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Yıl:2008; Cilt: 1; Sayı: 1>> Özet
Türkiye Klinikleri Psikiyatri Özel Dergisi; 2008;1(1):88-94
Yeme Bozukluklarında Psikofarmakolojik Tedavi
A Duran
İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Psikiyatri ABD, İSTANBUL
Yeme bozuklukları, önemli morbidite ve mortalite oranları ile ilgili iyi tanınan psikiyatrik hastalıklardır. Yeme bozukluğu hastalarında farmakolojik tedavi hayal kırıklığına neden olabilmektedir. Yeme bozukluğu tedavisinde anoreksiya, bulimia ve çok belirtili bulimia gibi alt gruplara göre tedavi seçimi yapılmalıdır. Anoreksia hastalarında trisiklik antidepresanların etkinliği hakkında bilgiler sınırlıdır. Serotonin geri alım inhibitörleri, yeme davranışı üzerine serotoninin etkileri, obsesif kompulsif spektrum içinde yer alması nedeniyle önerilmektedir. Yeme ve doymada dopaminin belirgin rolü, artmış reseptör aktivitesi nedeniyle antipsikotik ilaç kullanımını araştıran ama çoğunluğu kontrol grubunda yoksun çalışmalar vardır. Bulimia hastalarında ilaçlara yanıt daha ümit vericidir. Aslında yeme bozukluğunda ilaçlar tek başına yeterli olmamaktadır. Beslenme rejimleri, beslenme danışmanlığı, davranış modifikasyon teknikleri, bireysel, grup ve aile terapisi ve beraberinde SSRI'lar, ikinci kuşak antipsikotikler ya da iştah stimülanlarını içeren, kapsamlı bir tedavi yaklaşımı ile daha iyi sonuçlar mümkün görünmektedir.
Psychopharmacological Treatment In Eating Disorders
Eating disorders are well known psychiatric diseases which have highly morbidity and mortality rates. Psychopharmacological treatment of eating disorders is disappointing. The treatment in eating disorder should be planned among sub dimensions including anorexia nervosa, bulimia, multi-symptomatic bulimia. The data about the efficacy of tricyclic antidepressants are limited. Serotonin reuptake inhibitors may be suggested because of the role of serotonin in eating behavior, and being considered under obsessive compulsive disorder spectrum. The role of dopamine in eating and satiety led the investigators to use antipsychotic drugs, most of which were lack of placebo-controlled studies. The response to psychopharmacologic drugs in bulimia is promising. However, the psychopharmacologic treatment alone is insufficient. In addition to serotonin reuptake inhibitors, second generation antipsychotics, consulting about dieting, dieting programs, techniques about modifying eating behaviors, individual, group or family therapies should be more efficient in the treatment of eating disorders.

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