USE OF CENTRAL NERVOUS
SYSTEM STIMULATORS BY HEALTH SCIENCE STUDENTS IN THE PERNAMBUCO DRYLANDS AR=
EA
USO DE ESTIMULANTES DO SISTEMA NERVOSO CENTRAL =
POR
ESTUDANTES DE SAÚDE DO SERTÃO DE PERNAMBUCO
Gustavo da
Silva Cândido[1]
* João Paulo da Silva Teixeira[2]
* Larissa Gabrielle Torres Príncipe[3]
* Maria Viviane Mariano Terto[4]
* Vitória Mayane Amorim Roque[5]
* Viviane da Silva Lima[6]
* Gabriela Cavalcante da Silva[7]
ABSTRACT
Introduction: Psychostimulant= s are substances capable of acting on the brain, producing effects by modul= ating synaptic transmission, stimulating or inhibiting some neurotransmitte= rs. Its main pharmacological effects have a role on mood and wakefulness, i= n addition to increasing alertness and cognitive improvement. They have bee= n used by individuals who have no neuropsychiatric or cognitive disorders. = Objective: To evaluate the use of= central nervous system stimulants by health students in the municipality o= f Serra Talhada - PE. Methodology: Cross-sectional study, wit= h a quantitative approach with 325 health students from the Faculty of Inte= gration of the Sertão, Serra Talhada. Fo= r data collection, a self-structured questionnaire was used, using the Goog= le form. Results: There was a high rate of= academics who self-medicate 71.1% (n =3D 231). Of the 325 students, 69.84%= (n =3D 227) reported that they had already used some psychostimulant such = as hypnotic, Ginkgo biloba, ritalin (methylphenidate), energy drink and caffeine = to assist in the routine of studies. Conclusion: The irrational use of= psychotropic drugs in the academic context is growing, and it should be co= nsidered a public health problem, especially in view of the risks of damage= and adverse adverse effects on mental and physical health associa= ted with its use. Investigations must be developed in order to make the pro= blem sizing feasible, supporting actions to prevent damage and dependence r= elated to this class of medication.
Keywords: Mental health. Self-medication. Ce=
ntral Nervous System Stimulants=
.
In=
trodução: O=
s psicoestimulantes são substâncias capazes de atuar no
cérebro, produzindo efeitos ao modular a transmissão sináptica, estimulam ou
inibem alguns neurotransmissores. Seus efeitos farmacológicos principais
exercem função sobre o humor e estado de vigília, além de aumentar o estado=
de
alerta e aprimoramento cognitivo. Eles têm sido usados por indivíduos que não possuem nenhum distúrbio
neuropsiquiátrico ou cognitivo. Objetivo: Avaliar o uso de
estimulantes do sistema nervoso central por estudantes de saúde do municípi=
o de
Serra Talhada – PE. Metodologia=
: Estudo transversal, com abordagem quan=
titativa
com 325 estudantes de saúde da Faculdade de Integração do Sertão, Serra
Talhada. Para a coleta de dados, utilizou-se um questionário auto
aplicativo estruturado, via formulário Google. Resultados: Houve um =
alto
índice de acadêmicos que se automedicam 71,1% (n=3D231). Dos 325 estudantes,
69,84% (n=3D227) relataram que já fizeram uso de algum psicoestimulante
como hipnótico, Ginkgo biloba, rita=
lina
(metilfenidato), bebida energética e cafeína pa=
ra
auxiliar na rotina dos estudos. Conclusão:
O uso irracional de psicofármacos no âmbito
acadêmico crescimento é crescente, e deve ser considerado problema de
saúde pública, principalmente diante dos riscos de danos e efeitos adversos
prejudiciais à saúde mental e física associados ao seu uso. Investigações d=
evem
ser desenvolvidas a fim de viabilizar o dimensionamento do problema,
subsidiando ações de prevenção aos danos e
dependência relacionados a esta classe de medicamento.
Palavras-chave: Saúde mental. Automedicação. Estimulantes do
Sistema Nervoso Central.
INTRODUCTION
Psychostimulants
are substances that act on
the central nervous system (CNS), producing
effects by modulating synaptic neurotransmission. In
general, their main pharma=
cological
stimulant effects p=
lay a
role in mood and wakefulne=
ss,
in addition to increasing<=
/span> productivity power, allowing for greater alertness and cognitive <=
span
class=3DSpellE>enhancement. The main
Self-medication is understood =
as an individual's initiative to ingest drug-active substances
Self-medication with methylphenidate<=
/span>
as a pharmacological cogni=
tive
improvement practice is part of the lives of many=
university students. This=
needs to be understood an=
d faced as a public health problem due to exposure to risks of damage and adver=
se effects associated with the phys=
ical
and mental health of acade=
mics
in Health Science courses (4).
The practice
of consumption of brain stimulants among university students in th=
e Health
Sciences area should be less prevalent, as these individuals<=
/span> have access to discipline=
s that
cover scientific knowledge=
on the subject. However,
the individual's accumulat=
ion
of general knowledge, adde=
d
to life experience, can lead to self-confidence to self-medication, as
occurs among some <=
span
class=3DSpellE>health professionals
Related
to misuse and sometimes irrational is the problem=
of chemical dependency, characterized by continuous, exaggerated use as well a=
s tolerance to some type of substa=
nce,
where social and cultural =
means
can also encourage =
this practice, generating nega=
tive consequences. A health
professional who is depend=
ent
on some type of drug, for example, exposes their patients to greate=
r
risks, as their skills and judgment
might be impaired <=
sup>(6).
The
components present =
in energy drinks can lead to severa=
l
side effects such as cramps, kidney failure, dependence, liver failure, weight gain, insomnia, tachycardia, dehydration,=
excessive agitation. This=
is the
reason why one should be a=
ware
of the frequency of drinki=
ng
these beverages and pay attention to the signs of=
the
body, as there may be into=
xication
(7). Short-term methylphenidate
can reduce appetite=
and insomnia and cause abdominal pai=
n,
high blood pressure=
, and headaches. In the long
From
the above, given th=
is
reality and the lack of in=
formation
in this context, it is rel=
evant
to evaluate the use of central nervous
system stimulants by healt=
h
students in the city of
Serra Talhada - PE. It is worth noting
that this type of study can be useful to identify the need for
MATERIALS AND METHODS<=
/b>
This
cross-sectional study, with a quantitative appr=
oach, was carried out through t=
he
online application of the =
collection
instrument to students in
the health area of
the Sertão Integration Faculty - FIS, Rua João Luiz de Melo, 2110 - Tancredo
Neves, Serra Talhada - PE, 56909-205, from August to O=
ctober
2020, upon proper authoriz=
ation
from the institution's dir=
ectors
and after deliberation by the ethics
committee, through protocol number
CAAE: 36968820.6.0000.8267 and opinion: 4,357,3=
38.
The
FIS institution is located=
in the municipality of Serra Talhada, located in the Pernambuco drylan=
ds
area, at a distance=
of 415
km from the capital of Pernambuco, Recife. The municip=
ality
has an estimated
population of 86,350 thous=
and
inhabitants (2019) accordi=
ng
to the panorama of the Brazilian Institute of <=
span
class=3DSpellE>Geography and Statistics =
(IBGE,
2019). This institution ha=
s
1,305 (one thousand three<=
/span> hundred and five) students with active enrollment in the health =
center, semester 2020.2. The sample cons=
isted
of Health Sciences student=
s
covering seven courses, which were: Nursing, Physiotherapy, Pharmacy, Physical Education, Nutrition,
Included
in this study were student=
s
duly enrolled in th=
e educational institution, =
in the
Health Sciences area, individuals of both sexes, who spontaneously
agreed to participate in
the research, by signing
the Free and Informed Consent Term - FICT, which was made
available virtually=
in the
first section of the Google Forms that also contained the collection instrument.
The
variables included =
in the collection instrument
RESULTS AND DISCUSSION=
Of
the 325 questionnaires col=
lected,
26.5% (n=3D86) of the students are between 18-2=
0 years old, (66.12) (n=3D2=
15)
between 21-30 years old,
6.2% (n=3D20) between 31 -40 years, 0.9% (n=3D3=
) between
41-50 years and in the gro=
up
above 51 years, 0.3=
% (n=3D1) was recorded. The volunteers were concentrated between 21-30 years=
66.15% (n=3D215) (Chart 1A). The gender of respondents was more prevalent among females, representing 76.=
9/% (n =3D
250) of the students, wher=
eas
males represented 23.1% (n=3D75) (Chart 1B).
In
a recent study, 200 questi=
onnaires
were applied to
Chart 1 – Age (A) and ge=
nder
(B) of health students at
the Sertão Integration Fac=
ulty
(FIS institution), Serra Talhada, 2020
=
A B
=
Source:
The authors
Regarding
the marital status of the interviewed students, 87.69% (n=3D285) decla=
red
to be single, representing the majority.
Married people represent
9.23% (n=3D30) of those wh=
o participated in the survey, in addition to 2.77% (n=3D9) divorc=
ed
and only 0.31% (n=3D1) widowed. (Chart 2) shows=
the distribution of students =
participating in the study in their respective
courses, with the particip=
ation
of pharmacy students 30.15%
(n=3D98) and nursing 28.31% (n=3D92) prevailing.
At
a higher education institu=
tion
in the Federal District, 144 students
participated in a survey.
This research was <=
span
class=3DSpellE>carried out with students=
from several higher education =
courses, and pharmacy
Chart 2 - Course =
of health students interviewed at the Sertão Integr=
ation
Faculty, Serra Talhada, 2020
Source: The authors
As
illustrated in Chart 3, 71.1% (n=3D231) of the =
students responded that t=
hey usually use medication
Chart 3 – Respondents who usually use over-the-=
counter medication, Sertã=
o Integration College, Serra Talhada, 2020.
Source: The authors
Brazil occupies the fifth positi=
on among the countries that consume medicines the most, configuring the fir=
st place in Latin America. U=
sing
over-the-counter medicatio=
n,
for self-care, can have beneficial results for the individual, such=
as
the improvement of symptom=
s,
resolution of health problems, but at other times it can be harmful to
the individual's health and
may mask health problems, cause
Regarding
the degree of knowledge about psychostimulants, 1=
1.38% (n=3D37)
of respondents answered
that they have broad knowledge, 45.23% (n=3D147) reas=
onable
knowledge, 34.77% (n=3D113) answered
that they have restricted<=
/span> knowledge, and 8.62% (n=3D28) are unaware
of this subject (Chart 4 A). The indiscriminate
use of these drugs has been increasingly discussed in several coun=
tries,
as, nowadays, the fast pace and lifestyle
lead the population, espec=
ially
students and health=
professionals, to experience stressful and difficult <=
span
class=3DSpellE>situations. One of the options adopted refers to the use=
of psychoactive substances (=
PAS), as
an attempt to alleviate or reduce stres=
s and
fatigue (12).
Chart 4 – Degree =
of knowledge about psychostimulants (A) and use of some medication
to help in study (B) by the health students interviewed at t=
he
Sertão Integration Faculty=
,
Serra Talhada, 2020.
=
A =
B
Source: The authors
The
prevalence of use of medic=
ation
to assist in the study, in general, was 28.3% (n=3D92) (Chart 4B). 69.84% (n=3D227) of th=
e students reported that th=
ey had already used some central=
nervous system stimulant =
listed in the questionnaire, such as anxiolytic, antidepressant, hypnotic,=
Ginkgo biloba, Ritalin (<=
span
class=3DSpellE>methylphenidate), energy =
drink,
and caffeine, as described=
in the chart (Chart 5).
Chart 5 - Description
of the use of psychostimulant substances
by health students =
interviewed at the Sertão Integr=
ation
Faculty, Serra Talhada, 2020
Source: The authors=
Regarding
the frequency of use of st=
imulants,
34.8% (n=3D113) answered that they use it daily, 21.8% (n=3D71) sporadical=
ly
(Chart 6A). A higher percentage of use of energy drinks to assist i=
n the
study was found, 76%
(n=3D247), such as açaí (a=
cai
berry), coffee,
Chart 6 - Frequency of brain stimulant use (A) a=
nd use
of brain stimulant =
energy drink (B) by respondents<=
/span>
from the Sertão Integration College, Serra Talh=
ada,
2020.
=
Source:
The authors
Caffeine
is the most used
In
a survey of students from Biomedicine, Nursing, Pharmacy
and Nutrition courses at a private college in the Fe=
deral District, 19.5% of a total of 400 respondents
(78 respondents) stated
that they had already used=
some medication to help with their study routine, such as guarana powder, being the most cited substance (49%), followed=
by Ginkgo biloba (35%). Of the total respondents,
6.0% reported using methyl=
phenidate,
and among these, only 16.7% had a medical diagnosis of ADHD (15). The
results of the study showe=
d
that, among students who declared that they ha=
d already used or are using=
some
CNS stimulant, methylpheni=
date
represents 2.15% (n=3D7) of the responses (Char=
t 5). Another study carried out=
with students at the Federal University of Minas Gerais Regarding
the areas of knowledge, students of mathematical =
sciences and humanities <=
span
class=3DSpellE>formed a group more likely to use methylphenidate for
neuroenhancement, regardle=
ss
of the time of life. On the other hand,
a quantitative observational cross-sectional
study carried out with 200 undergraduate
medical students showed
that the prevalence of sti=
mulant
substances consumption was 57.5%, and 51.3% of these be=
gan
to use them during college=
.
The use of psychostimulants at the time of the =
survey had a prevalence o=
f 52.3%.
It is also noteworthy that
16.6% of students consumed=
more than one psychostimul=
ant
substance (1). The
most consumed substances were energy drinks (38.0%) and caffei=
ne
more than five time=
s a week (27.0%). The main
Among
the main benefits, =
the
reason most mentioned by research participants for=
the consumption of brain stimulants was decreased sleep, (55%, n=3D180) (Chart 7A). Regarding post-use symptoms, respondents
Most
clinical manifestations re=
sulting
from the use of amphetamines, for example, are =
due to prolonged adrenergic stimulation, <=
span
class=3DSpellE>mainly in the CNS and cardiovascular. These range fro=
m manifestations of agitation, sweating, mydriasis, nausea, abdominal pain, <=
span
class=3DSpellE>hypertension, tachycardia=
, and headache, to more severe =
manifestations resulting =
from the
use of high doses, such as severe
hyperthermia (> 40°C), =
dehydration,
arrhythmias, severe=
hypertension, acute myocardial infarction,
Chart 7- Benefits=
of
the use of brain stimulant=
s
(A) and symptoms after the use of brain
stimulants (B) presented by
respondents from the Sertão Integration
College, Serra Talhada, 2020.
A B
=
Source: The authors
No
CNS stimulant substance is
safe when used irrationall=
y
and unsupervised, as it can harm
the user and, above=
all,
can cause dependence. The =
growing
search for pharmacological=
cognitive improvement (PC=
I) has become a worrying
aspect, since there=
is
common, sometimes even abusive and uncontrolled =
consumption by the population (17).
Adverse drug events=
are defined as injuries resulting
from the use of medications. This term
has a variety of
In
the long term, brain stimulants can generate dependence, which leads to both physical and psychological suffering, and sometimes =
disrupts people's daily activities, leading to difficulty in =
concentration and anxiety=
. Dependence can have characteristics such as <=
span
class=3DSpellE>tolerance, abstinence, an=
d lack of interest in important activities due to substance use.
CONCLUSION
Psychostimulants,
although they promote concentration, disposition, attention, and energy,
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Submission: 2021-04-30
Approval: 2021-07-28
[1] Enfermeiro pela Faculdade de
Integração do Sertão-FIS. Residente em Saúde Coletiva com ênfase em
Agroecologia (Universidade de Pernambuco/Instituto Agg=
eu
Magalhães). E-mail: gustavocandidogu@gmail.com Orcid: https://orcid.org/0000-0002=
-3505-3634
[2] Enfermeiro pela Faculdade de Integração=
do
Sertão-FIS. E-mail: joaopaulo77teixeira@gmail.com
[3] Enfermeira pela Faculdade de Integração=
do
Sertão-FIS. E-mail: gabriellyprincipe@hotmail.c=
om
Orcid: https://orcid.org/0000-0002=
-3505-3634
[4] Enfermeira pela Faculdade de
Integração do Sertão-FIS. E-mail: tertoviviane1998@gmail.com Orcid:https://orcid.=
org/0000-
[5] Enfermeira pela Faculdade de Integração=
do
Sertão-FIS. E-mail: vitoriamayaneamorim@outlook=
.com
Orcid: https://orcid.org/0000-0003=
-0412-6973
[6] Farmacêutica Generalista pela Facu=
ldade
de Integração do Sertão-FIS. Esp. em Gestão Clínica do Medicamento pela
Universidade Cruzeiro do Sul- UNICSUL. E-mail: limmavivianne@gmail.com
Orcid: https://orcid.org/0000-0003=
-0412-6973
[7] Mestre em Ciências Farmacêutic=
as –
UFPE. Doutora em Bioquímica e Fisiologia – UFPE. Docente da Faculdade de Integração d=
o Sertão – FIS. E-mail: gcavalcante1988@gmail.com <=
span
style=3D'font-size:8.0pt;font-family:"Times New Roman",serif;mso-bidi-font-=
family:
Arial;color:#222222'>Orcid: https://orcid.org/0000-0003-=
3390-6645
ORIGINAL ARTICLE