Dispensações de psicotrópicos anorexígenos no município de Juiz de Fora, Minas Gerais, Brasil

Abstract

Obesity is a serious public health problem in Brazil, with prevalence figures increasing at epidemic rates. The degree of obesity is directly related to the risk of morbidity and mortality. A pharmacological approach must always be preceded by a change of eating habits along with the regular practice of physical exercises. Drugs should only be used under medical supervision and after a careful assessment of the individualized risk-benefit ratio. In 2005, Brazil had the world´s largest per capita consumption of amphetamines for weight loss. Previous studies have suggested that magistral pharmacies are responsible for the largest percentage of notifications referring to appetite suppressants. This study assesses the dispensations of appetite-suppressant psychotropics during the year 2009, in Juiz de Fora, through information obtained from the municipal sanitary surveillance authority (consisting of monthly consumption bulletins [RMNRB2] and data from the Brazilian sanitary surveillance agency [ANVISA]). Of the 7,759 notifications of drugsuppressant psychotropics, 93.3% were dispensed by magistral pharmacies, while only 6.7% were dispensed by drugstores. Of the total, 55.4% were of amphepramone, followed by 33.1% of fenproporex and 11.5% of mazindol. The large majority of the prescribing physicians did not have their specialty registered with the Regional Medical Council (57%). Seven physicians were responsible for 6,492 dispensed prescriptions, accounting for 83.7% of the total. A single physician had been responsible for 3,535 dispensed prescriptions, corresponding to 45.6% of all prescriptions during the study period. Of the 3,535 prescriptions of appetitesuppressant psychotropics signed by this physician, 99.5% were dispensed by a single magistral pharmacy. The prescriptions signed by this physician corresponded to 94.3% of all appetite-suppressants dispensed by this pharmacy during the study period. Compared with the ANVISA report, referring to the national consumption during the same period, the three substances had a greater consumption in Juiz de Fora (daily defined dose/thousand inhabitants/year). This scenario points to the dispensation of appetite-suppressant psychotropics as a relevant public health issue, indicating the need to reassess the criteria guiding the monitoring of their prescription, dispensation and consumption.