Efeitos do biperideno para reduzir recaídas em pessoas com transtorno por uso de cocaína/crack: um ensaio clínico controlado e randomizado
Data
2023-03
Autores
Campos Junior, Miguel Siqueira 
Orientadores
Galduróz, José Carlos Fernandes
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O uso de cocaína afetou aproximadamente 21,5 milhões de pessoas em 2020, ou 0,4% da população mundial entre 15 e 64 anos. Vários autores descrevem a dependência de drogas como sendo uma doença do sistema de recompensa cerebral. Dado que o sistema colinérgico afeta os mecanismos de recompensa e a autoadministração de drogas, a acetilcolina pode desempenhar um papel importante no processo de dependência de cocaína. O objetivo do presente trabalho foi avaliar o efeito do biperideno (antagonista de receptores muscarínicos - preferencialmente M1, o principal tipo de receptor muscarínico no cérebro) na recaída do uso de crack/cocaína em comparação com um grupo controle que recebeu placebo. Métodos: O presente estudo consistiu de um ensaio clínico duplo-cego, randomizado e controlado por placebo. O grupo intervenção recebeu 2mg de cloridrato de biperideno, 3 vezes por dia, por um período de 3 meses. O grupo controle recebeu cápsulas de placebo, na mesma posologia e período de tempo. Todos os participantes foram acompanhados por um período total de seis meses. Resultados: Observou-se menor consumo de substâncias no grupo que recebeu o tratamento com biperideno em dois (bT2=-2,2 [-3,3;-1,0], p<0,001) e seis meses (bT4 = -6,2 [- 8,6; -3,9], p<0,001) após o início da intervenção. O grupo que recebeu tratamento com biperideno apresentou maior latência até um possível primeiro dia de consumo, nos mesmos períodos de avaliações, ou seja, após 2 e 6 meses do início da intervenção (bT2 = 0,26 [0,080; 0,44], p = 0,004; bT4 = 0,63 [0,32; 0,93], p<0,001). Conclusões: Apesar das grandes limitações do presente estudo, o grupo que recebeu o biperideno, reduziu o número de dias de uso de cocaína/crack e também apresentou aumento do tempo de latência para a recaída. Estudos mais robustos são necessários para confirmar ou refutar esses achados.
Introduction: Cocaine use affected approximately 21.5 million people in 2020, or 0.4% of the world's population between 15 and 64 years old. Several authors describe drug addiction as a brain reward system disease. Given that the cholinergic system affects reward mechanisms and drug selfadministration, acetylcholine may play an important role in the process of cocaine dependence. The objective of this study was to evaluate the effect of biperiden (muscarinic receptor antagonist preferably M1, the main type of muscarinic receptor in the brain) on crack/cocaine use relapse compared to a control group that received placebo. Methods: The present study consisted of a doubleblind, randomized, placebocontrolled clinical trial. The intervention group received 2mg of biperiden hydrochloride, 3 times a day, for a period of 3 months. The control group received placebo capsules, in the same dosage and period of time. All participants were followed for a total period of six months. Results: Lower substance consumption was observed in the group that received biperiden treatment in two (bT2=2.2 [3.3; 1.0], p<0.001) and six months (bT4 = 6, 2 [8.6; 3.9], p<0.001) after the beginning of the intervention. The group that received biperiden treatment had a higher latency until a possible first day of consumption, in the same evaluation periods, that is, after 2 and 6 months from the beginning of the intervention (bT2 = 0.26 [0.080; 0.44], p = 0.004; bT4 = 0.63 [0.32; 0.93], p<0.001). Conclusions: Despite the major limitations of the present study, the group that received biperiden reduced the number of days of cocaine/crack use and showed an increase in the latency time for relapse. More robust studies are needed to confirm or refute these findings.
Introduction: Cocaine use affected approximately 21.5 million people in 2020, or 0.4% of the world's population between 15 and 64 years old. Several authors describe drug addiction as a brain reward system disease. Given that the cholinergic system affects reward mechanisms and drug selfadministration, acetylcholine may play an important role in the process of cocaine dependence. The objective of this study was to evaluate the effect of biperiden (muscarinic receptor antagonist preferably M1, the main type of muscarinic receptor in the brain) on crack/cocaine use relapse compared to a control group that received placebo. Methods: The present study consisted of a doubleblind, randomized, placebocontrolled clinical trial. The intervention group received 2mg of biperiden hydrochloride, 3 times a day, for a period of 3 months. The control group received placebo capsules, in the same dosage and period of time. All participants were followed for a total period of six months. Results: Lower substance consumption was observed in the group that received biperiden treatment in two (bT2=2.2 [3.3; 1.0], p<0.001) and six months (bT4 = 6, 2 [8.6; 3.9], p<0.001) after the beginning of the intervention. The group that received biperiden treatment had a higher latency until a possible first day of consumption, in the same evaluation periods, that is, after 2 and 6 months from the beginning of the intervention (bT2 = 0.26 [0.080; 0.44], p = 0.004; bT4 = 0.63 [0.32; 0.93], p<0.001). Conclusions: Despite the major limitations of the present study, the group that received biperiden reduced the number of days of cocaine/crack use and showed an increase in the latency time for relapse. More robust studies are needed to confirm or refute these findings.