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Yıl:2017; Cilt: 24; Sayı: 2>> Özet
Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2017;24(2):171-187
Atipik Antipsikotikler: Güvenilirlik, Tolerabilite ve Kullanımlarına Dair Riskler Konusunda Bir Gözden Geçirme
TC Özçelik, E Karagöz, SA Güney
Dokuz Eylül Üniversitesi, İzmir
Son yirmi yılda, nörolojik yan etkilerin yani ekstrapiramidalsemptomların ortaya çıkma riskinin düşük olması nedeniyle, atipik antipsikotikler (AAP) hem psikotik hem de psikotik olmayan psikiyatrik bozuklukların tedavisinde, çocuklarda ve ergenlerde tipik antipsikotiklerden (TAP) daha sık olarak kullanılmaya başlanmıştır. Atipik antipsikotiklerin başlangıçta TAP’lerden daha etkili ve tolere edilebilirliklerinin daha yüksek olduğuna inanılmasına rağmen, birçok veri AAP'lerin TAP'lardan daha fazla etkili olmadığını göstermektedir. Klinik uygulamada, yetersiz etkinlik, olumsuz yan etkiler ve ilaca kısmi veya uyumsuz yanıt gibi nedenlerle, antipsikotik ilaçların değiştirilmesi oldukça yaygındır. Hem ayaktan hem de yataklı servislerde tedavi gören gençlerin psikiyatrik tanılarının tipine bakılmaksızın yaygın biçimde kullanımları nedeniyle, AAP’lerinetkinlik ve yan etki profi lleri üzerine odaklanılan bir konu haline gelmiştir. Bununla birlikte, çocuk ve ergen popülasyonda, yazında sınırlı sayıda çalışma vardır ve AAP’lerin metabolik ve endokrin yan etkileri ile ilgili yapılan çalışmalarda örneklem sayısının düşük ve takip sürelerinin kısa olduğu dikkati çekmektedir. Bu nedenlerle bu gözden geçirme yazısında AAP'lerin çeşitli psikiyatrik hastalıklarda kullanımına dair iyi bilinen yan etkileri üzerine odaklanılması amaçlanmıştır.
Atypical Antipsychotics an Overview about Risks in Their Use, Reliability and Tolerability
Within the last two decades, atypical antipsychotics (AAPs) have increasingly been used in children and adolescents, for the treatment of both psychotic and non- psychotic psychiatric disorders, when compared to typical antipsychotics (TAAs) , due to their lower overall risk of adverse neurological effects, as extra pyramidal symptoms. Although initially AAPs were believed to be more effi cient in treatment and well-tolerated than TAAs, results of several studies suggest AAPs were no more effective in comparison to TAAs. in clinical practice, frequent switching of antipsychotic medications is common, due to lack of effi cacy, adverse side effects, and partial or no- response. Widespread use of AAPs for youth treated in both inpatient and outpatient settings, regardless of their diagnoses, has been the focus of increasing attention due to the effectiveness and side effects of these drugs. However, limited number of studies conducted in children and adolescent populations exist and most of these researches with objectives of assessing metabolic and endocrine side effects of AAPs were carried out with small sample sizes and had short clinical follow-up periods. For all these reasons, we have aimed to focus on well- identifi ed side effects of AAPs, that were prescribed for the treatment of various psychiatric diagnoses.

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