Hanım Hülya ALINAY, Ali KARAYAĞMURLU, Murat COŞKUN

SEÇİCİ SEROTONİN GERİ ALIM İNHİBİTÖRLERİYLE TEDAVİ EDİLEN ÇOCUK VE ERGENLERDE YAN ETKİLERİN SIKLIĞI VE İLİŞKİLİ FAKTÖRLER: BİR DOSYA TARAMA ÇALIŞMASI

Amaç: Bu çalışma, seçici serotonin geri alım inhibitörü (SSRI) monoterapisi alan genç hastalar arasında ilaç yan etki sıklığını ve bu yan etkilerle ilişkili klinik ve sosyodemografik faktörleri incelemeyi amaçlamaktadır. Gereç ve Yöntem: Bir üniversite hastanesinin çocuk ve ergen psikiyatrisi kliniklerinde SSRI monoterapisi alan 85 hastanın tıbbi kayıtları incelendi. Dahil edilme kriterlerini karşılayan hastalar çalışmaya dahil edildi. Bulgular: Toplam 67 hasta (10,82±3,63 yıl) dahil edildi. Hastaların yarısından fazlası (n=39, %58,9) muhtemelen SSRI tedavisi ile ilişkili en az bir yan etki geliştirdi. En sık bildirilen yan etkiler; psişik (n=25, %37,3) ve otonomik yan etkilerin (n=20, %29,9) yanısıra davranışsal aktivasyondu (n=13, %19,4). Yan etkiler nedeniyle 13 hastada (%19,4) ilaç tedavisi sonlandırıldı ve en sık ilaç kesme nedeni davranışsal aktivasyondu (13 hastanın 6’sı). Davranış aktivasyonunun ortaya çıkması; daha küçük yaş, hastada obsesif kompulsif bozukluk tanısı varlığı ve babada psikiyatrik hastalık varlığı ile anlamlı olarak ilişkiliydi (p değeri<0,05). Sonuç: SSRI’lar genç hastalarda genellikle güvenli ve iyi tolere edilmesine rağmen, yan etkiler sık olabilir ve bazı durumlarda ilacın kesilmesi gerekebilir. Bu nedenle, genç hastaları tedavi eden klinisyenler, özellikle davranışsal aktivasyonun gelişimi konusunda dikkatli olmalıdır. Ayrıca SSRI tedavisi sırasında ortaya çıkabilecek yan etkilerle ilişkili klinik ve sosyodemografik faktörleri de dikkate almalıdırlar.

Anahtar Kelimeler:

ergen, yan etki, çocuk, seçici seratonin geri alım inhibitörü, davranışsal aktivasyon

PREVALENCE AND ASSOCIATED FACTORS OF ADVERSE EFFECTS IN CHILDREN AND ADOLESCENTS TREATED WITH SELECTIVE SEROTONIN REUPTAKE INHIBITORS: A CHART REVIEW STUDY

Objective: This study aims to examine the prevalence and associated clinical and sociodemographic factors of adverse effects in medication among naïve young subjects who received selective serotonin reuptake inhibitor (SSRI) monotherapy. Material and Methods: The medical records of 85 patients who had received SSRI monotherapy in a university hospital’s child and adolescent psychiatry clinic were reviewed. The subjects who met the inclusion criteria were included in the study. Results: A total of 67 subjects (10.82±3.63 years) were included. More than half (n=39, 58.9%) developed at least one adverse effect possibly associated with SSRI treatment, with psychic (n=25, 37.3%) and autonomic (n=20, 29.9%) adverse effects as well as behavioral activation (n=13, 19.4%) being the most frequently reported. Medication was discontinued in 13 subjects (19.4%) due to adverse effects, with behavioral activation (6 out of 13 subjects) being the most frequent reason for discontinuation. The development of behavioral activation was significantly associated with younger age, diagnosis of obsessive compulsive disorder in the subjects, and psychiatric history in the subjects’ fathers (p value<0.05). Conclusions: Despite the fact that SSRIs are generally safe and well-tolerated in young subjects, adverse effects may be frequent, and medication discontinuation may be required under some conditions. Thus, clinicians treating young subjects should be cautious, particularly about the development of behavioral activation. They should also be mindful of the clinical and sociodemographic factors associated with the adverse effects that may arise during SSRI treatment.

Keywords:

adolescents adverse effects, children, side effects, selective serotonin reuptake inhibitors, behavioral activation,

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