Tratamento de depressão em indivíduos infectados pelo HIV

Abstract

A infecção pelo HIV/Aids é freqüentemente associada a transtornos psiquiátricos. Dentre eles, a depressão é o mais comum. O diagnóstico e o tratamento dos transtornos depressivos são fundamentais para melhorar a qualidade de vida desses pacientes. Esta revisão tem como objetivo sintetizar e discutir os resultados mais importantes da literatura a respeito das particularidades do tratamento dos transtornos depressivos em indivíduos infectados pelo HIV. São discutidos a epidemiologia, o quadro clínico, a influência da depressão na evolução da infecção, o tratamento farmacológico com antidepressivos, testosterona e psicoestimulantes e a interação farmacológica entre os antidepressivos e benzodiazepínicos e as drogas antivirais. Conclui-se que o tratamento antidepressivo nessa população é eficaz, seguro e não promove imunossupressão nos indivíduos afetados.HIV. Aids. Depressão. Antidepressivos.HIV/AIDS infection is frequently associated with psychiatric disorders, especially depression. The diagnosis and treatment of depression are essential to improve quality of life in these individuals. This review intends to summarize and discuss the most important results in the literature about the treatment of depression in HIVinfected individuals. The epidemiology, clinical presentation, contribution of depression on HIV infection, pharmacological treatment with antidepressants, testosterone, and psychostimulant drugs, and pharmacological interactions between antidepressants, benzodiazepines, and antiviral medications are discussed. The conclusion drawn from this study is that the treatment of depression in this population is effective, safe and does not promote immunosupression. A Aids tem se tornado objeto de interesse por parte de psiquiatras, psicólogos e outros profissionais de saúde mental essencialmente por duas razões: o tropismo do HIV pelo sistema nervoso central (SNC) e o impacto psicológico do diagnóstico e da evolução da infecção nos indivíduos afetados. Diante disso, desenvolveram-se duas grandes áreas de interesse. A primeira situa-se nos limites da psiquiatria e da neurologia e tem como foco de interesse as conseqüências clínicas da ação do HIV e de outras patologias associadas (p. ex., neurotoxoplasmose e HIV. AIDS. Depression. Antidepressive agents. Resumo

Prevalence and factors associated with depressive symptoms in individuals living with HIV/AIDS

“…Additionally, there is a perception that depressive symptoms are merely adverse consequences of diseases (Teng, Humes & Demetrio, 2005). The detection of depressive symptoms is often difficult due to the clinical manifestations of chronic diseases, such as fatigue, weight loss, and weakness, often found in PLWHA (Malbergier & Schöffel, 2001).…”

Symptoms of depression and quality of life of people living with HIV/AIDS

“…Moreover, depression has been associated with alterations in immunological function, with decreases in the activity of Natural Killer cells and CD8 lymphocytes (8) impacting the progression of the HIV infection (6) . Nevertheless, the diagnosis and treatment of depression in people living with HIV/AIDS occur in only 40% to 50% of the cases (11) . The variability observed between the rates reported in the literature can be attributed to factors such as the instrument used and the characteristics of the study population, the location in which the research was performed and the stage of disease (18) .…”

“…It has been well established that HIV/AIDS infection compromises the quality of life of the sufferer (10) . However, other authors highlight a close relationship between depression and quality of life (5) , especially in individuals with chronic diseases (11) . Considering that AIDS is a chronic disease and that its sufferers have a high risk of developing depressive symptoms, which has been associated with a decrease in the quality of life, the aims of this study were to investigate the intensity of (12) .…”

Human Immunodeficiency Virus and Depression in Primary Care

“…13 Because HIV-related symptoms can mimic the neurovegetative symptoms of depression, we find the diagnostic value of classic depression indicators (changes in sleep, appetite, and energy) to vary with the stage of HIV illness; neurovegetative symptoms are of less consistent value during later stages of the disease (i.e., Centers for Disease Control and Prevention [CDC] category B or C). [14][15][16] Fatigue is a nonspecific symptom common both to HIV illness and depression. Ferrando et al 17 reported fatigue in 14% of HIV-infected patients with CD4+ counts less than 500.…”