Mustafa ARI, M. Hanifi KOKAÇYA, Ü. Sertan ÇÖPOĞLU, Musa ŞAHPOLAT

Amotivasyonel Sendrom: Az Bilinen ve Tanı Konulan Bir Klinik

Amotivasyonel sendrom (AS) süreğen esrar kullananlardatanımlanmış geniş anlamıyla ilgisizlik, vurdumduymazlıkve asosyal davranışı içermektedir. Bu etkilerin bir kısmıgenel olarak diğer santral sinir sistemi baskılayıcılarındada görülmektedir, bundan dolayı bu sendromu esrarkullanımına özgülemenin ne kadar doğru olduğu halatartışılmaktadır. AS genellikle ergenlik çağında ve erkek- lerde görülmektedir. Farklı çalışmalarda AS görülme sıklığıolarak düzenli esrar kullananlarda %16 ve %21 gibi oranlarbildirilmiştir. Patofizyolojisinde rol oynayan nedenler halatartışmalı olmakla birlikte etiyolojide en sık suçlanan etmenesrardır. Nörobiyolojisinde noradrenerjik ve dopaminerjiksistemleri içeren limbik yolakta meydana gelen değişiklikler suçlanmaktadır. Tanısı öznel yakınmalara dayanır,tanı klinik belirtiler ve Apati Değerlendirme Ölçeği (ADÖ)kullanılarak konmaktadır. AS tedavisi konusunda günümüzde çok az deneysel veriler mevcuttur ve klinik deneyimde oldukça azdır. Aralık 2013te seçilen amotivationalsyndrome, cannabis and amotivational syndrome, cannabis and motivation anahtar sözcükleriyle yapılan PUBMEDtaraması sonucunda 1960dan beri yayınlanan, esrar veAS ilişkisini inceleyen çalışmalar gözden geçirilmiştir. Buyöntem sonunda 76 tanesi direkt AS ile ilişki olmak üzere536 makaleye ulaşılmıştır. İngilizce olmayan makalelerdeğerlendirme dışı bırakılmıştır.

Amotivational syndrome: less known and diagnosed as a clinical

Amotivational syndrome (AS) is a disorder that includesapathy, callousness and antisocial behavior in chroniccannabis users. Some of these effects may generally beseen in other central nervous system depressants as well.Therefore, to make these effects specific for this syndromeis still debated. AS is usually seen among men duringpuberty. In different studies, the incidence of AS in regularcannabis users has been reported as between 16 to 21%.Although the causes accused in pathophysiology is stillcontroversial, cannabis is the most commonly accusedfactor in the etiology. In neurobiology of the disease,noradrenergic and dopaminergic systems containingchanges in limbic road have been blamed. The diagnosisis based on subjective complaints, and scored by clinicalsigns and Apathy Evaluation Scale (AES). There are veryfew experimental data available in treatment of AS, andclinical experience is very limited. By PubMed searchingthe keywords of amotivational syndrome, cannabis andamotivational syndrome, cannabis and motivation from1960 to December 2013, the published studies examiningthe relationship between marijuana and AS have beenreviewed. We have reached 536 articles, of which 76include direct relationship with AS, by the end of thissearch. Non-English articles were excluded from the study.

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