Dergi Ara >>
Yıl:2004; Cilt: 7; Sayı: 2>> Özet
TAM METİN
Klinik Psikiyatri Dergisi; 2004;7(2):120-126
Depresyonda uyku yoksunluğu tedavisi uygulamaları
O Çalıyurt, F Güdücü
Trakya Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı, Edirne
Total uyku yoksunluğu %40?60 hastada depresif semptomları ertesi gün azaltmaktadır. Uyku yoksunluğuna yanıt, uyku yoksunluğunun olduğu gece ve takip eden günde ortaya çıkmaktadır. Bazı hastalarda ise yanıt takip eden toparlanma uykusundan sonraki günde ortaya çıkmaktadır. Diğer yandan çoğu hastada ise toparlanma uykusundan sonra depresif yakınmalarda geriye dönüş ortaya çıkmaktadır. Bununla beraber depresyonda düzelme birkaç hafta sürmektedir. Ayrıca ilaç tedavisi kullanan hastalarda toparlanma uykusundan sonraki yineleme oranları daha düşük düzeyde olmaktadır. Bir çok araştırmada uyku yoksunluğu tedavisinden hemen sonra başlanılan antidepresan ilaç tedavisinin uyku yoksunluğunun antidepresan etkisini koruduğunu ortaya koymaktadır. Uyku yoksunluğu uykululuk, duygudurumda bozulma, bilişsel ve motor bozulma yapabilmekte ve bipolar I hastalarında manik atağı ortaya çıkarabilmektedir. Uyku yoksunluğunun diğer tipleri ise REM uykusu yoksunluğu ve kısmi uyku yoksunluğudur. Özellikle gecenin ikinci yarısında uygulanan kısmi uyku yoksunluğunun total uyku yoksunluğu kadar etkili olduğu bildirilmiştir. Uyku yoksunluğunun patofizyolojisi tam anlaşılamamakla birlikte monoaminerjik nörotransmisyonun uyku yoksunluğunda arttığı bildirilmiştir. En önemli tedavi etkinliği belirleyicisi gün içerisindeki duygudurum değişikliğinin olmasıdır. Uyku yoksunluğu, temel endikasyonu olan majör depresyon hastalarının yanı sıra premenstruel duygudurum dalgalanmalarını önleyebilmekte, gebelik ve postnatal dönemdeki depresyonlarda da invazif olmayan doğası nedeni ile kullanılmaktadır. Sonuç olarak ilaç tedavisi ile kıyaslandığında uyku yoksunluğu önemli bir ekonomik avantaj getirmekte ve hızlı etki başlangıcı ve antidepresif ilaç tedavisini güçlendirici etkileri ile de alternatif bir güçlendirme tedavisi seçeneği olmaktadır.
Therapeutic Sleep Deprivation in Depression
Total sleep deprivation for one whole night improves depressive symptomes in 40-60% of treatments. Sleep deprivation response shows up in the sleep deprivation night or on the following day. Some patients respond after recovery sleep only. But after recovery sleep most of the patients suffer a complete or partial relapse. On the other hand, improvement can last for weeks. Relapse after recovery sleep is less when patients are receiving medication. A number of studies have suggested that sleep deprivation followed by immediate treatment with an antidepressant sustains the antidepressant effect of sleep deprivation. Sleep deprivation leads to sleepiness, impairments in mood, cognitive and motor functions and also my precipitate mania in bipolar I patients. Other types of sleep deprivations includes REM sleep deprivation and partial sleep deprivation. Partial sleep deprivation in the second half of the night is equally effective as total sleep deprivation. The pathophysiology of sleep deprivation is not well understood; however, monoaminergic transmission is reportedly enhanced by sleep deprivation. The best predictor of a therapeutic effect is a large variability of mood. The main indication of sleep deprivation therapy is the depressive syndrome and sleep deprivation may prevent premenstrual mood swings, and could be use in partum and postpartum depression because of it's noninvasive nature. Finally there are considerable economic advantages of using sleep deprivation in major depression compared to drug therapy. Sleep deprivation therapy with fast acting antidepressive effects could be use an augmentation agent as an alternative antidepressive therapy with pharmacothearpy.

http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-black-gold.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-red.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-orange-golden.html http://www.simplehandbaga.com/hermes-jige-clutch-29cm-croco-white-grey.html http://www.simplehandbaga.com/hermes-kelly-32cm-ostrich-vein-6108-black-golden.html http://www.simplehandbaga.com/hermes-jige-clutch-29cm-croco-dark-red.html http://www.simplehandbaga.com/hermes-herbag-31cm-green-canvas-bag.html http://www.simplehandbaga.com/hermes-epsom-leather-wallet-camel-silver.html http://www.simplehandbaga.com/hermes-calf-leather-men-h-belt-138-silver-blue.html http://www.simplehandbaga.com/hermes-so-kelly-28cm-togo-leather-shoulder-bag-green-silver.html http://www.simplehandbaga.com/hermes-kelly-32cm-togo-leather-6108-electric-blue-silver.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-orange.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbag-blue-gold.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-burgundy.html http://www.simplehandbaga.com/hermes-bolide-31cm-togo-leather-pink-bag.html http://www.simplehandbaga.com/hermes-birkin-35cm-handbag-crocodile-leather-green-gold.html http://www.simplehandbaga.com/hermes-constance-23cm-croco-leather-black.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-pink-silver.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-elephant-grey.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-dark-blue-golden.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-black.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-brown.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-orange.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-electric-blue.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-pink.html http://www.simplehandbaga.com/hermes-h-wallet-royal-blue-silver.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbags-black-gold.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-electric-blue.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-blue-silver.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-burgundy.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-grey.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-epsom-leather-grey-gold.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-elephant-grey.html http://www.simplehandbaga.com/hermes-calf-leather-wallet-h005-red.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-camel-gold.html http://www.simplehandbaga.com/hermes-kelly-wallet-togo-leather-black.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-orange.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-pink.html http://www.simplehandbaga.com/hermes-herbag-31cm-burgundy-canvas-bag.html http://www.simplehandbaga.com/hermes-mini-kelly-22cm-epsom-leather-yellow-silver-with-chain-strap.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-blue-silver.html http://www.simplehandbaga.com/hermes-30cm-birkin-bag-togo-leather-with-strap-light-pink-gold.html http://www.simplehandbaga.com/hermes-jige-wallet-togo-leather-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-rose-silver.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-brown.html http://www.simplehandbaga.com/hermes-jige-clutch-29cm-croco-green.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-brown.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-blue-gold.html http://www.simplehandbaga.com/hermes-birkin-25cm-handbag-6068-orange-silver.html http://www.simplehandbaga.com/hermes-garden-party-handbag-large-36cm-black.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-red-silver.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-epsom-leather-pink-silver.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-pink.html http://www.simplehandbaga.com/hermes-calf-leather-wallet-h005-in-orange.html http://www.simplehandbaga.com/hermes-picotin-lock-togo-leather-red.html http://www.simplehandbaga.com/hermes-mini-kelly-22cm-epsom-leather-green-silver-with-chain-strap.html http://www.simplehandbaga.com/hermes-birkin-25cm-handbag-6068-orange-silver.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbag-yellow-gold.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-orange-golden.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-camel-gold.html http://www.simplehandbaga.com/hermes-calf-leather-men-h-belt-138-gold-light-coffee.html http://www.simplehandbaga.com/hermes-kelly-28cm-bag-togo-leather-blue-gold.html http://www.simplehandbaga.com/hermes-garden-party-handbag-small-31cm-pink.html http://www.simplehandbaga.com/hermes-garden-party-handbag-large-36cm-red.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbag-burgundy-gold.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-dark-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-light-coffee-silver.html http://www.simplehandbaga.com/hermes-so-kelly-28cm-togo-leather-shoulder-bag-hot-pink-silver.html http://www.simplehandbaga.com/hermes-birkin-30cm-togo-leather-handbags-black-gold.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-white.html http://www.simplehandbaga.com/hermes-garden-party-36cm-leather-handbag-black-hot-pink.html http://www.simplehandbaga.com/hermes-birkin-35cm-handbag-crocodile-leather-brown-gold.html http://www.simplehandbaga.com/hermes-constance-wallet-togo-leather-rose.html http://www.simplehandbaga.com/hermes-bi-fold-wallet-h006-black.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-epsom-leather-red-gold.html http://www.simplehandbaga.com/hermes-birkin-35cm-togo-leather-handbags-black-silver.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-blue.html http://www.simplehandbaga.com/hermes-calf-leather-men-h-belt-138-silver-blue.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-black.html http://www.simplehandbaga.com/hermes-epsom-leather-jige-clutch-29cm-brown.html http://www.simplehandbaga.com/hermes-bolide-31cm-togo-leather-orange-bag.html http://www.simplehandbaga.com/hermes-calf-leather-wallet-h005-h-red.html http://www.simplehandbaga.com/hermes-medor-clutch-29cm-croco-burgundy.html http://www.simplehandbaga.com/hermes-birkin-35cm-crocodile-leather-handbag-grey-white-gold.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-red-gold.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-dark-khaki-silver.html http://www.simplehandbaga.com/hermes-garden-party-36cm-canvas-handbag-yellow.html http://www.simplehandbaga.com/hermes-calf-leather-8616-handbag-cherry-pink.html http://www.simplehandbaga.com/hermes-kelly-cut-31cm-epsom-leather-clutch-orange.html http://www.simplehandbaga.com/hermes-lindy-30cm-handbag-orange-silver.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-blue.html http://www.simplehandbaga.com/hermes-birkin-35cm-handbag-crocodile-leather-green-gold.html http://www.simplehandbaga.com/hermes-mini-kelly-22cm-epsom-leather-yellow-silver-with-chain-strap.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-camel.html http://www.simplehandbaga.com/hermes-constance-bag-23cm-togo-leather-black-gold.html http://www.simplehandbaga.com/hermes-mini-evelyne-tpm-bag-green.html http://www.simplehandbaga.com/hermes-dogon-wallet-togo-leather-h001-green.html http://www.simplehandbaga.com/hermes-birkin-35cm-cattle-skin-vein-handbags-blue-gold.html http://www.simplehandbaga.com/hermes-constance-23cm-togo-leather-orange-silver.html