Pharmacotherapy of Suicidal Patients

Yıl 2007, Cilt: 15 Sayı: 3, 31 - 38, 01.09.2007

A. Altındağ M. Güneş

https://doi.org/10.1501/Kriz_0000000268

Öz

The mainstay of the pharmacotherapeuticapproach of suicidal patients is the treatment ofunderlying disorder. Rational use of pharmacotherapeutic agents such as antidepressants,lithium, mood-stabilizing anticonvulsant agents,antipsychotics and anxiolitics, which are themain options in the treatment of psychiatric disorders, not only treat the underlying disorderbut also be helpful to rapidly address insomnia,anxiety, and agitation, which are additional riskfactors for suicide. Antisuicidal effects of lithiumin patients with bipolar disorders and clozapinein patients with schizophrenia are well established. After publication of several case reportssuggesting that specific serotonin reuptakeinhibitor (SSRI) antidepressants might be associated with increased risks of aggressive orimpulsive acts, including suicide, a number ofinvestigators retrospectively analyzed clinicaltrial data to determine whether suicidality and/orsuicide rates are increased with SSRI treatment.These studies did not show evidence that suicide or suicidality is increased by treatment withspecific types of antidepressants. Further largescaled prospective, controlled studies arerequired for a more general view on pharmacotherapeutic options in suicidal patients

Anahtar Kelimeler

Suicidality, pharmacotherapy, antidepressants, lithium, antipsychotics

İntihar Eğilimi Olan Hastalarda İlaç Tedavisi

Öz

İntihar eğilimi olan kişide ilaç tedavisiyaklaşımının temel belirleyicisi altta yatan bozukluktur. Psikiyatrik bozuklukların tedavisindebaşlıca ilaç tedavisi seçenekleri olan antidepresanlar, lityum, duygudurum düzenleyici antikonvülzan ilaçlar, antipsikotikler ve anksiyolitiklerindoğru bir şekilde kullanımı bir yandan altta yatanhastalığı tedavi ederken, diğer yandan intihariçin risk faktörleri olan uykusuzluk, anksiyete veajitasyonu azaltabilir. Bipolar bozukluk hastalarında lityum ve şizofreni hastalarında klozapinintiharı önleyici etkinlikleri kanıtlanmış psikoterapötik ilaçlardır. Özgül serotonin gerialımengelleyicileri (SSRI) grubu antidepresan kullanan kişilerde ortaya çıkan saldırgan, tepiseldavranışlar ve intiharları bildiren birkaç olgubildiriminin yayınlanması sonrasında, bazıaraştırmacılar geriye dönük olarak intihar eğilimive/veya intihar hızlarındaki artışın SSRI tedavisiile ilişkili olup olmadığını araştırmıştır.

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