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Yıl:2014; Cilt: 51; Sayı: 4>> Özet
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Nöropsikiyatri Arşivi; 2014;51(4):403-404
Bir Paradoks Olarak Risperidon Kullanımına Bağlı Kekemelik Olgusu
İM Atay, B Tanrıtanır, A Akpınar, A Demirdaş
Süleyman Demirel Üniversitesi, Isparta, Türkiye
Kekemeliğin temel özelliği, bireyin konuşmasının gerek akıcılık, gerekse zamanlama yönünden yaşına uygun olmayan biçimde bozulmasıdır. Bu bozukluk seslerin ve hecelerin sık sık yinelemeleri ve uzatılmaları ile belirlidir. Kekemeliğin edinsel ve gelişimsel olarak iki tipi mevcuttur. Edinsel kekemelik herhangi bir yaşta aniden başlayabilmektedir ve ilaç yan etkilerine bağlı olarak nadir de olsa edinsel kekemelik görülebilmektedir. Antipsikotiklere bağlı kekemelik ise çok nadir gelişmektedir. Risperidon dopamin 2 (D2) ve serotonin 2A (5 HT2A) reseptörlerinin güçlü antagonisti olup, noradrenalin ?1 ile ?2 reseptörlerine yüksek afinite göstererek etki etmektedir. Psikotik bozukluklar, duygudurum bozuklukları ve davranım bozuklukları hatta kekemelik tedavisi dahil olmak üzere geniş bir spektrumda kullanılmaktadır. Risperidon, D2 reseptör antagonizmasıyla striatal metabolizmayı artırarak kekemelik semptomlarını iyileştirmektedir. Literatürde psikotik bozukluğu olan kısa süreli ve yüksek doz risperidon tedavisine bağlı gelişen iki kekemelik olgusu dışında başka vaka sunumuna rastlanılmamıştır. Olgumuzda ise kronik düşük doz risperidon kullanımı sonrası gelişen kekemelik yan etkisi dikkat çekici olup ilk kez tartışılmıştır. Risperidon’un kekemelik tedavisinde kullanılmasının yanı sıra kekemelik yan etkisinin de bulunması bir paradoks olarak ilginç görünmektedir.
A Case of Risperidone Induced Stuttering as a Paradox
The main feature of stuttering is the disturbance in terms of both timing and fluency of speech inappropriate with the age. This disturbance is characterized with the repetition and prolongation of sounds and syllables. There are two types of stuttering as acquired and developmental. Acquired stuttering may begin suddenly at any age and may be seen rarely due to the adverse effects of drugs. Stuttering induced by antipsychotics may develop very rarely. Risperidone is a strong antagonist of dopamin 2 (D2) and serotonin 2A (5 HT2A) and shows a high affinity for ?1 and ?2 noradrenaline receptors. It’s used in a wide spectrum including psychotic disorders, mood disorders, and behavioral disorders, even for the treatment of stuttering. Risperidone treats the symptoms of stuttering by the antagonism of D2 receptors with an increase in striatal metabolism. In literature, we haven’t observed any other case reports except the two stuttering cases with psychotic disorders due to the short term and high-dose risperidone treatment. In our case, stuttering adverse effect of chronic low-dose risperidone treatment is remarkable that is discussed for the first time. As well as the use of risperidone for the treatment of stuttering, stuttering adverse effect seems to be interesting as a paradox.

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