Fitoterápicos e Psicofármacos: O Erro Invisível do Consultório
📚Download your free Guide to Prescribing Psychotropic Drugs in the Real World here https://wa.me/553199727834?text=Ol%C3... In this video, I discuss one of the most neglected causes of apparent therapeutic failure in psychiatry: the silent use of herbal remedies. In practice, the scenario is very common: the patient worsens, develops unexpected symptoms, or loses response to treatment, and the immediate reaction is usually to increase the dose, change the psychotropic drug, or add another medication. The problem is that, often, the explanation lies outside the prescription. More than half of severely ill psychiatric patients may be using some type of "invisible pharmacopoeia," frequently without spontaneously reporting it to their doctor. As shown in the material, patients with severe depression may exhibit particularly high rates of this behavior. Throughout the lesson, I explain the metabolic logic behind these interactions: St. John's wort as a potent inducer of CYP3A4, accelerating metabolism and reducing serum levels; kava-kava as an inhibitor of multiple pathways; in addition to examples such as ginkgo, chamomile, valerian, and passionflower. The central point is understanding the so-called "yo-yo effect": some herbal remedies cause the concentration of the psychotropic drug to plummet; others cause it to explode. And the classic mistake is interpreting this as psychiatric worsening or therapeutic failure. I also organize a practical consultation model: actively asking questions, mapping the metabolic pathway involved, considering the time window, and avoiding improvising dose adjustments. If you prescribe psychotropic drugs, this video is about anticipating interactions before they appear as relapses. 🔗 Instagram: @drrafaelgomespsiquiatra Dr. Rafael Q D Gomes Psychiatrist CRM/SP 169.787 – RQE 71.591 ⚠️ LEGAL NOTICE: The information contained in these videos is not intended to replace consultation with a medical professional or serve as a recommendation for any treatment plan. In accordance with the Medical Code of Ethics, the videos are for educational purposes only, and do not disclose addresses or telephone numbers of offices, clinics, or health services. The videos on this channel are produced based on Dr. Rafael Gomes' experience, practical observation of patients, and the most recent scientific research available at the time. If you have any questions, consult your doctor.
