Psicoestimulantes no manejo da perda de peso: Evidências científicas na modulação do apetite

Abstract

Introduction: According to the World Health Organization, obesity is defined as the presence of excess fat at a level that can compromise health, increasing the risk of developing chronic diseases that impair the individual's quality of life. Studies and research point to an alarming scenario resulting from the increase in the prevalence of obesity in the global context, corroborating the conceptualization of this disease as a pandemic and a potentially lifethreatening condition. In view of this, new therapeutic options have been increasingly highlighted in the management of the condition in question, and some psychotropic drugs have already demonstrated a significant effect on weight loss and appetite control. However, according to the main medical societies in Brazil, there are still scientific differences when it comes to the safety and efficacy of prescribing these drugs in order to reduce body weight. Objectives: To carry out a literature review based on studies of the scientific evidence on the effectiveness and safety of using psychostimulants in the management of significant weight loss for the treatment of obesity. Specific Objectives: To stimulate the curiosity of the scientific community about the importance of further studies to provide a consistent basis for protocols for the drug treatment of obesity, to provide resources for the development of new, safer and more effective technologies for weight loss and consequently to improve the clinical condition of patients, contributing to the health and quality of life of those affected. Methodology: This study was based on data obtained from clinical trials published in the last 30 years and indexed on the digital platforms PUBMED and PERIÓDICOS CAPES under keywords related to the effect of psychostimulants on weight and body composition in obese or non-obese patients, with or without associated comorbidities. Results/Discussion: Among the possibly slimming psychostimulants researched, only 5 substances presented satisfactory evidence to be included in this review. Amfepramone (diethylpropion), bupropion, modafinil, lisdexamfetamine and phentermine demonstrated a potentially slimming/anorexic profile and were well tolerated by most patients in the short, medium or long term, according to the particularities of the drug and the needs of each individual. Conclusion: The impact of psychostimulants on body weight and appetite was significant in most of the populations studied, possibly favoring weight loss and control of hyperphagic eating behavior. The main adverse effects reported were related to sympathetic hyperstimulation and were resolved after treatment was discontinued. However, more specific clinical trials with larger samples are needed to better understand the applicability of this class of psychotropic drugs in the treatment of obesity.