OPENING OF PSYCHIATRIC CONDITIONS DUE TO INAPPROPRIATE USE OF SIBUTRAMINE

Abstract

Understand the relationship between medication and the development of mental disorders. Methodology: Integrative review of the literature carried out in the Virtual Health Library (VHL) and Google Scholar databases, using the Health Sciences descriptors (DeCS): “Sibutramine”, “Risks”, “Adverse Reactions” combined by the operator boolean AND. Results: Sibutramine, a medication for obesity, can trigger psychiatric conditions, such as anxiety and depression, through biological mechanisms, such as neurochemical changes and dysfunction of the hypothalamic – pituitary – adrenal axis, in addition to psychological mechanisms, such as predisposition and stress factors. Prevalence estimates range from 1% to 10%, with an incidence of up to 2% per year. Recent meta-analyses indicate an average prevalence of 3.5% for anxiety disorders and 2.8% for depressive disorders. This variation can be attributed to methodological differences between studies, as well as a lack of standardization in diagnostic criteria. Identifying the risk factors associated with the development of these disorders is crucial for a more effective preventive approach. Previous history of mental disorders, concomitant use of other psychoactive medications and stressful events are some of the factors that increase the likelihood of developing psychiatric conditions in patients using sibutramine. The lack of medical monitoring and aesthetic use contribute to increased risks. Healthcare professionals should closely monitor patients, especially young adults and women, and advise against sibutramine in cases of psychiatric history, use of antidepressants or severe stress. Recent studies reinforce this association, highlighting the importance of caution and medical monitoring. Although there is evidence of an association between the use of sibutramine and the emergence of psychiatric conditions, establishing a definitive causal relationship is challenging due to methodological differences between studies and possible influences from the pharmaceutical industry. However, Bradford Hill criteria suggest a plausible relationship between the medication and psychiatric disorders. Conclusion: In short, sibutramine presents a real risk of triggering psychiatric disorders. The decision to use it must be considered, taking into account individual risks and benefits, and always with specialized medical monitoring.