Dergi Ara >>
Yıl:2014; Cilt: 7; Sayı: 2>> Özet
Türkiye Klinikleri Psikiyatri Özel Dergisi; 2014;7(2):44-50
Bipolar Bozukluğun Sürdürüm Tedavisi
S Nurmedov, A Enez Darçın, CO Noyan
Özel NPİSTANBUL Nöropsikiyatri Hastanesi, İstanbul
Bipolar bozukluk yineleme riski yüksek olan bir hastalıktır. Sürdürüm tedavisinin temel hedefi depreşme ve yinelemenin önlenmesi, epizot sayılarının azaltılması, epizotların şiddetinin azaltılması, epizotlarının süresinin kısaltılması, özkıyım girişimlerinin azaltılması, hastaların hastalık öncesi işlevsellik düzeylerinin sürdürmesi ve eşik altı belirtilerin ortadan kaldırılmasıdır. Birçok tedavi kılavuzu ilk manik epizot sonrasında sürdürüm tedavisine başlanmasını önermektedir. Sürdürüm tedavisinde başta lityum olmak üzere akut atak tedavisinde kullanılan birçok ilaç kullanılmaktadır. Gebelik ve emzirmede sürdürüm tedavisinin planlanmasında tedavide kullanılan ilaçların teratojenik etkileri, gebelik esnasında tedavi edilmeyen bipolar bozukluğun hasta ve fetüse olan olumsuz etkileri ve hastalığın yineleme riski göz önünde bulundurulmalıdır. Hastaların ilaç tedavisini kabullenmesi, tedavi uyumunun artması ve stres ile baş edebilmelerinde psikoeğitim ve diğer psikoterapotik müdahaleler gerekmektedir.
Maintenance Treatment in Bipolar Disorder
Bipolar disorder is an illness that has increased risk of recurrence. Main goals of maintenance treatment are to prevent recurrence and deterioration, to decrease the number, severity and duration of epizods, to control suicide attempts, to sustain the level of functioning as before the illness and to cure subthreshold symptoms. Several threatment guidelines recommend maintenance treatment even after first episode. Several medications that can be used in acute episode including lithium can also be used in maintenance treatment. Teratogenic side effects of medication, negative effects of untreated disorder to both mother and fetus and risk of recurrence should be considered while maintenance treatment in pregnancy and nursing. Psychoeducation and other psychotherapeutic approaches should be considered for patients in context of treatment adaptation, therapeutic alliance and coping strategies against stress.

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