Atomoksetin Tedavisine Bağlı Ayrılma Anksiyetesi: Bir Olgu Sunumu

Atomoxetine, DEHB, (Dikkat Eksikliği Hiperaktivite Bozukluğu) tedavisinde, özellikle eş tanı olarak anksiyete bozukluğu ve Tourette bozukluğunun olduğu durumlarda uyarıcı olmayan, güvenilir bir alternatif tedavi olarak bilinen seçici norepinefrin geri alım inhibitörüdur. Çoğunlukla bilinen yan etkileri kilo kaybı, iştahta azalma, bulantı, uykuya eğilim ve tiklerde alevlenmedir. Bu yazıda Atomoksetin tedavisi sırasında ayrılma anksiyetesi geliştiren DEHB-dikkat eksikliği tanılı bir ergen olgu sunulacaktır. Güncel bilgiler ışığında Atomoksetine yan etkileri ile ilişkili muhtemel nörotransmitter sistemleri tartışılacaktır. Sonuç olarak Atomokseetin tedavisi premorbid psikopatoloji olmamasına rağmen anksiyeteyi ve obsesyonel düşünceleri tetikleyebilir. Ancak bu reaksiyonun cinsiyet, ergenlik ve genetik etkenlerle ilişkilendirilip ilişkilendirilemeyeceği kesin değildir

Anahtar Kelimeler:

Atomoksetin, DEHB, Ayrılma Kaygısı

Atomoxetine Induced Seperation Anxiety: A Case Report

Atomoxetine, a selective norepinephrine (NE) inhibitor, is introduced as a safe non-stimulant alternative treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD), especially co-morbid ADHD and anxiety disorder and/or Tourette syndrome. Generally known side effects were including weight loss, decrease appetite, nausea and somnolence, exacerbation of tics. In this paper, we want to present an adolescent case with ADHD-inattention type who developed separation anxiety during Atomoxetine treatment. It will be discussed in light of current knowledge about possible neurotransmitter systems associated with side effects of Atomoxetine. Consequently, atomoxetine treatment may trigger anxiety or obsessional thoughts although without any premorbid psychopathology. However, it is unclear whether effects of genetic, gender or adolescence period are associated with this.

Keywords:

Atomoxetine, ADHD, Separation Anxiety,

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Yazışma Adresi / Address for Correspondence: Dr. Gonca Gül Çelik Cukurova University School of Medicine Department of Child and Adolescent Psychiatry 01330 Balcalı-ADANA e-mail: goncagulcelik@gmail.com geliş tarihi/received :11.12.2012 kabul tarihi/accepted:28.12.2012