Navegando por Palavras-chave "Ideação Suicida"

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    Comparação da eficácia de doses repetidas de escetamina subcutânea no tratamento da suicidalidade na depressão unipolar e bipolar
    (Universidade Federal de São Paulo (UNIFESP), 2021) Surjan, Juliana Canada [UNIFESP]; Lacerda, Acioly Luiz Tavares De [UNIFESP]; Universidade Federal de São Paulo
    Background: Major depressive and bipolar disorders account for most cases of suicide. The pharmacological arsenal to treat suicidality is limited and available agents take too long to take effect. There is a growing body of evidence showing the optimal results of ketamine for treating depression, but the evidence concerning suicidality has not been fully described. Herein, we report the first real-world study with severely depressed patients presenting with suicide ideation that were treated with repeated infusions of subcutaneous esketamine. Methods: Data from 70 acutely depressed subjects diagnosed with unipolar or bipolar major depressive episode who had failed to respond to ≥ 2 treatments were analyzed. Subjects were administered subcutaneous esketamine once a week for 6 weeks. The primary efficacy endpoint, change from baseline to 24h post-infusion 6 in item 10 MADRS score, was analyzed using a mixed-effects repeated measures model. Results: We found significant effects for time on item 10 MADRS scores (F=5.657; p<0.0001) but not for time x diagnosis interaction (F=1.48; p=0.164) from baseline to end of study. Efficacy of esketamine did not differ between groups (MDD vs bipolar depression) at any time point. Statistical significance in both groups was observed since 24h after the first infusion (t=5.811; p<0.001), and further reduction on suicidality scores were observed with repeated infusions. Conclusions: Repeated SC esketamine infusions had significant antisuicidality effects in both unipolar and bipolar groups, with a rapid onset of action. Limitations: Large randomized controlled trials are warranted to confirm these preliminary findings.