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Yıl:2016; Cilt: 2; Sayı: 1>> Özet
Türkiye Klinikleri Çocuk Psikiyatrisi Özel Dergisi; 2016;2(1):55-61
Çocuk ve Ergenlerde Depresif Bozukluk Farmakolojik Tedavisi
EB Koç, G Karaçetin
Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul
Çocuk ve ergenler de depresif bozuklukların farmakolojik tedavisi akut, sürdürüm ve idame tedavi olmak üzere üç evreden oluşur. Akut tedavide, birinci basamak olarak bir SSGİ (Selektif Seratonin Geri alım İnhibitörü); ikinci basamak olarak ise, ilk basamakta kullanılmayan bir SSGİ önerilmektedir. Tedaviye yanıt yoksa, üçüncü basamak olarak SSGİ dışında farklı bir antidepresan (bupropion, venlafaksin, mirtazapin, duloksetin) kullanılabilir. Sürdürüm tedavisi, akut tedaviye cevap veren her hastada uygulanması önerilen en az 6 ila 12 ay arası süren bir te da vi dir. İdame tedavi, ciddi, tekrarlayıcı ve kronik depresyona sahip olan çocuk ve ergenlerde kullanılan, depresyonun yinelenmesini engellemeye yönelik yapılan tedavidir. Çocuk ve ergenlerde depresif bozuklukların tedavisinde ilaç seçiminde depresif bozukluğunun şiddeti ve işlevsellik üzerindeki etkisi ve komorbid durumlar değerlendirilmelidir. Tedavisi sırasında ilaçların yan etkilerine dikkat edilmeli ve yan etki gelişimi açısından sık kontrollerle hasta takip edilmelidir.
The Pharmacological Treatment of Children and Adolescents with Depressive Disorders
The pharmacological treatment of children and adolescents with depressive disorders is divided in to three phases: acute, continuation, and maintenance. In the first stage of acute treatment. Selective Serotonin Reuptake Inhibitor (SSRI) is used. In second stage, different type of SSRI which is not used in the first stage is recommended. If treatment does not respond yet; as a third stage an alternate antidepressant (bupropion, venlafaxine, mirtazapine, duloxetine) can be used. Continuation treatment for at least 6 to 12 months is recommended for all patients who have responded to the acute treatment. Maintenance treatment is used to avoid recurrences in some youths who have had a more severe, recurrent, and chronic disorder. Selection of the drug in treatment of children and adolescents with depressive disorders should include consideration of the severity and impairment of the depressive disorder and comorbid disorders. Patients should be monitorised closely for side effects of treatment.

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