Substância da maconha vai tratar doenças

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hempadao 1 outubro, 2014
Fonte: Gazeta
Conselho Federal de Medicina confirma eficácia do medicamento, e publicará em outubro orientações sobre prescrição da substância

Há uma semana ela atravessou o corredor da igreja em direção ao altar, levando em mãos as alianças do casamento do tio. Um desafio para a garota que não caminhava sozinha e que emocionou os convidados. Para os pais de Giovanna de Souza Guisso estes são os primeiros reflexos do novo medicamento que a adolescente, de 12 anos, começou a tomar há duas semanas: o Canabidiol, um das substâncias da maconha.

"Giovanna tinha convulsões desde os dois meses. Estava sempre apegada aos mesmos brinquedos. Hoje ela está mais colaborativa, atenta, descobrindo novas formas de brincar. Sinto que o universo dela está se expandindo." Patrícia Guisso, Mãe de Giovanna, 12 anos, na foto também com o pai, Geberson.

Até chegar a este momento, Geberson e Patrícia Guisso enfrentaram muitas dificuldades geradas pela Síndrome de Dravet, um tipo de epilepsia severa da infância que gera crises convulsivas graves. Giovanna tinha 25 delas por mês, e precisa tomar dez comprimidos por dia. “Há mais de uma semana está sem crises”, comemora o pai.
Outra conquista veio na última quinta-feira: não foi preciso correr atrás da garota para que ela almoçasse. “Ela sentou na mesa conosco, almoçou tranquila e só se levantou quando terminou. Ganhei na megassena”, diz a mãe, emocionada. A família é a única no Estado a receber autorização da Anvisa para importar o medicamento, que está na lista dos remédios proibidos no Brasil.
Resolução
As propriedades medicinais do Canabidiol no tratamento de epilepsias – como a de Giovanna – e de esquizofrenias refratárias (que não respondem aos tratamentos convencionais) já estão comprovadas cientificamente, segundo o Conselho Federal de Medicina (CFM).
Convencido disso, o CFM publicará em outubro uma resolução com orientações para os médicos. Ela conterá sugestões sobre as substâncias, as dosagens mínimas e máximas que devem ser utilizadas, os efeitos colaterais e os adversos, as interações medicamentosas, dentre outros pontos. “Será um suporte para os médicos”, destaca o psiquiatra Emmanuel Fortes, 3º vice-presidente do CFM.
Já os pacientes de outras doenças, como Alzheimer, Parkinson, esclerose múltipla, aids, dores crônicas, tratamentos decorrentes dos efeitos da quimioterapia, terão que aguardar. “Para elas ainda há um longo caminho”, destaca Fortes.
São tratamentos que ainda não possuem comprovação científica, na avaliação do Conselho, explica Fortes. E vão depender dos estudos feitos pelos centros de pesquisas e hospitais universitários.
Autorização
O documento a ser publicado pelo CFM não muda o fato de que as famílias vão precisar recorrer à Anvisa para obterem autorização para importar o Canabidiol. Há países – como estados Unidos, França, Reino Unido – onde a venda de substâncias da maconha para uso medicinal são liberadas. Não é o caso do Brasil, onde elas estão na lista dos medicamentos proibidos.
Em maio deste ano foi realizada uma reunião da direção da Anvisa para discutir a retirada destas substâncias da lista dos remédios proibidos. Sem consenso, ela foi adiada por tempo indeterminado. Desde então foi criado um procedimento para que as famílias não tenham que recorrer à Justiça para garantir a compra do medicamento.
A família Guisso levou quase dois meses para importar o produto (dois todos) , que custou U$ 950 (cerca de R$ 2.166), e que devem durar três meses. “Depois teremos que renovar o pedido”, conta Patrícia. Os pedidos foram feitos pelo site da Anvisa e foi necessário apresentar documentos da família e laudos médicos.
O medicamento atua no cérebro, inibindo, no caso das epilepsias, as crises convulsivas. Nos casos de esquizofrenia elas reduzem as alucinações, os delírios, os sintomas negativos da doenças, como explica o psiquiatra Fortes.
Ele acrescenta que para estas duas doenças, os efeitos psicotrópicos (alucinógenos) existentes no Canabidiol – e que preocupam algumas famílias e até médicos – “são quase irrisórios”.
Estudos
Mas ainda não há um consenso sobre o uso destes medicamentos, tanto na comunidade científica quanto entre os médicos.
Ester Nakamura, doutora e professora de neuropsicofarmacologia, do Laboratório de Ciências Cognitivas da Universidade Federal do Espírito Santo (Ufes), explica que a maconha tem várias substâncias, uma parte delas são as que causam os efeitos alucinógenos, os mais procurados para os efeitos recreativos. “Já os canabinóides, quando usados sozinhos, não apresentam os efeitos psicotrópicos, na maioria das situações”, diz.
Um deles é o Canabidiol – substância usada por Giovanna –, mas que demanda, na avaliação de Ester Nakamura, um estudo mais detalhado. “Feito com responsabilidade, para identificar seus benefícios, seus efeitos”, pondera.
Ela, inclusive, acena com a possibilidade de retomar um estudo sobre o assunto, até com a possibilidade de um “ensaio clínico”, com pacientes. “Se houver possibilidades estamos dispostos a voltar ao assunto e avaliar os seus efeitos”, diz Ester, lembrando que este tipo de trabalho esbarra em várias dificuldades, que vão da falta de recursos à legislação.
Para o médico especialista em dependência química João Chequer, algumas substâncias da maconha podem atuar como antiemético (contra vômitos), para analgesia e até para abrir o apetite. E no tratamento de doenças como câncer, aids, dentre outras. “Mas é ilusão achar que tem a função só de deixar o paciente tranquilo. Também pode estimular algumas doenças, como esquizofrenia”, diz.
Motivos que reforçam, segundo Chequer, a necessidade de que estes produtos sejam controlados e que tenham acompanhamento médico. Ele só é a favor da liberação de substâncias da maconha para uso terapêutico.
Outro que tem a mesma visão é o psiquiatra Fernando Furieri. “Sou contra a liberação da maconha para consumo, principalmente para adolescentes em formação”, destaca.
Posições que são acompanhadas pelo CFM, que em julho publicou um alerta informando, entre outros pontos, “ser contrário à liberação para uso recreativo de quaisquer substâncias que ofereçam riscos à saúde pública – incluindo a maconha – e que possam gerar despesas futuras para os sistemas de saúde e previdenciário”.
Futuro
Para a família Guisso, que já tinha tentado todos os tratamentos convencionais de epilepsia, sem sucesso, o Canabidiol vem como uma esperança. “O nosso sonho é qualidade de vida, para minha filha e para a família”, diz Patrícia. Sua filha, Giovanna será avaliada pelos médicos e, se tudo der certo, pode repetir a dose, com o reinício do processo daqui a três meses.
A gravidade da doença da garota mudou a vida da família. “Tive que deixar de trabalhar, um salário que nos faz muita falta”, conta a mãe. Hoje, além da fisioterapia, Giovanna vai à escola. “Acompanha a turma mais para sociabilizar”, diz Patrícia.
A mãe conta que a doença fez estragos que sua filha não terá como recuperar: “Não me engano a este respeito, ela não será uma criança como as outras”. Mas está feliz pelas conquistas das últimas semanas: “Ela está mais atenta, mais colaborativa. À sua maneira, está indo além de suas fronteiras”.


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