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Advisor(s)
Abstract(s)
Introdução: A Perturbação de Stress Pós-Traumático (PTSD) é uma perturbação mental complexa caracterizada por lembranças recorrentes e intrusivas de um evento traumático. Estima-se a prevalência desta perturbação em cerca de 1-9.2% da população adulta mundial e cerca de 13,5-30% da população que lida com situações de elevada exposição a trauma. A fisiopatologia da perturbação não é completamente compreendida e o tratamento consiste, por regra, na terapia cognitivo-comportamental focada no trauma e/ou terapêuticas farmacológicas. Ainda assim, parte dos doentes apresenta sintomatologia inadequadamente controlada, ou resistência à terapêutica. Sequelas do incorreto seguimento destes doentes são várias desde limitações ocupacionais, dificuldades nos relacionamentos interpessoais, perda de produtividade ao suicídio. A 3,4-metilenodioxi-metanfetamina (MDMA) apresenta-se como uma potencial alternativa, encontrando-se em estudo a sua utilização.
Objetivo: Explorar a viabilidade do uso de psicoterapia assistida por MDMA no tratamento da PTSD, avaliando a sua utilização, riscos, segurança e questões éticas associadas.
Métodos: Para esta revisão sistemática qualitativa, foram realizadas pesquisas literárias nos motores de busca Pubmed, SciELO, Science Direct, NCBI, entre 2010 e 2021, de ensaios clínicos que incidissem sobre a utilização de 3,4-metilenodioxi-metanfetamina no tratamento da PTSD.
Resultados: Os 6 ensaios clínicos incluídos nesta revisão conseguiram demonstrar, através do controlo com placebos inativos e ativos, que o uso da psicoterapia assistida por MDMA era eficaz, a curto e a longo prazo, com um bom perfil de segurança e eficácia.
Conclusões: Conclui-se após a análise nesta revisão, que a psicoterapia assistida por MDMA foi administrada de forma segura, eficaz e com efeitos duradores no tratamento da PTSD crónica e resistente ao tratamento.
Introduction: Post Traumatic Stress Disorder (PTSD) is a complex mental disorder characterized by recurrent and intrusive memories of a traumatic event. The prevalence of this disorder is estimated to be at 1-9.2% of the world's adult population and at 13.5-30% of the population dealing with situations of high-trauma exposure. The disorder’s pathophysiology is not fully understood and treatment usually consists of trauma-focused cognitive-behavioral therapy and/or pharmacological therapies. Even so, some patients have inadequately controlled symptoms, or are resistant to therapy. Sequels of incorrect follow-up of these patients are varied, ranging from occupational limitations, difficulties in interpersonal relationships, loss of productivity to suicide. 3,4-methylenedioxy-methamphetamine (MDMA) presents itself as a potential alternative, and its use is being studied. Objective: Explore the feasibility of using MDMA in the treatment of PTSD, evaluating its use, risks, safety and associated ethical issues. Methods: For this qualitative systematic review, literature searches were performed in the Pubmed, SciELO, Science Direct, NCBI search engines, between 2010 and 2021, of clinical trials that focused on the use of 3,4-methylenedioxy-methamphetamine in the treatment of PTSD. Results: The 6 clinical trials included in this review were able to demonstrate, through control with inactive and active placebos, that the use of MDMA-assisted psychotherapy was effective, in short and long term follow-up, with a good safety and efficacy profile. Conclusions: From the analysis in this review, MDMA-assisted psychotherapy was administered safely, effectively, and with lasting effects in the treatment of chronic and treatment-resistant PTSD.
Introduction: Post Traumatic Stress Disorder (PTSD) is a complex mental disorder characterized by recurrent and intrusive memories of a traumatic event. The prevalence of this disorder is estimated to be at 1-9.2% of the world's adult population and at 13.5-30% of the population dealing with situations of high-trauma exposure. The disorder’s pathophysiology is not fully understood and treatment usually consists of trauma-focused cognitive-behavioral therapy and/or pharmacological therapies. Even so, some patients have inadequately controlled symptoms, or are resistant to therapy. Sequels of incorrect follow-up of these patients are varied, ranging from occupational limitations, difficulties in interpersonal relationships, loss of productivity to suicide. 3,4-methylenedioxy-methamphetamine (MDMA) presents itself as a potential alternative, and its use is being studied. Objective: Explore the feasibility of using MDMA in the treatment of PTSD, evaluating its use, risks, safety and associated ethical issues. Methods: For this qualitative systematic review, literature searches were performed in the Pubmed, SciELO, Science Direct, NCBI search engines, between 2010 and 2021, of clinical trials that focused on the use of 3,4-methylenedioxy-methamphetamine in the treatment of PTSD. Results: The 6 clinical trials included in this review were able to demonstrate, through control with inactive and active placebos, that the use of MDMA-assisted psychotherapy was effective, in short and long term follow-up, with a good safety and efficacy profile. Conclusions: From the analysis in this review, MDMA-assisted psychotherapy was administered safely, effectively, and with lasting effects in the treatment of chronic and treatment-resistant PTSD.
Description
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021
Keywords
Perturbação de stress pós-traumático 3,4-metilenodioxi-metanfetamina (MDMA) MDMA no tratamento da PTSD Psicoterapia assistida por MDMA Psiquiatria