Dilek ÜNAL, Kevser NALBANT, Ekin GÜNAL, Mine AYBI

Okul Öncesi Dönemde Psikiyatrik İlaç Tedavisi Başlanan Hastaların İlaç Tedavisinden Fayda Görmeleri ve Yan Etkiler Açısından Retrospektif Taranması

Amaç: Okul öncesi yaş grubundaki çocuklarda psikiyatrik bozukluklar için giderek artan düzeyde ilaç tedavisi uygulanmasına rağmen, bu yaş grubundaki çocuklarda psikiyatrik ilaç yararlanımına, ilaç yan etkilerine ilişkin yeterli sayıda araştırma yoktur. Çalışmamızda bu yaş grubunda kliniğimizde değerlendirilen hastaların kayıtlarının, en sık kullanılan metilfenidat ve risperidon ilaç tedavilerinin yararlanımları, dozları, yan etkileri ve tedaviye yanıt üzerinde etkisi olabileceği düşünülen eşlik eden özellikler açısından araştırılması hedeflenmiştir. Gereç ve Yöntemler: Bu amaçla, kliniğimizde 0-6 yaş aralığındaki ilaç tedavisi başlanan hastaların retrospektif muayane kayıtları incelenmiştir. 45 risperidon ve 50 metilfenidat kullanan hastanın ilaç yararlanımı, Klinik Global İzlenim (KGİ) ve Global Değerlendirme Ölçeği (GDÖ) ölçekleri skorlanarak belirlenmiştir. Risperidon ve metilfenidat kullanan hastalar araştırılan parametreler açısından kendi grupları içinde ve her iki grup biribiriyle karşılaştırılmıştır. Bulgular: Risperidon ve metilfenidat kullanan hastaların ilaç tedavisi öncesi ve sonrası değerlendirmeleri arasında semptom şiddeti (KGİ-Ş skorlarındaki azalma) ve işlevsellik düzeyi (GDÖ skorlarındaki artış) açısından anlamlı düzelme bulunmuştur. Her iki grupta tedaviye yanıt üzerinde etkisi olabileceği düşünülen eşlik eden yaş, cinsiyet, okul öncesi eğitim alma, prenatal-natal-postnatal sorun, tıbbi hastalık gibi etkenlerin ilaçtan yararlanım ve yan etki açısından anlamlı bir ilişki bulunmamıştır. Sonuç: Okul öncesi yaş grubunda davranış sorunları, hiperaktivite, irritabilite tedavisi için önerilen ilaç tedavilerinden metilfenidat ve risperidon faydalı ve güvenilir bulunmuştur. Bu yaş grubunda psikofarmakolojik tedaviler ile ilgili daha net sonuçlara ulaşabilmek için, geniş örneklemli ve uzun süre izlem içeren, prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

metilfenidat, okul öncesi, risperidon

Retrospective Analysis of Risperidone and Methylphenidate Use in Preschool Age According to the Drug Benefit and Side Effects

Objective: Although there is increasing number of psychopharmacological treatments in preschoolers, there is still limited information in literature about the efficacy and safety of the drugs. In this study, we aimed to investigate the efficacy, doses, side effects and the variables that predict the clinical benefit of the most used drugs(methylphenidate and risperidone) in our clinic from preschoolers. Material and Methods: The patient records in our clinic, whose medication was started between 0-6 years old were scanned retrospectively. Fifty children using methylphenidate and 45 children using risperidone were evaluated with scored Clinical Global Impression Scale (CGI) and Global Assessment of Functioning Scale (GAS). Patients using methylphenidate and risperidone were compared in their own group and with each other concerning the parameters investigated. Results: There was a statistifically significant difference between before and after drug assessments of the patients according to symptom severity(CGI-S scores) and clinical functionality (GAS scores). The age, gender, presence of preschool education, prenatal—natal-postnatal problem or medical disease history had no significant relationship with the efficacy or side effects of the drugs. None of the medication investigated were found superior to other concerning the efficacy and side effect profiles. Conclusion: Methylphenidate and risperidone were found effective and safe among the drugs recommended for the pharmacological treatment of behaviour problems, hyperactivity and irritability in the preschool age. Further prospective studies in larger clinical samples with longer follow-up periods are needed to draw certain conclusions about the psychopharmacological treatments in preschoolers.

Keywords:

preschool, methylphenidate, risperidone,

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