Bipolar bozukluk manik atakta ilaç tedavisi

TÜRKÇAPAR, M. Hakan

Bipolar bozukluk manik atakta ilaç tedavisi

M. Hakan TÜRKÇAPAR (SSK Ankara Eğitim Hastanesi, Psikiyatri Kliniği, Ankara, Türkiye)

3 P/ Psikiyatri Psikoloji Psikofarmakoloji Dergisi

87 0

Yıl: 2003 Cilt: 11 Sayı: supp3 Sayfa Aralığı: 29 - 37 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Bipolar bozukluk manik atakta ilaç tedavisi

Öz:

Bipolar bozukluk manik atağın tedavisinde ilaç tedavileri en önemli tedavi seçeneğidir. Manik atak tedavisinde kullanılan başlıca ilaçlar lityum, antikonvülsan ilaçlar (valproik asit, karbomazepin, lamotrigine), atipik antipsikotikler (olanıapin, risperidon, ketiapin, ziprasidon ve Idozapin) ve klasik antipsikotiklerdir. Tedavide kullanılan ilk etkili ilaç olarak lityum bipolar bozuklukta en yoğun biçimde üzerinde çalışılmış bir ajandır. Günümüzde klasik öforik mani için hala standart terapi olarak konumunu korumakla birlikte disforik veya mikst tip manili hastalarla hızlı döngülü hastalarda çok etkili olmadığı görülmektedir. Klinik piskofarmakoloji alanında valproik asit gibi antikonvulsanlar ve yeni kuşak antipsikotiklerle son zamanlarda yapılan çalışmalar manik atağın tedavisiyle ilgili önemli etkiler yaratmıştır. Bu yazıda manik epizodun tedavisinde kullanılan ilaçlar son çalışmalar ışığında gözden geçirilmiş ve daha sonra da klinik tedavi için bir algoritma önerilmiştir.

Anahtar Kelime: bipolar bozukluk psikoterapi lityum antipsikotikler ilaç tedavisi manik atak

Konular: Mühendislik, Biyotıp Psikiyatri

Öz:

Drug therapies for the treatment of bipolar disorder manic episodes is the most important treatment option. Lithium, anticonvulsant drugs (valproic acid, carbamazepine, lamotrigine), atypical antipsychotics (olanzapine, risperidone, quetiapine, ziprasidone and clozapine) and classical antipsychotics are the major drugs used in treatment. Lithium as an first effective treatment, is the most extensively studied agent in bipolar disorder. Today, lithium remains the standard treatment for a patient presenting with classical euphoric mania, altough it does not seem to be quite as effective as in patients presenting with dvsphoric mania or mixed states or in those patients with rapid cycling. A number of recent studies in clinical psychopharmacology regarding anticonvulsants such as valproic acid and new generation antipsychotic drugs have important implications with respect to the treatment of manic episodes. In this review available drug treatment options for the treatment of manic episodes is presented according to the recent studies. After that a clinical algorithm for treatment is offered.

Anahtar Kelime: drug therapy manic attack bipolar disorder psychotherapy lithium antipsychotics

Konular: Mühendislik, Biyotıp Psikiyatri

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

1.Potter WZ, Rudorfer MV, Goodwin FK Biological findings in bipolar disorders Review of Psychiatry 1987;6:32-61
2.Blackwood DH, Visscher PM, Muir WJ Genetic studies of bipolar affective disorder in large families.Br J Psychiatry Suppl2001;41:sl34-6
3.Rice JP, McGuffin P Genetic etiology of schizophrenia and affective disorders Psychiatry Ed. Michels Vol.1 Clip.62 .IB Lippincott company Philadelphia 1990
4.Kaplan HI, Sadock BJ (1998) Major depressive disorder, bipolar I disorder and bipolar II disorders. Synopsis of Psychiatry, Baltimore, Williams&Wilkins, s.538-580
5.Scott J overcoming mood swings Robinson London 2001
6.Paykel ve Scott Treatment of mood disorder New Oxford Textbook of Psychiatry Eds. Gelder, Lopez-Ibor Jr, Andreasen. Oxford University Press2000 725-7369
7.Teboul E, Choinard G. A guide to benzodiazepine selection. Part II: Clinical Aspects. Can J Psychiatry 1991; 36: 62-73
8.Keck PE Clinical Management of Bipolar Disorder Psychiatry Clinical Management Volume 4 June 20, 2001
9.Baktır G, Baktır E İlaç Rehberi 2001 Rehber Tıbbi Yayınlar İstanbul 2001
10.Sachs GS, Printz DJ, Kahn DA, Carpenter D, Docherty JP the expert consensus Guideline series Medication treatment of bipolar disorder 2000 Expert knowledge Systems LLC 2000
11.Practice guideline for the treatment of patients with bipolar disorder (revision).American Psychiatric Association. Am J Psychiatry. 2002; 159(4 Suppl):l-50.
12.Suppes T, Dennehy EB TIMA Procedural Manual, Bipolar Disorder Algorithms University of Texas , Dallas 2002
13.Özerdem A Manik-Hipomanik Dönem Sağaltımı. İki Uçlu Duygudurum Bozuklukları Sağaltım Kılavuzu TPD-Duygu-durum Bozuklukları Bilimsel Çalışma Birimi Editörler Simavi Vahip-Olcay Yazıcı, İstanbul 2003
14.Zarate CA Jr, Quiroz JA. Combination treatment in bipolar disorder: a review of controlled trials. Bipolar Disord. 2003;5:217-25
15.Alderfer BS, Allen MH. Treatment of agitation in bipolar disorder across the life cycle. J Clin Psychiatry. 2003;64 Suppl 4:3-9.
16.Jefferson JW, Greist JH (2000), Lithium. Kaplan and Sa-dock's. Comprehensive Textbook of Psychiatry. Seventh Edition. BJ Sadock ve VA Sadock (Ed), Philadelphia, Lippincott Williams&Wilkins, s.2377
17.Bowden CL Key treatment studies of lithium in manic depressive ilness: Efficacy and side effects Dosing strategies and time course of response to antimanic drugs J Clin Psychiatry 1998:59[suppl6]:13-19
18.Bowden CL Dosing strategies and time course of response to anlimanic drugs J Clin Psychiatry 1996:57 [suppl 13]:4-9
19.Arana GW, Rosenbaum JF (2000) Handbook of Psychiatric . Drug Therapy. Fourth Edition. Lippincott Williams&Wilkins, Philadelphia
20.Lennox RH, Manji HK Lithium The American Textbook of psychopharmacology, AF Schatzberg, CB Nemeroff (Ed.) London, American Psychiatric Press Inc, 1995:303-349
21.Keck PE Jr, Strakowski SM, Hawkins JM, Dunayevich E, Tuğrul KC, Bennett JA, McElroy SL. A pilot study of rapid lithium administration in the treatment of acute mania. Bipolar Disord 2001 Apr;3(2):68-72
22.Swann AC, Bowden CL, Calabrese JR, Dilsaver SC, Morris DD. Mania: differential effects of previous depressive and manic episodes on response to treatment. Acta Psychiatr Scand. 2000 Jun;101(6):444-51.
23.Swann AC, Bowden CL, Calabrese JR, Dilsaver SC, Morris DD. Differential effect of number of previous episodes of affective disorder on response to lithium or divalproex in acute mania. Am J Psychiatry. 1999 Aug;156(8):1264-6.
24.Palmer CM, Pope Jr HG Antiepileptic drugs New Oxford Textbook, of Psychiatry Eds. Gelder, Lopez-Ibor Jr, Andreasen. Oxford University Press; 2000:1326-1333
25.Quay DRP theemerging role of valproate in bipolar disorder and other psychiatric disorders Pharmacotherapy 1995; 15:631-647
26.Keck PE, Me Elroy SL, Strakowski SM Anticonvulsants and antipsychotics in the treatment of Bipolar disorder J Clin Psychiatry 1998:59 [suppl 6]:74-81
27.Vasudev K, Goswami U, Kohli K.Carbamazepine and valproate monotherapy: feasibility, relative safety and efficacy, and therapeutic drug monitoring in manic disorder. Psychopharmacology (Berl) 2000; 150:15-23
28.Muller-Oerlinhausen Muller-Oerlinghausen B, Retzow A, Henn FA, Giedke H, Walden J. Valproate as an adjunct to ne-uroleptic medication for the treatment of acute episodes of mania: a prospective, randomized, double-blind, placebo-controlled, multicenter study. European Valproate Mania Study Group. J Clin Psychopharmacol. 2000;20:195-203.
29.Hirschfeld RM, Allen MH, McEvoy JP, Keck PE Jr, Russell JM. Safety and tolerability of oral loading divalproex sodium in acutely manic bipolar patients. J Clin Psychiatry. 1999; 60:815-818.
30.Okuma T Therapeutic and prophylactic effects of carbamaze-pine in bipolar disorders. Psychiatr Clin North Am 1983 Mar;6(l):157-74
31.Post RM, Uhde TW Clinical approahes to treatment resistant bipolar ilness. Review of Psychiatry 1987;6:125-150
32.Goodwin FK, Roy Byrne p Treatment of bipolar disorder Review of Psychiatry 1987;6:81-107
33.McElroy SL, Keck PE Jr Pharmacologic agents for the treatment of acute bipolar mania. Biol Psychiatry 2000 Sep 15;48(6):539-57
34.Gadde KM, Krishnan KRN Recent advances in the pharmacologic treatment of bipolar illness Psychiatric Annals 1997; 27:496-505
35.Milller AA, Stoll K-D, Wendt G ozcarabazepine in acute mania CIBA Geigy GMBH-Medizin-D-6000 Frankfurt am Main Tarihsiz:495-501
36.Emrich HM, Studies with oxcarabazepine in acute mania Int Clin Psychopharmacol 1990;5 Suppl 1:83-88
37.Keck PE Jr, Mendlwicz J, Calabrese JR, Fawcett J, Suppes T, Vcstergaard PA, Carbonell C. A review of randomized, controlled clinical trials in acute mania. J Affect Disord. 2000;59 Suppl 1:31-537.
38.Berk M. Lamotrigine and the treatment of mania in bipolar disorder. Eur Neuropsychopharmacol. 1999;9 Suppl 4:119-123.
39.Ichim L, Berk M, Brook S. Lamotrigine compared with lithium in mania: a double-blind randomized controlled trial. Ann Clin Psychiatry 2000;12:5-10
40.Frye MA, Ketter TA, Kimbrell TA, Dunn RT, Speer AM, Osuch EA,Luckenbaugh DA, Cora-Locatelli G,Leverich GS, Post RM: A placebo-controlled study of lamotrigine and gabapentin monotherapy in refractory mood disorders. J Clin Psychopharmacol 2000; 20:607-614
41.Botts SR, Raskind J. Gabapentin and lamotrigine in bipolar disorder. Am J Health Syst Pharm. 1999 Oct 1;56:1939-I944.
42.Bowden CL. Expert Opin Pharmacother. Lamotrigine in the treatment of bipolar disorder. 2002 Oct;3(10): 1513-9.
43.Calabrese JR, Keck PE Jr, McElroy SL, Shelton MD. A pilot study of topiramate as monotherapy in the treatment of acute maniaJ Clin Psychopharmacol. 2001;21:340-342.
44.Chengappa KN, Rathore D, Levine J, Atzert R, Solai L, Parepally H, Levin H, Moffa N, Delaney J, Brar JS. Topiramate as add-on treatment for patients with bipolar mania. Bipolar Disord. 1999;l:42-53.
45.Suppes T. Review of the use of topiramate for treatment of bipolar disorders. J Clin Psychopharmacol. 2002;22:599-609.
46.Ghaemi SN, Goodwin FK. Gabapentin treatment of the non-refractory bipolar spectrum: an open case series. J Affect Di-sord. 2001;65:167-171.
47.Altshuler LL, Keck PE Jr, McElroy SL, Suppes T, Brown ES, Denicoff K, Frye M, Gitlin M, Hwang S, Goodman R, Leverich G, Nolen W, Kupka R, Post R. Gabapentin in the acute treatment of refractory bipolar disorder. Bipolar Disord. 1999;l:61-5.
48.Vieta E, Martinez-Aran A, Nieto E, Colom F, Reinares M, Benabarre A, Gasto C. Adjunctive gabapentin treatment of bipolar disorder.Eur Psychiatry. 2000;15:433-437.
49.Frye MA, Ketter TA, Kimbrell TA, Dunn RT, Speer AM, Osuch EA, Luckenbaugh DA, Cora-Locatelli G, Leverich GS, Post RM: A placebo-controlled study of lamotrigine and gabapentin monotherapy in refractory mood disorders. J Clin Psychopharmacol 2000; 20:607-614
50.Pande AC, Crockatt JG, Janney CA, Werth JL, Tsaroucha G (Gabapentin Bipolar Disorder Study Group): Gabapentin in bipolar disorder: a placebo-controlled trial of adjunctive therapy. Bipolar Disord 2000; 2:249-255
51.Kanba S, Yagi G, Kamijima K, Suzuki T, Tajima 0, Otaki J, Arata E, Koshikawa H, Nibuya M, Kinoshita N, et al. The first open study of zonisamide, a novel anticonvulsant, shows efficacy in mania. Prog Neuropsychopharmacol Biol Psychiatry 1994Jul;18(4):707-15
52.Sachs G. New approaches to bipolar disorder http://medsca-pe/psychiatry/treatment update / 2000 / tu05 / public / toc-tu05.html
53.Braunig P, Kruger S J Levetiracetam in the treatment of rapid cycling bipolar disorder. Psychopharmacol. 2003; 17:239-41
54.Suppes T, Chisholm KA, Dhavale D, Frye MA, Altshuler LL, McElroy SL, Keck PE, Nolen WA, Kupka R, Denicoff KD, Leverich GS, Rush AJ, Post RM.Tiagabine in treatment refractory bipolar disorder: a clinical case series. Bipolar Disord. 2002 ;4:283-9.
55.Johnson GFS Highlights on the main pharmacological treatments for mania Depression and Mania Eds. A Georgotas, R anro New York Elsevier Science Publishing 1998:392-407
56.Janicak PG, Davis JM, Preskorn SH, Ayd FJ Priniples and pratice of psychopharmacotherapy Williams and Wilkins Bal-timorel993 148, 350
57.Ohaeri JU. Naturalistic study of olanzapine in treatment-resistant schizophrenia and acute mania, depression and obsessional disorder. East Afr Med J. 2000;77:86-92.
58.Tohen M, Sanger TM, McElroy SL, Tollefson GD, Chengappa KN, Daniel DG, Petty F, Centorrino F, Wang R, Gruncly SL, Greaney MG, Jacobs TG, David SR, Toma V. Olanzapine versus placebo in the treatment of acute mania. Olanzapine HGEH Study Group. Am J Psychiatry. 1999;156:702-709.
59.Soutullo CA, Sorter MT, Foster KD, McElroy SL, Keck PE. Olanzapine in the treatment of adolescent acute mania: a report of seven cases. J Affect Disord. 1999:53:279-283.
60.Meehan K, Zhang F, David S, Tohen M, Janicak P, Small J, Koch M.Rizk R, Walker D,Tran P,Breier A. A double-blind, randomized comparison of the efficacy and safety of intramuscular injections of olanzapine, lorazepam, or placebo in treating acutely agitated patients diagnosed with bipolar mania. J Clin Psychopharmacol. 2001;21:389-397.
61.Tohen M, Jacobs TG, Grundy SL, McElroy SL, Banov MC, Janicak PG, Sanger T, Risser R, Zhang F, Toma V, Francis J, Tollefson GD, Breier A. Efficacy of olanzapine in acute bipolar mania: a double-blind, placebo-controlled study. The Olanzipine HGGW Study Group. Arch Gen Psychiatry. 2000;57:841-849.
62.Berk M, Ichim L, Brook S. Olanzapine compared to lithium in mania: a double-blind randomized controlled trial. Int Clin Psychopharmacol. 1999;14:339-343.
63.Berk M, Ichim L, Brook S: Olanzapine compared to lithium in mania: a double-blind randomized controlled trial. Int Clin Psychopharmacol 1999; 14:339-343
64.Zajecka JM, Weisler R, Sachs G, Swann AC, Wozniak P, Sommerville KW.A comparison of the efficacy, safety, and tolerability of divalproex sodium and olanzapine in the treatment of bipolar disorder. J Clin Psychiatry. 2002;63:1148-55.
65.Gonzalez-Pinto A, Lalaguna B, Mosquera F, Perez de Heredia JL, Gutierrez M, Ezcurra J, Gilaberte I, Tohen M. Use of olanzapine in dysphoric mania. J Affect Disord. 2001;66:247-253.
66.Gonzalez-Pinto A, Tohen M, Lalaguna B, Perez-Heredia JL, Fernandez-Corres B, Gutierrez M, Mico JA. Treatment of bipolar I rapid cycling patients during dysphoric mania with olanzapine. J Clin Psychopharmacol. 2002;22:450-4
67.Sanger TM, Tohen M, Vieta E, Dunner DL, Bowden CL, Ca-labrese JR, Feldman PD, Jacobs TG, Breier A.Olanzapinc in the acute treatment of bipolar I disorder with a history of rapid cycling. J Affect Disord. 2003;73(1-2):155-61.
68.Green AI, Tohen M, Patel JK, Banov M, DuRand C, Herman I, Chang H, Zarate C Jr, Posener J, Lee H, Dawson R, Richards C, Cole JO, Schatzberg AF. Clozapine in the treatment of refractory psychotic mania. Am J Psychiatry 2000;157:982-6
69.Tohen M, Zarate CA Jr, Centorrino F, Hegarty JI, Froeschl M, Zarate SB. Risperidone in the treatment of mania. J Clin Psychiatry. 1996;57:249-253.
70.Licht RW, Bysted M, Christensen H. Fixed-dosed risperidone in mania: an open experimental trial. Int Clin Psychopharmacol. 2001:16:103-110.
71.Sajatovic M, DiGiovanni SK, Baştanı B, Hattab H, Ramirez LF. Risperidone therapy in treatment refractory acute bipolar and schizoaffective mania. Psychopharmacol Bull. 1996:32:55-61.
72.Segal J, Berk M, Brook S. Risperidone compared with both lithium and haloperidol in mania: a double-blind randomized controlled trial. Clin Neuropharmacol. 1998:21:176-80.
73.Vieta E, Parramon G, Padrell E, Nieto E, Martinez-Aran A, Corbella B, Colom F, Reinares M, Goikolea JM, Torrent C Quetiapine in the treatment of rapid cycling bipolar disorder Bipolar Disord. 2002; 4:335-40.
74.Ghaemi SN, Katzow JJ. The use of quetiapine for treatment-resistant bipolar disorder: a case series. Ann Clin Psychiatry. 1999:11:137-40.
75.Del Bello MP, Schwiers ML, Rosenberg HL, Strahowshr SM. A Double - Blind, Rondomized, Plosebo Controlled study of Quethopine as Adjunctive Treatment of Adolescent Monta. J Am Acod Child Adoles Psychiatry 2002; 41(10) 1216-1223.
76.Keck PE Jr, Versiani M, Potkin S, West SA, Ciller E, Ice K; Ziprasidone in Mania Study Group. Ziprasidone in the treatment of acute bipolar mania: a three-week, placebo-controlled, double-blind, randomized trial. Am J Psychiatry. 2003:160:741-8.
77.Levy NA, Janicak PG. Calcium channel antagonists for the treatment of bipolar disorder Bipolar Disord 2000;2:108-119.
78.Fink M. Convulsive therapy: a review of the first 55 years. J Affect Disord. 2001;63:1-15
79.Mukherjee S, Sackeim HA, Schnur DB. Electroconvulsive therapy of acute manic episodes: a review of 50 years' experience. Am J Psychiatry. 1994:151:169-176.
80.Edwards R, Stephenson U, Flewett T.Clonazepam in acute mania: a double blind trial. Aust N Z J Psychiatry 1991:25:238-42.

APA	TÜRKÇAPAR M (2003). Bipolar bozukluk manik atakta ilaç tedavisi. , 29 - 37.
Chicago	TÜRKÇAPAR M. Hakan Bipolar bozukluk manik atakta ilaç tedavisi. (2003): 29 - 37.
MLA	TÜRKÇAPAR M. Hakan Bipolar bozukluk manik atakta ilaç tedavisi. , 2003, ss.29 - 37.
AMA	TÜRKÇAPAR M Bipolar bozukluk manik atakta ilaç tedavisi. . 2003; 29 - 37.
Vancouver	TÜRKÇAPAR M Bipolar bozukluk manik atakta ilaç tedavisi. . 2003; 29 - 37.
IEEE	TÜRKÇAPAR M "Bipolar bozukluk manik atakta ilaç tedavisi." , ss.29 - 37, 2003.
ISNAD	TÜRKÇAPAR, M. Hakan. "Bipolar bozukluk manik atakta ilaç tedavisi". (2003), 29-37.

APA	TÜRKÇAPAR M (2003). Bipolar bozukluk manik atakta ilaç tedavisi. 3 P/ Psikiyatri Psikoloji Psikofarmakoloji Dergisi, 11(supp3), 29 - 37.
Chicago	TÜRKÇAPAR M. Hakan Bipolar bozukluk manik atakta ilaç tedavisi. 3 P/ Psikiyatri Psikoloji Psikofarmakoloji Dergisi 11, no.supp3 (2003): 29 - 37.
MLA	TÜRKÇAPAR M. Hakan Bipolar bozukluk manik atakta ilaç tedavisi. 3 P/ Psikiyatri Psikoloji Psikofarmakoloji Dergisi, vol.11, no.supp3, 2003, ss.29 - 37.
AMA	TÜRKÇAPAR M Bipolar bozukluk manik atakta ilaç tedavisi. 3 P/ Psikiyatri Psikoloji Psikofarmakoloji Dergisi. 2003; 11(supp3): 29 - 37.
Vancouver	TÜRKÇAPAR M Bipolar bozukluk manik atakta ilaç tedavisi. 3 P/ Psikiyatri Psikoloji Psikofarmakoloji Dergisi. 2003; 11(supp3): 29 - 37.
IEEE	TÜRKÇAPAR M "Bipolar bozukluk manik atakta ilaç tedavisi." 3 P/ Psikiyatri Psikoloji Psikofarmakoloji Dergisi, 11, ss.29 - 37, 2003.
ISNAD	TÜRKÇAPAR, M. Hakan. "Bipolar bozukluk manik atakta ilaç tedavisi". 3 P/ Psikiyatri Psikoloji Psikofarmakoloji Dergisi 11/supp3 (2003), 29-37.