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Yıl:2010; Cilt: 17; Sayı: 2>> Özet
TAM METİN
Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2010;17(2):31-36
Çocuk ve ergenlerde obsesif kompulsif bozuklukta aripiprazol kullanımı: Olgu Örnekleri
HT Ulay
SB Mardin Devlet Hastanesi, Mardin, Türkiye
Aripiprazol özgül farmakolojik özelliklere sahip yeni bir antipsikotik ilaç olup, kısmi dopamıh agonisti olarak etkinlik gösteren bir dopamin sistem dengeleyicisidir. Bu yazıda obsesif kompulsif bozukluk tanısıyla izlenen üç ergende aripiprazol güçlendirme tedavisi sonuçlarının sunulması amaçlanmıştır. Ergenlerden birinin eşlik eden Tourette bozukluğu bulunmaktadır. Her üç olguda kullanılmakta olanflu-oksetin ya da klomipramin tedavisi aripiprazol 5 mg/gün ile güçlendirilmiş ve bir olguda aripiprazol 10 mg/güne çıkılmıştır. Tüm olgularda aripiprazol güçlendirme tedavisinin 2-3. haftaları içinde obsesif kompulsif bozukluk belirtilerinde ve bir olguda tiklerde önemli derecede iyileşme sağlanmıştır. Aripiprazol olgularda iyi tolere edilmiş; hafif sedasyon, uykusuzluk, bulantı, halsizlik ve baş dönmesi olmak üzere tedavinin ilk 2 haftasına yayılabilen ve en fazla 4 hafta içinde azalan, ilaç uyumsuzluğuna neden olmayan yan etkiler görülmüştür. Aripiprazol ergenlerde obsesif kompulsif bozukluk güçlendirme tedavisinde güvenilir ve etkin bir seçenek olarak görünmektedir. Çocuk ve ergenlerde aripiprazolün obsesif kompulsif bozukluk tedavisinde kullanımı ile ilgili randomize kontrollü ileriye dönük klinik çalışmalara ihtiyaç vardır.
Aripiprazole for obsessive compulsive disorder in children and adolescents: Case reports
Aripiprazole is a new antipsychotic agent that possesses a unique pharmacologic profile as a dopamine system stabilizer with a partial dopamine agonistic activity. The aim of this report was to present the use of aripiprazole augmentation therapy in three adolescents with obsessive-compulsive disorder, with one having Tourette's syndrome comorbidity. In all cases psychotropic medication either fluoxetine or chlomipiramine was augmented with aripiprazole 5mg daily and in one case up to 10 mg daily. Aripiprazole augmentation therapy was effective on both obsessive compulsive symptoms and tics in the first 2 to 3 weeks of aripiprazole initiation. Aripiprazole was well tolerated in all three cases. No serious side effects except mild sedation, insomnia, nausea, fatigue which resolved in 2 to 4 weeks were reported. Aripiprazole appears to be a safe and efficacious augmentation alternative in adolescents with obsessive compulsive disorder. Prospective clinical trials with a randomized controlled design in children and adolescents are needed.

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