What is known about the drugs Bolsonaro uses and how the defense intends to act

• Pregabalin and sertraline: Understand the effect of the medications Bolsonaro uses
• Homemade food, bread with eggs, and visits: What were Bolsonaro’s first hours like in the National Front prison?

Moraes’ decision will be presented to the other members of the court’s first panel today. The defense used mental confusion as an argument to request reconsideration of pretrial detention.

During the video hearing, the former president said that he acted under the influence of two drugs, which caused his mental disorders. The former client said he started taking one of the medications four days before the operation, which was prescribed to him by a doctor who was not part of the team who regularly monitored him. He mentioned two medications: pregabalin, an anticonvulsant used to treat anxiety; Sertraline, an antidepressant.

“The defendant responded that he had been suffering from ‘paranoia’ from Friday to Saturday due to medications he was taking that were prescribed to him by various doctors and which had reacted inappropriately,” the court transcript, published by STF, read.

According to psychiatrist Natalia Travinic Hof, the two medications can be used together. She finds that although sertraline can cause hallucinations and agitation, this occurs in less than 2% of patients. Pregabalin can also cause confusion in less than 2% of patients and disorientation in less than 7% of patients.

— an effect that will occur more frequently at the beginning of treatment (in the first weeks) or when there are sudden dose adjustments — explains Hoff.

Bolsonaro used a soldering iron to try to separate the part of the ankle bracelet that indicates the location of the belt that connects it to the ankle. In a video recorded by the Federal District Prisons Department Secretariat (Seape-DF), the former president said he tried to open the equipment out of “curiosity.”

Bolsonaro added to STF that he did not receive any assistance in the initiative and that the three people who were in his house (his daughter, brother and advisor) were asleep at the time. The former president also said he “started fiddling with the anklet late Saturday night and stopped around midnight,” but later “came to his senses” and stopped the attempt to destroy it. In the early hours of Saturday, he gave a different account to agents who went to the scene to verify the violation, saying it began in the “late afternoon.”

The former president also explained that he “had no intention of escaping and that the strap” of the ankle bracelet was not broken, referring to the piece that attaches the device to the ankle. He added that he knew how to use the soldering iron that was used in the attempt to damage the device, because he had previously taken a course on how to use it.

Regarding the vigil called by Senator Flavio Bolsonaro (PL-RJ), another reason cited for the arrest, the former president stressed that “the site is located 700 meters from his home, with no possibility of creating any disturbance that could facilitate a virtual escape.”

At the end of the hearing, Assistant Judge Luciana Sorrentino approved the arrest warrant, as Bolsonaro had not reported “any abuse or violation on the part of police officers responsible for compliance.”

After giving testimony, the defense took advantage of the former president’s medical condition, classified as “mental confusion,” to request a reconsideration of pretrial detention. On Saturday, Moraes gave Bolsonaro’s lawyers 24 hours to explain the ankle bracelet violation. They say: “It is necessary to take this new information about mental confusion that may be caused by the medications taken into account to reconsider the decision on pretrial detention.”

In a bulletin issued after analyzing the former president’s health condition, Bolsonaro’s medical team says that the mental confusion “may have been caused by the use of the drug pregabalin, which was prescribed by another doctor, with the aim of improving treatment, but without the knowledge or consent” of doctors Claudio Pierolini and Leandro Echenique, who signed the document:

The bulletin says: “This drug has a significant interaction with the medications that (Bolsonaro) regularly uses to treat hiccups (chlorpromazine and gabapentin) and its recognized side effects include mental status changes with the possibility of mental confusion, disorientation, abnormal coordination, sedation, balance disorders, hallucinations, and cognitive disturbances.”

Bolsonaro’s doctors confirm that the use of Pregabalin has been “immediately suspended, with no remaining symptoms at the present time” and that they will conduct periodic evaluations of the former president. Doctor Marina Pasolini was appointed as the prescriber, and was also on PF’s watch yesterday. Upon his arrival, he said that he would assess the health condition of the former president. She left the scene without making any statement.

In addition to doctors and lawyers, the former president received a visit yesterday from his wife, former First Lady Michelle Bolsonaro, with permission from Moraes. She remained there for approximately two hours, and when she left, the former president was seen moving between the visiting room and the place where he was being held. Michelle was in Fortaleza attending a PL event at the time Bolsonaro was arrested, on Saturday morning.

Moraes allowed family visits “on Tuesdays and Thursdays, from 9 a.m. to 11 a.m., for thirty minutes, with a maximum of two family members on the day of the visit.”

According to people close to him, on the first day of his arrest, the former president avoided eating meals containing items provided by the National Front, and chose a low-fat menu, following recommendations. On Sunday, he ate bread with eggs and coffee with milk in the morning. At lunch, allies say the choice was again to eat homemade food, described as simple and fat-free.

Causes and effects: mentioned medications

• Pregabalin – It is an anticonvulsant that works by regulating the transmission of excitatory messages between nerve cells, according to the leaflet. It is most commonly used for anxiety and chronic pain conditions. Bolsonaro started using it because of hiccups.
• sertraline – It is a selective serotonin reuptake inhibitor for depression and anxiety. According to psychiatrist Natalia Hoff, the two medications can be used together, but it is necessary to pay attention to the increased risk of developing some disorders.
• Chlorpromazine and gabapentin – These are the two medications mentioned by the medical team, which the former president uses to treat the hiccups he suffers from. The first is used for psychological disorders. The second is an anti-epileptic and anti-neuropathic drug.
• What Bolsonaro claims – At the custody hearing, Bolsonaro indicated the use of pregabalin and sertraline and that the paranoia was “due to medications prescribed to him by different doctors that interacted inappropriately.”
• What the defense claimed – The lawyers claim that this condition may have been caused by the use of the drug Pregabalin, which was prescribed by another doctor, without the knowledge of the specialists who signed the document. It may interact with two medications: chlorpromazine and gabapentin.
• What the experts say – Regarding the medications mentioned by Bolsonaro, the main risk of using them together is low sodium in the blood, which can cause nausea, vomiting, headache, difficulty concentrating, mental confusion, drowsiness and, in more serious cases, hallucinations.