Green coffee extract attenuates Parkinson's-related behaviors in animal models.

Epidemiological studies have shown an inverse association between coffee consumption and the development of Parkinson's disease (PD). The effects of the oral treatment with green (non-roasted) coffee extracts (CE, 100 or 400 mg/kg) and caffeine (31.2 mg/kg) were evaluated on catalepsy induced by haloperidol in mice, and unilateral 6-OHDA lesion of medial forebrain bundle (MFB) or striatum in rats. Also, the in vitro antioxidant activity and the monoamine levels in the striatum were investigated. CE presented a mild antioxidant activity in vitro and its administration decreased the catalepsy index. CE at the dose of 400 mg/kg induced ipsilateral rotations 14 days after lesion; however, chronic 30-day CE and caffeine treatments did not interfere with the animals' rotation after apomorphine or methamphetamine challenges in animals with MFB lesion, nor on monoamines levels. Furthermore, CE and caffeine were effective in inhibiting the asymmetry between ipsilateral and contralateral rotations induced by methamphetamine and apomorphine in animals with lesion in the striatum but did not avoid the monoamines depletion. These results indicate that CE components indirectly modulate dopaminergic transmission, suggesting a pro-dopaminergic action of CE, and further investigation must be conducted to elucidate the mechanisms of action and the possible neuroprotective role in PD.

From an Alternative Medicine to a New Treatment for Refractory Epilepsies: Can Cannabidiol Follow the Same Path to Treat Neuropsychiatric Disorders?

Although cannabis has been known for ages as an "alternative medicine" to provide relief from seizures, pain, anxiety, and inflammation, there had always been a limited scientific review to prove and establish its use in clinics. Early studies carried out by Carlini's group in Brazil suggested that cannabidiol (CBD), a non-psychotropic phytocannabinoid present in Cannabis sativa, has anticonvulsant properties in animal models and reduced seizure frequency in limited human trials. Over the past few years, the potential use of cannabis extract in refractory epilepsy, including childhood epilepsies such as Dravet's syndrome and Lennox-Gastaut Syndrome, has opened a new era of treating epileptic patients. Thus, a considerable number of pre-clinical and clinical studies have provided strong evidence that phytocannabinoids has anticonvulsant properties, as well as being promising in the treatment of different neuropsychiatric disorders, such as depression, anxiety, post-traumatic stress disorder (PTSD), addiction, neurodegenerative disorders and autism spectrum disorder (ASD). Given the advances of cannabinoids, especially CBD, in the treatment of epilepsy, would the same expectation regarding the treatment of other neuropsychiatric disorders be possible? The present review highlights some contributions from Brazilian researchers and other studies reported elsewhere on the history, pre-clinical and clinical data underlying the use of cannabinoids for the already widespread treatment of refractory epilepsies and the possibility of use in the treatment of some neuropsychiatric disorders.

Pharmacological and Toxicological Study of Maytenus ilicifolia Leaf Extract. Part I - Preclinical Studies.

One of the Brazilians medicinal plants most cited in ethnopharmacological surveys for the treatment of ulcers and gastric diseases was evaluated for its efficacy and toxicity. Maytenus ilicifolia leaf extract (MIE) was acutely and chronically (180 days) administered to rats, mice, and dogs. Acute tests were antiulcer effect and toxicological trials (observational pharmacological screening, LD50, motor coordination, sleeping time and motor activity). Chronic tests were the following: weight gain/loss and behavioral parameters in rats and mice; estrus cycle, effects on fertility, and teratogenic studies in rats and mutagenic features in mice, in addition to the Ames and micronucleus test. The following parameters were assessed in dogs: weight gain/loss, general physical conditions, water/food consumption, and anatomopathological examination of the organs subsequent to the 180-day treatment. The results showed a clear antiulcer activity for MIE from 70 mg/kg and an absence of toxicological effects in the three animal species, even if given in high doses or over a long period. The present results confirm the antiulcer property and absence of toxicological effects in three animal species of MIE, which is in line with its current popular medicinal use. Copyright © 2017 John Wiley & Sons, Ltd.

The association of psychiatric symptomatology with patterns of alcohol, tobacco, and marijuana use among Brazilian high school students.

BACKGROUND AND OBJECTIVES: Studies have highlighted psychosocial factors associated with drug use among adolescents. Association of specific psychiatric comorbidity with substance use has not been properly established in Brazil. This study aimed to investigate alcohol, tobacco, and marijuana use by 15-18-year-old high school Brazilian students and to estimate associations with psychiatric symptoms. METHODS: A cross-sectional survey of 4,034 students from 128 public and private schools in São Paulo State was carried out using a two-step probability sample. Data were collected through self-report standardized questionnaires including questions on substance use patterns and the Strengths and Difficulties Questionnaire (SDQ). Key outcome variables were past-month use and past-month frequent use of alcohol, tobacco and marijuana. Questionnaires with missing information were excluded, resulting in a final sample of 2,532 adolescents. Weighted data was analyzed through logistic regressions, adjusted by gender and by socio-economic status (SES). RESULTS: Regarding SDQ total score, 43.6% of students had no psychiatric symptoms, 7.9% had subclinical symptoms and 48.5% presented clinically significant symptoms. Respondents with a clinically significant SDQ score were more likely to be past month alcohol (aOR = 1.51; 95%CI 1.22-1.88), tobacco (aOR = 1.82; 95%CI 1.25-2.66), and marijuana (aOR = 1.79; 95%CI 1.21-2.64) users as compared to those with no symptomatology. DISCUSSION AND CONCLUSIONS: Psychopathological symptoms were associated with alcohol, tobacco and marijuana use by 15-18-year-old adolescents. These associations should also be considered when planning public policies of mental health promotion. SCIENTIFIC SIGNIFICANCE: This study discusses the importance of the association between psychopathological symptoms and substance use in a middle-income country, with high level of social inequalities, in a state representative sample. (Am J Addict 2016;25:416-425).

Trends in alcohol and tobacco use among Brazilian students: 1989 to 2010.

OBJECTIVE To analyze temporal trends of the prevalence of alcohol and tobacco use among Brazilian students.METHODS We analyzed data published between 1989 and 2010 from five epidemiological surveys on students from the 6th to the 12th grade of public schools from the ten largest state capitals of Brazil. The total sample consisted of 104,104 students and data were collected in classrooms. The same collection tool - a World Health Organization self-reporting questionnaire - and sampling and weighting procedures were used in the five surveys. The Chi-square test for trend was used to compare the prevalence from different years.RESULTS The prevalence of alcohol and tobacco use varied among the years and cities studied. Alcohol consumption decreased in the 10 state capitals (p < 0.001) throughout 21 years. Tobacco use also decreased significantly in eight cities (p < 0.001). The highest prevalence of alcohol use was found in the Southeast region in 1993 (72.8%, in Belo Horizonte) and the lowest one in Belem (30.6%) in 2010. The highest past-year prevalence of tobacco use was found in the South region in 1997 (28.0%, in Curitiba) and the lowest one in the Southeast in 2010 (7.8%, in Sao Paulo).CONCLUSIONS The decreasing trend in the prevalence of tobacco and alcohol use among students detected all over the Country can be related to the successful and comprehensive Brazilian antitobacco and antialcohol policies. Despite these results, the past-year prevalence of alcohol consumption in the past year remained high in all Brazilian regions.

Trends in alcohol and tobacco use among Brazilian students: 1989 to 2010 / Tendência no uso de álcool e tabaco em estudantes brasileiros: 1989-2010

OBJECTIVE To analyze temporal trends of the prevalence of alcohol and tobacco use among Brazilian students. METHODS We analyzed data published between 1989 and 2010 from five epidemiological surveys on students from the 6th to the 12th grade of public schools from the ten largest state capitals of Brazil. The total sample consisted of 104,104 students and data were collected in classrooms. The same collection tool - a World Health Organization self-reporting questionnaire - and sampling and weighting procedures were used in the five surveys. The Chi-square test for trend was used to compare the prevalence from different years. RESULTS The prevalence of alcohol and tobacco use varied among the years and cities studied. Alcohol consumption decreased in the 10 state capitals (p < 0.001) throughout 21 years. Tobacco use also decreased significantly in eight cities (p < 0.001). The highest prevalence of alcohol use was found in the Southeast region in 1993 (72.8%, in Belo Horizonte) and the lowest one in Belem (30.6%) in 2010. The highest past-year prevalence of tobacco use was found in the South region in 1997 (28.0%, in Curitiba) and the lowest one in the Southeast in 2010 (7.8%, in Sao Paulo). CONCLUSIONS The decreasing trend in the prevalence of tobacco and alcohol use among students detected all over the Country can be related to the successful and comprehensive Brazilian antitobacco and antialcohol policies. Despite these results, the past-year prevalence of alcohol consumption in the past year remained high in all Brazilian regions.

OBJETIVO Analisar a tendência temporal da prevalência de uso de álcool e tabaco por estudantes brasileiros. MÉTODOS Foram analisados, entre 1989 e 2010, dados de cinco inquéritos epidemiológicos com estudantes do sexto ano do ensino fundamental ao terceiro do ensino médio, matriculados em escolas públicas nas 10 maiores capitais do Brasil. A amostra foi de 104.104 estudantes e os dados foram coletados em sala de aula. O instrumento de coleta - questionário de autopreenchimento da Organização Mundial da Saúde - e os procedimentos de amostragem e ponderação foram os mesmos nos cinco inquéritos. Teste de Qui-quadrado de tendências foi utilizado para comparar as prevalências entre os anos. RESULTADOS A prevalência de uso de álcool e tabaco variou nos anos e entre as capitais estudadas. O uso de álcool diminuiu em todas as 10 capitais (p < 0,001), em 21 anos. Houve também diminuição significativa do uso de tabaco em oito capitais (p < 0,001). A maior prevalência de uso de álcool foi observada na região Sudeste, em 1993 (72,8% em Belo Horizonte), e a menor, em Belém (30,6%), em 2010. A maior prevalência de uso do tabaco no último ano foi na região Sul, em 1997 (28,0% em Curitiba) e a menor na região Sudeste, em 2010 (7,8% em São Paulo). CONCLUSÕES A tendência de queda na prevalência de tabagismo e uso de álcool entre estudantes, observada em todo o País, pode estar relacionada com políticas antitabaco e antiálcool bem-sucedidas e abrangentes. Apesar destes resultados, a prevalência de uso de álcool no último ano continuou elevada em todas as regiões brasileiras.

Sexual behavior among high school students in Brazil: alcohol consumption and legal and illegal drug use associated with unprotected sex.

OBJECTIVE: Alcohol and other drug use appears to reduce decision-making ability and increase the risk of unsafe sex, leading to possible unplanned pregnancies, sexually transmitted diseases/human immunodeficiency virus/HIV transmission, and multiple sexual partners. This study aimed to test the hypothesis that risky sexual behaviors among adolescents are associated with legal and illegal drug use. METHODS: A national cross-sectional survey of 17,371 high-school students was conducted in 2010. Students were selected from 789 public and private schools in each of the 27 Brazilian state capitals by a multistage probabilistic sampling method and answered a self-report questionnaire. Weighted data were analyzed through basic contingency tables and logistic regressions testing for differences in condom use among adolescents who were sexually active during the past month. RESULTS: Approximately one third of the high school students had engaged in sexual intercourse in the month prior to the survey, and nearly half of these respondents had not used a condom. While overall sexual intercourse was more prevalent among boys, unsafe sexual intercourse was more prevalent among girls. Furthermore, a lower socioeconomic status was directly associated with non-condom use, while binge drinking and illegal drug use were independently associated with unsafe sexual intercourse. CONCLUSION: Adolescent alcohol and drug use were associated with unsafe sexual practices. School prevention programs must include drug use and sexuality topics simultaneously because both risk-taking behaviors occur simultaneously.

Sexual behavior among high school students in Brazil: alcohol consumption and legal and illegal drug use associated with unprotected sex

OBJECTIVE: Alcohol and other drug use appears to reduce decision-making ability and increase the risk of unsafe sex, leading to possible unplanned pregnancies, sexually transmitted diseases/human immunodeficiency virus/HIV transmission, and multiple sexual partners. This study aimed to test the hypothesis that risky sexual behaviors among adolescents are associated with legal and illegal drug use. METHODS: A national cross-sectional survey of 17,371 high-school students was conducted in 2010. Students were selected from 789 public and private schools in each of the 27 Brazilian state capitals by a multistage probabilistic sampling method and answered a self-report questionnaire. Weighted data were analyzed through basic contingency tables and logistic regressions testing for differences in condom use among adolescents who were sexually active during the past month. RESULTS: Approximately one third of the high school students had engaged in sexual intercourse in the month prior to the survey, and nearly half of these respondents had not used a condom. While overall sexual intercourse was more prevalent among boys, unsafe sexual intercourse was more prevalent among girls. Furthermore, a lower socioeconomic status was directly associated with non-condom use, while binge drinking and illegal drug use were independently associated with unsafe sexual intercourse. CONCLUSION: Adolescent alcohol and drug use were associated with unsafe sexual practices. School prevention programs must include drug use and sexuality topics simultaneously because both risk-taking behaviors occur simultaneously. .(AU)

Sexual behavior among high school students in Brazil: alcohol consumption and legal and illegal drug use associated with unprotected sex

OBJECTIVE: Alcohol and other drug use appears to reduce decision-making ability and increase the risk of unsafe sex, leading to possible unplanned pregnancies, sexually transmitted diseases/human immunodeficiency virus/HIV transmission, and multiple sexual partners. This study aimed to test the hypothesis that risky sexual behaviors among adolescents are associated with legal and illegal drug use. METHODS: A national cross-sectional survey of 17,371 high-school students was conducted in 2010. Students were selected from 789 public and private schools in each of the 27 Brazilian state capitals by a multistage probabilistic sampling method and answered a self-report questionnaire. Weighted data were analyzed through basic contingency tables and logistic regressions testing for differences in condom use among adolescents who were sexually active during the past month. RESULTS: Approximately one third of the high school students had engaged in sexual intercourse in the month prior to the survey, and nearly half of these respondents had not used a condom. While overall sexual intercourse was more prevalent among boys, unsafe sexual intercourse was more prevalent among girls. Furthermore, a lower socioeconomic status was directly associated with non-condom use, while binge drinking and illegal drug use were independently associated with unsafe sexual intercourse. CONCLUSION: Adolescent alcohol and drug use were associated with unsafe sexual practices. School prevention programs must include drug use and sexuality topics simultaneously because both risk-taking behaviors occur simultaneously. .

Childhood alcohol use may predict adolescent binge drinking: a multivariate analysis among adolescents in Brazil.

OBJECTIVES: To test the hypothesis that first alcohol use during childhood is associated with heavy drinking patterns during adolescence and with parental drinking patterns and parental rules about alcohol consumption. STUDY DESIGN: A national cross-sectional survey of 17,371 high-school students. Students were drawn from 789 public and private schools in all the Brazilian state capitals using a multistage probabilistic sampling method and a self-report questionnaire. Weighted data were analyzed through logistic regression testing for differences on the associated factors for first use of alcohol during childhood. Survival analysis and Cox proportional hazard models were used to confirm results. RESULTS: Among the 82% alcohol lifetime users, 11% had first used alcohol before age 12 years. The lack of perception of possible punishment by parents is associated with childhood alcohol use (OR 2.22, 95% CI 1.67-2.95). Adolescents who first used alcohol during childhood compared with those who only used alcohol at later ages are more likely to engage in binge drinking behaviors (OR 1.57, 95% CI 1.17-2.10), to have a pattern of heavy alcohol use (OR 1.98, 95% CI 1.26-3.09), and to have recently used illegal drugs (OR 1.74, 95% CI 1.39-2.16). According to hazard ratios, students with an earlier age of onset were more likely to have used tobacco and any illegal drug in the past year. CONCLUSIONS: Childhood alcohol may be a risk factor for the most dangerous patterns of alcohol use in adolescence and is associated with parental alcohol use. Parental rules about child alcohol use must be clear because perception of punishment might delay the age of first alcohol use.

Comparison of the chemical composition and biological effects of the roots, branches and leaves of Heteropterys tomentosa A. Juss.

ETHNOPHARMACOLOGICAL RELEVANCE: HETEROPTERYS TOMENTOSA: A. Juss (Malpighiaceae), commonly mistaken as Heteropterys aphrodisiaca, is chronically used by the Brazilian population to improve general health due to its claimed protective effects against a wide range of medical conditions. AIM OF THE STUDY: This study in rodents aimed to verify the adaptogenic potential of the hydroalcoholic extracts of the roots (the most commonly used portion), branches and leaves of the plant. MATERIALS AND METHODS: The phytochemical constitution of the extracts was analyzed through thin-layer chromatography and high-performance liquid chromatography. Restriction- and cold-induced stress in rats treated for 14 days with 100 or 300 mg/kg of the extracts were used to evaluate parameters such as ulceration, adrenals, thymus and spleen weights, as well as ACTH and corticosterone plasmatic levels. The stress response also was evaluated in mice by self-analgesia induced by restraint stress, after 7 days of treatment at doses of 100 and 300 mg/kg. The learning and memory of aged rats treated with extracts of root or branches at the dose of 50 mg/kg for 80 days were evaluated in the elevated T-maze test. RESULTS: The chemical constituents of the three parts of the plant were relatively similar in the presence of saponins, hydrolysable tannins, flavonoids, polyphenols and triterpenes. None of the three extracts were capable of protecting the stomach from ulcerations in rats submitted to cold restraint stress or protecting from alterations in adrenal or spleen weight (p>0.05). Furthermore, the extracts did not inhibit increases in plasma levels of corticosterone and adrenocorticotropic hormone. Moreover, the extracts did not inhibit self-analgesia induced by restraint stress in mice and did not improve the performance of aged rats in the T-maze test (p>0.05). CONCLUSION: The tests employed in this study did not show evidence of adaptogenic activity in the three extracts of Heteropterys tomentosa.

Effects of a hydroalcoholic extract of Turnera diffusa Willd. ex Schult., Turneraceae, in tests for adaptogenic activity

The objective of the present study was to assess whether Turnera diffusa Willd. ex Schult., Turneraceae, (TD), plant known in popular medicine as tonic and aphrodisiac, has other effects that are characteristic of an adaptogen substance, such as improvement of the memory and reduction of the damage caused by stress. We carried out an initial screening to detect a possible toxicity of the plant. In that phase of the study we used tests of observational screening; evaluation of acute toxicity; measurement of motor activity and motor coordination, and sleeping time induced by pentobarbital, and observed that the extract presented low toxicity and no stimulant or depressant effect on the animals. We then performed specific tests for the evaluation of an adaptogen effect. TD did not protect the stomach of the animals from the formation of ulcers, neither did it alter the plasmatic levels of adrenocorticotropic hormone (ACTH) and corticosterone of the animals submitted to immobilization and cold. As regards the evaluation of memory in passive avoidance, TD did not inhibit scopolamine-induced amnesia. Additionally, the hydroalcoholic extract presented low antioxidant activity in vitro. In the models used, TD produced no changes in relation to a possible adaptogen effect.

Antiulcer effect of the pepper trees Schinus terebinthifolius Raddi (aroeira-da-praia) and Myracrodruon urundeuva Allemão, Anacardiaceae (aroeira-do-sertão) / Ação antiúlcera das aroeiras Schinus terebinthifolius Raddi (aroeira-da-praia) e Myracrodruon urundeuva Allemão, Anacardiaceae (aroeira-do-sertão)

Schinus terebinthifolius Raddi and the Myracrodruon urundeuva Allemão were evaluated in rats and mice for antiulcer effects, as these two plants are widely used in Brazil for gastric ulcer treatment. Extracts of the plants showed a marked protective effect against gastric ulcerations induced by immobilization stress at low temperature in rats. They also showed an increase in the pH and volume of the gastric contents, and reduction in gastric hemorrhage in rats, and decrease in intestinal transit in mice, even at the low doses of 3.4 mg/kg (1/4 of the dose used by humans).

Foram avaliados, em ratos e camundongos, os efeitos antiúlcera de duas plantas usadas popularmente no Brasil para o tratamento de "males gástricos": a Schinus terebinthifolius Raddi (aroeira-da-praia) e a Myracrodruon urundeuva Allemão (aroeira-do-sertão). Os decoctos de ambas as plantas apresentaram um marcante efeito protetor da mucosa gástrica contra as ulcerações induzidas por estresse de imobilização em baixa temperatura em ratos. Ambas as plantas apresentaram, ainda: elevação do pH, do volume do conteúdo gástrico, redução das hemorragias gástricas e do trânsito intestinal em camundongos, mesmo em doses tão reduzidas quanto 3,4 mg/kg (1/4 da dose utilizada pelo homem).

"O que vêm da terra não faz mal": relatos de problemas relacionados ao uso de plantas medicinais por raizeiros de Diadema/SP / "Natural and therefore free of risks": adverse effects, poisonings and other problems related to medicinal herbs by "raizeiros" in Diadema/SP

A crença de que medicamentos à base de plantas são isentos de riscos à saúde faz parte da bagagem cultural da população afeita ao seu uso: "o que vêm da terra não faz mal". No entanto, o potencial tóxico, as características específicas do usuário, a possibilidade de contaminação e a falta de regulamentação constituem fatores de risco para a ocorrência de reações adversas, intoxicações e outras complicações decorrentes de seu uso. Foram realizadas entrevistas semi-estruturadas junto a 20 raizeiros (vendedores de ervas "in natura") na cidade de Diadema/SP. Foram relatados 40 casos de problemas relacionados ao uso de 22 espécies de plantas medicinais. As espécies mais citadas foram Luffa operculata - buchinha (7 casos), Senna alexandrina - sene (4 casos) e Paullinia cupana - guaraná (3 casos). Dentre os sinais e sintomas relatados, os mais freqüentes foram relacionados ao sistema nervoso central, problemas gastrointestinais e cardiovasculares. Os entrevistados também relataram um caso de aborto relacionado ao uso de S. alexandrina e três casos de óbito após a ingestão do chá do fruto de L. operculata. O caráter "natural" das plantas medicinais não é sinônimo de ausência de riscos para a população usuária. É necessária a implantação de políticas de fitofarmacovigilância eficientes, a fim de tornar o consumo mais racional e, deste modo, minimizar os riscos à população usuária.

Traditionally, medicinal herbs have been considered gentle and harmless because of their natural origin: "natural and therefore free of risks". However, toxic potential, various consumer-related factors (such as age, disease factors, pregnancy, etc), contamination, and lack of regulation concerning quality control are some of the risk factors deemed to be associated with herbal adverse reactions, poisonings and other complications. Over a 7-month period, semi-structured interviews were carried out with 20 "raizeiros" (traditional healers) in Diadema/SP. We found 40 unexpected events related to 22 species of medicinal herbs. The most frequent species reported were Luffa operculata - "buchinha" (7 reports), Senna alexandrina - "sene" (4 reports) and Paullinia cupana - "guaraná" (3 reports). Among the adverse events, the most frequent signs and symptoms reported involved the central nervous, gastrointestinal and cardiovascular systems. They also reported one case of abortion (related with S. alexandrina) and three deaths related with L. operculata. Adverse events that result from "natural" medicines are relatively uncommon, but they certainly occur more often than acknowledged. Medicinal plants are traditionally considered as innocuous, but as commercially available medicinal products they require sanitary surveillance in order to identify their risks, to give them a legal status, to evaluate their efficacy and to ascertain their safety.

Antinociceptive peripheral effect of Achillea millefolium L. and Artemisia vulgaris L.: both plants known popularly by brand names of analgesic drugs.

The hydroalcohol extracts of Achillea millefolium L. (AM) and Artemisia vulgaris L. (AV), both belonging to the Asteraceae family, were evaluated by the hot plate, writhing, formalin and intestinal transit tests in an attempt to confirm their folk use as analgesic, antiinflammatory and antispasmodic agents. AM 500 and 1000 mg/kg significantly inhibited abdominal contortions by 65% and 23%, respectively, whereas AV 500 and 1000 mg/kg inhibited them by 48% and 59%, respectively. None of the extracts produced differences in the intestinal transit in mice, nor in the response time in the hot plate or in the immediate or late responses in the formalin test. In HPLC/DAD analyses 'fingerprint', monitored at 360 and 270 nm, both hydroalcohol extracts showed the same flavonoid glycoside as a principal constituent, which was identified as rutin. A high content of caffeic acid derivatives were also found in both extracts. The main differences were observed at 240 nm: AM had a higher content of rutin, while in AV the hydroxybenzoic acid derivative was the major component.

Fluoxetina: indícios de uso inadequado / Fluoxetine: indication of inadequate use

OBJETIVO: Investigar o uso da fluoxetina na cidade de Santo André, SP, por meio de coleta e análise das receitas especiais (RE) prescritas por médicos e arquivadas nas farmácias e drogarias daquela cidade. MÉTODOS: Foram coletadas as receitas especiais retidas durante os meses de agosto do ano de 2005 a julho de 2006, em 13 farmácias de manipulação e em 27 drogarias em diferentes regiões de Santo André. Cada receita especial foi analisada em relação à presença de fluoxetina, em associação ou não a outros princípios ativos, e o sexo do(a) paciente foi anotado. RESULTADOS: Foram analisadas 39.782 RE - 16.124 coletadas das farmácias magistrais e 23.658 das drogarias. Desses totais, 10.919 prescrições continham fluoxetina - 9.259 provenientes das farmácias magistrais (84,8 por cento) e apenas 1.660 (15,2 por cento) das drogarias. As prescrições de fluoxetina eram predominantemente destinadas a mulheres (79,8 por cento). Na imensa maioria das RE, a fluoxetina foi prescrita em associação com um grande número de outras substâncias ativas, inclusive anfetaminas anoréticas, chegando a mais de dez outras em quase a metade das prescrições. Esse tipo de prescrição múltipla, principalmente para mulheres, é comparado com as prescrições de fórmulas magistrais para emagrecer, muito utilizadas no Brasil. CONCLUSÃO: Os dados obtidos sugerem que a utilização de fluoxetina teria um fim estético (perda de peso), e não um fim terapêutico (tratamento de depressão). Discute-se a relação risco-benefício desse possível uso, que poderia ser classificado de inadequado dado as conhecidas reações adversas da fluoxetina e a sua interferência no sistema citocromo P450.

OBJECTIVE: Investigate the use of fluoxetine in Santo André city, SP, by collecting and analyzing special prescriptions (SP) issued by physicians and filed in compounding pharmacies and drugstores of that city. METHODS: Special prescriptions were collected during August 2005 to July 2006 in 13 compounding pharmacies and 27 drugstores, in different regions of Santo André. Each prescription has been examined for the presence of fluoxetine, in combination or not with other active ingredients, and sex (a) patient was noted. RESULTS: We examined 39,782 SP; 16,124 of them were collected from compounding pharmacies and 23,658 from drugstores. Of these totals, 10,919 prescriptions contained fluoxetine as follows: 9,259 from the compounding pharmacies (84.8 percent) and only 1,660 (15.2 percent) from drugstores. Fluoxetine was manly prescribed for women (79.8 percent). In the vast majority of SP, fluoxetine was prescribed in combination with a large number of other active substances reaching more than ten others in almost half of the prescriptions. CONCLUSION: It is suggested that the large use of fluoxetine possibily aims to an aesthetic objective (to lose weight) and not as a therapeutic aim (treatment of depression). This work discusses the risk/benefit of this use which could be described as inappropriate, given the known adverse reactions of fluoxetine and its interference with the cytochrome P450 system.

Brazilian plants as possible adaptogens: an ethnopharmacological survey of books edited in Brazil.

In a survey, from Brazilian books, we searched plants that are in popular use for purposes resembling those of an adaptogen. This study focused on 24 books by authors from diverse regions in the country, resulting in a total of 1317 citations of uses related to a possible adaptogen effect from approximately 766 plants. Only species native to Brazil, cited in at least four books, were selected, resulting a total of 33 species, belonging to 24 families. Of these, four species have been studied previously in relation to effects that are considered as part of an adaptogen effect (anti-stress, memory enhancement, increased physical and/or sexual performance): Heteropterys aphrodisiaca (Malpighiaceae), Paullinia cupana (Sapindaceae), Ptychopetalum olacoides (Olacaceae), and Turnera diffusa (Turneraceae). Three others--Pfaffia glomerata, Pfaffia paniculata (Amaranthaceae), and Trichilia catigua (Meliaceae)--have also been the object of pharmacological studies that support their use as a possible adaptogen, but they are listed in less than four books. The overall results obtained in the present review of Brazilian folk literature reveals that Brazil is rich in plants with potential adaptogen-like effect, but lacks pharmacological studies (mostly clinical ones) to confirm these therapeutic properties.

Treatment of drug dependence with Brazilian herbal medicines / Tratamento da dependência de drogas com plantas medicinais brasileiras

The topic "Herbal Medicines in the Treatment of Addictions" in a country must be preceded by answers to four questions: 1. Does the country in question possess a biodiversity rich enough to allow the discovery of useful medicines? 2. Do local people have tradition and culture to look for and use resources from Nature to alleviate and cure diseases, including drug dependence? 3. Is drug dependence (or addiction) present in the country in question? 4. Do people of that country recognize and diagnose such problem as a serious one? Alcohol is, by far, the most serious health problem when drug abuse is considered, reaching all of Brazilian society, including the Indians. On the contrary, other drugs may be considered as minor problems and they are not the main focus of this manuscript. The people living in Brazilian hinterland don’t have access to public health systems. Consequently, these people seek assistance from "curandeiros" and "raizeiros"; the Indians are assisted by the shaman. These "folk doctors" do not know the academic medicine and therapeutics, and resort to the local plants to treat different ailments of their patients. Furthermore, alcohol abuse and dependence are not recognized by them, according to the rules and criteria of academic medicine. We have conducted a survey in many Brazilian books, Thesis concerning phytotherapy, and several databank. The results of such searches were very disappointing. No published papers from Brazilian authors concerning the use of plants for the treatment of addictions were found in the databases and there were only three very short notes in the masterly book written by Shultes and Raffauf (1990). From the Brazilian books on folk medicine employing medicinal plants, ten mentions were disclosed: most of them dealing with treatment of alcohol problems and two to counteract "Ayahuasca" dependence.

O tema "Plantas medicinais no tratamento de dependência" em um país deve ser precedido pela resposta a quatro questões: 1. O país em questão possui biodiversidade suficiente para permitir a descoberta de remédios naturais úteis? 2. Seus habitantes possuem tradição e cultura de procurar e utilizar recursos da natureza para aliviar e curar doenças, incluindo dependência de drogas? 3. O problema de dependência de drogas está presente no país em questão? 4. Seus habitantes reconhecem e diagnosticam a dependência de drogas como um sério problema? O álcool é, de longe, o mais sério problema de saúde quando o assunto abuso de drogas é considerado, atingindo toda a sociedade brasileira, incluindo os índios. Ao contrário, outras drogas podem ser consideradas como problemas menores e não são o foco principal deste artigo. As pessoas vivendo nas terras brasileiras mais isoladas não têm acesso ao sistema público de saúde. Conseqüentemente, estas pessoas procuram tratamento com curandeiros e raizeiros; ou, no caso dos indígenas, com os shamans. Estes doutores populares não conhecem a medicina e terapêutica acadêmicas e recorrem a plantas locais para tratar as diferentes patologias que acometem seus pacientes. Entretanto, o abuso e dependência de álcool não são vistos por eles como problemas de saúde segundo as regras e critérios da medicina acadêmica. Um levantamento foi feito em diversos livros brasileiros, teses sobre fitoterapia e alguns bancos de dados. Os resultados de tal pesquisa foram frustrantes. Não foram encontrados artigos de autores brasileiros sobre o uso de plantas para o tratamento de dependência de drogas nos bancos de dados consultados e apenas três notas muito curtas em um livro clássico escrito por Shultes e Raffauf (1990). Dos livros brasileiros sobre o uso popular de plantas medicinais, foram obtidas dez menções: a maioria delas sobre o tratamento de problemas relatados ao álcool e duas delas a respeito do tratamento da dependência de "Ayahuasca".