Inibidores da monoaminoxidase e cetamina intravenosa: uma associação segura?

Autores

  • Juliana Machado Leal dos Santos Médica Residente do Programa de Residência Médica em Psiquiatria pela Secretaria de Saúde do Recife https://orcid.org/0000-0002-9759-1542
  • Hugo Leonardo de Oliveira Couto Médico Psiquiatra da Secretaria de Saúde do Recife, PE, Brasil https://orcid.org/0000-0002-1868-9817
  • Dennison Carreiro Monteiro Doutorando em Neuropsiquiatria e Ciências do Comportamento da Universidade Federal de Pernambuco https://orcid.org/0000-0002-3672-9894

DOI:

https://doi.org/10.25118/2763-9037.2022.v12.219

Palavras-chave:

segurança, inibidores da monoaminoxidase, cetamina, pressão sanguínea

Resumo

Introdução: A Cetamina emerge como uma droga rápida e efetiva no tratamento da Depressão Resistente ao Tratamento (DRT) e é a primeira droga com mecanismo de ação fora do sistema monoaminérgico aprovada para tal finalidade. Os pacientes com DRT, com frequência, estarão em uso, ou terão indicação de inibidores da monoaminoxidase (IMAOs). A cetamina tem efeitos simpaticomiméticos através, dentre outros mecanismos, de inibição da recaptura de noradrenalina; os riscos do uso concomitante dos IMAOs e de algumas drogas noradranérgicas já é estabelecido. Diante disto, a possibilidade de crises hipertensivas resultantes da combinação destes medicamentos requer atenção clínica. Objetivo: O objetivo desta revisão foi verificar aspectos importantes a respeito desta combinação, com enfoque na ocorrência de crises hipertensivas e outros efeitos cardiovasculares. Método: O estudo foi realizado através das bases de dados Pubmed, Scielo e Lilacs, datadas de 1990 até março de 2021, utilizando-se a combinação dos descritores: (Monoamine oxidase inhibitor) AND (Ketamine). Resultado: Os resultados demonstram segurança e eficácia da combinação, com elevações transitórias da frequência cardíaca e pressão arterial, sem consequências para os pacientes. Conclusão: Entretanto, tratam-se de dados de relatos e séries de casos e de uma pequena coorte retrospectiva. Portanto é possível que efeitos colaterais graves não sejam detectados nestas amostras por serem reduzidas.

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Biografia do Autor

Juliana Machado Leal dos Santos, Médica Residente do Programa de Residência Médica em Psiquiatria pela Secretaria de Saúde do Recife

Hugo Leonardo de Oliveira Couto, Médico Psiquiatra da Secretaria de Saúde do Recife, PE, Brasil

Dennison Carreiro Monteiro, Doutorando em Neuropsiquiatria e Ciências do Comportamento da Universidade Federal de Pernambuco

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Publicado

2022-07-01

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Santos JML dos, Couto HL de O, Monteiro DC. Inibidores da monoaminoxidase e cetamina intravenosa: uma associação segura?. Debates em Psiquiatria [Internet]. 1º de julho de 2022 [citado 29º de março de 2024];12:1-20. Disponível em: https://revistardp.org.br/revista/article/view/219

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