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Yıl:2016; Cilt: 3; Sayı: 3>> Özet
TAM METİN
The Journal of Neurobehavioral Sciences; 2016;3(3):122-124
Bir İlk Atak Psikoz Olgusunda Başarılı Bir Tedavi Güçlendirme Yaklaşımı Olarak Tekrarlayıcı Transkraniyal Manyetik Uyarım Tedavisi
BÖ Ünsalver, H Gülmez, A Evrensel, N Tarhan
Üsküdar Üniversitesi, İstanbul
Tekrarlayıcı transkraniyal manyetik uyarım tedavisi (tTMU), psikotrop ilaçlara yeterli alınamamış psikiyatrik hastalıklarda, tedaviyi güçlendirme amacıyla tercih edilebilecek, invazif olmayan bir beyin uyarım yöntemidir. Psikoz olgularında, tTMU, kortikal uyarılabilirliği, konnektiviteyi ve plastisiteyi değiştirerek etki ediyor olabilir. tTMU transkallozal inhibisyonu indükleyebilir ve antipsikotikler bu inhibisyonun süresini uzatabilir. Bu makalede, ilk antipsikotik ilaç tedavisine yanıtsız bir ilk atak psikoz olgusunda, 20 seans 1Hz sağ tTMU güçlendirmesiyle klinik yanıt gözlenen ve tedavinin 8. ayında remisyonu devam eden bir olguyu sunuyoruz. tTMU’nun sadece tedaviye dirençli olguların tedavisinde değil, aynı zamanda, psikiyatrik bozuklukların erken dönem tedavisinde klinisyenin düşünebileceği umut vaat eden bir yöntem olduğunu öneriyoruz.
Repeated Transcranial Magnetic Stimulation as a Successful Augmentation Strategy in a Patient with First Episode Psychosis
Repeated transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation method that may be preferred as an augmentation strategy for psychiatric patients who may not have responded well enough to psychotropic drugs. In psychoses rTMS may act via changing cortical excitability, connectivity and plasticity. rTMS may induce transcallosal inhibition and antipsychotic drugs may extend the duration of this inhibition. We present a first episode psychosis patient initially unresponsive to antipsychotic treatment, in whom 20 sessions of right 1Hz rTMS augmentation resulted in clinical response and who remained in remission by the 8th month of treatment. We suggest that rTMS is a well-tolerated treatment that may not be reserved only for treatment resistant patients but may also be considered early on in the management of psychiatric disorders.

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