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Yıl:2005; Cilt: 15; Sayı: 4>> Özet
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Klinik Psikofarmakoloji Bülteni; 2005;15(4):182-186
Atipik Antipsikotiklerin Kadın Fertilitesi ve Gebelik Üzerine Etkileri: Olgu Sunumu
AE Altıntoprak, A Erol, G Koturoğlu, AS Gönül
Ege Üniv. Tıp Fakültesi Psikiyatri ABD
Klinik çalışmalar atipik antipsikotiklerin klasik antipsikotiklere göre prolaktin düzeylerinde doza bağımlı artış gibi yan etkilerinin insidan-sının daha düşük olduğunu bildirmektedir. Olanzapinin daha az ekstrapiramidal hareket bozukluğuna, hiperprolaktinemiye ve seksüel disfonksiyona yol açtığı gösterilmiştir. Klinisyenler gebe olan ve aynı zamanda mental bir hastalığı bulunan kadınlarla çalışırken zor durumlarla karşı karşıya kalırlar. Tedavi edilmeyen bir psikotik atağın sonuçlarının ağır olabileceği ve annenin intiharına ya da bebeğini öldürmesine neden olabileceği iyi bilinmektedir. Bu nedenle klinisyenlerin annelere psikiyatrik hastalık tedavi edilmezse, kendilerinde ve bebeklerinde ortaya çıkacak potansiyel risklerle ilaç kullanımına bağlı fetal ve neonatal riskleri değerlendirmeleri konusunda yardım etmeleri gerekmektedir. Elde klasik antipsikotikler ve gebelik ile ilgili veriler bulunmasına rağmen atipik antipsikotik kullanan kadınlarda gebelik ile ilgili raporlar yetersizdir. Prenatal dönemde atipik antipsikotiklere maru-ziyetin sonuçlarının anlaşılması tedavi seçiminde yarar sağlayacaktır. Aşağıda olanzapin kullanırken gebe kalan ve gebeliği sırasında ilaç kullanmayı sürdüren bir anne ve bebeği sunulmaktadır.
The Effects Of Atypical Antipsychotics On Woman's Fertility and Pregnancy: Case Report
Clinical reports indicate that atypical antipsychotics are associated
with a lower incidence of adverse events such as dose-related
increases in prolactin concentrations than conventional
antipsychotics. It has been shown that olanzapine causes less
extrapyramidal movement disorder, hyperprolactinemia and sexual
disfunction. Clinicians are confronted with challenging situations
when working with women who are pregnant and have a co-existing
mental illness. It is well known that potential consequences of an
untreated psychotic episode may be severe and may lead to the
mother attempting suicide and/or infanticide. For these reasons,
clinicians need to help mothers weigh both fetal and neonatal risks of
exposure to drugs against the potential risk they and their infant may
incur if the psychiatric illness is not treated. Although data regarding
conventional antipsychotics and pregnancy are available, reports
about the course of pregnancy in women treated with atypical agents
are insufficient. Understanding the risk of prenatal antipsychotic
exposure can be of benefit in selecting therapies. Here we present a
woman who was treated with olanzapine before and during her
pregnancy and her baby.

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