Şizofreni ve bipolar bozukluk hastalarında depo antipsikotik kullanımının etkinliği ve güvenirliği

Amaç: Bu çalışmada remisyondaki şizofreni ve bipolar bozukluk hastalarında depo antipsikotik kullanmanın etkinliği ve güvenirliğinin sosyodemografik özellikler, ilaç yan etkileri, hastalık şiddeti, yaşam kalitesi ve diğer klinik değişkenler açısından incelenmesi amaçlanmıştır.Gereç ve Yöntem: Psikiyatri polikliniğinde izlenen DSM-IV TR ölçütlerine göre şizofreni ve bipolar tip I bozukluk tanısı konan ve çalışmaya katılım ölçütlerini karşılayan, remisyon dönemindeki 100 bipolar bozukluk, 100 şizofreni hastası ardışık olarak çalışmaya alınmıştır. Şizofreni ve bipolar grubu depo antipsikotik kullanan ve kullanmayan olarak ikişer gruba ayrılmıştır. Katılımcılar Sosyodemografik Bilgi Formu, MINI Uluslarararası Psikiyatrik Görüşme, UKU Yan Etki Ölçeği, Kısa Psikiyatrik Değerlendirme Ölçeği (KPDÖ), Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği Kısa Formu Türkçe Versiyonu (WHOQOL-BREF) ile değerlendirildi.Bulgular: Depo nöroleptik kullanan ve kullanmayan tüm hastalar ek psikiyatrik tanı, ailede ruhsal hastalık, ailede intihar öyküsü açısından farklılaşmamaktadır. Hastalar intihar girişimi ve EKT öyküsü açısından depo antipsikotik kullananlar ve kullanmayanlar olarak karşılaştırıldığında anlamlı fark saptanmıştır.Sonuç: Kronik hastalarda depo ilaç kullanımının etkinliği incelendiğinde, intihar girişimi ve EKT kullanımında azalma olacak şekilde görüldüğü ve depo antipsikotik kullanımının yan etkilerinin de oral kullanımı ile benzer olduğunu göstermektedir.

Efficacy and tolerability of depot antipsychotic use in patients with schizophrenia and bipolar disorder

Purpose: The purpose of this study is to examine the efficacy and tolerability of depot antipsychotic use in patients with schizophrenia and bipolar disorder in remission and to compare these patient groups in terms of sociodemographic characteristics, drug side effects, disease severity and other clinical variables Materials and Methods: One hundred patients diagnosed with schizophrenia, 100 patients diagnosed with bipolar disorder who are improved taken into the study. Schizophrenia and bipolar group were divided into two groups according to depot antipsychotic use and non-use. Schizophrenia patients' group and the bipolar disorder group were both administered the following battery of tests: Mini International Neuropsychiatric Interview, UKU Side Effect Rating Scale (The Udvalg for Kliniske Undersøgelser Side Effect Rating Scale), Brief Psychiatric Rating Scale (BPRS) World Health Organization Questionnaire on Quality of Life: Short Form (WHOQOL-BREF). Results: All patients using and not using long acting neuroleptics do not differ in terms of additional psychiatric diagnosis, family history of mental illness, family history of suicide. There was a significant difference between the patients using and not using the depot antipsychotic in terms of ECT story and suicide attempt. Conclusion: Examination of the efficacy of depot drug use in chronic patients shows that reduction of suicide attempt and in use of ECT are similar, and side effects of depot antipsychotic use are similar to oral use.

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  • 1. Sacchetti E, Grunze H, Leucht S, Vita A. Long-acting injection antipsychotic medications in the management of schizophrenia. Evidence-based Psychiatric Care. 2015;1:27-36.
  • 2. Miyamoto S, Wolfgang Fleischhacker W. The use of long-acting injectable antipsychotics in schizophrenia. Curr Treat Options Psychiatry. 2017;4:117-26.
  • 3. Llorca PM, Abbar M, Courtet P, Guillaume S, Lancrenon S, Samalin L. Guidelines for the use and management of long-acting injectable antipsychotics in serious mental illness. BMC Psychiatry. 2013;13:340.
  • 4. Sheehan DV, Lecrubier Y, Sheehan KH. The Mini-International Neuropsychiatric Interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59:22-33.
  • 5. Lingjærde O, Ahlfors UG, Bech P, Dencker SJ, Elgen K. The UKU side effect rating scale. A new comprehensive rating scale for psychotropic drugs and a cross-sectional study of side effects in neuroleptic-treated patients. Acta Psychatr Scand. 1987;76(334).
  • 6. Eser E, Fidaner H, Fidaner C, Yalçın ES, Elbi H, Göker E. WHOQOL-100 ve WHOQOL-BREF’in psikometrik özellikleri. Psikiyatri Psikoloji Psikofarmakoloji Dergisi. 1999;7:23-40.
  • 7. Peuskens J, Olivares JM, Pecanak J, Tuma I, Bij de Weg H, Eriksson L et al. Treatment retention with risperidone long-acting injection: 24-month results from the Electronic Schizophrenia Treatment Adherence Registry (eSTAR) in six countries. Curr Med Res Opin. 2010;26:501–9.
  • 8. Olivares JM, Pinal B, Cinos C. Comparisons of long-acting antipsychotics injection and oral antipsychotics in schizophrenia. Neuropsychiatry. 2011;1:275-89.
  • 9. Rosenheck RA, Krystal JH, Lew R, Barnett PG, Fiore L, Valley D et al. Long-acting risperidone and oral antipsychotics in unstable schizophrenia. New Engl J Med. 2011;364:842-51.
  • 10. Kishimoto T, Robenzadeh A, Leucht C, Leucht S, Watanabe K, Mimura M et al. Long-acting injectable vs oral antipsychotics for relapse prevention in schizophrenia: a meta-analysis of randomized trials. Schizophr Bull. 2013;2.
  • 11. Osborne RH, Dalton A, Hertel J, Schrover R, Smith DK. Health related quality of life advantage of long-acting injectable antipsychotic treatment for schizophrenia: a time-trade-off study. Health Qual Life Outcomes. 2012;10:35.
  • 12. Heres S, Lambert M, Vauth R. Treatment of early episode in patients with schizophrenia: the role of long acting antipsychotics. Eur Psychiatry. 2014;29:1409-13.
  • 13. Adams CE, Fenton MK, Quraishi S, David AS. Systematic meta-review of depot antipsychotic drugs for people with schizophrenia. Br J Psychiatry. 2001;179:290-99.
  • 14. Biagi E, Capuzzi E, Colmegna F, Mascarini A, Brambilla G, Ornaghi A et al. Long-acting injectable antipsychotics in schizophrenia: literature review and practical perspective, with a focus on aripiprazole once-monthly. Adv Ther. 2017;34:1036-48.
  • 15. Alpak G, Demir B, Aksoy I, Kaya H, Unal A, Bulbul F et al. Both typical and atypical long-acting injectable antipsychotics in bipolar disorder: a retrospective chart review. Journal of Mood Disorders. 2014;4:20.
  • 16. Prajapati AR, Wilson J, Maidment I. Efficacy and safety of secondgeneration antipsychotic long-acting injections (SGA LAIs) in maintenance treatment of bipolar disorder: protocol for a systematic review and meta-analysis. BMJ Open. 2016;6:e010237.