Existem diversas evidências a respeito dos potencial terapêutico dos dois compostos majoritários presentes nas plantas do gênero Cannabis – canabidiol e Δ-9-tetraidrocanabinol – especialmente em relação à sua relevância clínica no tratamento da epilepsia. Anedoticamente, extratos padronizados com alto teor de canabidiol tem se mostrado eficaz na redução da frequência e a severidade das convulsões, particularmente em crianças com tipos raros de epilepsia que são refratárias aos fármacos convencionais. Essas evidências têm motivado a regulamentação do uso clínico de extratos padronizados contendo canabidiol para tratamento de casos graves de epilepsia no Brasil. A presente revisão traz um apanhado geral sobre a farmacologia do sistema endocanabinoide, os medicamentos baseados da Cannabis disponíveis para uso clínico, bem como do uso do canabidiol no tratamento da epilepsia em humanos. No entanto, apesar dos resultados promissores, ainda existem poucos de estudos clínicos bem delineados que garantam a eficácia, segurança e tolerabilidade do CBD no tratamento de pacientes com epilepsia intratável, tais como nas síndromes Dravet e de Lennox-Gastaut.

(1) Objectives: Epilepsy disorder is likely to increase with aging, leading to an increased incidence of comorbidities and mortality. In spite of that, there is a lack of information regarding this issue and little knowledge of cognitive and emotional responses in aging subjects following epileptogenesis. We investigated whether and how aging distress epilepsy-related behavioral and biochemical outcomes are associated with cognition and emotion. (2) Methods: Young and middle-aged Wistar rats (3 or 12 months old) were treated with pentylenetetrazol (PTZ, 35 mg/kg) and injected on alternated days for 20 (young rats) and 32 days (middle-aged rats). Kindling was reached after two consecutive stages 4 plus one stage 5 or 6 in Racine scale. Control and kindled rats were evaluated in the elevated plus-maze (EPM) and object-recognition tests and their hippocampus was collected 24 h later for mitogen-activated protein kinases (MAPK) dosage. (3) Results: Middle-aged rats presented a higher resistance to develop kindling, with a decrease in the seizure severity index observed following the 4th and 9th PTZ injections. Middle-aged rats displayed an increased duration of the first myoclonic seizure and an increased latency to the first generalized seizure when compared to younger rats. The induction of kindling did not impair the animals’ performance (regardless of age) in the object-recognition task and the EPM test as well as it did not alter the hippocampal levels of MAPKs. (4) Significance: Our findings reveal that, despite age-related differences during epileptogenesis, middle-aged rats evaluated after kindling performed similarly during discriminative learning and emotional tasks in comparison to young animals, with no alteration of hippocampal MAPKs. Additional investigation must be carried out to explore the electrophysiological mechanisms underlying these responses, as well as the long-term effects displayed after kindling.

Objectives: To compare health-related quality of life (QoL) of medical students in initial and final phases of the program, and to evaluate the association between ego defense mechanisms and specific healthrelated QoL domains within each group. Methods: This was an observational, cross-sectional study. Quality of life was assessed according to the World Health Organization Quality of Life instrument-Abbreviated Version (WHOQOL-Bref); anxiety and depression symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS); defense mechanisms were assessed using the Defense Style Questionnaire (DSQ-40). Results: A total of 139 medical students were evaluated. Students in the initial semesters of the program (1st and 3rd) presented more depressive symptoms and worse quality of life in the psychological domain of WHOQOL-Bref when compared to those in the final semesters (8th and 12th). In a later analysis, conducted to identify the variables associated with the psychological domain of the WHOQOL-Bref for each group, both depressive symptoms and defense mechanisms were independently associated with the outcome for medical students in the beginning and in the end of the graduation program. Conclusions: Students in the initial phases of medical school may need more specific attention from educational managers. Understanding the role of ego defense mechanisms in the quality of life of medical students may help identify effective psychopedagogical interventions for this population. In addition, the results reinforce the impact of depressive symptoms on quality of life, an association already well evidenced in the literature.