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Publication
Prescrição off-label da gabapentina
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Abstract(s)
A utilização off-label de fármacos é uma prática habitual a nível mundial. Esta define-se como uma utilização de medicamentos em indicações terapêuticas diferentes daquelas para os quais obtiveram aprovação pelas autoridades reguladoras aquando da sua autorização de introdução no mercado.
Apresenta maior prevalência nas áreas de pediatria e psiquiatria, uma vez que estes demonstram ser os grupos mais restritos em termos de aplicação de terapêuticas farmacológicas. Em particular, na psiquiatria parece ser recorrente a prescrição em regime off-label da classe farmacoterapêutica anticonvulsivante.
A gabapentina enquadra-se nessa classe, demonstrando ser um fármaco aplicado em diferentes condições patológicas que envolvem o sistema nervoso. Numa fase inicial, esta molécula foi unicamente autorizada para doentes com epilepsia, tendo como principal objetivo o controlo adequado das suas crises. Com o decorrer dos anos, tal como a ciência, a experiência profissional de médicos psiquiatras e neurologistas também evoluiu, fazendo com que a gabapentina começasse a ser utilizada para outras patologias, como é o caso da ansiedade, depressão e distúrbios bipolares.
Esta molécula evidenciou ser uma alternativa válida às terapêuticas que já não demonstravam ter efeitos benéficos para estas patologias, constituindo igualmente uma opção na abordagem farmacológica da dor, permitindo contornar uma das classes farmacológicas que maior habituação causa, os opióides.
Tal como a gabapentina, existem outros fármacos que são prescritos em modo off-label, sendo este um tema controverso pelas consequências que poderá ter ao nível da saúde dos doentes e da sociedade em geral, frequentemente descurado tanto pela comunidade científica como pela indústria farmacêutica.
The off-label use of drugs is a common practice worldwide. This is defined as the use of medication different from the therapeutic indications obtained by the regulation authorities when it was attributed marketing authorization. It presents a higher prevalence on the areas of pediatrics and psychiatry, since these are the most restricted groups when it comes to usage of pharmacological therapeutics. In particular, the pharmacotherapeutic class of anticonvulsants are often prescribed as an off-label regimen. Gabapentin fits in this class, proving to be drug applied in different pathological conditions that involve the nervous system. In the initial phase, this molecule was only authorized for patients with epilepsy, having as the main therapeutic goal the adequate control of seizures. Over the years, likewise science, the professional experience of psychiatrics and neurologists also developed. As a result, gabapentin started to be used for other pathologies, such as anxiety, depression and bipolar disorder. This molecule proved to be a valid alternative for therapeutics that no longer demonstrated beneficial effects for these pathologies. In addition, it was established as another option to approach pain pharmacological treatment, allowing to circumvent one of the pharmacologic classes that causes dependency the most, the opioids. Just like gabapentin, there are other prescribed drugs in off-label mode. It is a controversial topic due to the consequences that might have both in patients’ and in general society’s health, often being neglected by the scientific community and the pharmaceutical industry.
The off-label use of drugs is a common practice worldwide. This is defined as the use of medication different from the therapeutic indications obtained by the regulation authorities when it was attributed marketing authorization. It presents a higher prevalence on the areas of pediatrics and psychiatry, since these are the most restricted groups when it comes to usage of pharmacological therapeutics. In particular, the pharmacotherapeutic class of anticonvulsants are often prescribed as an off-label regimen. Gabapentin fits in this class, proving to be drug applied in different pathological conditions that involve the nervous system. In the initial phase, this molecule was only authorized for patients with epilepsy, having as the main therapeutic goal the adequate control of seizures. Over the years, likewise science, the professional experience of psychiatrics and neurologists also developed. As a result, gabapentin started to be used for other pathologies, such as anxiety, depression and bipolar disorder. This molecule proved to be a valid alternative for therapeutics that no longer demonstrated beneficial effects for these pathologies. In addition, it was established as another option to approach pain pharmacological treatment, allowing to circumvent one of the pharmacologic classes that causes dependency the most, the opioids. Just like gabapentin, there are other prescribed drugs in off-label mode. It is a controversial topic due to the consequences that might have both in patients’ and in general society’s health, often being neglected by the scientific community and the pharmaceutical industry.
Description
Keywords
Uso off-label de fármacos Gabapentina Anticonvulsivantes