Atypical Antipsychotics in the Treatment of Substance-related Psychotic Disorders

Year 2020, , 49 - 58, 13.03.2020

Melis Karaoğlan Göksu Kaşarcı Elif Şahin , Elif Sinem İplik

https://doi.org/10.26650/experimed.2020.0005

Abstract

In recent years, substance-related disorders have become an important public health problem due to the effects of substance use on the nervous system later in life periods. Substance-related disorders are basically divided into two categories; substance use disorders and substance-induced disorders. Substance-related disorders consist of substance intoxication, substance withdrawal and other substance-induced disorders such as substance-induced psychotic disorders. The possibility of conversion of substance use disorders to chronic psychotic disorders such as schizophrenia, bipolar disease reveals the importance of its diagnosis and treatment. In related cases, it is important to make distinction between the primer psychotic disorder and substance related disorder for correct diagnosis and effective treatment. Current treatment options for psychotic disorders caused by the substance include the use of typical (classic) and atypical antipsychotics. Nowadays, atypical antipsychotics are the primary drug of choice in the treatment of substance-induced psychotic disorders, not only because of their positive impacts on psychotic symptoms but also because of their reducing effect on substance craving and seeking and fewer extrapyramidal side effects compared to typical antipsychotics. This review aims to explain the pathogenesis of substance-related psychotic disorders and to discuss the atypical antipsychotics used in the treatment within the framework of current literature.

Keywords

Atypical antipsychotics, substance-related disorder, psychotic disorder

Madde İlişkili Psikotik Bozuklukların Tedavisinde Kullanılan Atipik Antipsikotikler

Abstract

Son yıllarda madde ile ilişkili bozukluklar, madde bağımlılığının gittikçe yaygınlaşması ve madde kullanımının daha ileri dönemlerde kişinin sinir sistemi üzerinde yarattığı etkileri dolayısıyla önemli bir halk sağlığı sorunu haline gelmiştir. Maddenin yol açtığı bozukluklar temel olarak 2 gruba ayrılmaktadır; madde kullanım bozuklukları ve maddenin yol açtığı bozukluklar. Maddenin yol açtığı bozukluklar; maddenin intoksikasyonu, madde yoksunluğu ve maddenin yol açtığı psikotik bozukluklar gibi diğer madde ilişkili bozukluklardır. Madde ilişkili psikotik bozuklukların ileriki dönemlerde şizofreni veya bipolar bozukluk gibi kronik psikotik bozukluklara dönüşme olasılığı, bozukluğun tanı ve tedavisinin oldukça önemli olduğunu gözler önüne sermektedir. İlgili vakalarda birincil psikotik bozukluk ve maddenin yol açtığı psikotik bozukluk ayrımlarının yapılması, doğru tanı ve etkin tedavi uygulamaları açısından önem arz etmektedir. Maddenin yol açtığı psikotik bozuklukların güncel tedavi seçenekleri arasında tipik (klasik) ve atipik antipsikotiklerin kullanımı yer almaktadır. Günümüzde, psikotik belirtiler üzerindeki olumlu etkilerinin yanı sıra; madde kullanma arzusu ve madde arayışını azaltmaları ve klasik antipsikotiklere oranla daha az ekstrapiramidal sistem yan etkilerine sahip olmaları sebebiyle atipik antipsikotikler ilk tercih edilen ilaç grubudur. Bu derleme kapsamında madde ilişkili gelişen psikotik bozuklukların patogenezi ve farmakoterapide kullanılan atipik antipsikotiklerin güncel bilgiler ışığında tartışılması amaçlanmıştır..

Keywords

Atipik antipsikotikler, madde ilişkili bozukluklar, psikotik bozukluk

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