Case Report
Antipsikotik İlaç Tedavisini Bıraktığında ve Belirgin Yaşam Tarzı Değişikliği Yaptığında Remisyona Giren ve İşlevselliği Düzelen Şizoaffektif Bozukluk Olgusu
Abstract
Şizofreni spektrumunda yer alan bozukluklarda antipsikotikler (AP) tedavinin ana öğesini
oluşturmaktadır. Ancak uzun süreli AP kullanımı birçok yan etki ile ilişkili olduğu
bilinmektedir. Hatta beyin hacminde azalma ve tedaviye direnç gelişimi ile ilişkili olabileceği
düşünülmektedir. Son zamanlarda kesintisiz idame tedavi yerine doz azaltımı ve tedavi
sonlanımı ile ilgili çalışmaların arttığı görülmektedir. Bu olgu bildiriminde birçok farmakolojik
tedavi denemesine rağmen iyileşme sağlanamayan bir hastanın kendi kararıyla ilaçlarını
bırakması ve yaşam tarzında belirgin değişiklik yapması sonrası remisyona girişi ve
işlevselliğinin düzelmesi sunulmuştur.
References
- 1.American Psychiatric Association. The American Psychiatric Association practice guideline for the treatment of patients with schizophrenia. Third Ed,. Washington,2021;23-87
- 2. Danacı AE, Böke Ö, Saka MC,Erol A,Ulusoy Kaymak S. Şizofreni ve diğer psikotik bozukluklar. Second Ed., Ankara: Türkiye Psikiyatri Derneği Yayınları 2018.
- 3. Sadock VA, Sadock BJ, eds. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. Ankara: Güneş Kitabevi, 2017
- 4.Aleman A, Lincoln TM, Bruggeman R,Melle I, Arends J,Arango C, et al. Treatment of negative symptoms: where do we stand, and where do we go? Schizophrenia research2017;186: 55-62.
- 5. Kane JM, Agid O, Baldwin ML, Howes O, Pierre Lindenmayer J, Marder S,et al. Clinical guidance on the identification and management of treatment-resistant schizophrenia. The Journal of clinical psychiatry 2019;80: 2783.
- 6. Chakrabarti S. Clozapine resistant schizophrenia: Newer avenues of management.World Journal of Psychiatry 2021; 11(8): 429.
- 7 Goff DC, FalkaiP, Fleischhacker WW, Girgis RR, Kahn RM, Urhida H,et al. The long-term effects of antipsychotic medication on clinical course in schizophrenia. American Journal of Psychiatry 2017; 174(9): 840-849.
- 8.Bowtell M, Eaton S,Thien K,Williams MB,Downey L,Ratheesh A, et al. Rates and predictors of relapse following discontinuation of antipsychotic medication after a first episode of psychosis. Schizophrenia research 2018;195: 231-236.
- 9.Hui CLM,Honer WG, Lee EHM,Chang WC, Chan SKW, Emily SM ,et al. 8. Long-term effects of discontinuation from antipsychotic maintenance following first-episode schizophrenia and related disorders: a 10 year follow-up of a randomised, double-blind trial. The Lancet Psychiatry 2018;5(5) :432-442.
- 10. Kishi T,Ikuta T,Matsui Y,Inada K,Matsuda Y,Kazuo Mishima K,et. Effect of discontinuation v. maintenance of antipsychotic medication on relapse rates in patients with remitted/stable first-episode psychosis: a meta-analysis. Psychological Medicine 2019;49(5): 772-779.
- 11. Tiihonen J, Tanskanen A, Taipale H. 20-year nationwide follow-up study on discontinuation of antipsychotic treatment in first-episode schizophrenia.American Journal of Psychiatry 2018;175(8): 765-773.
- 12. Leucht S,Tardy M, Komossa K, Heres S, Kissling W, Salanti G. Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: a systematic review and metaanalysis. The Lancet 2012;379(9831): 2063-2071.
- 13.JohnY, Alasdair MB, Alfredo RM, Ric MP. Antipsychotic-induced dopamine supersensitivity psychosis: pharmacology, criteria, and therapy. Psychotherapy and Psychosomatics 2017;86(4): 189-219.
- 14. Harrow M, JobeTH,Tong L. Twenty-year effects of antipsychotics in schizophrenia and affective psychotic disorders.Psychological medicine 2021: 1-11.
- 15. Omachi Y, Sumiyoshi T. Dose reduction/discontinuation of antipsychotic drugs in psychosis; effect on cognition and functional outcomes. Frontiers in psychiatry 2018: 447.
- 16. Centorrino F,Masters GA,Talamo A, Baldessarini RJ,Öngür D. Metabolic syndrome in psychiatrically hospitalized patients treated with antipsychotics and other psychotropics. Human Psychopharmacology: Clinical and Experimental 2012;27(5) : 521-526.
- 17.Huhn M, Leucht C, Rothe P ,Dold M ,Heres S, Bornschein S,et al. Reducing antipsychotic drugs in stable patients with chronic schizophrenia or schizoaffective disorder: a randomized controlled pilot trial. European archives of psychiatry and clinical neuroscience 2021;271(2): 293-302.
- 18. Çetin M. Şizofreni tedavisi: Geçmişi, bugünü ve geleceği.Bulletin of Clinical Psychopharmacology 2015;25(2): 95-99.
- 19. Gevrek EH. (2017). Fiziksel egzersizin, şizofreni hastalarında pozitif negatif semptomlarına ve depresyon düzeylerine etkisi.Master's thesis, Üsküdar University Institute of Social Sciences Clinical Psychology Department,Istabul,2017 (Turkish).
- 20.Gökçe, Güneş E, Erhan Nalçac E. Egzersizin depresyon ve şizofreni üzerine Etkisi: BDNF odaklı bir bakış.Noro-Psikyatri Arsivi 2019;56(4): 302-310.
- 21. Lök S, Lök N. Kronik psikiyatri hastalarına uygulanan fiziksel egzersiz programlarının etkinliği: sistematik derleme. Psikiyatride Güncel Yaklaşımlar 2016;8(4): 354-366.
Year 2022,
Volume: 5 Issue: 3, 223 - 227, 15.10.2022
Abstract
References
- 1.American Psychiatric Association. The American Psychiatric Association practice guideline for the treatment of patients with schizophrenia. Third Ed,. Washington,2021;23-87
- 2. Danacı AE, Böke Ö, Saka MC,Erol A,Ulusoy Kaymak S. Şizofreni ve diğer psikotik bozukluklar. Second Ed., Ankara: Türkiye Psikiyatri Derneği Yayınları 2018.
- 3. Sadock VA, Sadock BJ, eds. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. Ankara: Güneş Kitabevi, 2017
- 4.Aleman A, Lincoln TM, Bruggeman R,Melle I, Arends J,Arango C, et al. Treatment of negative symptoms: where do we stand, and where do we go? Schizophrenia research2017;186: 55-62.
- 5. Kane JM, Agid O, Baldwin ML, Howes O, Pierre Lindenmayer J, Marder S,et al. Clinical guidance on the identification and management of treatment-resistant schizophrenia. The Journal of clinical psychiatry 2019;80: 2783.
- 6. Chakrabarti S. Clozapine resistant schizophrenia: Newer avenues of management.World Journal of Psychiatry 2021; 11(8): 429.
- 7 Goff DC, FalkaiP, Fleischhacker WW, Girgis RR, Kahn RM, Urhida H,et al. The long-term effects of antipsychotic medication on clinical course in schizophrenia. American Journal of Psychiatry 2017; 174(9): 840-849.
- 8.Bowtell M, Eaton S,Thien K,Williams MB,Downey L,Ratheesh A, et al. Rates and predictors of relapse following discontinuation of antipsychotic medication after a first episode of psychosis. Schizophrenia research 2018;195: 231-236.
- 9.Hui CLM,Honer WG, Lee EHM,Chang WC, Chan SKW, Emily SM ,et al. 8. Long-term effects of discontinuation from antipsychotic maintenance following first-episode schizophrenia and related disorders: a 10 year follow-up of a randomised, double-blind trial. The Lancet Psychiatry 2018;5(5) :432-442.
- 10. Kishi T,Ikuta T,Matsui Y,Inada K,Matsuda Y,Kazuo Mishima K,et. Effect of discontinuation v. maintenance of antipsychotic medication on relapse rates in patients with remitted/stable first-episode psychosis: a meta-analysis. Psychological Medicine 2019;49(5): 772-779.
- 11. Tiihonen J, Tanskanen A, Taipale H. 20-year nationwide follow-up study on discontinuation of antipsychotic treatment in first-episode schizophrenia.American Journal of Psychiatry 2018;175(8): 765-773.
- 12. Leucht S,Tardy M, Komossa K, Heres S, Kissling W, Salanti G. Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: a systematic review and metaanalysis. The Lancet 2012;379(9831): 2063-2071.
- 13.JohnY, Alasdair MB, Alfredo RM, Ric MP. Antipsychotic-induced dopamine supersensitivity psychosis: pharmacology, criteria, and therapy. Psychotherapy and Psychosomatics 2017;86(4): 189-219.
- 14. Harrow M, JobeTH,Tong L. Twenty-year effects of antipsychotics in schizophrenia and affective psychotic disorders.Psychological medicine 2021: 1-11.
- 15. Omachi Y, Sumiyoshi T. Dose reduction/discontinuation of antipsychotic drugs in psychosis; effect on cognition and functional outcomes. Frontiers in psychiatry 2018: 447.
- 16. Centorrino F,Masters GA,Talamo A, Baldessarini RJ,Öngür D. Metabolic syndrome in psychiatrically hospitalized patients treated with antipsychotics and other psychotropics. Human Psychopharmacology: Clinical and Experimental 2012;27(5) : 521-526.
- 17.Huhn M, Leucht C, Rothe P ,Dold M ,Heres S, Bornschein S,et al. Reducing antipsychotic drugs in stable patients with chronic schizophrenia or schizoaffective disorder: a randomized controlled pilot trial. European archives of psychiatry and clinical neuroscience 2021;271(2): 293-302.
- 18. Çetin M. Şizofreni tedavisi: Geçmişi, bugünü ve geleceği.Bulletin of Clinical Psychopharmacology 2015;25(2): 95-99.
- 19. Gevrek EH. (2017). Fiziksel egzersizin, şizofreni hastalarında pozitif negatif semptomlarına ve depresyon düzeylerine etkisi.Master's thesis, Üsküdar University Institute of Social Sciences Clinical Psychology Department,Istabul,2017 (Turkish).
- 20.Gökçe, Güneş E, Erhan Nalçac E. Egzersizin depresyon ve şizofreni üzerine Etkisi: BDNF odaklı bir bakış.Noro-Psikyatri Arsivi 2019;56(4): 302-310.
- 21. Lök S, Lök N. Kronik psikiyatri hastalarına uygulanan fiziksel egzersiz programlarının etkinliği: sistematik derleme. Psikiyatride Güncel Yaklaşımlar 2016;8(4): 354-366.
There are 21 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences, Psychiatry |
| Journal Section | Olgu Sunumu |
| Authors | |
| Publication Date | October 15, 2022 |
| Submission Date | April 5, 2022 |
| Acceptance Date | August 25, 2022 |
| Published in Issue | Year 2022 Volume: 5 Issue: 3 |
The articles in the Journal of "Acta Medica Nicomedia" are open access articles licensed under a Creative Commons Attribution-ShareAlike 4.0 International License at the web address https://dergipark.org.tr/tr/pub/actamednicomedia