Effectiveness of hypnotherapeutic and pharmacological treatment in primary monosymptomatic enuresis / Efectividad del tratamiento hipnoterapéutico y farmacológico en la enuresis primaria monosintomática

Abstract: Background: In primary monosymptomatic enuresis, it is not clear what dynamic changes occur in the efficacy of hypnotherapeutic versus pharmacological treatment plan. Objective: Determine the changes over time in the effectiveness of hypnotherapy and a pharmacological treatment plan in primary monosymptomatic enuresis. Method: A prospective, longitudinal and analytical study (time series) was performed on a universe of 119 patients between 7 and 16 years old, with primary monosymptomatic enuresis. 40 patients treated with imipramine and 79 patients with 1 session/1 hour /week of hypnotherapy were evaluated on the frequency of temporal changes of enuretic episodes during 14 weeks of treatments at the Hypnosis Clinic. Results: A logarithmic scale of the distributions of temporal changes in the frequencies of enuretic episodes in hypnotherapeutic and pharmacological treatments is presented, with an enuretic plateau from week 3 to week 6 in hypnotherapy. Conclusions: The hypnotherapeutic treatment was more favorable, as it had an early and efficient response compared to treatment with imipramine.

Resumen: Antecedentes: En la enuresis monosintomática primaria, no está claro qué cambios dinámicos ocurren en la eficacia del plan de tratamiento hipnoterapéutico versus farmacológico. Objetivo: Determinar los cambios dinámicos a lo largo del tiempo en la efectividad de la hipnoterapia y un plan de tratamiento farmacológico en la enuresis infantil no orgánica. Método: Se realizó un estudio prospectivo, longitudinal y analítico (serie temporal) en un universo de 119 pacientes entre 7 y 16 años, con enuresis nocturna no orgánica. 40 pacientes tratados con imipramina y 79 pacientes con 1 sesión / 1 hora / semana de hipnoterapia fueron evaluados en la frecuencia de cambios temporales de episodios enuréticos durante 14 semanas de tratamientos en la Clínica de Hipnosis. Resultados: Se presenta un modelo logarítmico de las distribuciones de cambios temporales en las frecuencias de episodios enuréticos en tratamientos hipnoterapéuticos y farmacológicos, con una meseta enurética desde la semana 3 a la semana 6 en hipnoterapia. Conclusiones: El tratamiento hipnoterapéutico fue más favorable, ya que tuvo una respuesta temprana y eficaz en comparación con el tratamiento con imipramina.

Treatment effect on temperament and character in panic disorder: a prospective randomized double-blind study / Efeito de tratamento sobre temperamento e caráter no transtorno de pânico: estudo randomizado prospectivo duplo-cego

OBJECTIVE: The present study aims to analyze the effect of pharmacological treatment for panic disorder on temperament and character dimensions and to compare the effect of imipramine and fluoxetine on this outcome. METHOD: Temperament and character dimensions were evaluated in panic disorder patients before and after six months of pharmacological treatment with imipramine and fluoxetine, using the Temperament and Character Inventory-Revised. Patients were randomized between groups and both (patient and investigators) were blinded to the intervention drug. Furthermore, 34 non-panic controls answered the revised Temperament and Character Inventory through an Internet survey. RESULTS: Panic disorder patients showed higher scores for Harm Avoidance and lower scores for Persistence, Self-Directedness, and Cooperativeness than controls at baseline, but only the low Persistence value remained different from controls after treatment. Responder patients presented significant reduction in Harm Avoidance scores and a significant increase in Self-Directedness scores, whereas non-responders showed a significant increase of Harm Avoidance levels. Fluoxetine and Imipramine showed similar effects on the revised Temperament and Character Inventory dimensions. CONCLUSION: High Harm Avoidance and low Self-Directedness, Persistence, and Cooperativeness are associated with panic disorder. Treatment of acute panic disorder symptoms lead to the reduction of Harm Avoidance and to an increase in Self-Directedness scores. However, there was no difference between treatment with fluoxetine and imipramine for the effect on the revised Temperament and Character Inventory dimensions.

OBJETIVO: O presente estudo tem como objetivo analisar o efeito do tratamento farmacológico do transtorno do pânico nas dimensões de temperamento e caráter, comparando os efeitos das medicações imipramina e fluoxetina neste desfecho. METODOLOGIA: As dimensões de temperamento e caráter foram avaliadas em pacientes com transtorno do pânico antes e depois de seis meses de tratamento com imipramina ou fluoxetina, utilizando-se o "Temperament and Character Inventory- Revised" (TCI-R). O estudo foi randomizado e duplo-cego. Além disso, 34 controles sem transtorno do pânico responderam ao TCI-R via internet. RESULTADOS: Pacientes com transtorno do pânico apresentaram maior pontuação para "Harm Avoidance" e menor pontuação para "Persistence", "Self-Directedness" e "Cooperativeness" que os controles antes do tratamento, mas apenas "Persistence" manteve a diferença após o tratamento. Pacientes respondedores apresentaram redução significativa da pontuação para "Harm Avoidance" e aumento significativo para "Self-Directedness" após o tratamento, enquanto os não-respondedores mostraram aumento significativo na pontuação para "Harm Avoidance". A fluoxetina e a imipramina apresentaram efeitos semelhantes nas dimensões do TCI-R. CONCLUSÃO: Alta pontuação para "Harm Avoidance" e baixa para "Persistence", "Self-Directness" e "Cooperativeness" estão associados ao transtorno do pânico. O tratamento sintomático do transtorno do pânico leva a redução da pontuação para "Harm Avoidance" e aumento de pontuação para "Self-Directedness". No entanto, não há diferença entre os efeitos da imipramina e da fluoxetina nestas dimensões do TCI-R.

Enuresis infantil tratada con imipramina / Imipramine-treated infant enuresis

Introducción: la enuresis, que se define como la emisión involuntaria de orina después de la edad en que el control vesical debía haberse alcanzado, alrededor de los 5 años, es un trastorno conocido desde épocas remotas, que ha merecido la atención de numerosos investigadores, y sobre el cual se plantean aún en la actualidad criterios muy disímiles en relación con su etiología. Objetivo: identificar la efectividad de la imipramina en la enuresis nocturna. Métodos: se investigan 150 niños de ambos sexos procedentes del área de salud del Policlínico Docente Plaza de la Revolución que presentaban enuresis nocturna, previamente estudiados, sin encontrar lesión orgánica. Se les impuso tratamiento con imipramina durante un año. Se analizan en estos pacientes variables como la edad y el sexo, se estudió la escolaridad, la clasificación de la enuresis, la frecuencia de las micciones y el umbral de sueño recogido de forma muy subjetiva. Resultados: se obtuvo que el grupo mayor de niños osciló entre los 6 a 8 años de edad, con predominio del sexo femenino en todos los grupos de edades. La escolaridad fue normal en 145 niños, que representa la inmensa mayoría de la muestra. Predominó ampliamente la enuresis primaria, que se manifestó en 148 pacientes, y fueron más frecuentes las micciones diarias y más de una vez por semana en el grupo de 6 a 8 años de edad. Casi todos los pacientes (132) permanecían dormidos después de orinarse. El tratamiento con imipramina se realizó con dosis crecientes de acuerdo con la edad, hasta una dosis máxima de 75 mg, y resultó eficaz en el 48,6 por ciento de los pacientes, en los cuales desapareció totalmente la sintomatología, y en un 28 por ciento se produjo mejoría en la presentación del síntoma. Conclusiones: la imipramina fue eficaz en la mayoría de los pacientes, pues desapareció totalmente la sintomatología

Introduction: enuresis, which is said to be the involuntary discharge of urine after the age at which the urinary control should has been achieved, that is, around 5 years-old, is a well-known disorder since ancient times. It has deserved the attention of numerous researchers but there are still very different criteria about its etiology at the present time. Objective: to identify the effectiveness of imipramine to treat night enuresis. Methods: one hundred and fifty children of both sexes with no previous lesions and night enuresis, who were attended at Plaza de la Revolucion teaching polyclinics, were studied. They were treated with imipramine for a year. Several variables such as age, sex, schooling, classification of enuresis, frequency of urination and sleep threshold, the latter being determined in a very subjective way, were all analyzed. Results: the elder group of children aged 6 to 8 years, with females predominating in all the age groups. Schooling was normal in 145 children who accounted for the vast majority of the sample. Primary enuresis extensively prevailed and the most frequent forms were daily involuntary urination and once a week in the 6-8 years-old group. Almost all the patients (132) remained asleep after urination. The imipramine-based treatment was given at growing doses, according to the age, up to maximum dose of 75 mg, and proved to be effective in 48.6 percent of patients, whose symptoms completely disappeared and in 28 percent of them who experienced some improvement in the presentation of symptoms. Conclusions: imipramine was effective in most of patients since the symptoms disappeared completely

Comparación de los efectos del D-004, imipramina y sertralina en el modelo de nado forzado en ratones / Comparative effects of D-004, Imipramine and Sertraline in the forced swimming test in mice

Introducción: La finasterida, inhibidor de la 5 a-reductasa, se emplea en el tratamiento de la hiperplasia prostática benigna, y ocasiona entre sus efectos adversos un aumento de cuadros de depresión. El D-004 es un extracto lipídico extraído a partir del fruto de la palma real (Roystonea regia), inhibe la 5 a-reductasa y previene la hiperplasia prostática benigna, y muestra un efecto antidepresivo moderado en el ensayo de nado forzado y suspensión por la cola. Objetivo: comparar el efecto del D-004 con la imipramina y la sertralina sobre la duración de las conductas de inmovilidad, nado y escalado en el ensayo de nado forzado. Métodos: se distribuyeron los ratones en ocho grupos: control (vehículo), tres tratados con D-004 (100, 250 y 500 mg/kg), dos con sertralina y dos con imipramina (30 y 50 mg/kg) respectivamente. Estos se colocaron en un cilindro de cristal que contenía agua a una altura de 6 cm y se cuantificaron las conductas. Resultados: la administración oral de D-004 (100, 250 y 500 mg/kg) durante 14 días redujo significativamente el tiempo de inmovilidad con respecto al grupo control (17, 22 y 25 porciento) y aumentó significativamente la conducta de nado en 1,58, 1,68 y 1,74 veces. Este efecto resulta moderado (25 porciento) comparado con las reducciones alcanzadas por la sertralina y la imipramina (³ 60 porciento). Las dosis mayores (250 y 500 mg/kg) ocasionaron incrementos de la conducta de escalado, 2,79 y 3,55 veces superiores a la del grupo control, lo que mostró semejanza con la imipramina, aunque con una menor eficacia. Conclusiones: el D-004 ejerce un moderado efecto antidepresivo, lo que pudiera contribuir al manejo de los pacientes con hiperplasia prostática benigna en los cuales se informa coincidencia de cuadros depresivos

Introduction: Finasteride is a 5 a-reductase inhibitor to treat benign prostatic hyperplasia (BPH) and one of the adverse effects is the increase of depressive symptoms. D-004 is a lipid extract from the real palm fruit (Roystonea regia) that is effective to prevent prostatic hyperplasia by inhibiting 5 a-reductase and shows moderate antidepressant effects in the forced swimming test (FST) and tail suspension test. Objective: to compare the effects of D-004, Imipramine and Sertraline on the duration of behaviours under conditions of immobility, swimming and climbing in the forced swimming test. Methods: mice were randomly distributed in 8 groups: control (vehicle), 3 treated with D-004 (100, 250 and 500 mg/kg), 2 with Sertraline and 2 with Imipramine (30 and 50 mg/kg) respectively. Mice were placed in a glass cylinder containing 6 cm high column of water and their behaviours were quantified. Results: oral administration of D-004 (100, 250 and 500 mg/kg) during 14 days reduced the length of time of immobility with respect to the control group (17, 22 and 25 percent), and significantly increased the behaviours at swimming by 1.58, 1.68 and 1.74 times. This is a moderate effect (25 percento) if compared with Sertraline and Imipramine (³ 60 percent) The doses of 250 and 500 mg/kg showed that climbing behaviours were 2.79 and 3.55 times higher than the control group. The results were similar to those of Imipramine but less effective. Conclusions: D-004 showed moderate antidepressant effect. This fact could help in the treatment of patients with benign prostatic hyperplasia, who reported similar depressive status

Antidepressant and skeletal muscle relaxant effects of the aqueous extract of the Prosopis cineraria

The aqueous leaves extract of Prosopis cineraria (AEPC) is used traditionally for the treatment of various CNS disorder. The purpose of this study was to evaluate the extract for antidepressant and skeletal muscle relaxant activity. The antidepressant effect of the extract was evaluated using Forced swim test (FST). The immobility periods of control and treated mice were recorded. The antidepressant-like effect of tested compound was compared to that of imipramine (15 mg/kg. p.o). Muscle relaxant property was studied using rotarod apparatus and total fall off time for standard and control group was recorded. Phytochemical screening revealed the presence of saponins, flavonoids, alkaloids, glycosides, tannins and phenolic compounds. The leaf extract at doses of 200 mg/kg significantly decreased the duration of immobility time in FST. The efficacy of tested extract was found to be comparable to that of imipramine. Our results suggested that the aqueous extract of Prosopis cineraria leaves exerts antidepressant-like effect.

O extrato aquoso de folhas de Prosopis cineraria (AEPC) é utilizado, tradicionalmente, para o tratamento de várias disfunções do SNC. O propósito desse estudo foi avaliar o extrato quanto às atividades antidepressiva e relaxante muscular esquelética. O efeito antidepressivo do extrato foi avaliado usando o teste do nado forçado (FST). Registraram-se os períodos de imobilidade dos camundongos controle e dos tratados. O efeito antidepressivo do composto testado foi comparado com a imipramina ((15 mg/kg. p.o). A propriedade relaxante muscular foi estudada usando o cilindro giratório e o tempo total de queda para os grupos padrão e controle foram registrados. A triagem fitoquímica revelou a presença de saponinas, flavonoides, alcaloides, glicosídeos, taninos e compostos fenólicos. O extrato da folha em doses de 200 mg/kg diminui significativamente a duração do tempo de imobilidade no FST. A eficácia do extrato testado foi comparável àquela da imipramina. Nossos resultados sugeriram que o extrato aquoso das folhas da Prosopis cineraria exerce efeito semelhante ao antidepressivo.

Patrones de prescripción de antidepresivos en pacientes afiliados al sistema general de seguridad social en salud de Colombia / Antidepressant prescription patterns in patients affiliated with the general social security health system of Colombia

OBJETIVO: Determinar los patrones de prescripción de medicamentos antidepresivos en un grupo de afiliados al Sistema General de Seguridad Social en Salud de Colombia. MÉTODOS: Estudio descriptivo observacional con 9 881 pacientes medicados con antidepresivos, de ambos sexos, mayores de 5 a±os, con tratamiento continuo de agosto a octubre de 2009 y residentes en 56 ciudades colombianas. Se dise±ó una base de datos sobre consumo de medicamentos, obtenidos por la empresa que distribuye los medicamentos a los pacientes. RESULTADOS: Edad promedio de 59,1 ± 16,1 a±os; 73,7 por ciento de los participantes fueron mujeres. Del total de pacientes, 83,3 por ciento recibían monoterapia y 16,7 por ciento dos o mßs antidepresivos. El orden de prescripción de los medicamentos fue: inhibidores selectivos de la recaptación de serotonina 47,0 por ciento, atípicos 37,8 por ciento, tricíclicos 31,8 por ciento, inhibidores selectivos de la recaptación de serotonina y norepinefrina 1,8 por ciento e inhibidores selectivos de la recaptación de norepinefrina 0,03 por ciento. Las combinaciones mßs empleadas fueron fluoxetina + trazodona (n = 1 029), amitriptilina + fluoxetina (n= 265), amitriptilina + trazodona (n = 122), fluoxetina + imipramina (n = 106) e imipramina + trazodona (n = 71). Las comedicaciones mßs prescritas fueron antihipertensivos (52,3 por ciento), hormona tiroidea (23,3 por ciento), antiinflamatorios (19,6 por ciento), antiepilépticos (15,4 por ciento), antidiabéticos (13,8 por ciento), ansiolíticos e hipnóticos (12,4 por ciento), antipsicóticos (7,4 por ciento), antiparkinsonianos (4,3 por ciento) y antineoplßsicos (2,2 por ciento). CONCLUSIONES: Predominan hßbitos de prescripción de medicamentos de alto valor terapéutico, principalmente en monoterapia antidepresiva. La mayoría de los antidepresivos se emplean en dosis menores que las recomendadas. Se plantea la necesidad de dise±ar estrategias educativas para corregir algunos hßbitos de prescripción...

OBJECTIVE: Determine patterns of antidepressive drug prescription in a group of patients affiliated with the General Social Security Health System in Colombia. METHODS: Observational descriptive study of 9 881 patients, of both sexes and older than 5 years of age, medicated with antidepressants and continuously treated from August to October 2009. The patients include residents from 56 Colombian cities. A database was designed based on the consumption of medicines obtained from the company that distributes them to the patients. RESULTS: The average age was 59.1 ± 16.1 years; 73.7 percent of the participants were women. Of the total number of patients, 83.3 percent were treated with monotherapy and 16.7 percent with two or more antidepressants. The order of the prescription of the medicines was: selective serotonin reuptake inhibitors, 47.0 percent; atypical, 37.8 percent; tricyclical, 31.8 percent; selective serotonin reuptake inhibitors and norepinephrine, 1.8 percent; and selective norepinephrine reuptake inhibitors, 0.03 percent. The combinations most used were fluoxetine + trazodone (n = 1 029); amitriptyline + fluoxetine (n = 265); amitriptyline + trazodone (n = 122); fluoxetine + imipramine (n = 106); and imipramine + trazodone (n = 71). The most prescribed co-medications were anti-hypertensives (52.3 percent); thyroid hormones (23.3 percent); anti-inflammatories (19.6 percent); anti-epileptics (15.4 percent); anti-diabetics (13.8 percent); anti-anxiety and hypnotics (12.4 percent); antipsychotics (7.4 percent); anti-Parkinsons (4.3 percent); and anti-neoplastics (2.2 percent). CONCLUSIONS: The practice of prescribing medicines with a high therapeutic value predominates, mainly for antidepressive monotherapy. Most of the antidepressants are prescribed at dosages lower than those recommended. There is a need to design educational strategies to correct some prescription practices and to conduct research.

Imipramine for vestibular dysfunction in panic disorder: a prospective case series / Imipramina para disfunção vestibular em transtorno do pânico: uma série de casos prospectiva

OBJECTIVE: The purpose of this study was to evaluate the efficacy and effectiveness of imipramine on the treatment of comorbid chronic dizziness and panic disorder. METHOD: Nine patients with panic disorder and agoraphobia associated with chronic dizziness underwent otoneurological screening and were treated with a 3-months course of imipramine. Anxiety levels were measured with the Hamilton Anxiety Scale (HAM-A), dizziness levels were evaluated using the Dizziness Handicap Inventory (DHI), and panic severity and treatment outcome were assessed with the Clinical Global Impression Scale (CGI). RESULTS: At the baseline 33.3 percent (n=3) had a bilateral peripheral deficit vestibulopathy, the mean scores for HAM-A were 27.2±10.4, for DHI were 51.7±22.7, and for CGI-S were 4.8±0.9. All patients had a significant reduction in their HAM-A (11.1±5.5, p=0.008), DHI (11.5±8.1, p=0.008) and CGI-I (1.8±0.7, p=0.011) levels after 3-months imipramine treatment (mean=72.2±23.2 mg/day). CONCLUSION: This study found a decrease in anxiety levels and in the impact of dizziness in the patients' quality of life after a 3-months treatment course with imipramine.

OBJETIVO: O objetivo deste estudo foi avaliar a eficácia e efetividade da imipramina no tratamento da tontura crônica e do transtorno de pânico comórbidos. MÉTODO: Nove pacientes com transtorno do pânico e agorafobia associada com tontura crônica foram submetidos à avaliação otoneurológica e tratados durante 3 meses com imipramina. Os níveis de ansiedade foram medidos através da Escala Hamilton de Ansiedade (HAM-A); os de tontura foram avaliados usando o Dizziness Handicap Inventory (DHI), e a gravidade do pânico e sua resposta pela Escala de Impressão Clínica Global (CGI). RESULTADOS: Na avaliação inicial, 33,3 por cento (n=3) da amostra apresentavam vestibulopatia periférica deficitária bilateral; as médias foram: da HAM-A 27,2±10,4, do DHI 51,7±22,7 e do CGI-S 4,8±0,9. Todos tiveram uma redução significativa nos escores de HAM-A (11,1±5,5, p=0,008), DHI (11,5±8,1, p=0,008) e CGI-I (1,8±0,7, p=0,011), após 3 meses de tratamento com imipramina (média=72,2±23,2 mg/dia). CONCLUSÃO: Este estudo encontrou uma diminuição dos níveis de ansiedade e do impacto da tontura na qualidade de vida dos pacientes após um curso de 3 meses de tratamento com imipramina.

Effects of fluoxetine and imipramine in rat fetuses treated during a critical gestational period: a macro and microscopic study / Efeitos da fluoxetina e imipramina em fetos de ratas tratadas durante o período crítico da gestação: estudo macro e microscópico

OBJECTIVE: To evaluate morphological alterations in rat fetuses treated with fluoxetine and imipramine during the "critical" period of gestation. METHOD: Fifteen female rats were separated into three groups (n = 5) and treated with 10 mg/kg/day of test substances on the ninth, tenth and eleventh day of pregnancy: G1, fluoxetine; G2, imipramine hydrochloride; G3 (control), saline. On day 21, cesarean sections were performed to release the fetuses, whose bodies were weighed and macroscopically analyzed. The placenta was also weighed. The fetuses were then fixed and their encephala removed and weighed. Sections of the frontal lobe were taken for histological neuron counting. RESULTS: G1 and G2 showed the highest fetal body weight. Placental weight showed statistical differences (p < 0.01): G1 weighed more than G2 and G3. Otherwise, G2 exhibited the highest encephalon weight, statistically differing from G3 (control) and fluoxetine-treated G1 (p < 0.01). However, G1 did not statistically (p > 0.01) differ from the control group. G3 showed the highest number of neurons per area when compared to G1 and G2 (p < 0.01). CONCLUSION: The use of antidepressants in rats caused an increase in fetal weight and a decrease in the number of fetal frontal lobe neurons, thus suggesting that the use of antidepressants by pregnant women can induce depression in fetuses due to alterations in their neural development.

OBJETIVO: Avaliar as possíveis alterações ocorridas em nível macroscópico e microscópico de fetos de ratas submetidas ao tratamento com fluoxetina e imipramina durante o período "crítico" da gestação. MÉTODO: Quinze ratas, posteriormente ao acasalamento, foram divididas em três grupos experimentais (n = 5): G1, tratadas com 10mg/kg/dia de fluoxetina; G2, tratadas com 10mg/kg/dia de cloridrato de imipramina, e G3 (controle), tratadas com 10mg/kg/dia de solução fisiológica a 0,9 por cento, no 9º, 10º e 11º dias de prenhez das ratas. Posteriormente à cesária, no 21º dia de prenhez, analisou-se macroscopicamente o peso fetal e placentário. Os fetos foram fixados e houve a remoção do encéfalo para pesagem e preparação das lâminas do tecido neuronal para contagem de neurônios do lobo frontal. RESULTADOS: O G1 e G2 apresentaram maior peso fetal. O G1 apresentou maior peso placentário, diferindo do G2 e G3 (p < 0,01). De forma diferente, o G2 possuiu maior peso encefálico, diferindo do G3 e G1 (p < 0,01). G1 não diferiu estatisticamente do grupo controle (p > 0,01). O G3 exibiu maior número de neurônios, por área, do lobo frontal em relação a G1 e G2 (p < 0,01). CONCLUSÃO: A adoção dos antidepressivos causou, nos fetos, aumento de peso e redução da contagem de neurônios do lobo frontal, sugerindo que a indicação de antidepressivos às gestantes pode induzir a depressão nos fetos por alterações em seu neurodesenvolvimento.

Effect of acute administration of ketamine and imipramine on creatine kinase activity in the brain of rats / Efeito da administração aguda da cetamina e imipramina sobre a atividade da creatina quinase no encéfalo de ratos

OBJECTIVE: Clinical findings suggest that ketamine may be used for the treatment of major depression. The present study aimed to compare behavioral effects and brain Creatine kinase activity in specific brain regions after administration of ketamine and imipramine in rats. METHOD: Rats were acutely given ketamine or imipramine and antidepressant-like activity was assessed by the forced swimming test; Creatine kinase activity was measured in different regions of the brain. RESULTS: The results showed that ketamine (10 and 15mg/kg) and imipramine (20 and 30mg/kg) reduced immobility time when compared to saline group. We also observed that ketamine (10 and 15mg/kg) and imipramine (20 and 30mg/kg) increased Creatine kinase activity in striatum and cerebral cortex. Ketamine at the highest dose (15mg/kg) and imipramine (20 and 30mg/kg) increased Creatine kinase activity in cerebellum and prefrontal cortex. On the other hand, hippocampus was not affected. CONCLUSION: Considering that metabolism impairment is probably involved in the pathophysiology of depressive disorders, the modulation of energy metabolism (like increase in Creatine kinase activity) by antidepressants could be an important mechanism of action of these drugs.

OBJETIVO: Vários achados clínicos sugerem que a cetamina apresenta efeito antidepressivo. O presente estudo tem como objetivo comparar efeitos comportamentais e a atividade da creatina quinase em regiões específicas do encéfalo após a administração de cetamina e imipramina em ratos. MÉTODO: Ratos Wistar receberam uma administração aguda de cetamina ou imipramina e a atividade antidepressiva foi avaliada pelo teste de nado forçado; a atividade da creatina quinase foi medida em diferentes regiões encefálicas. RESULTADOS: Os resultados mostraram que a cetamina (10 e 15mg/kg) e a imipramina (20 e 30mg/kg) diminuíram o tempo de imobilidade quando comparados ao grupo salina. Também foi observado que a cetamina (10 e 15mg/kg) e a imipramina (20 e 30mg/kg) aumentaram a atividade da creatina quinase no estriado e córtex cerebral. A dose mais alta de cetamina (15mg/kg) e a imipramina (20 e 30mg/kg) aumentaram a atividade da creatina quinase no cerebelo e córtex pré-frontal. Por outro lado, o hipocampo não foi alterado. CONCLUSÃO: Considerando que a diminuição no metabolismo provavelmente está envolvida na fisiopatologia da depressão, a modulação do metabolismo energético (como um aumento na atividade da creatina quinase) por antidepressivos pode ser um importante mecanismo de ação destes fármacos.