DESCONTINUAÇÃO DE BENZODIAZEPINAS – QUANDO E COMO?

Queiroz Machado, J. Sousa, T. Malheiro, A. Moreira

Resumo


Introdução: Atendendo que não existe evidência sobre malefícios associados à descontinuação de benzodiazepinas e que a terapêutica
crónica com estes fármacos pode causar prejuízos para a saúde, existe necessidade de desenvolver protocolos adequados de descontinuação.
Métodos: Revisão bibliográfica de revisões sistemáticas, meta-análises e guidelines que abordaram estratégias de descontinuação de
benzodiazepinas em adultos submetidos a tratamentos de longo prazo, publicados de 2008 a 2018, em 8 bases de dados eletrónicas.
Resultados: Foram selecionados 8 artigos de revisão considerando os critérios de inclusão e exclusão. Os sintomas de privação são um
dos mais importantes fatores que dificultam a descontinuação. Os doentes devem ser previamente avaliados, tendo em conta, a sua saúde,
motivação e autonomia funcional. A descontinuação deve ser feita de forma gradual e personalizada, sendo que não existe evidência
robusta que suporte o uso de intervenções farmacológicas para facilitar este processo. A terapia cognitivo-comportamental parece trazer, a
curto prazo, benefícios na taxa de sucesso de suspensão destes fármacos. Conclusão: Até à data, não existem orientações estabelecidas
para descontinuar benzodiazepinas, muito embora tenham sido propostos esquemas. Os estudos não comparam diretamente diferentes
esquemas entre si e a maioria não avalia os outcomes na qualidade de vida e nos eventuais ganhos funcionais. É, portanto, necessária
mais investigação para reconhecer as melhores estratégias de descontinuação.


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