Taha Can TUMAN, Nefise KAYKA, Cafer ALHAN, Tarık EROĞLU, Osman YILDIRIM

Psikotik belirtilerin eşlik ettiği Huntington hastalığında olanzapin kullanımı

Huntington hastalığı otozomal dominant geçişli, nörodejeneratif bir hastalıktır. Hastalık 30-50 yaşlar arasında başlayan motor belirtiler olmak üzere, psikiyatrik belirtiler ve ilerleyici demans ile karakterizedir. Huntington hastalığında görülen psikiyatrik bozukluklar sıklıkla duygu durum ve anksiyete bozuklukları, davranış ve kişilik değişiklikleridir. Psikoz ise nisbeten nadir görülür. Bu sunumda psikotik belirtilerle seyreden bir Huntington olgusu sunulacaktır. 25 yıldır Huntington hastalığı nedeniyle takip edilen 61 yaşında erkek hasta zehirlendiğini düşünme ve yemek yemeyi reddetme şikayetleri ile başvurdu. Hastaya olanzapin 5 mg/gün tedavisi başlandı. İzlemlerde psikotik belirtileri ortadan kalktı. Huntington hastalığında ortaya çıkan psikotik belirtiler, antipsikotik tedavi ihtiyacı oluşturmaktadır. Tedavide atipik antipsikotikler tercih edilmeli ve bu olguda olduğu gibi olanzapin, psikotik belirtilerin eşlik ettiği Huntington olgularında psikozu ve istemsiz hareketleri kontrol altına almada tedavi seçeneği olarak akılda tutulmalıdır.

The use of olanzapine in Huntington disease accompanied by psychotic symptoms

Huntington's disease is an autosomal dominant neurodegenerative disease. The disease begins between the ages of 30-50, including motor symptoms, psychiatric symptoms and is characterized by progressive dementia. Common psychiatric disorders of Huntington's disease include mood and anxiety disorders, behavior and personality changes. Psychosis is relatively rare. Here, a patient is present, who has Huntington's disease, which is associated with psychotic symptoms. 61-year-old male patient who were followed for Huntington disease for 25 years was admitted for complaints of thinking of poisoning and refuse to eat something. Patient was started on olanzapine at dose of 5 mg/day. In follow up psychotic symptoms disappeared. Emerging psychotic symptoms in Huntington disease is created a need for antipsychotic treatment. Atypical antipsychotic agents should be preferred in the treatment and as in the case olanzapine may be used as a treatment option should be kept in mind to control both involuntary movements and psychotic symptoms in Huntington's disease with psychotic features.

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