Asena UZDU YAŞAR, Buket CİNEMRE, Ali ERDOĞAN

Majör Depresif Bozukluk ve Obsesif-Kompulsif Bozukluğa Eşlik Eden Nikotin Bağımlılığında Tekrarlayan Transkraniyal Manyetik Stimülasyon (rTMS) Tedavisinin Etkileri

Amaç: Psikiyatrik bozukluklarda nikotin bağımlılığı çok sık eşlik eden bir sağlık sorunudur. Bu çalışmanın amacı, majör depresif bozukluk (MDB) ve obsesif-kompulsif bozukluk (OKB) için tekrarlayan Transkraniyal Manyetik Stimülasyon (rTMS) tedavisi alan hastalarda, rTMS'nin komorbid nikotin bağımlılığı üzerindeki etkilerini analiz etmektir. Yöntem: rTMS tedavisi alan 32 hastadan (23 MDB, 9 OKB) elde edilen verilere dayanan retrospektif bir kohort yaptık. Hamilton Depresyon Derecelendirme Ölçeği (HAM-D), Beck Anksiyete Envanteri (BAS), Yale-Brown Obsesyon Kompulsiyon Ölçeği (Y-BOCS) ve Fagerström Nikotin Bağımlılığı Testi (FTND) puanlarını üç zaman noktasında karşılaştırdık (tedaviden önce “0. hafta", tedavinin sonunda "6. hafta" ve bu değerlendirmeden 12 hafta sonra "18. hafta"). Bulgular: Hastaların yaş ortalaması 40,47±10,20, 13'ü (%40,6) kadındı. HAM-D, BAS, FTND'de 6. haftalarda (tümü için p<0,001) ve 18. haftada (tümü için p<0,001) başlangıç puanlarına göre anlamlı bir azalma bulundu. İkili bir lojistik regresyon, depresyon ve anksiyete semptomlarındaki değişikliklerin 6. ve 18. haftalarda FTND puanlarındaki değişikliklerle ilişkili olmadığını gösterdi (sırasıyla p=0.158, p=0.251). Sonuç: Bu çalışmada rTMS tedavisinin psikiyatrik hastalığın iyileşmesinden bağımsız olarak MDB ve OKB'ye eşlik eden nikotin bağımlılığının şiddetini azalttığı söylenebilir. Bu çalışma, rTMS'nin psikiyatrik bozukluklarla birlikte görülen nikotin bağımlılığı için etkili bir tedavi olabileceğini düşündürmektedir. Plasebo kontrollü randomize çift kör çalışmaları öneriyoruz.

Anahtar Kelimeler:

Nöromodülasyon, nikotin bağımlılığı, psikiyatrik bozukluklar, transkraniyal manyetik stimülasyon, rTMS

Effects of Repetitive Transcranial Magnetic Stimulation (rTMS) Treatment in Comorbid Nicotine Addiction with Major Depressive Disorder and Obsessive-Compulsive Disorder

Objective: Nicotine addiction is a common health problem in psychiatric disorders. The aim of this study was to analyze the effects of rTMS on comorbid nicotine addiction in patients receiving recurrent Transcranial Magnetic Stimulation (rTMS) therapy for major depressive disorder (MDD) and obsessive-compulsive disorder (OCD). Method: Data of 32 patients (23 MDD, 9 OCD) were evaluated retrospectively. We compared the Hamilton Depression Rating Scale (HAM-D), Beck Anxiety Inventory (BAS), Yale-Brown Obsession Compulsion Scale (Y-BOCS), and Fagerström Test for Nicotine Dependence (FTND) scores at three time points (before treatment "0th week", at the end of treatment “6th week”, and 12 weeks after this assessment “18th week”). Results: The patients’ mean age was 40.47±10.20, 13(40.6%) were women. A significant reduction was found in HAM-D, BAS, FTND at weeks 6 (p<0.001 for all) and 18 (p<0.001 for all) compared to baseline scores. A binary logistic regression showed that changes in depression and anxiety symptoms were not associated with the changes in FTND ratings at weeks 6 and 18 (p=0.158, p=0.251, respectively). Conclusion: In this study, it can be said that rTMS treatment reduces the severity of nicotine addiction accompanying MDD and OCD, independent of the recovery of the psychiatric disease. This study suggests that rTMS can be an effective treatment for nicotine addiction comorbid with psychiatric disorders. We recommend placebo-controlled randomized double-blind studies.

Keywords:

Neuromodulation, nicotine addiction, psychiatric disorders, transcranial magnetic stimulation, rTMS,

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