Sono e ritmos circadianos na depressão resistente
DOI:
https://doi.org/10.25118/2763-9037.2014.v4.240Palavras-chave:
Depressão, Depressão resistente, Tratamento dos transtornos do sonoResumo
Os distúrbios do sono e do ritmo circadiano constituem características essenciais dos quadros depressivos. As alterações do ciclo vigília-sono são frequentemente sintomas prodrômicos dos transtornos depressivos e desempenham um papel na patofisiologia dos transtornos do humor. Essas alterações predizem um novo episódio, aumentam o risco de recaída e de recorrência e correlacionam com maior risco de suicídio. A permanência de transtornos de sono pode aumentar a refratariedade ao tratamento. Os pacientes com depressões resistentes ao tratamento farmacológico apresentam uma importante desregulação circadiana e diminuição da amplitude do ritmo delta durante o sono. Os tratamentos disponíveis para os distúrbios do sono na depressão resistente incluem medicações com efeitos hipnóticos e intervenções não farmacológicas. Drogas como os agonistas de receptores benzodiazepínicos, agonistas melatoninérgicos e antagonistas dos receptores serotonérgicos do tipo 2C têm demonstrado eficácia na regularização das alterações do sono em pacientes com depressão. Intervenções não farmacológicas como a terapia cognitivo-comportamental e a fototerapia também são úteis, particularmente quando associadas à medicação antidepressiva.
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