Associação entre episódio de mania e indução por vortioxetina: uma revisão de literatura

• Autor(a) principal: Nóbrega, Lucas Sebadelhe
• Data de Publicação: 2022
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório do Centro Universitário Braz Cubas
• Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/4174
• topic: Mania; Vortioxetine; Transtorno bipolar; CNPQ::CIENCIAS DA SAUDE::MEDICINA

A manic episode associated with the use of antidepressants is well defined and described in the literature,among the newest drugs on the marketwe have Vortioxetinean atypical antidepressant. This work aims to investigate the possibility of a Vortioxetine-induced manic episode in a patient with no history of maniatiform turn. A bibliographic review was carried out in the PubMed and Virtual Health Library databases, between August 2021 and May 2022, using the descriptors: “Mania”, “Vortioxetine”, “Bipolar disorder” and "Neuroimaging". Of the 85articles, after applying the inclusion and exclusion criteria, and performing the full reading, 8articles were selected. Most of the works are case reports (n=6), retrospective cohort study (n =1) and double-blind randomized controlled clinical trial (n=1) Episodes of mania/hypomania were observed after the use of Vortioxetine in all studies, the underlying psychiatric disorder being unipolar depression (n=6),bipolar disorder( n=1) and no previous psychiatric history (n=1). In all case reports, other pathologies were ruled out to generate maniatiform symptoms. The withdrawal of this atypical antidepressant occurred in all publications, at the time when the symptoms (n=8). As an outcome of reports we have that the euthymic state was reached after discontinuation of the antidepressant (n=6), requiring in some studies the addition of quetiapine (n=2), valproic acid (n=2), olanzapine (n=2), intramuscular lorazepam (n=1), lamotrigine (n=1), bupropion (n=2) and lithium carbonate (n=1). There was also a resolution of the case with withdrawal of vortioxetine (n=1). Variables such as time between diagnoses of mania/bipolar disorder associated with antidepressant use, age, sex and previous antidepressant treatment (n=1) were used and the tolerability and safety of vortioxetine were evaluated (n=1). The importance of careful use of antidepressants and the possibility of inducing mania/hypomania (n=1) and the need for pharmacovigilance studies to monitor the safety and tolerability of Vortioxetine (n=1) were also highlighted. In the cohort study, the importance of being careful with the use of antidepressants and the possibility of inducing mania/hypomania 8was highlighted (n=1). In the double-blind randomized controlled clinical trial, the tolerability and safety of vortioxetine were evaluated, requiring pharmacovigilance studies to monitor this drug. Finally, it is important to emphasize the need for further studies and the risk of a manic episode triggered by the use of Vortioxetine