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Yıl:2003; Cilt: 10; Sayı: 1>> Özet
TAM METİN
Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2003;10(1):22-28
Tourette Sendromunda Ketiapin Sağaltımı
ÖG Bozabalı, A Özbek, S Miral
Dokuz Eylül Üniv.. Tıp Fak. Çocuk ve\r\nErgen Psikiyatrisi Anabilim Dalı, İzmir
Tourette Sendromu'nun (TS) sağaltımında başta haloperidol ve pimozid olmak üzere klasik nöroleptikler ve bir a2 agonist olan klonidin kullanılmaktadır. Atipik antipsikotiklerin gündeme gelmesi ile risperidon da bu bozukluğun sağaltımında önemli bir psikofarmakolojik ajan olarak yerini almıştır. Ketiapin de Türkiye'de kısa bir süre önce kullanıma sunulmuş, yeni bir atipik antipsikotiktir. Ketiapinle ilgili çalışmalar gözden geçirildiğinde daha çok erişkin hastalarda kullanımına ilişkin bilgiler edinilmekte ve çocuk ve ergen yaş grubunda çalışmaların oldukça sınırlı olduğu dikkati çekmekte­dir. Biz bu yazıda, kliniğimizde TS tanısıyla izlenmekte olan ve daha önce en az bir psikotrop ilaca yanıt vermeyen iki olguda ketiapin kullanımına ait deneyimimizi aktarmayı amaçladık. Ketiapin etki ve yan etkileri Yale Genel Tik Ağırlığını Derecelendirme Ölçeği, Chouinard ve Ross-Chouinard'm Ekstrapramidal Belirti Derecelendirme Ölçeği, UKU Yan Etki Değerlendirme Ölçeğine ek olarak, vital ve diğer biyolojik ölçümler ile değerlendirilmiştir. Böylece hem ketiapinin TS'deki etkinliği, hem de er­gen yaş grubuna ait kullanım özelliklerine yönelik verilere katkıda bulunulması hedeflenmiştir. Bu iki olguda ketiapinin etkili olmadığı görülmüştür. Ayrıca olgulardan birinde, yalnızca Türk örnekleminde bildirilen bir yan etki olan eksitasyon tablosunun görülmesi ve bu konuda yapılacak çalışma­lara zemin oluşturması açısından da sunuma değer görülmüştür.
Quetiapine Treatment in Tourette's Syndrome
In the treatment of patients with Tourette's Syndrome, conventional neuroleptics, predominantly haloperidol and pimozide and á2 agonist clonide have been used. With the introduction of atypical neuroleptics, dominantly risperidone have been additional agents to take part in the treatment of this disorder. Quetiapine is a new antipsychotic which have been in use in Turkey recently. A search of literature reveals data on its use in the adult population with limited research in the child and adolescent age group. In this paper we aim to share our experience with two patients with Tourette's Syndrome, who had persistent symptoms despite the use of at least one psychotropic agent. The effectiveness and side effects of Quetiapine were evaluated with the Yale Tic Severity Scale and, Chouinard and Ross-Chouinard's Extrapyramidal Symptom Rating Scale, The UKU Side Effect Rating Scale in addition to the vital and other biological parameters. We also aim to provide data on the efficacy of Quetiapine in Tourette's Syndrome in addition to its use in adolescent age group. Quetiapine was not effective in these two patients. Excitation; a side effect reported only for the Turkish population, was induced in one of the cases presented. The present paper was thought to be worth presenting to contribute to basic data useful for further investigation on the topic.

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