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Yıl:2005; Cilt: 1; Sayı: 29>> Özet
Türkiye Klinikleri Dahili Tıp Bilimleri Dergisi Psikiyatri; 2005;1(29):32-37
Yaşlılarda Depresyon Tedavisinin Farmakokinetik Özellikleri
E Eşkazan
Farmakoloji ve Klinik Farmakoloji AD, İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Emekli Öğretim Üyesi, İSTANBUL
Bu çalışmada genel olarak, yaşlılıkta ortaya çıkan beden işlevlerinde ve kompozisyonundaki değişikliklerin ilaç kinetiğine yansıyan etkileri ele alınmıştır. Bu bilgiler ışığında özellikle antidepresan ilaçlarla tedavi sırasında yaşlılarda göz önünde tutulması gerekenler belirtilmiştir. Buna göre, yaşlılarda depresyon durumlarının tıbbi tedavi protokolleri belirlenirken, yaşlılık fizyolojinsin ve kompozisyonunun değişkenleri kadar, birlikte görülebilen başka hastalık değişkenlerinin ve ilaçlarının da dikkate alınması gerekmektedir. Bu amaçla, ilaç yan etkileri ve etkileşimleri göz önünde tutularak uygun antidepresan ilacın seçilmesi, genelde tedaviye gençlerdekine göre daha düşük dozlarla başlanılması ve hastaların daha yakından ve dikkatli izlenerek doz artırımının gerektiği vurgulanmıştır.
Pharmacokinetic Characteristics of Antidepressant Treatments In Elderly Patients
The purpose of this study is generally to assess the age-related changes in the body functions and composition, and their impact on drug kinetics. On the light of these changes, the characteristics of antidepressant therapy in elderly patients with depression were discussed. Therefore, it is concluded that when antidepressant drug use is necessary in elderly patients, age-related changes of body functions and composition as well as multimorbidity and drug interactions must be evaluated. Consequently, taking into consideration drug side effects and drug interactions, importance of selection of the most appropriate antidepressant therapy and start from a smaller initial dose than used in younger adults, and carefully dose titration was emphasized.

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