RESUMO
Few studies have described therapeutic options in brachioradial pruritus. We describe a cross-sectional study of brachioradial pruritus patients treated in an outpatient unit. We reviewed medical records and interviewed brachioradial pruritus patients without indication for decompressive surgery, in order to access the perceptions of intensity of pruritus prior to treatment and response to therapy. We found that antidepressants and anticonvulsants were the most frequently prescribed drugs. Best reductions in pruritus were associated with its highest intensities prior to treatment, and with longer periods of therapy.
Assuntos
Aminas/uso terapêutico , Amitriptilina/uso terapêutico , Antidepressivos Tricíclicos/uso terapêutico , Ácidos Cicloexanocarboxílicos/uso terapêutico , Doxepina/uso terapêutico , Prurido/tratamento farmacológico , Ácido gama-Aminobutírico/uso terapêutico , Antidepressivos Tricíclicos/classificação , Antipsicóticos/uso terapêutico , Estudos Transversais , Quimioterapia Combinada , Feminino , Gabapentina , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Abstract: Few studies have described therapeutic options in brachioradial pruritus. We describe a cross-sectional study of brachioradial pruritus patients treated in an outpatient unit. We reviewed medical records and interviewed brachioradial pruritus patients without indication for decompressive surgery, in order to access the perceptions of intensity of pruritus prior to treatment and response to therapy. We found that antidepressants and anticonvulsants were the most frequently prescribed drugs. Best reductions in pruritus were associated with its highest intensities prior to treatment, and with longer periods of therapy.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Prurido/tratamento farmacológico , Ácidos Cicloexanocarboxílicos/uso terapêutico , Doxepina/uso terapêutico , Aminas/uso terapêutico , Amitriptilina/uso terapêutico , Antidepressivos Tricíclicos/uso terapêutico , Antipsicóticos/uso terapêutico , Estudos Transversais , Quimioterapia Combinada , Antidepressivos Tricíclicos/classificaçãoRESUMO
Trichotillomania is a psychodermatologic disorder characterized by uncontrollable urge to pull one's own hair. Differential diagnoses include the most common forms of alopecia such as alopecia areata. It is usually associated with depression and obsessive-compulsive disorder. Trichotillomania treatment standardization is a gap in the medical literature. Recent studies demonstrated the efficacy of N-acetylcysteine (a glutamate modulator) for the treatment of the disease. We report the clinical case of a 12-year-old female patient who received the initial diagnosis of alopecia areata, but presented with clinical and dermoscopic features of trichotillomania. She was treated with the combination of psychotropic drugs and N-acetylcysteine with good clinical response. Due to the chronic and recurring nature of trichotillomania, more studies need to be conducted for the establishment of a formal treatment algorithm.
Assuntos
Alopecia em Áreas/diagnóstico , Psicotrópicos/uso terapêutico , Tricotilomania/diagnóstico , Acetilcisteína/uso terapêutico , Criança , Diagnóstico Diferencial , Doxepina/uso terapêutico , Feminino , Fluoxetina/uso terapêutico , Humanos , Pimozida/uso terapêutico , Tricotilomania/tratamento farmacológicoRESUMO
ABSTRACT Trichotillomania is a psychodermatologic disorder characterized by uncontrollable urge to pull one's own hair. Differential diagnoses include the most common forms of alopecia such as alopecia areata. It is usually associated with depression and obsessive-compulsive disorder. Trichotillomania treatment standardization is a gap in the medical literature. Recent studies demonstrated the efficacy of N-acetylcysteine (a glutamate modulator) for the treatment of the disease. We report the clinical case of a 12-year-old female patient who received the initial diagnosis of alopecia areata, but presented with clinical and dermoscopic features of trichotillomania. She was treated with the combination of psychotropic drugs and N-acetylcysteine with good clinical response. Due to the chronic and recurring nature of trichotillomania, more studies need to be conducted for the establishment of a formal treatment algorithm.
Assuntos
Humanos , Feminino , Criança , Psicotrópicos/uso terapêutico , Tricotilomania/diagnóstico , Alopecia em Áreas/diagnóstico , Pimozida/uso terapêutico , Acetilcisteína/uso terapêutico , Tricotilomania/tratamento farmacológico , Fluoxetina/uso terapêutico , Diagnóstico Diferencial , Doxepina/uso terapêuticoRESUMO
Abstract Among the wide range of symptoms neglected or resistant to conventional treatments in clinical practice, itch is emerging gradually as a theme to be studied. Itch complaints and the negative effects in the quality of life are observed in several medical fields. Although the partially obscure pathophysiology, some researchers decided to check and test the use of psychotropic drugs in resistant itch to conventional topical treatments and antihistamines. The objective of this study was to evaluate scientific evidence in psychotropic use in the treatment of itch of various causes. This is a systematic review of scientific literature. The following databases were used: PubMed, Web of Science, Scopus and Scielo. Randomized controlled trials that should focus on treatment with psychotropic drugs of pruritus of various causes were the inclusion criteria. All articles were analyzed by the authors, and the consensus was reached in cases of disagreement. Fifteen articles were included after analysis and selection in databases, with the majority of clinical trials focusing on psychopharmacological treatment of itch on account of chronic kidney disease. Clinical trials with psychotropic drugs mostly indicated significant improvement in the itching. In most trials of chronic kidney disease as basal disease for itch, greater effectiveness was observed with the use of psychotropic drugs compared with placebo or other antipruritic. However, the small amount of controlled trials conducted precludes the generalization that psychiatric drugs are effective for itch of various causes.
Assuntos
Humanos , Prurido/tratamento farmacológico , Psicotrópicos/uso terapêutico , Prurido/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Reprodutibilidade dos Testes , Resultado do Tratamento , Ácidos Cicloexanocarboxílicos/uso terapêutico , Doxepina/uso terapêutico , Ácido gama-Aminobutírico/uso terapêutico , Aminas/uso terapêutico , Nefropatias/complicações , Antipruriginosos/uso terapêuticoRESUMO
Among the wide range of symptoms neglected or resistant to conventional treatments in clinical practice, itch is emerging gradually as a theme to be studied. Itch complaints and the negative effects in the quality of life are observed in several medical fields. Although the partially obscure pathophysiology, some researchers decided to check and test the use of psychotropic drugs in resistant itch to conventional topical treatments and antihistamines. The objective of this study was to evaluate scientific evidence in psychotropic use in the treatment of itch of various causes. This is a systematic review of scientific literature. The following databases were used: PubMed, Web of Science, Scopus and Scielo. Randomized controlled trials that should focus on treatment with psychotropic drugs of pruritus of various causes were the inclusion criteria. All articles were analyzed by the authors, and the consensus was reached in cases of disagreement. Fifteen articles were included after analysis and selection in databases, with the majority of clinical trials focusing on psychopharmacological treatment of itch on account of chronic kidney disease. Clinical trials with psychotropic drugs mostly indicated significant improvement in the itching. In most trials of chronic kidney disease as basal disease for itch, greater effectiveness was observed with the use of psychotropic drugs compared with placebo or other antipruritic. However, the small amount of controlled trials conducted precludes the generalization that psychiatric drugs are effective for itch of various causes.
Assuntos
Prurido/tratamento farmacológico , Psicotrópicos/uso terapêutico , Aminas/uso terapêutico , Antipruriginosos/uso terapêutico , Ácidos Cicloexanocarboxílicos/uso terapêutico , Doxepina/uso terapêutico , Gabapentina , Humanos , Nefropatias/complicações , Prurido/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Reprodutibilidade dos Testes , Resultado do Tratamento , Ácido gama-Aminobutírico/uso terapêuticoAssuntos
Humanos , Feminino , Antidepressivos Tricíclicos/uso terapêutico , Antagonistas Adrenérgicos beta/uso terapêutico , Doxepina/uso terapêutico , Efedrina/uso terapêutico , Estrogênios/uso terapêutico , Imipramina/uso terapêutico , Incontinência Urinária por Estresse/terapia , Fenilpropanolamina/uso terapêutico , Propranolol/uso terapêutico , Antidepressivos Tricíclicos , Antidepressivos Tricíclicos/efeitos adversos , Terapia por Estimulação Elétrica , Incontinência Urinária por Estresse/classificação , Incontinência Urinária por Estresse/diagnósticoRESUMO
O objetivo deste artigo é rever a literatura no que se refere à eficácia, efeitos colaterais e uso de antidepressivos tricíclicos e de segunda geraçäo em geriatria. Os vários ensaios clínicos duplo-cegos com esses psicofármacos aplicados a idosos, relatados na literatura de língua inglesa até 1989, foram resenhados