L B. KIRAÇ, F. BADEMKIRAN, N. KARAPINAR, Z. ÇOLAKOĞLU

Parkinson hastalarında antipsikotik kullanımı

Amaç: Parkinson hastalarında psikotik bir tablonun gelişmesi, mortaliteyi ve bakıcıların bakım yükünü arttıran, hastaneye veya bakım evlerine yatışa neden olan ciddi bir klinik tablodur. Bu nedenle Parkinson Hastalığında psikozun tedavisi önemlidir. Bu çalışmada psikoz gelişmiş Parkinson hastalarında, olanzapin ve ketiyapin kullanımını retrospektif olarak değerlendirilerek, olanzapin ve ketiyapinin etkinliğini karşılaştırmayı amaçladık. Gereç ve Yöntem: Bu çalışmada Parkinson polikliniğimize başvuran Parkinson hastalarının dosyaları tarandı. Psikotik tablo gelişmiş olan olgulardan ketiyapin ve olanzapin kullanan 32 olgu belirlendi. Olanzapin ve ketiyapin kullanan hastalar tedaviye yanıt verme, motor semptomlarda kötüleşme ve yan etkiye bağlı ilaç bırakma açısından karşılaştırıldı. Bulgular: Antipsikotik kullanan 32 hastanın 20 tanesi olanzapin, 12 tanesi ise ketiyapin kullanmaktaydı. Olanzapin kullanan hastalardan yedisinde iyileşme, yedisinde motor bulgularda kötüleşme, üçünde etkisizlik görülürken, diğer üç olguda ise yan etkiler nedeniyle ilaç kesilmiştir. Ketiyapin kullanan hastalarda ise, 10 olguda düzelme saptandı. Bir olgu etkisizlik nedeniyle, bir olgu ise yan etki nedeniyle ketiyapin kullanımını bırakmıştır. Sonuç: Bu çalışmada Parkinson hastalarında gelişen psikoz tablosunun tedavisinde ketiyapin, Parkinson Hastalığının motor bulgularında kötüleşme sağlamaması ve daha az yan etki gelişmesi açısından olanzapine üstün bulunmuştur.

Antipsychotic medication in patients with Parkinson’s disease

Aim: Psychotic symptoms associated with Parkinson’s disease (PD) can lead to a serious condition that can increase mortality and hospitalization rates and can have a major impact on caregivers’ quality of life. In this study, we evaluated the efficacy and safety of olanzapine and quetiapine treatments in patients with PD who suffer from psychosis. Materials and Methods: We retrospectively inspected the files of patients who were diagnosed with PD. Among the patients who developed psychosis, 32 of them who used or were using quetiapin and olanzapin were enrolled in the study. The treatment response, deterioration of motor symptoms and interruption of treatment due to adverse effects were all evaluated. Results: In the group of the 32 patients, 20 had received olanzapin and 12 received quetiapine. Seven patients who received olanzapin presented an improvement of their condition, seven patients had motor worsening. Three subjects interrupted the use of olanzapine since it failed to induce the desired effect and three subjects interrupted due to adverse effects. Among the patients who received quetiapine, 10 presented an improvement. In one patient quetiapine was discontinued due to ineffectiveness and in another patient due to adverse effects. Conclusion: In our study treatment with quetiapine was found to be superior to olanzapine since it causes less worsening of motor functions and fewer side effects.

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