Gebelik ve Laktasyon Döneminde Ruhsal Bozukluklar ve Tedavisi

Ruhsal hastalıklar kadınlarda sıklıkla 18-45 yaşları arasındaki reprodüktif dönemde ortaya çıkmaktadır. Dolayısıyla gebelik ve postpartum dönem pek çok kadın için anksiyete bozukluğu, depresyon, yeme bozukluğu ve psikoz gibi ruhsal hastalıklara yatkınlığın arttığı bir dönem olabilmektedir. Bu yazıda gebelik ve laktasyon döneminde ruhsal bozukluklar ve tedavi seçenekleri güncel tedavi kılavuzları ışığında gözden geçirilmiştir. Gebelikte psikofarmakolojik tedavinin yararları ve riskleri dikkate alınmalı, teratojenite ve laktasyon riski göz önünde bulundurulmalıdır.  Gebelik ve laktasyon döneminde en düşük etkin dozda ve mümkünse tek ilaç kullanılmalıdır ve fetüs/bebek yakından izlenmelidir.Anahtar kelimeler: Gebelik ve laktasyon, ruhsal bozukluklar, tedavi, ilaç kullanımı, teratojenit

Use of Modafinil in Psychiatric Disorders

Modafinil, is a psychostimulant drug with neurochemical and behavourial effects, distinct from those of amphetamine. It is used to treat patients with narcolepsy and other excessive sleepiness. Modafinil has dopaminergic, noradrenergic, histaminergic, glutamergic, serotonergic and GABAergic interactions. It is also shown that modafinil has neuroprotective effects via antioxidative mechanisms. Besides modafinil shows initial promise for a variety of off-label indications in psychiatry, including bipolar disorder, attention-deficit/hyperactivity disorder, and schizophrenia . The aim of this article is to review the literature on clinical use of modafinil in psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(1): 42-51

PROLIDASE ACTIVITY AND OXIDATIVE STRESS IN PATIENTS WITH MAJOR DEPRESSIVE DISORDER

Background: The aim of the current study was to determine whether the serum prolidase levels are associated with the etiopathogenesis of depression. Subjects and methods: This study included 29 patients with major depressive disorder (MDD), who were consecutively recruited from the psychiatric outpatient clinic, and 30 healthy individuals recruited from the general community. Each patient underwent a detailed diagnostic evaluation by two psychiatrists using the Structured Clinical Interview for DSM-IV (SCID-I). Serum prolidase activity and oxidative parameters were measured in the patient and control groups. The severity of depressive symptoms was assessed using the Hamilton Depression Rating Scale. Results: Serum prolidase level was significantly higher in patients with MDD compared to healthy subjects (p<0.001). Total Oxidant Status (TOS) levels and Oxidative Stress Index (OSI) were also significantly higher in patients with MDD (p<0.001), whereas no significant difference was observed between the groups in the TAS levels (p=0.297). Serum prolidase level did not show any correlation with markers of oxidative stress in patients with MDD. Conclusion: Increased serum prolidase levels in patients with MDD may be interpreted as the interaction of prolidase activity, glutamate transmission and oxidative stress. It is suggested that prolidase activity is involved in the etiopathogenesis of depressive disorder

Symptomatic Remission Determines Functional Improvement and Quality of Life in Schizophrenia

WOS: 000391572500008PubMed: 28360807Introduction: Schizophrenia is a chronic illness that negatively affects the quality of life and psychosocial functions. Defined criteria to assess remission in schizophrenia are considered to be useful in the longterm follow-up of patients and in discriminating diagnostic factors. This study investigated the quality of life and functionality in schizophrenia patients in symptomatic remission (R-Sch) and not in remission (NonR- Sch). Methods: Sociodemographic data were collected for 40 R-Sch and 40 Non-R-Sch patients, and the following scales were administered: the Clinical Global Impression-Severity (CGI-S) Scale; Positive and Negative Syndrome Scale (PANSS), World Health Organization Quality of Life Questionnaire-Short Form, Turkish Version (WHOQOL-BREF-TR), Quality of Life Scale for Schizophrenia Patients (QLS), and Global Assessment of Functioning Scale (GAF). Results: the total and all subscale scores of PANSS and the CGI-S score were significantly lower in the R-Sch group than in the NonR- Sch group, whereas the GAF scores and all subscales of QLS and WHOQOL-BREF-TR were significantly higher. Conclusion: This study demonstrates that improvement in symptoms in schizophrenia patients improves quality and functionality in all areas of life, suggesting that an improvement in symptoms is the most important determinant of functional recovery in the treatment of schizophrenia