. Montgomery SA, Kasper S, Stein DJ, Bang Hedegaard K,<br />
Lemming OM. Citalopram 20 mg, 40 mg and 60 mg are all<br />
effective and well tolerated compared with placebo in<br />
obsessive-compulsive disorder. Int Clin Psychopharmacol<br />
2001;16(2):75-86.<br />
9. Furmark T, Tillfors M, Marteinsdottir I, Fischer H, Pissiota<br />
A, Langstrom B, Fredrikson M. Common changes in cerebral<br />
blood flow in patients with social phobia treated with<br />
citalopram or cognitive-behavioral therapy. Arch Gen<br />
Psychiatry 2002; 59(5): 425-33.<br />
10. Stahl SM. Basic Psychopharmacology of antidepressants,<br />
part 1: antidepressants have seven distinct mechanisms of<br />
action. J Clin Psychiatry 1998: 59 (4): 5-14.<br />
11. Koran LM, Chuong HW, Bullock KD, Smith SC. Citalopram<br />
for compulsive shopping disorder: an open-label study<br />
followed by double-blind discontinuation. J Clin Psychiatry<br />
2003; 64(7):793-8.<br />
12. McElroy SL, Hudson JI, Malhotra S, Welge JA, Nelson<br />
EB, Keck PE Jr. Citalopram in the treatment of binge-eating<br />
disorder: a placebo-controlled trial. J Clin Psychiatry 2003;<br />
64(7):807-13.<br />
13. Anderberg UM, Marteinsdottir I, von Knorring L. Citalopram<br />
in patients with fibromyalgia—a randomized, doubleblind,<br />
placebo-controlled study. Eur J Pain 2000; 4(1): 27-35.<br />
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with citalopram. Lancet 1996; 348 (3): 339-340.<br />
15. Laine K, Heikkinen T, Ekblad U, Kero P. Effects of exposure<br />
to selective serotonin reuptake inhibitors during pregnancy<br />
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Psychiatry 2003; 60(7):720-6.<br />
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CLOBAZAM<br />
FRISIUM (Lab. Aventis Pharma)<br />
• Embalagens com 20 comprimidos de 10 mg e<br />
20 mg.<br />
URBANIL (Lab. Aventis Pharma)<br />
• Embalagens com 20 comprimidos de 10 e 20<br />
mg.<br />
FARMACOCINÉTICA<br />
E MODO DE USAR<br />
O clobazam é um benzodiazepínico com propriedades<br />
ansiolíticas e anticonvulsivantes, miorrelaxantes<br />
e hipnóticas, provocando um pouco menos<br />
sedação e comprometimento motor que o diazepam.<br />
O clobazam em si tem uma meia-vida de 18<br />
horas, mas a meia-vida do seu principal metabólito,<br />
o n-desmetilclobazan, é de 50 horas. A eliminação<br />
é predominantemente renal (90%). Ligase<br />
às proteínas plasmáticas em 85 a 90%. Como<br />
os demais benzodiazepínicos, tem uma ampla<br />
margem de segurança 1 .<br />
Ensaios clínicos indicam que o clobazam é eficaz<br />
no tratamento da ansiedade 2-4 .Parece ter um efei-<br />
CLOBAZAM<br />
MEDICAMENTOS: INFORMAÇÕES BÁSICAS<br />
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