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Yıl:2017; Cilt: 10; Sayı: 2>> Özet
Türkiye Klinikleri Psikiyatri Özel Dergisi; 2017;10(2):79-87
Majör Depresyon Tedavisinde Transkraniyal Manyetik Uyarım Tedavisi Kullanımı
BÖ Ünsalver, N Tarhan
Üsküdar Üniversitesi, İstanbul
Majör depresyon (MD), tüm dünyada yetiyitimiyle giden tıbbi tablolar arasında üst sıralarda yer almaktadır. Deneyimli klinisyenler dahi MD tedavisinde zaman zaman zorlanabilmektedirler. MD tanısı yeterince konulmadığı gibi tanı konan olguların kabaca yarısı tedaviden fayda sağlamaktadır. Antidepresan ilaçlar ve psikoterapi yaklaşımlarının yetersiz kalması, klinisyenleri MD tedavisinde alternatif yöntemler aramaya yöneltmektedir. MD tedavisindeki alternatif yöntemler arasında, merkezi sinir sistemi elektrik etkinliğini değiştirmeyi amaçlayan çeşitli cihazların kullanıldığı terapötik nöromodülasyon yer alır. Transkraniyal Manyetik Uyarım (TMU) tedavisi de bu nöromodülasyon tekniklerinden biridir. TMU, çok sayıda randomize, sham-kontrollü çalışmada MD tedavisinde etkisi gösterilmiş ve girişimsel olmayan bir prosedürdür. İlaçlarla ya da elektrokonvulzif terapi gibi diğer nöromodülasyon teknikleriyle karşılaştırıldığında TMU'nun yan etki profili de daha iyidir. Bu makalede TMU'nun özellikle tedaviye dirençli MD tedavisindeki etkililiğini gösteren çalışmaların yanısıra, ilaç kullanım kısıtlılığı olan geriyatrik, adölesan, gebe ya da emziren popülasyonda kullanımı da özetlenmiştir.
Transcranial Magnetic Stimulation in the Treatment of Major Depressive Disorder
Major Depressive disorder (MDD), is one of the leading causes of disability worldwide. Even the most experienced clinicians may have difficulty treating some MDD patients. It is not just that MDD is underdiagnosed but also only half of the patients benefit from treatment. Available psychotropic drug treatments and psychotherapeutic approaches may be insufficient for MDD treatment which necessitates the search for alternative treatment methods. One of the alternative approaches for MDD is neuromodulation that aims to change the electrical activity of the central nervous system. Transcranial Magnetic Stimulation (TMS) is one of the neuromodulation techniques. Efficacy of TMS on MDD treatment has been proven in various randomized, sham-controlled studies. Side-effect profile of TMS is better than psychotropic drugs and other neuromodulation techniques such as electroconvulsive therapy. In this paper, we present a summary of the various studies regarding the efficacy of TMS on MDD.

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