Tratamento farmacológico e não-farmacológico da depressão

Abstract

Depression is a type of mood disorder that affects more than 300 million people worldwide and, according to the WHO, by 2030 depression will be the most common disease across the globe. Its pathophysiology is not fully defined, but there are hypotheses such as monoamine deficiency (especially serotonin, dopamine and noradrenaline), the neurotrophic hypothesis (deficit of brain-derived neurotrophic factor - BDNF) and the neuroendocrine hypothesis, which relates high levels of cortisol to depressive disorder. The monoamine hypothesis is the one used as the basis for drug therapy to date. The objective of the present study was to describe the main pharmacological and non-pharmacological treatment lines for depression. To this end, scientific articles were searched in the Google Scholar database using the terms 'antidepressants', ' therapies to combat depression', 'antidepressant drugs' and 'non-pharmacological alternatives for depression' being bibliographical sources from the last 10 years. According to the survey carried out, synthetic antidepressant drugs are the most used approach in treatment. Most patients respond to pharmacological treatment, but 10 to 30% have a partial response to their symptoms and the medications end up causing side effects that result in a lower quality of life and high rates of relapse and can even trigger suicide attempts. The most prescribed classes of antidepressants are Serotonin Reuptake Inhibitors (SSRIs), Monoamine Oxidase Inhibitors (MAOIs), Tricyclic antidepressants (TCAs) and Serotonin and Noradrenaline Reuptake Inhibitors. Non-pharmacological alternatives are also known that benefit treatments for depression and Integrative and Complementary Health Practices (PICs) that aim to guarantee quality of life for individuals undergoing treatment fit into these possibilities. Currently, 29 PICs are regulated, all of which are important in the management of depression. Both pharmacological and non-pharmacological treatments require specific knowledge to promote patient adherence and rational use of these therapies in favor of the evolution of the condition, requiring health professionals to have knowledge and skills to meet patients' demands. Therefore, for pharmaceutical professionals it is important to understand the mechanisms and effects induced by antidepressant drugs so that their guidance on the use of these drugs is clear and safe, guaranteeing good therapeutic responses and, qualifying in PICs to offer techniques that add quality of life.