Efeito dos inibidores de recaptação da serotonina na plasticidade neural após Acidente Vascular Cerebral
DOI:
https://doi.org/10.34024/rnc.2015.v23.8035Palavras-chave:
Acidente Vascular Cerebral, Farmacoterapia, Inibidores de Receptação de Serotonina, Plasticidade Neuronal, Atividade Motora, Incapacidade Funcional, ReabilitaçãoResumo
Introdução. O uso de inibidores seletivos da recaptação da serotonina (ISRs) tem sido destacado como agentes de neuroplasticidade para recuperação motora e funcional em pacientes após acidente vascular cerebral (AVC). Objetivo. Considerando a disponibilidade desses fármacos em nosso meio, mesmo no sistema de atendimento público, objetivamos realizar revisão de literatura com intuito de melhor tomada de decisão. Método. Realizada revisão nas bases de dados até fevereiro de 2013, foram incluídos estudos que levassem em consideração as propriedades neuroprotetoras, anti-fadiga e efeito na capacidade de recuperação motora após AVC. Resultados. Dentre os estudos randomizados e controlados (RCT), observou-se melhora da recuperação motora com uso de Fluoxetina avaliada por meio da Fugl-Meyer Motor Scale após 90 dias de tratamento, melhora da independência funcional por meio da escala modificada de Rankin e Índice de Barthel com uso de Nortriptilina, maior ativação no córtex sensório-motor contralateral com uso de paroxetina e nenhum efeito positivo no controle da fadiga após AVC. Conclusão. Os estudos sugerem melhor recuperação motora e funcional com o uso dos SSRI. Não foi possível determinar diferença entre os agentes, pois os estudos disponíveis são heterogêneos em diferentes comparações, sendo que essas e outras lacunas estão sendo abordadas com estudos em andamento
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Publicado: 2015-06-30