Tedaviye dirençli tek uçlu depresyonun tedavisinde yenilikler

Günümüzde en önemli sağlık sorunlarından biri olan depresyonun tedavisinde kaydedilen gelişmelere rağmen, tedaviye direnç ve kronikleşme hala büyük bir sorundur. Depresyonun etyolojisi ve tedavisinde yeni araştırmalar ve yeni tedaviler “genetik ya da çevre rollerinden genetik-çevre etkileşimine, kimyasal dengesizlikten inflamatuvar süreçlere, nörotransmitterlerden nöroplastisiteye ve nörotrofik faktörlere, serotonin, norepinefrin ve dopaminden glutamata, haplardan intravenöz infüzyonlara, monoterapiden güçlendirme stratejilerine, farmakoterapiden nöromodülasyona” yönelmiştir. Tedaviye dirençli tek uçlu depresyon (TDD) tedavisinde “aynı gruptan başka bir ilaca geçme, farklı gruptan bir ilaç seçme, mevcut ilaca başka bir ilaç ekleme, elektrokonvulzif tedavi” gibi bilinen yöntemlerin yanında son zamanlarda “tekrarlayan transmanyetik uyarımı (rTMS), derin beyin uyarımı (DBS), vagal sinir uyarımı (VNS)” gibi farmakolojik olmayan tedaviler de giderek kabul görmeye ve kullanımı yaygınlaşmaya başlamıştır.

Anahtar Kelimeler:

tedaviye dirençli tek uçlu depresyon, tedavi, yenilikler

Innovations in treatment of treatment-resistant unipolar depression

Today, depression is one of the most important health problems. Despite the progress made in the treatment of depression, treatment resistance and chronicity still remains a major problem. New research and the new treatments on the etiology and treatment of depression are directed from “genetic versus environmental roles to genetic-environmental interactions”, from “chemical imbalance to inflammatory processes”, from “neurotransmitters to neuroplasticity and neurotrophic factors”, from “serotonin, norepinephrine and dopamine to glutamate”, from “pills to intravenous infusions”, from “monotherapy to augmentation strategies”, from “pharmacotherapy to neuromodulation”. In the treatment of treatment-resistant unipolar depression (TRUD) “switch to another drug from the same group, choosing a drug from different groups, add another drug to available drug, electroconvulsive therapy” as is known methods beside recently “repetitive transmagnetic stimulation (rTMS), deep brain stimulation (DBS), vagal nerve stimulation (VNS)” such non-pharmacological treatments have been accepted and the use of them has become common.

Keywords:

treatment-resistant unipolar depression, treatment, innovations,

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