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Yıl:2017; Cilt: 28; Sayı: 1>> Özet
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Türk Psikiyatri Dergisi; 2017;28(1):71-73
Otizm Spektrum Bozukluğu Olan Beş Yaş Öncesi İki Çocukta Aripiprazol Kullanımına Bağlı Akut Distoni
M Küçükköse, BK Başay
Aydın Devlet Hastanesi, Aydın
Otistik Spektrum Bozukluğu (OSB) yaşamın ilk üç yılı içinde ortaya çıkan, sosyal etkileşim, sözel ve sözel olmayan iletişim sorunlarıyla ve tekrarlayıcı ve kısıtlı ilgi ve davranışlar ile kendini gösteren nöropsikiyatrik bir bozukluktur. OSB olan hastaların öfke nöbetleri, saldırganlığı, hiperaktivitesi ve stereotipileri için farmakolojik girişimler gerekebilmektedir. Amerikan Gıda ve İlaç Dairesi (FDA) aripiprazolün OSB olan çocuk ve ergenlerin öfke nöbeti tedavisinde kullanılmasına onay vermesi ile birlikte bu ilacın OSB olan çocuk ve gençlerde kullanımına ilişkin bir ilgi artışı olmuştur. Aripiprazol, dopamin D2, serotonin 5-HT1A reseptörlerinin parsiyel agonisti ve 5-HT2A reseptörlerinin antagonistidir. Aripiprazolün parsiyel agonist olması nedeniyle ekstrapiramidal yan etkilere, hareket bozukluklarına ve metabolik sorunlara karşı koruyucu bir etkisinin olabileceği düşünülmüş, ancak çocuk ve ergenlerde kullanım sıklığının artışı ile birlikte bu yan etkilerle ilgili olgu sunumlarında bir artış olmuştur. Bununla birlikte yazın bilgileri gözden geçirildiğinde OSB olan beş yaş altındaki çocukların aripiprazol kullanımı ve akut distoni arasındaki ilişki ile ilgili bilgilerin kısıtlı olduğu görülmüştür. Bu yazıda, düşük dozda aripiprazol tedavisi sırasında distoni gelişen ve Naranjo’nun ilaç yan etki olasılığı skalasına göre bu yan etkilerin kuvvetli olasılıkla aripiprazole bağlı olduğu belirlenen beş yaş altında OSB olan iki olgu sunulmuştur.
Acute Dystonia due to Aripiprazole Use in Two Children with Autism Spectrum Disorder in the First Five Years of Life
Autism spectrum disorders (ASD) are neuropsychiatric disorders characterized by impairment in social interactions, in verbal and nonverbal communication, and restricted and stereotyped patterns of interest and behavior within the first 3 years of life. Pharmacologic interventions may be needed for the treatment of temper tantrums, aggression, hyperactivity, and stereotypes in children with ASD. The approval of aripiprazole by the United States Food and Drug Administration (USFDA) for the treatment of temper tantrums in children and adolescents with ASD has gained increased interest for the use in these patients. Aripiprazole is a partial agonist for the dopamine D2, serotonin 5-HT1A receptors, and an antagonist for 5HT2A receptors. Because aripiprazole is a partial agonist, it has been is speculated that aripiprazole has a protective effect for extrapyramidal side effects, movement disorders, and metabolic problems. But the increased use in children and adolescents is associated with an increase in the number of case reports related with such problems. Nevertheless, our review of the literature uncovered limited data regarding the association between acute dystonia and aripiprazole use in ASD children under five years of age is. In this paper, we present two cases of autistic spectrum disorder children with ages under 5 years that developed acute dystonia taking aripiprazole.

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