Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)
January 1, 2021
Alvaro V Jardim, Dora V Jardim, Bruno Rasmussen Chaves et al.
54 citations
In Brazil's first clinical trial of MDMA-assisted psychotherapy for post-traumatic stress disorder (PTSD), three patients with PTSD from sexual abuse completed treatment. The protocol involved 15 weekly therapy sessions, with three sessions including orally administered MDMA combined with psychotherapy and music, spaced about a month apart. Two months after the final MDMA session, all three patients showed clinically significant improvement, with CAPS-4 scores dropping by more than 30% from baseline. Final scores were 61, 27, and 8, down from 90, 78, and 72. No serious adverse events occurred; common side effects were somatic pains and anguish. Secondary outcomes also improved. MDMA-assisted psychotherapy could become a viable PTSD treatment in Brazil.
Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)
May 1, 2026
Marcelo Pinheiro Machado Adelino, Julia Diniz Grossi, Marcel Vella Nunes et al.
An overview of systematic reviews and meta-analyses on pharmacological treatments for major depressive disorder (MDD) was conducted to update Brazilian clinical guidelines. Forty studies were included. For acute treatment, selective serotonin reuptake inhibitors (SSRIs), venlafaxine, mirtazapine, and vortioxetine showed consistent evidence across efficacy and tolerability. For adjunctive treatment, atypical antipsychotics had the highest certainty of evidence, with short-term support for benzodiazepines. In treatment-resistant depression, ketamine, esketamine, and atypical antipsychotic augmentation showed moderate certainty for response outcomes. In the maintenance phase, SSRIs and SNRIs had the most consistent evidence for relapse prevention and acceptability. The findings support a hierarchy of pharmacological strategies across MDD stages, but implementation should consider local healthcare context and resource availability.
Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)
January 1, 2026
Eduardo Aliende Perin, Nelson Carvas, Vinicius Tassoni Civile et al.
A systematic review and meta-analysis of six randomized controlled trials involving 499 adults with obsessive-compulsive disorder (average age 32.8 years, average disorder duration 9.83 years) found that mindfulness-based interventions did not significantly differ from cognitive-behavioral techniques (including exposure with response prevention, psychoeducation, and cognitive restructuring) in reducing obsessive-compulsive symptoms, anxiety, or depression. Dropout rates were similar between groups. A small improvement in mindfulness skills was observed, but it was not clinically relevant. Quality of life findings were inconsistent and could not be pooled. The certainty of evidence ranged from low to high.