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Yıl:2015; Cilt: 26; Sayı: 4>> Özet
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Türk Psikiyatri Dergisi; 2015;26(4):291-294
Şiddetli Bir Çocukluk Çağı Başlangıçlı Obsesif Kompulsif Bozukluk Olgusunda Güçlendirme Tedavisi Olarak Klonazepam
S Halayem, S Othman, HB Youssef, A Belhaj, A Bouasker, R Ghachem, K Tabbane, A Bouden
Tunus Tıp Fakültesi, Tunus
Bu çalışmanın amacı, genellikle çocukluk çağı ve ergenlikte ortaya çı- kan ve kronik yeti yitimine neden olan obsesif kompulsif bozukluğun (OKB) tedavisini irdelemektir. OKB tedavisi için klonazepam kullanan erişkinlere dair bildirimler çocuklarda kullanımına dair bildirimlerden oldukça fazladır. OKB’de güçlendirme tedavisi olarak klonazepam kullanımı üzerindeki tartışmalar hala sürmektedir. Bu olgu bildirimi ile amacımız şiddetli OKB tedavisinde klonazepam ile güçlendirmenin yararlılığını göstermektir. Bu yazıda yüksek doz seratonin geri alım inhibitörü ve ikinci kuşak antipsikotik birlikte kullanımında hafif bir düzelme gösterdikten sonra sertralin (200mg/gün) ve olanzapin (15 mg/gün) tedavisinin klonazepam (3mg/gün) ile güçlendirilmesine yanıt veren çok şiddetli (Çocuklar için Yale-Brown Obsesif Kompulsif Bozukluk Ölçeği puanı 32) bir ergen kız OKB olgusu sunulmuştur. Klonazepam sadece anksiyete belirtilerini azaltmakla kalmamış, ayrıca obsesyonlar ve komp ulsiyonların sıklığını da altı hafta içinde azaltmış ve Çocuklar için YaleBrown Obsesif Kompulsif Bozukluk Ölçeği puanını 16’ya düşürmüştür. Sonuç olarak, klonazepamın genç hastalarda şiddetli OKB’nin ilk basamak tedavisinde faydalı olabileceği düşünülmüştür.
The Usefulness of Clonazepam as an Augmentative Treatment in a Case of Severe Childhood Onset Obsessive-Compulsive Disorder
The goal of this study is to report on the treatment of obsessivecompulsive disorder (OCD), a chronic disabling condition that often presents during childhood and adolescence. Reports on adults using clonazepam for the treatment of OCD are more numerous than on children. Clonazepam as an augmentative treatment in OCD is still controversial. Our aim is to illustrate in a case report the efficacy of clonazepam as an augmentative treatment for severe childhood onset OCD. We report on the case of a young teenage girl with an extremely severe form of obsessive–compulsive disorder (score of 32 on the Children’s Yale-Brown Obsessive Compulsive Scale), who, after a mild improvement with a combination of serotonin recapture inhibitors and second generation antipsychotics at high doses, has responded to clonazepam (3mg/day) augmentation of sertraline (200mg/day) and olanzapine (15mg/day). Clonazepam was effective not only in reducing anxiety symptoms, but also in lowering compulsions and obsessions frequency within 6 weeks with a drop in the Children’s Yale-Brown Obsessive Compulsive Scale of 16 points. It may be asserted that clonazepam could be useful in the initial stage for severe OCD in young patients.

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