Tardive Dyskinesia in Mentally Retarded Patients under Long-Term Antipsychotic Treatment

Uzun süre antipsikotik tedavisi alan mental retardasyonlu hastalarda tardif diskinezi. Amaç: Tardif diskinezi (TD) uzun süreli dopamin reseptör blokajı oluşturan ilaçlara bağlı olarak gelişen, vücudun çeşitli bölgelerini tutabilen iatrojenik bir hareket bozukluğudur. Yapılan çalışmalarda prevalansının %5 ila %30 aralığında değiştiği görülmektedir. Bu araştırma, ruh sağlığı hastanesinde uzun süredir yatan ve düzenli olarak ilaç almakta olan mental retardasyonlu hastalarda tardiv diskineziyi araştırmayı amaçlamaktadır.Yöntem: Bu çalışmaya Bakırköy Ruh ve Sinir Hastalıkları Hastanesi kronik servislerinde uzun süredir yatmakta olan ve DSM-IV TR'ye göre mental retardasyon ve eşlik eden şizofreni veya diğer psikotik bozukluk tanısı alan 40 hasta dâhil edildi. Hastaların halen kullandıkları antipsikotik türü (birinci kuşak ve ikinci kuşak) ve süresi ile geçmişte en uzun süre kullandıkları antipsikotik türü ve süresi incelenmiştir. Tardiv diskineziyi saptamak amacıyla Anormal İstemsiz Hareketler Ölçeği (AİHÖ) kullanılmıştır. Ek olarak Barnes Akatizi Ölçeği (BADÖ) ve Simpson-Angus Nöroleptiklere Bağlı İstemsiz Hareket Bozukluklarını Değerlendirme Ölçeği ile akatizi ve parkinsonizm varlığına bakılmıştır.Bulgular: AİHÖ puanlarına göre değerlendirildiğinde katılımcıların 9'una (%22.5) TD tanısı kondu. TD tanısı konanlarda geçmişte ya da halen kullanılan antipsikotik türü ve süresi ile TD arasında bir ilişki saptanmadı. Katılımcıların yaşlarıyla TD arasında istatistiksel olarak anlamlı ilişki bulundu (p=0.009). Kadınlarla erkekler arasında TD açısından fark saptanmadı. Sonuç: Araştırmamızda uzun süreli antipsikotik kullanımının TD ile ilişkisiz olduğu, yaşın ise TD riski açısından önemli bir etken olduğu saptanmıştır. Birinci kuşak antipsikotik tedaviden ikinci kuşağa geçmesinin ise TD sıklığını azaltmadığı söylenebilir.

Uzun süre antipsikotik tedavisi alan mental retardasyonlu hastalarda tardif diskinezi

Tardive dyskinesia in mentally retarded patients under long-term antipsychotic treatment. Objective: Tardive dyskinesia (TD) is an iatrogenic movement disorder, developing due to prolonged use of dopamine receptor blocking agents, that may affect various parts of the body. In a number of studies, prevalence rates between 5 and 30% have been reported. This study aims to research TD in patients with mental retardation who have been hospitalized for a long time and medicated regularly.Method: Included in this study were 40 patients with a diagnosis of mental retardation comorbid with schzophrenia or other psychotic disorders according to DSM-IV TR that had been hospitalized in the chronic patients' ward of Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery for a long period. Duration and type of antipsychotics both at the time of interview and over the preceding years were recorded. Dyskinesia was assessed using the Abnormal Involuntary Movements Scale (AIMS). We also used the Simpson-Angus Rating Scale (SAS) for Parkinsonism. Akathisia was measured using the Barnes Akathisia Rating Scale (BARS).Results: According to AIMS scores, 9 participants (22.5%) received a diagnosis of TD. There was no significant correlation between the type and duration of ongoing or the longest used treatment and the prevalence of TD. There was a statistically significant correlation between the participants' age and TD (p=0.009). There were no gender differences for TD Conclusion: We found that long-term use of antipsychotics is unrelated with TD, while age is an important risk factor for TD. It can be said that switching from first generation to second generation antipsychotics does not reduce the prevalence of TD.

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Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi-Cover
  • ISSN: 1018-8681
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1984
  • Yayıncı: Kare Yayıncılık
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