Migren tedavisinde antidepresan ilaçların rolü

Migren, çocukluk, ergenlik veya erken erişkin dönemde başlayan, sıklıkla bulantı, ışık ve ses duyarlılığı gibi semptomların eşlik ettiği, periyodik aralıklarla gelen zonklayıcı karakterde bir baş ağrısı türüdür. Migrenli hastalarda en çok görülen psikiyatrik bozukluklarda ilk sırada depresyon yer almaktadır. Migren ve depresyon birçok kişiyi etkiler ve yaklaşık %10-15 dolayında benzer prevalansa sahiptir. Migren tedavisi eğer eksik yapılırsa durumun kontrol edilemez olmasının getirdiği çaresizliğin sonucunda hastalarda depresyon ortaya çıkabilmektedir. Migrenin akut ataklarının profilaksi ve tedavisi iki aşamada gerçekleştirilmektedir. Akut atakta; analjezikler ve non-steroid antiinflamatuar ilaçlar, ergot alkoloidleri ve triptanlar kullanılırken, profilaktik tedavide; beta blokörler, antiepileptikler, antidepresanlar, kalsiyum kanal blokörleri gibi ilaçlar kullanılmaktadır. Bu ilaçlarla hastalarda atakların sayısının ve şiddetinin azaltılmasında tam bir başarı elde edilememektedir. Bu sebeple son zamanlarda antidepresan ilaç gruplarının tedavideki yeri araştırılmaktadır. Özellikle depresyon, stres, anksiyete ve uyku bozukluğu ile birlikte sık migren atağı geçirenlerin, profilaktik farmakolojik tedavisinde başta trisiklik antidepresanlar (TSA) olmak üzere, selektif serotonin geri alım inhibitörleri (SSRI) ve selektif serotonin-noradrenalin geri alım inhibitörleri (SNRI) tercih edilmektedir. Bu çalışmamızda migren tedavisinde kullanılan antidepresanların migrenin şiddeti ve süresindeki etkilerini incelemek amaçlanmıştır.

Role of antidepressant drugs in migraine treatment

Migraine is a type of headache with a throbbing character that begins at childhood, adolescence or early adulthood, often accompanied by symptoms such as nausea, light and sound sensitivity. Depression is the most common psychiatric disorder among migraine patients. Migraine and depression affect many people and have a similar prevalence of about 10 and 15%. If migraine treatment is incomplete, depression may occur as a result of the helplessness. Treatment in migraine is carried out in two stages; acute attack and prophylactic treatment. While analgesics, non-steroidal antiinflammatory drugs, ergot alkaloids and triptans are used in acute attack, drugs such as beta blockers, antiepileptics, antidepressants are used in prophylactic treatment. The success of these drugs in reducing the number and severity of attacks in patients can not be achieved with full success. Therefore, the effects of different antidepressant drug groups are investigated. Selective serotonin reuptake inhibitors (SSRIs), selective serotonin-noradrenaline reuptake inhibitors(SNRIs) and especially tricyclic antidepressants (TCA) are preferred especially with depression, stress, anxiety and sleep disturbance in the prophylactic pharmacological treatment of patients with frequent migraine attacks. In this study we aimed to investigate the effects of antidepressants used in migraine treatment on the severity and duration of migraine.

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Kaynak Göster

MLA Berktaş, F , Ekemen, E , Kıroğlu, O , Aksu, F . "Migren tedavisinde antidepresan ilaçların rolü" . Cukurova Medical Journal 44 (2019 ): 555-566 <https://dergipark.org.tr/tr/pub/cumj/issue/36346/570837>