Banca de DEFESA: FERNANDA SANTANA CORREIA DE MELO

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
DISCENTE : FERNANDA SANTANA CORREIA DE MELO
DATA : 24/07/2020
HORA: 10:00
LOCAL: De forma remota (online)
TÍTULO:

SCETAMINE AND KETAMINE IN THE TREATMENT OF RESISTANT DEPRESSION

PALAVRAS-CHAVES:

Unipolar depression. Bipolar depression. Treatment-resistant depression. NMDA antagonists. Ketamine. Esketamine. Arketamine.

PÁGINAS: 84
GRANDE ÁREA: Ciências da Saúde
ÁREA: Medicina
RESUMO:

This Thesis aimed to review and evaluate the use of N-Methyl-D-Aspartate (NMDA) antagonists in the treatment of depressive episodes, especially ketamine and its enantiomers: S (+): ketamine and R (-): arcetamine. As a result, 4 articles were published: a literature review that aimed to study the role of NMDA antagonists in the treatment of mood disorders, especially in bipolar depression; an original article with primary data that constitutes the main study of this Thesis - a double-blind, bicentric non-inferiority clinical trial in which participants with unipolar treatment-resistant depression (TRD) were randomized to the group of esketamine or ketamine in order to assess the clinical remission of depression 24h after infusion; a third methodological article referring to this study. For the evaluation of depressive symptoms, the Montgomery-Asberg Depression Rating Scale (MADRS) was used. The rates of remission and therapeutic response of ketamine and ketamine in the treatment of TRD were similar 24h after infusion. We did not observe any difference in tolerability between ketamine and ketamine. Finally, the fourth article from the Thesis was an open pilot study whose objective was to analyze the efficacy and safety of arketamine in TRD in humans. In conclusion, NMDA antagonists, such as ketamine and its enantiomers, have been considered promising discoveries in the treatment of TRD, with the antidepressant effect of these drugs being related to glutamatergic action. According to the main study of the Thesis, esketamine was non-inferior to ketamine 24h after the infusion and both were considered effective, safe and well tolerated. In addition, the pilot study originating from the Thesis demonstrated that arketamine has the potential to produce rapid and sustained onset antidepressant effects with a good safety and tolerability profile. In this context, the findings of the Thesis studies corroborate the evidence found in the literature, reinforcing the importance of understanding the role of the glutamatergic system in the pathophysiology of mood disorders, which may facilitate the development of more effective treatments in the treatment of unipolar and bipolar depression, more specifically in TRD.

MEMBROS DA BANCA:
Externo à Instituição - ANDRE CARVALHO CARIBE DE ARAUJO PINHO - EBMSP
Interno - 3215394 - ANGELA MARISA DE AQUINO MIRANDA SCIPPA
Externo ao Programa - 7287642 - ESDRAS CABUS MOREIRA
Externo à Instituição - MONICA DE ANDRADE NASCIMENTO
Externo à Instituição - SIDELCINA RUGIERI PACHECO - Fiocruz-Ba