Erhan Kurt - Academia.edu (original) (raw)

Papers by Erhan Kurt

The aim of this naturalistic study was to compare the influence of haloperidol and new generation... more The aim of this naturalistic study was to compare the influence of haloperidol and new generation antipsychotics on prolactin levels is in patients with schizophrenia or delusional disorder. Methods: The participants were 109 patients who were drug free at least for one week (for depot/long action antipsychotic users, drug free at least one month) at the beginning. The data of 64 patients who were receiving haloperidol, clozapine, olanzapine, risperidone, quetiapine or sulpiride were analyzed. No intervention was made to the treatment regimens of the patients. The blood prolactin levels of the patients were measured at the beginning and after the second month of the treatment who had complied with the treatment regimens. Results: In haloperidol, risperidone, and sulpiride groups, the blood prolactin level was found to be increased significantly after two months. There were no significant changes in prolactin levels among clozapine, olanzapine and quetiapine receivers two moths later. Conclusion: Within the widespread use of antipsychotics in schizophrenia and other psychotic disorders, the endocrinological side effects related with drug use like hyperprolactinemia should be kept in mind. Hyperprolactinemia without any comorbidity is not seen a serious problem to cease the treatment. Anatolian Journal of Psychiatry 2008; 9:44-48 Kurt ve ark. 45 _____________________________________________________________________________________________________ However, the treatment should be revised in a patient with hyperprolactinemia and if needed, further endocrinological examinations should be made. (Anatolian Journal of Psychiatry 2008; 9:44-48)

Lityum iki uçlu duygudurum bozukluğu tedavisinde başlıca tedavi seçeneklerindendir ve lityum teda... more Lityum iki uçlu duygudurum bozukluğu tedavisinde başlıca tedavi seçeneklerindendir ve lityum tedavisi sırasında dermatolojik yan etkiler oldukça sık görülmektedir. Bu yan etkilerden en sık görülenleri akneiform döküntüler, folikülit, makülopapüler döküntüler ve psöriyazistir. Psöriyazis kronik gidişli inflamatuar bir deri hastalığı olup lityumun neden olduğu dermatolojik yan etkilerin başında gelir. Lityumla ortaya çıkan psöriyazis ve psöriyatik alevlenmeler oldukça sık görülen yan etkiler olmasına karşın, ortaya çıkış düzenekleri halen çok iyi anlaşılamamıştır. Ancak son dönemdeki çalışmalardan elde edilen kanıtlar lityumla ortaya çıkan psöriyazisin oluş düzeneğinin farklı olduğunu göstermektedir. Klasik psöriyazis oluşumunda proinflamatuar sitokinlerin artmış üretimi önemliyken, lityuma bağlı psöriyaziste bu düzenek daha az önemli görülmektedir. İn-vitro insan deri kültürlerinde, lityumun keratinosit proliferasyonu üzerine doğrudan uyarıcı etkisi olduğu bulunmuştur. Ayrıca, klasik psöriyazisli hastaların monositlerinde bazal proinflamatuar sitokin (IL-1β, TNF-α, IL-6) üretiminin arttığı görülmüşken, lityuma bağlı psöriyazisliler ve sağlıklı kontrollerde anlamlı artış saptanmamıştır. Bununla birlikte, in-vitro koşullarda lipopolisakkarid ile uyarılmış monositlerin bulunduğu ortama lityum klorür eklendiğinde, sağlıklı kişilerde ve lityuma bağlı psöriyazislilerde monositlerin IL-1beta ve TNF-alfa üretimi anlamlı olarak azalmışken, klasik psöriyazisli hastalarda anlamlı azalma olmamıştır. Bu bulgular ışığında, lityuma bağlı psöriyazis ve klasik psöriyazisin ortaya çıkış düzeneklerinin farklı olduğu söylenebilir. Ancak günümüzde bu farklılığı ortaya koyan yeterli veri bulunmamaktadır. Bu yazıda 41 yaşında, 12 yıllık hastalık öyküsü olup son 5 yıldır lityum tedavisi gören ve 35 yaşında, 13 yıllık hastalık öyküsü olup yaklaşık 11 yıldır lityum kullanan iki erkek hasta sunulmuştur. Bu olgu sunumu ile 'lityuma bağlı psöriyazis' fenomenine dikkat çekmek istemekteyiz. (Anadolu Psikiyatri Dergisi 2006; 7:244-247)

fiizofreni tan›l› hastalarda antipsikotik ilaçlar›n kardiyak etkilerinin karfl›laflt›r›lmas› Amaç... more fiizofreni tan›l› hastalarda antipsikotik ilaçlar›n kardiyak etkilerinin karfl›laflt›r›lmas› Amaç: Antipsikotik ilaçlar, sonuçta torsades de pointes ve ani ölüme neden olabilen, QT aral›¤›nda uzama gibi ciddi kardiyovasküler yan etkiler oluflturabilir. Bu çal›flmada antipsikotik ilaçlar›n, özellikle QTc olmak üzere, EKG parametreleri üzerine olan etkisinin karfl›laflt›r›lma-s› hedeflenmifltir. Yöntem: DSM-IV tan› kriterlerine göre flizofreni tan›s›n› karfl›layan ve en az 1 haftad›r (depo antipsikotik kullananlarda en az 1 ayd›r) ilaç kullanmayan hastalardan, tesadüfi örnekleme metodu ile seçilen 69 hasta de¤erlendirmeye al›nm›flt›r. Çal›flman›n bafllang›c›nda ve çal›flmaya baflland›ktan 2 ay sonra elektrokardiyogram incelemesi yap›larak bulgular ba¤›ms›z iki kardiyolog taraf›ndan de¤erlendirilmifltir. Bulgular: Çal›flmada hastalara reçete edilen antipsikotikler aras›nda (klozapin, olanzapin, risperidon, ketiapin, sülpirid, haloperidol), yal-n›zca klozapinin EKG üzerine istatistiksel anlaml› etkilerinin oldu¤u (kalp h›z› için p<0.0001; QTc için p=0.003) saptanm›flt›r. ‹statistiksel olarak anlaml› olmasa da, sülpirid ve haloperidol alan hastalar›n kalp at›m say›lar› düflmüfltür. Sonuç: Klozapin, kardiyak etkileri aç›s›ndan farkl› bir ilaç olarak, di¤er atipik antipsikotiklerden ayr› de¤erlendirilmelidir. QTc uzamas› ve tafliaritmi riski nedeniyle daha dikkatli olunmal›d›r. Klozapin tedavisi öncesi, hastalarda ayr›nt›l› kardiyovasküler de¤erlendirme (özellikle EKG) yap›lmal› ve gerekti¤inde tekrarlanmal›d›r.

Journal of Affective Disorders, 2007

Background: This is the first study in bipolar patients, aimed to evaluate possible roles of the ... more Background: This is the first study in bipolar patients, aimed to evaluate possible roles of the drugs, [atypical antipsychotics (AA) and mood stabilizers (MS)], inducing metabolic syndrome (MetS). Methods: 125 bipolar patients, diagnosed according to the DSM IV, were assessed cross-sectionally for MetS according to the National Cholesterol Educational Program criteria (NCEP ATP III). Patients included in the study were required to receive medications (AAs: quetiapine, risperidone and olanzapine, and MSs: Lithium, Sodium Valproate, Carbamazepine, Lamotrigine) for at least 3 months. Patients are divided into three groups as only AA users, AA + MS users and only MS users. Results: Of the patients, 32% were MetS, a proportion higher than normal population and similar as previous studies in bipolar patients. AA taking patients had significantly higher MetS rates than the others (χ 2 = 10.47 df = 2 p = 0.005). Also, AA taking patients had significantly higher MetS rates than MS taking patients (χ 2 = 8.86 df = 1 p = 0.003). There was no significant difference among quetiapine, olanzapine, risperidone usage for MetS prevalences (χ 2 = 0.38 df = 2 p = 0.82). Conclusions: AA taking bipolar patients had higher MetS rates. Despite already existing data on MetS and antipsychotics, this cross-sectional study is the first research, discusses AAs and MSs for inducing MetS in bipolar disorder. Prospectively designed researches should be conducted for further clarification of the role of these drugs in MetS.

Molecular Biology Reports, 2009

P-glycoprotein (P-gp), an efflux transporter protein, is an ABC transporter encoded by the multid... more P-glycoprotein (P-gp), an efflux transporter protein, is an ABC transporter encoded by the multidrug resistance 1 gene (MDR1, ABCB1). The common synonymous C3435T polymorphism in exon 26 is reported to associate with lower P-gp functional expression and drug uptake. Many extended pharmacogenomics, functional, and complex disease association studies focused mainly on this polymorphism. We investigated the association of exon 26 C3435T genetic variants of MDR1 gene with susceptibility to bipolar disorder and serum valproic acid concentration. Totally, 104 patients meeting DSM-IV criteria for bipolar disorder and 169 controls were admitted to the study. There was statistically significant difference between the genotypes of bipolar patients (CT 91.2%, TT 6.8%, and CC 2%) and controls (CT 52.7%, TT 26%, CC 21.3%) although their allelic distribution was similar. The serum valproic acid concentrations of the patients with CT, TT and CC genotypes were 72.92 ± 20.55, 80.47 ± 14.01 and 68.29 ± 12.17 μg/ml, respectively, and there was no significant difference between the C3435T genotypes.

Journal of Psychophysiology, 2008

Previous studies have reported a relationship between cholesterol and leptin levels, and suicide ... more Previous studies have reported a relationship between cholesterol and leptin levels, and suicide attempts, impulsivity, and aggressive behaviors. An orexigenic hormone seems to be strongly associated with lipid metabolism and leptin levels. Therefore, we aimed to compare serum cholesterol, leptin, and ghrelin levels in 36 patients with suicide attempts and 25 healthy controls. Patients with suicide attempts had decreased leptin levels and significantly higher ghrelin levels compared to healthy controls. While the serum ghrelin level did not show any correlation with the demographic and clinical factors, leptin showed a correlation with body mass index (BMI), and cholesterol levels were correlated with the age, BMI, and number of suicide attempts in the suicidal group. The results suggest that suicide attempts seem to be related with higher serum ghrelin values, decreased leptin, and cholesterol levels.

Progress in Neuro-psychopharmacology & Biological Psychiatry, 2007

To examine the importance of ghrelin and leptin in the pathogenesis of obsessive-compulsive disor... more To examine the importance of ghrelin and leptin in the pathogenesis of obsessive-compulsive disorder (OCD), we measured serum ghrelin and leptin levels, lipid profile and body mass index (BMI) in 43 patients with OCD and 20 healthy controls. The patients were divided into two subgroups according to whether DSM-IV OCD was accompanied with major depressive disorder (MDD) (OCD + MDD) or not (OCD − MDD). There was no statistically significant difference in ghrelin and leptin levels between groups. The OCD + MDD group had a trend of higher ghrelin levels and lower leptin levels than the OCD − MDD and control groups. There was a negative correlation between change in serum ghrelin and leptin levels only in the OCD + MDD group. Neither ghrelin nor leptin showed any correlation with severity of MDD and OCD. In conclusion, our results suggest that OCD is not associated with leptin or ghrelin levels. More comprehensive and detailed studies are needed to decipher the exact role of ghrelin and leptin in OCD.

Neuroscience Letters, 2007

The effects of electroconvulsive therapy (ECT), which is a widely used treatment for psychiatric ... more The effects of electroconvulsive therapy (ECT), which is a widely used treatment for psychiatric disorders, have not yet been established. Therefore, we aimed to explore whether the patients' serum ghrelin and leptin levels are associated with the action of ECT treatment. In the case of the mood disorders, which occurred in 16 patients with major depressive episode (MDE) and 12 patients with bipolar disorder-manic episode (BD-me) and 25 healthy controls, we have determined the serum levels of ghrelin, leptin and cholesterol before ECT and 2 days after ECT. The BMI was also calculated in all subjects. Although ECT treatment did not change mean the BMI and serum leptin level, the mean serum ghrelin level decreased and the total cholesterol level increased after ECT compared with before ECT. While the leptin levels in the patient group were significantly lower than the controls before and after ECT, the mean serum ghrelin and total cholesterol levels differed statistically only before ECT, but not after ECT than those in controls. The ghrelin levels have decreased significantly after ECT in both sub-groups MDE and BB-me. However, the mean serum total cholesterol level increased statistically after ECT only in the MDE sub-group, and the leptin levels did not differ in both sub-groups after ECT compared with before ECT. In conclusion, ECT treatment seems to be associated with decreased ghrelin levels and increased cholesterol levels but not leptin levels. However, more comprehensive and detailed studies are needed to decipher the exact role of ECT on ghrelin, leptin and total cholesterol in mood disorders.

Acta Neuropsychiatrica, 2008

Objective: The aims of this study were to determine the dominant affective temperament changes i... more Objective: The aims of this study were to determine the dominant affective temperament changes in stroke survivors and whether temperament affects the disability.Methods: A total of 63 stroke patients were included in this study. Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire was used to determine the dominant affective temperament (depressive, hyperthymic, cyclothymic, irritable or anxious). The disability level was measured with the Barthel index (BI).Results: Depressive temperament (17.5%) and anxious temperament (12.7%) were the most common dominant affective temperaments. The frequencies of irritable, cyclothymic and hyperthymic temperaments were 4.8, 3.2 and 0%, respectively. The mean BI score was 78.1 ± 18.3 in patients with depressive temperament and 67.4 ± 28.4 in patients without depressive temperament (p = 0.403). The mean BI score was 78.1 ± 15.3 in patients with anxious temperament and 68.0 ± 28.3 in patients without anxious temperament (p = 0.541). Multiple linear regression analysis indicated that BI score was not associated with affective temperament changes.Conclusion: The results of the current study suggest that depressive and anxious temperaments are the most common affective temperaments and that there appears to be no association between disability level and dominant affective temperament in stroke survivors.