asli SARANDÖL - Academia.edu (original) (raw)

Papers by asli SARANDÖL

Research paper thumbnail of Romatoid artritli hastalarda anksiyete ve depresyon

…, 2004

... Lale Altan1, Ümit Bingöl1, Zeynep Sağırkaya1, Aslı Sarandöl2, Merih Yurtkuran1 ... Anksiyete ... more ... Lale Altan1, Ümit Bingöl1, Zeynep Sağırkaya1, Aslı Sarandöl2, Merih Yurtkuran1 ... Anksiyete ve depresyon sıklıkla birbirine eşlik eden bozukluklar olmalarına karşın, RA'li hastalarda anksiyete depresyon kadar ilgi konusu olmamıştır. Ancak anksiyetenin de ...

Research paper thumbnail of Seizure Activity after Venlafaxine Overdose

Journal of Pharmacy Technology, 2003

Objective: To report the findings from the case of a patient developing first-time seizure activi... more Objective: To report the findings from the case of a patient developing first-time seizure activity following an overdose of venlafaxine. Case Summary: A 27-year-old man with major depression ingested 60 venlafaxine 75-mg capsules in an apparent suicide attempt. The patient experienced generalized seizure activity 9 and 11 hours after ingestion. The electroencephalogram showed a pathologic pattern, with several generalized epileptiform discharges. Venlafaxine was discontinued, and no further sequelae were observed. Discussion: The Naranjo probability scale indicated a probable relationship between the seizures and venlafaxine overdose. The mechanism of seizures associated with venlafaxine overdose is unclear. Neurotransmitters play an important role in seizure genesis, and hepatic damage may occur. Conclusions: Clinicians should be aware of proconvulsant effect and the risk of hepatocellular injury from venlafaxine overdose when prescribing this drug.

Research paper thumbnail of Depresyon, Nöroplastisite ve Nörotrofik Faktörler

Yaygin bir psikiyatrik bozukluk olan depresyon patofizyolojisinin altinda yatan norobiyolojik deg... more Yaygin bir psikiyatrik bozukluk olan depresyon patofizyolojisinin altinda yatan norobiyolojik degisiklikler hakkinda halen cok az sey bilinmektedir. Depresyonun biyolojik etiyolojisi hakkinda gelistirilen kuramlardan monoamin hipotezi ve norotransmitter reseptor hipotezine son yillarda depresyonun noroplastisite hipotezi eklenmistir. Noroplastisite, cesitli ic ve dis uyaranlara bagli olarak beyindeki noronlarin ve bunlarin olusturdugu sinapslarin yapisal ozellikleri ve islevlerindeki degisiklikler olarak tanimlanabilir. Norotrofik faktorler; noronlarin gelisimi ve korunmasi icin buyuk oneme sahip olan molekullerdir. Noron yasamak, farklilasmak ve noroplastisite icin kendi salgiladigi norotrofik faktorlere gereksinim duymaktadir. Hipokampus noroplastisitesi en yuksek beyin bolgelerinden biridir. Beyin goruntuleme calismalari; depresyonlu olgularda hipokampal hacim azalmasi oldugunu gostermektedir. Bu durum hipokampustaki norogenez ve norotrofik faktor ekspresyonunda stresle induklene...

Research paper thumbnail of Art Therapy with Psoriatic Patients

This study aimed at investigating the themes that emerged after an art therapy and assessing the ... more This study aimed at investigating the themes that emerged after an art therapy and assessing the effectiveness of art therapy using psychological scales and dermatological evaluation indices before and after the therapy in individuals with psoriasis. The study included patients aged 18-65 with moderate psoriasis who had the disease for 5 or more years and were in need of systemic treatment. Those who had a concomitant physical disorder including another skin disease, an active joint disorder or a psychiatric diagnosis other than adjustment disorder were excluded from the study. A total of 15 sessions each lasting 150 minutes were held once a week. Various art techniques including music, painting and ceramics were practised to evaluate within the group patients’ understanding of the illness and their self-awareness. The outcomes of the study were presented over three patients who attended the sessions regularly. The dermatological evaluations, patient feedbacks and observations of th...

Research paper thumbnail of Comparison of The Efficacy and Safety of Sertraline, Reboxetine, and Venlafaxine in Patients with Major Depressive Disorder: A Pooled Analysis of Four Randomized, Open-Label Trials

Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychopharmacology, 2010

Major depresif bozukluk'ta sertralin, venlafaksin ve reboksetinin etkiliği ve güvenilirliğinin ka... more Major depresif bozukluk'ta sertralin, venlafaksin ve reboksetinin etkiliği ve güvenilirliğinin karşılaştırılması: dört randomize, açık çalışmanın verilerinin analizi Amaç: Bu araştırma major depresif bozukluk (MDB) tedavisinde sıkça kullanılan sertralin, reboksetin, venlafaksin ve sertralin-reboksetin kombinasyonunun depresif belirtiler üzerine etkisi ile bu tedavilerin etkililik ve güvenlik açısından birbiriyle karşılaştırılmasını amaçlamıştır. Yöntem: Daha önceki dört çalışmaya alınmış ve bu çalışmaları tamamlamış hastaların verileri bir arada değerlendirilmiştir. 206 hasta reboksetin, venlafaksin, sertralin ve sertralin-reboksetin kombinasyon gruplarına dahil edilmiş olup 37 hasta çalışmaları tamamlayamamıştır. Kalan 169 hastanın 43'er tanesi reboksetin ve venlafaksin, 42'si sertralin, 41'i sertralin-reboksetin kombinasyon grubunda yer almaktaydı. Bulgular: MDB klinik özellikleri ile sosyodemografik özellikler açısından gruplar arasında fark yoktu. Hamilton Depresyon Derecelendirme Ölçeği (HAM-D) değerlerindeki yüzdelik düşüş venlafaksin grubunda vizit 2 ve 3'te sertraline göre [sırasıyla p=0.001, ES: 0.1404 (büyük) ve p=0.002, ES: 0.1109 (orta)] ve sertralin-reboksetin kombinasyonuna göre vizit 2 ve 3'te [sırasıyla p=0.006, ES: 0.0910 (orta) ve p=0.004, ES: 0.1023 (orta)] daha yüksek olduğu saptanmıştır. Yine HAM-D değerlerindeki yüzdelik düşüş reboksetin grubunda sertraline göre vizit 2'de daha yüksek bulundu [p=0.02, ES: 0.0615 (orta)]. En sık rastlanan kalıntı belirtileri 1., 7., 10., 11., 13., ve 14. HAM-D maddeleriydi. Sonuç: Farklı nörotransmiter mekanizmaları üzerinden etki etmekle beraber bu çalışmadaki antidepresanlar benzer etkililik göstermişlerdir. Bununla beraber her tedavi yöntemi farklı belirti ve belirti grupları üzerinde etkili bulunmuş, antidepresan etkililiğin ortaya çıkış zamanları açısından farklılık göstermişlerdir. Bir takım kısıtlılıklarına karşın, bu alandaki çalışmaların az olması da göz önüne alındığında, bu çalışmanın bir ön çalışma olarak literatüre katkı sağlayacağı kanısındayız.

Research paper thumbnail of Work motivation and related demographic factors in unemployed patients with schizophrenia

Anatolian Journal of Psychiatry, 2019

Objective: Working rate in patients with schizophrenia is considerably low. Nonetheless, unemploy... more Objective: Working rate in patients with schizophrenia is considerably low. Nonetheless, unemployed patients might have desire to work and look for a job. Identifying the reasons underlying the patients’ work motivation and related factors can be instructive for the vocational rehabilitation services. The purpose of this study was to deter-mine the reasons for work motivation and to identify the predictors of motivation in unemployed patients with schizo-phrenia. Methods: Sociodemographic and working life information of 379 unemployed patients with schizophrenia or schizoaffective disorder diagnosed for at least two years was collected from six different centers. The patients were questioned about their desire to work and its reasons. Having desire to work and job seeking behavior together was considered as work motivation. Patients with and without having work motivation were compared regarding to their sociodemographic information and illness characteristics. Logistic regression analysis was conducted to find the factors predicting the work motivation. Results: The participants’ mean age was 42, level of education was nine years, duration of illness was 18 years, and majority consisted of males and single patients. It was found that 33% of the patients were motivated to work. While distinct underlying reasons of the work motivation were found as financial needs (45%) and will for independent living (35%), idea of not being able to deal with the requirements of the job (66%) and not receiving social welfare payment (24%) were dominant in patients who weren’t motivated to work. The predictors of work motivation were found as male gender (OR=2.0), having a profession (OR=2.0), having work experience after the illness (OR=1.2), level of education (OR=1.1), and duration of illness (OR=0.9). Conc-lusion: We found that one-third of unemployed patients with schizophrenia have work motivation as an important finding. The patients may feel more comfortable and motivated to work if they would continue to receive social wel-fare payment after they started a job. It could be concluded patients who have a profession, high level of education, previous job experience, and who are at the early stage of their illness are suitable candidates for the vocational rehabilitation services.

Research paper thumbnail of Rates and correlates of employment in patients with schizophrenia: A multicenter study in Turkey

International Journal of Social Psychiatry, 2019

Background: There is not enough information regarding the participation in the working life of th... more Background: There is not enough information regarding the participation in the working life of the patients with schizophrenia in Turkey. Aims: The aim of this study was to examine the occupational experiences of patients with schizophrenia before and after the illness and to investigate the factors that predict work participation. Methods: The data on occupational life of the patients with schizophrenia, which were treated as outpatients in six different centers, were examined. The rates of participation in working life before and after the disease were evaluated. Patients with and without occupational life history after the disease were compared in terms of demographic characteristics. Factors predicting participation in work life after the disease were analyzed by logistic regression analysis. Results: Out of the 587 patients evaluated in the study, 73% were males, 73% were single, the mean age was 42, mean level of education was 9 years and the average duration of illness was 18...

Research paper thumbnail of The relationship between psychopathology, psychosocial adjustment, social support and quality of life in multiple sclerosis

The European Research Journal, 2018

Objectives: Multiple Sclerosis (MS) is a chronic disease which affects physical,psychological and... more Objectives: Multiple Sclerosis (MS) is a chronic disease which affects physical,psychological and social functioning of patients. In this study we aim to indicate psychiatric comorbidity, some psychosocial factors and their associations with quality of life in patients with MS. Methods: A total of 227 patients underwent psychiatric examination and the following scales were applied: Socio-demographic data form, Hospital Anxiety and Depression Scale (HADS), Multiple Sclerosis Quality of Life-54 (MSQOL-54), Psychosocial Adjustment to Illness Scale-Self report (PAIS-SR) and Multidimensional Scale of Perceived Social Support (MSPSS). Results: Among 227 patients with MS, 67.8% (n = 154) had psychiatric diagnosis; 24.2% (n = 55) had depression,19.8% (n = 45) had adjustment disorder, 14.9% (n = 34) had anxiety disorder, 7.1% (n=16) had dysthymic disorder and 1.8% (n = 4) had bipolar disorder. Patients with a psychiatric diagnosis had lower scores in role limitations due to emotional problem...

Research paper thumbnail of First‐episode psychosis is associated with oxidative stress: Effects of short‐term antipsychotic treatment

Psychiatry and Clinical Neurosciences, 2015

AimsIn the present study, our aim was to investigate the oxidative–antioxidative systems in unmed... more AimsIn the present study, our aim was to investigate the oxidative–antioxidative systems in unmedicated first‐episode psychosis (FEP) patients at the beginning and after short‐term treatment.MethodsThis study consisted of 29 patients who experienced an FEP and 25 control subjects. In order to investigate the oxidative status, we determined plasma malondialdehyde (MDA) levels, oxidizability of red blood cells, oxidation and oxidizability of apolipoprotein B‐containing lipoproteins (apo B‐basal MDA and apo B‐ΔMDA). In order to evaluate the antioxidative defense, we measured serum total antioxidative capacity, uric acid, albumin, total bilirubin and vitamin E levels and serum paraoxonase/arylesterase, whole blood glutathione peroxidase (GPx) and red blood cell superoxide dismutase activities before and after 6 weeks of treatment in patients with FEP.ResultsPlasma MDA and apo B‐basal MDA levels and red blood cell superoxide dismutase activity were significantly higher and serum aryleste...

Research paper thumbnail of Reboxetine induced erectile dysfunction and spontaneous ejaculation during defecation and micturition

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2007

This is a case report of reboxetine induced erectile dysfunction, seminal emission and ejaculatio... more This is a case report of reboxetine induced erectile dysfunction, seminal emission and ejaculation during defecation and micturition. A 44 year old male who had been suffering from depression without any sexual dysfunction was put on venlafaxine XR treatment. Due to delayed ejaculation and occasional episodes of absence of ejaculation he was switched to reboxetine. At the second week of treatment he reported erectile dysfunction and premature ejaculation, and seminal emission and ejaculation during defecation and micturition occurred later at 8th week of treatment. After he was switched to sertraline 50 mg/day, his erectile dysfunction, premature and spontaneous ejaculation symptoms subsided in 2 weeks. Although reboxetine is reported to be free of sexual side effects, individual vulnerabilities to such unwanted effects should be considered, and sexual dysfunction should be assessed thoroughly during the treatment.

Research paper thumbnail of Are there differences between serotonergic, noradrenergic and dual acting antidepressants in the treatment of depressed women?

The World Journal of Biological Psychiatry, 2009

Research paper thumbnail of A patient using ziprasidone with polydipsia, seizure, hyponatremia and rhabdomyolysis

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2006

We aimed to report a case with rhabdomyolysis related to hyponatremia and/or its correction. A 32... more We aimed to report a case with rhabdomyolysis related to hyponatremia and/or its correction. A 32-year-old male schizophrenic patient on ziprasidone treatment was admitted to the hospital following a seizure. Patient had primary polydipsia and secondarily developed hyponatremia. After the correction of hyponatremia, due to the high liver enzyme levels, he was diagnosed as rhabdomyolysis. Although the role of antipsychotics in this situation is speculative, development of rhabdomyolysis related to hyponatremia and/or its correction should not be underestimated and should be assesed throughly.

Research paper thumbnail of Oxidation of apolipoprotein B-containing lipoproteins and serum paraoxonase/arylesterase activities in major depressive disorder

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2006

Major depressive disorder (MDD) is blaimed to play a role in the onset of coronary artery disease... more Major depressive disorder (MDD) is blaimed to play a role in the onset of coronary artery disease (CAD). The aim of the present study was to investigate serum paraoxonase/arylesterase activities and oxidation of apolipoprotein B-containing lipoproteins in patients with MDD. Oxidation of lipoproteins plays an important role in atherogenesis and the enzyme paraoxonase, has been shown to prevent lipoprotein oxidation. Furthermore, low paraoxonase activity was suggested to predict CAD. Eighty-six patients who fully met the fourth Diagnostic and Statistical Manual of Mental Disorders criteria for MDD and 36 healthy control subjects were included in the study. Serum paraoxonase and arylesterase activities were determined spectrophotometrically. Malondialdehyde (MDA) levels of apolipoprotein B-containing lipoproteins were determined before (basal) and after incubation with copper-sulphate, that yielded basal-and Δ-MDA values, respectively. Serum paraoxonase/arylesterase activities were significantly reduced in the post-treatment group compared with the pre-treatment group. Basal-MDA (MDA) level was significantly higher in the MDD group compared with the control group. Δ-MDA level of the severe MDD group was significantly higher than that of the control group. There was a positive correlation between the oxidizability of apolipoprotein B-containing lipoproteins and the severity of the disease. Total cholesterol, HDL-cholesterol, LDL-cholesterol, apolipoprotein B levels were significantly higher and apolipoprotein AI levels were significantly lower in the MDD group compared with those of the control group. The findings of the present study suggest that: 1) antidepressant treatment might reduce serum paraoxonase activity/mass; 2) oxidation and oxidizability of apolipoprotein B-containing lipoproteins seem to be increased in MDD.

Research paper thumbnail of Effects of various antidepressants on serum thyroid hormone levels in patients with major depressive disorder

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2008

A total of 62 patients with major depressive disorder were analyzed in the study. Patients were e... more A total of 62 patients with major depressive disorder were analyzed in the study. Patients were evaluated for 11 weeks in an open label design to investigate the differential effects of reboxetine, sertraline and venlafaxine on thyroid hormones. Serum thyrotrophin (TSH), thyroxine (T4) and free (f)T4 levels were measured before and after treatment. All groups showed significant improvement in HAM-D scores. TSH level significantly reduced and T4 level significantly increased in the reboxetine group, however TSH level significantly increased and T4 level significantly reduced in the sertraline group. Percent changes of TSH (p = 0.007) and T4 (p = 0.001) were significantly different between the reboxetine and sertraline groups. In the sertraline group, baseline TSH levels were correlated with response to treatment as determined by the change in HAM-D scores (p = 0.03, r = 0.648). There was a significant association between the percent changes in TSH values and the reduction in HAM-D scores in the reboxetine group (p = 0.03, r = −0.434). In the whole study group, female patients had lower values of basal T4 compared with men (p = 0.043), however percent changes of T4 did not differ between genders. In the treatment-responders significant increase in the reboxetine group and significant decrease in the sertraline group regarding the T4 values were found. We observed that various antidepressants had different effects on thyroid hormone levels and this could be attributed to the different mechanisms of actions of these antidepressants.

Research paper thumbnail of Addiction to topically used cyclopentolate hydrochloride: A case report

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2008

Research paper thumbnail of Oxidative–antioxidative systems and their relation with serum S100 B levels in patients with schizophrenia: Effects of short term antipsychotic treatment

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2007

Oxidative stress may be a contributing factor in the etiopathophysiology of schizophrenia, which ... more Oxidative stress may be a contributing factor in the etiopathophysiology of schizophrenia, which may be exacerbated by the treatment with antipsychotics with pro-oxidant properties. Increased levels of S100 B are associated with neurodegenerative disorders, including schizophrenia. The aim of the present study was to investigate the role of oxidative cell damage in the pathogenesis of schizophrenia. Forty patients who fully met the fourth Diagnostic and Statistical Manual of Mental Disorders criteria for schizophrenia and 35 healthy control subjects were included in the study. Serum S100 B level was determined to investigate brain damage. Plasma malondialdehyde (MDA) levels and susceptibility of red blood cell (RBC) to oxidation were determined to investigate the oxidative status and plasma vitamin E, vitamin C, serum total carotenoid levels and total antioxidant capacity and RBC superoxide dismutase (SOD) and whole blood glutathione peroxidase activities were measured to investigate the antioxidative defence before and after 6 weeks of antipsychotic treatment. Plasma MDA and serum S100 B levels and RBC-SOD activity were significantly higher in the schizophrenia group than those of the control group. Treatment did not modify any of the oxidative-antioxidative system parameters or serum S100 B levels. S100 B level was significantly higher in patients with negative symptoms than the patients with positive symptoms and the control subjects. S100 B levels were significantly reduced after 6 weeks of treatment in patients with negative symptoms. The results of the present study might support the oxidative cell injury hypothesis of the schizophrenia. Furthermore, the underlying mechanisms of the subgroups of schizophrenia might be different as suggested by the increased S100 B levels and its decrement after treatment in patients with negative symptoms.

Research paper thumbnail of Majör Depresif Bozuklukta Düzelmenin Öngörücüleri

Nöro Psikiyatri Arşivi, 2013

Ge liş ta ri hi/Re cei ved: 15.08.2011 Ka bul ta ri hi/Ac cep ted: 12.01.2012 © Nö rop si ki yat ... more Ge liş ta ri hi/Re cei ved: 15.08.2011 Ka bul ta ri hi/Ac cep ted: 12.01.2012 © Nö rop si ki yat ri Ar şi vi Der gi si, Ga le nos Ya yı ne vi ta ra f›n dan ba s›l m›fl t›r. / © Arc hi ves of Neu ropsy chi atry, pub lis hed by Ga le nos Pub lis hing ÖZET Amaç: Bu çalışmada antidepresan (AD) tedavi ile Majör Depresif Bozuklukta (MDB) düzelmenin öngörücülerinin araştırılması amaçlanmıştır. Yöntem: Bu çalışmanın örneklemi, MBD'de AD etkinliğini araştıran, 4 çalışmaya ait veri havuzundan oluşturulmuştur. Bu çalışmada 178 hasta, son vizit olan vizit 5'te düzelip düzelmediklerine göre 2 gruba ayrıldı. Böylelikle hastalar kullandıkları AD'den bağımsız olarak sosyodemografik ve klinik özellikleri açısından birbirleriyle karşılaştırıldı. Bulgular: Düzelen ve düzelmeyen hastalar arasında sosyodemografik ve hastalık özellikleri açısından herhangi bir fark bulunamamıştır. Beşinci vizitte düzelen hastaların düzelmeyenlere göre birinci vizitte daha düşük Hamilton Depresyon Derecelendirme Ölçeği (HAM-D), Montgomery-Asberg Depresyon Değerlendirme Ölçeği, Hamilton Anksiyete Değerlendirme Ölçeği ve Klinik Global Değerlendirme Ölçeği-Hastalığın Şiddeti değerleri ile daha yüksek Sosyal Uyum Kendini Değerlendirme Ölçeği (SUKDÖ) değeri gösterdikleri tespit edilmiştir. Tedavinin başındaki ölçek değerlerinin (HAM-D ve SUKDÖ) düzelememe üzerinde bir risk faktörü olup olmadıklarını belirlemek amacıyla oluşturulan lojistik regresyon modeli anlamlı bulunmuştur (χ2=22,692 p<0,001). Bu model için düzelememe değişkeninin doğru sınıflandırma oranı %66'dir. Modelde 1. vizit HAM-D ve SUKDÖ ölçek değerleri, istatistiksel olarak anlamlı risk faktörleridir (p<0,001). HAM-D değişken değeri artıkça düzelememe riski 1,095 (Odds oranı için %95 güven aralığı: 1,045-1,147) kat artarken, SUKDÖ değişken değerinin düşük olması ise riski 1,076 (Odds oranı için %95 güven aralığı: 1,042-1,114) kat artırır. Bu model aracılığıyla her bir birey için düzelememe olasılığı "p(Düzelememe)=1/[(1+exp(-0,093×V1HAM-D+0,075×V1SUKDÖ)]" eşitliği kullanılarak tahmin edilebilir. Sonuç: AD tedavi ile düzelmeyi öngörmekte başlangıçta kaydedilen depresyonun, anksiyetenin ve sosyal uyum bozukluğunun şiddet düzeyinin etkili olduğu saptanmıştır. (Nöropsikiyatri Arşivi 2013; 50: 122-129) Anah tar ke li me ler: Majör depresif bozukluk, düzelme, antidepresan Çıkar çatışması: Yazarlar bu makale ile ilgili olarak herhangi bir çıkar çatışması bildirmemişlerdir. ABS TRACT Background: We aimed to determine the predictors of remission in major depressive disorder (MDD) with antidepressant treatment (AT). Methods: The subjects were recruited from the databases of the previous four studies. 178 patients were separated in to two groups at the final visit regarding remission. The patients were analyzed in terms of sociodemographic and clinical features regardless of their AT. Results: The difference in sociodemographic and clinical features was insignificant between the groups. Remitted patients had lower scores on the Hamilton Depression Rating Scale (HDRS), Montgomery-Asberg Depression Scale, Hamilton Anxiety Rating Scale, and the Clinical Global Impression Scale compared to baseline whereas Social Adaptation Self-evaluation Scale (SASS) scores were higher. To evaluate the impact of basal scores of HDRS and SASS on non remission rates, logistic regression analysis was performed. The analysis result was significant (p<0.001). Valid classification rate was 66% for this model. For this model, the scores of HDRS and SASS at visit 1 are significant risk factors for non-remission (p<0.001). As the value of HDRS increases, the risk of nonremission increases 1.095 fold (Odds ratio 95%, confidence interval: 1.045-1.147), whereas as the value of SASS decreases the risk of non-remission increases 1,076 fold (Odds ratio 95%, confidence interval: 1.042-1.114). For each patient, non-remission possibility can be predicted by "p(non remission)=1/[(1+exp (-0,093×V1HDRS+0,075×V1SASS)]" equivalent via this model. Conclusion: The findings of the present study suggest that severe level of depression, anxiety and social maladaptation at baseline are more likely to predict remission.

Research paper thumbnail of Hyperprolactinemia and possibly related development of prolactinoma during amisulpride treatment; three cases

Journal of Psychopharmacology, 2008

Schizophrenia is a chronic and debilitating psychotic mental disorder that affects about 1% of th... more Schizophrenia is a chronic and debilitating psychotic mental disorder that affects about 1% of the world's population. Antipsychotic drugs are the mainstay of treatment in schizophrenia. Hyperprolactinemia, which is a common side effect of typical antipsychotics, is also associated with the use of some of the newer atypical agents. Antipsychotics may enhance prolactinoma growth as manifested by an increase in serum prolactin concentration. Prolactin-secreting pituitary adenomas possibly related with antipsychotics have been described in the literature. To our knowledge, this is the first series of cases showing a possible relation between pituitary adenomas and amisulpride treatment in patients with schizophrenia.

Research paper thumbnail of Pathological yawning in a patient with anxiety and chronic disease anaemia

Journal of Psychopharmacology, 2008

Yawning, frequent in daily life, is accepted as a complex arousal reflex. Excessive yawning may b... more Yawning, frequent in daily life, is accepted as a complex arousal reflex. Excessive yawning may be due to neurological, psychiatric, infectious, gastrointestinal or metabolic diseases. This reflex has also been associated with different selective serotonin reuptake inhibitors. We report a female patient, with excessive yawning, who was on selective serotonin reuptake inhibitor treatment with the diagnosis of generalised anxiety disorder. She was then found to have endometrial carcinoma. Her complaints of palpitation, shortness of breath and loss of energy might be explained by a psychiatric disease and/or anaemia. Previous anaemic periods and partial response of her psychiatric symptoms during last 3 years alerted us to think about an organic cause. Investigations for chronic disease anaemia resulted in diagnosis of endometrial carcinoma. This case is a good example showing misdiagnosis caused by medical stigmatisation.

Research paper thumbnail of Urticaria and angio-oedema due to ziprasidone

Journal of Psychopharmacology, 2006

Antipsychotic medications are commonLy associated with adverse cutaneous reactions (ACRs) in appr... more Antipsychotic medications are commonLy associated with adverse cutaneous reactions (ACRs) in approximately 5% of patients. Angio-oedema accompanying urticaria is one of the most serious ACRs. The 36-year-old female patient who was diagnosed with `Paranoid schizophrenia' 6 years ago, was commenced on ziprasidone 120 mg/day. On day 30 of the treatment, the patient presented urticarial papules and plaques all over the body and angio-oedema in the face. The patient was diagnosed as `Urticaria + Angio-oedema'. The development of ACRs after the initation of ziprasidone monotherapy, disappearance of lesions after the discontinuation of this antipsychotic, and positive intradermal skin test all suggests a possible causal relationship between ACRs and ziprasidone. To our knowledge, this is the first reported case of urticaria and angio-oedema due to ziprasidone monotherapy. Ziprasidone is a valid and effective choice amongst antipsychotic medications, but this case calls for caution ...

Research paper thumbnail of Romatoid artritli hastalarda anksiyete ve depresyon

…, 2004

... Lale Altan1, Ümit Bingöl1, Zeynep Sağırkaya1, Aslı Sarandöl2, Merih Yurtkuran1 ... Anksiyete ... more ... Lale Altan1, Ümit Bingöl1, Zeynep Sağırkaya1, Aslı Sarandöl2, Merih Yurtkuran1 ... Anksiyete ve depresyon sıklıkla birbirine eşlik eden bozukluklar olmalarına karşın, RA&amp;amp;amp;amp;amp;#x27;li hastalarda anksiyete depresyon kadar ilgi konusu olmamıştır. Ancak anksiyetenin de ...

Research paper thumbnail of Seizure Activity after Venlafaxine Overdose

Journal of Pharmacy Technology, 2003

Objective: To report the findings from the case of a patient developing first-time seizure activi... more Objective: To report the findings from the case of a patient developing first-time seizure activity following an overdose of venlafaxine. Case Summary: A 27-year-old man with major depression ingested 60 venlafaxine 75-mg capsules in an apparent suicide attempt. The patient experienced generalized seizure activity 9 and 11 hours after ingestion. The electroencephalogram showed a pathologic pattern, with several generalized epileptiform discharges. Venlafaxine was discontinued, and no further sequelae were observed. Discussion: The Naranjo probability scale indicated a probable relationship between the seizures and venlafaxine overdose. The mechanism of seizures associated with venlafaxine overdose is unclear. Neurotransmitters play an important role in seizure genesis, and hepatic damage may occur. Conclusions: Clinicians should be aware of proconvulsant effect and the risk of hepatocellular injury from venlafaxine overdose when prescribing this drug.

Research paper thumbnail of Depresyon, Nöroplastisite ve Nörotrofik Faktörler

Yaygin bir psikiyatrik bozukluk olan depresyon patofizyolojisinin altinda yatan norobiyolojik deg... more Yaygin bir psikiyatrik bozukluk olan depresyon patofizyolojisinin altinda yatan norobiyolojik degisiklikler hakkinda halen cok az sey bilinmektedir. Depresyonun biyolojik etiyolojisi hakkinda gelistirilen kuramlardan monoamin hipotezi ve norotransmitter reseptor hipotezine son yillarda depresyonun noroplastisite hipotezi eklenmistir. Noroplastisite, cesitli ic ve dis uyaranlara bagli olarak beyindeki noronlarin ve bunlarin olusturdugu sinapslarin yapisal ozellikleri ve islevlerindeki degisiklikler olarak tanimlanabilir. Norotrofik faktorler; noronlarin gelisimi ve korunmasi icin buyuk oneme sahip olan molekullerdir. Noron yasamak, farklilasmak ve noroplastisite icin kendi salgiladigi norotrofik faktorlere gereksinim duymaktadir. Hipokampus noroplastisitesi en yuksek beyin bolgelerinden biridir. Beyin goruntuleme calismalari; depresyonlu olgularda hipokampal hacim azalmasi oldugunu gostermektedir. Bu durum hipokampustaki norogenez ve norotrofik faktor ekspresyonunda stresle induklene...

Research paper thumbnail of Art Therapy with Psoriatic Patients

This study aimed at investigating the themes that emerged after an art therapy and assessing the ... more This study aimed at investigating the themes that emerged after an art therapy and assessing the effectiveness of art therapy using psychological scales and dermatological evaluation indices before and after the therapy in individuals with psoriasis. The study included patients aged 18-65 with moderate psoriasis who had the disease for 5 or more years and were in need of systemic treatment. Those who had a concomitant physical disorder including another skin disease, an active joint disorder or a psychiatric diagnosis other than adjustment disorder were excluded from the study. A total of 15 sessions each lasting 150 minutes were held once a week. Various art techniques including music, painting and ceramics were practised to evaluate within the group patients’ understanding of the illness and their self-awareness. The outcomes of the study were presented over three patients who attended the sessions regularly. The dermatological evaluations, patient feedbacks and observations of th...

Research paper thumbnail of Comparison of The Efficacy and Safety of Sertraline, Reboxetine, and Venlafaxine in Patients with Major Depressive Disorder: A Pooled Analysis of Four Randomized, Open-Label Trials

Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychopharmacology, 2010

Major depresif bozukluk'ta sertralin, venlafaksin ve reboksetinin etkiliği ve güvenilirliğinin ka... more Major depresif bozukluk'ta sertralin, venlafaksin ve reboksetinin etkiliği ve güvenilirliğinin karşılaştırılması: dört randomize, açık çalışmanın verilerinin analizi Amaç: Bu araştırma major depresif bozukluk (MDB) tedavisinde sıkça kullanılan sertralin, reboksetin, venlafaksin ve sertralin-reboksetin kombinasyonunun depresif belirtiler üzerine etkisi ile bu tedavilerin etkililik ve güvenlik açısından birbiriyle karşılaştırılmasını amaçlamıştır. Yöntem: Daha önceki dört çalışmaya alınmış ve bu çalışmaları tamamlamış hastaların verileri bir arada değerlendirilmiştir. 206 hasta reboksetin, venlafaksin, sertralin ve sertralin-reboksetin kombinasyon gruplarına dahil edilmiş olup 37 hasta çalışmaları tamamlayamamıştır. Kalan 169 hastanın 43'er tanesi reboksetin ve venlafaksin, 42'si sertralin, 41'i sertralin-reboksetin kombinasyon grubunda yer almaktaydı. Bulgular: MDB klinik özellikleri ile sosyodemografik özellikler açısından gruplar arasında fark yoktu. Hamilton Depresyon Derecelendirme Ölçeği (HAM-D) değerlerindeki yüzdelik düşüş venlafaksin grubunda vizit 2 ve 3'te sertraline göre [sırasıyla p=0.001, ES: 0.1404 (büyük) ve p=0.002, ES: 0.1109 (orta)] ve sertralin-reboksetin kombinasyonuna göre vizit 2 ve 3'te [sırasıyla p=0.006, ES: 0.0910 (orta) ve p=0.004, ES: 0.1023 (orta)] daha yüksek olduğu saptanmıştır. Yine HAM-D değerlerindeki yüzdelik düşüş reboksetin grubunda sertraline göre vizit 2'de daha yüksek bulundu [p=0.02, ES: 0.0615 (orta)]. En sık rastlanan kalıntı belirtileri 1., 7., 10., 11., 13., ve 14. HAM-D maddeleriydi. Sonuç: Farklı nörotransmiter mekanizmaları üzerinden etki etmekle beraber bu çalışmadaki antidepresanlar benzer etkililik göstermişlerdir. Bununla beraber her tedavi yöntemi farklı belirti ve belirti grupları üzerinde etkili bulunmuş, antidepresan etkililiğin ortaya çıkış zamanları açısından farklılık göstermişlerdir. Bir takım kısıtlılıklarına karşın, bu alandaki çalışmaların az olması da göz önüne alındığında, bu çalışmanın bir ön çalışma olarak literatüre katkı sağlayacağı kanısındayız.

Research paper thumbnail of Work motivation and related demographic factors in unemployed patients with schizophrenia

Anatolian Journal of Psychiatry, 2019

Objective: Working rate in patients with schizophrenia is considerably low. Nonetheless, unemploy... more Objective: Working rate in patients with schizophrenia is considerably low. Nonetheless, unemployed patients might have desire to work and look for a job. Identifying the reasons underlying the patients’ work motivation and related factors can be instructive for the vocational rehabilitation services. The purpose of this study was to deter-mine the reasons for work motivation and to identify the predictors of motivation in unemployed patients with schizo-phrenia. Methods: Sociodemographic and working life information of 379 unemployed patients with schizophrenia or schizoaffective disorder diagnosed for at least two years was collected from six different centers. The patients were questioned about their desire to work and its reasons. Having desire to work and job seeking behavior together was considered as work motivation. Patients with and without having work motivation were compared regarding to their sociodemographic information and illness characteristics. Logistic regression analysis was conducted to find the factors predicting the work motivation. Results: The participants’ mean age was 42, level of education was nine years, duration of illness was 18 years, and majority consisted of males and single patients. It was found that 33% of the patients were motivated to work. While distinct underlying reasons of the work motivation were found as financial needs (45%) and will for independent living (35%), idea of not being able to deal with the requirements of the job (66%) and not receiving social welfare payment (24%) were dominant in patients who weren’t motivated to work. The predictors of work motivation were found as male gender (OR=2.0), having a profession (OR=2.0), having work experience after the illness (OR=1.2), level of education (OR=1.1), and duration of illness (OR=0.9). Conc-lusion: We found that one-third of unemployed patients with schizophrenia have work motivation as an important finding. The patients may feel more comfortable and motivated to work if they would continue to receive social wel-fare payment after they started a job. It could be concluded patients who have a profession, high level of education, previous job experience, and who are at the early stage of their illness are suitable candidates for the vocational rehabilitation services.

Research paper thumbnail of Rates and correlates of employment in patients with schizophrenia: A multicenter study in Turkey

International Journal of Social Psychiatry, 2019

Background: There is not enough information regarding the participation in the working life of th... more Background: There is not enough information regarding the participation in the working life of the patients with schizophrenia in Turkey. Aims: The aim of this study was to examine the occupational experiences of patients with schizophrenia before and after the illness and to investigate the factors that predict work participation. Methods: The data on occupational life of the patients with schizophrenia, which were treated as outpatients in six different centers, were examined. The rates of participation in working life before and after the disease were evaluated. Patients with and without occupational life history after the disease were compared in terms of demographic characteristics. Factors predicting participation in work life after the disease were analyzed by logistic regression analysis. Results: Out of the 587 patients evaluated in the study, 73% were males, 73% were single, the mean age was 42, mean level of education was 9 years and the average duration of illness was 18...

Research paper thumbnail of The relationship between psychopathology, psychosocial adjustment, social support and quality of life in multiple sclerosis

The European Research Journal, 2018

Objectives: Multiple Sclerosis (MS) is a chronic disease which affects physical,psychological and... more Objectives: Multiple Sclerosis (MS) is a chronic disease which affects physical,psychological and social functioning of patients. In this study we aim to indicate psychiatric comorbidity, some psychosocial factors and their associations with quality of life in patients with MS. Methods: A total of 227 patients underwent psychiatric examination and the following scales were applied: Socio-demographic data form, Hospital Anxiety and Depression Scale (HADS), Multiple Sclerosis Quality of Life-54 (MSQOL-54), Psychosocial Adjustment to Illness Scale-Self report (PAIS-SR) and Multidimensional Scale of Perceived Social Support (MSPSS). Results: Among 227 patients with MS, 67.8% (n = 154) had psychiatric diagnosis; 24.2% (n = 55) had depression,19.8% (n = 45) had adjustment disorder, 14.9% (n = 34) had anxiety disorder, 7.1% (n=16) had dysthymic disorder and 1.8% (n = 4) had bipolar disorder. Patients with a psychiatric diagnosis had lower scores in role limitations due to emotional problem...

Research paper thumbnail of First‐episode psychosis is associated with oxidative stress: Effects of short‐term antipsychotic treatment

Psychiatry and Clinical Neurosciences, 2015

AimsIn the present study, our aim was to investigate the oxidative–antioxidative systems in unmed... more AimsIn the present study, our aim was to investigate the oxidative–antioxidative systems in unmedicated first‐episode psychosis (FEP) patients at the beginning and after short‐term treatment.MethodsThis study consisted of 29 patients who experienced an FEP and 25 control subjects. In order to investigate the oxidative status, we determined plasma malondialdehyde (MDA) levels, oxidizability of red blood cells, oxidation and oxidizability of apolipoprotein B‐containing lipoproteins (apo B‐basal MDA and apo B‐ΔMDA). In order to evaluate the antioxidative defense, we measured serum total antioxidative capacity, uric acid, albumin, total bilirubin and vitamin E levels and serum paraoxonase/arylesterase, whole blood glutathione peroxidase (GPx) and red blood cell superoxide dismutase activities before and after 6 weeks of treatment in patients with FEP.ResultsPlasma MDA and apo B‐basal MDA levels and red blood cell superoxide dismutase activity were significantly higher and serum aryleste...

Research paper thumbnail of Reboxetine induced erectile dysfunction and spontaneous ejaculation during defecation and micturition

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2007

This is a case report of reboxetine induced erectile dysfunction, seminal emission and ejaculatio... more This is a case report of reboxetine induced erectile dysfunction, seminal emission and ejaculation during defecation and micturition. A 44 year old male who had been suffering from depression without any sexual dysfunction was put on venlafaxine XR treatment. Due to delayed ejaculation and occasional episodes of absence of ejaculation he was switched to reboxetine. At the second week of treatment he reported erectile dysfunction and premature ejaculation, and seminal emission and ejaculation during defecation and micturition occurred later at 8th week of treatment. After he was switched to sertraline 50 mg/day, his erectile dysfunction, premature and spontaneous ejaculation symptoms subsided in 2 weeks. Although reboxetine is reported to be free of sexual side effects, individual vulnerabilities to such unwanted effects should be considered, and sexual dysfunction should be assessed thoroughly during the treatment.

Research paper thumbnail of Are there differences between serotonergic, noradrenergic and dual acting antidepressants in the treatment of depressed women?

The World Journal of Biological Psychiatry, 2009

Research paper thumbnail of A patient using ziprasidone with polydipsia, seizure, hyponatremia and rhabdomyolysis

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2006

We aimed to report a case with rhabdomyolysis related to hyponatremia and/or its correction. A 32... more We aimed to report a case with rhabdomyolysis related to hyponatremia and/or its correction. A 32-year-old male schizophrenic patient on ziprasidone treatment was admitted to the hospital following a seizure. Patient had primary polydipsia and secondarily developed hyponatremia. After the correction of hyponatremia, due to the high liver enzyme levels, he was diagnosed as rhabdomyolysis. Although the role of antipsychotics in this situation is speculative, development of rhabdomyolysis related to hyponatremia and/or its correction should not be underestimated and should be assesed throughly.

Research paper thumbnail of Oxidation of apolipoprotein B-containing lipoproteins and serum paraoxonase/arylesterase activities in major depressive disorder

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2006

Major depressive disorder (MDD) is blaimed to play a role in the onset of coronary artery disease... more Major depressive disorder (MDD) is blaimed to play a role in the onset of coronary artery disease (CAD). The aim of the present study was to investigate serum paraoxonase/arylesterase activities and oxidation of apolipoprotein B-containing lipoproteins in patients with MDD. Oxidation of lipoproteins plays an important role in atherogenesis and the enzyme paraoxonase, has been shown to prevent lipoprotein oxidation. Furthermore, low paraoxonase activity was suggested to predict CAD. Eighty-six patients who fully met the fourth Diagnostic and Statistical Manual of Mental Disorders criteria for MDD and 36 healthy control subjects were included in the study. Serum paraoxonase and arylesterase activities were determined spectrophotometrically. Malondialdehyde (MDA) levels of apolipoprotein B-containing lipoproteins were determined before (basal) and after incubation with copper-sulphate, that yielded basal-and Δ-MDA values, respectively. Serum paraoxonase/arylesterase activities were significantly reduced in the post-treatment group compared with the pre-treatment group. Basal-MDA (MDA) level was significantly higher in the MDD group compared with the control group. Δ-MDA level of the severe MDD group was significantly higher than that of the control group. There was a positive correlation between the oxidizability of apolipoprotein B-containing lipoproteins and the severity of the disease. Total cholesterol, HDL-cholesterol, LDL-cholesterol, apolipoprotein B levels were significantly higher and apolipoprotein AI levels were significantly lower in the MDD group compared with those of the control group. The findings of the present study suggest that: 1) antidepressant treatment might reduce serum paraoxonase activity/mass; 2) oxidation and oxidizability of apolipoprotein B-containing lipoproteins seem to be increased in MDD.

Research paper thumbnail of Effects of various antidepressants on serum thyroid hormone levels in patients with major depressive disorder

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2008

A total of 62 patients with major depressive disorder were analyzed in the study. Patients were e... more A total of 62 patients with major depressive disorder were analyzed in the study. Patients were evaluated for 11 weeks in an open label design to investigate the differential effects of reboxetine, sertraline and venlafaxine on thyroid hormones. Serum thyrotrophin (TSH), thyroxine (T4) and free (f)T4 levels were measured before and after treatment. All groups showed significant improvement in HAM-D scores. TSH level significantly reduced and T4 level significantly increased in the reboxetine group, however TSH level significantly increased and T4 level significantly reduced in the sertraline group. Percent changes of TSH (p = 0.007) and T4 (p = 0.001) were significantly different between the reboxetine and sertraline groups. In the sertraline group, baseline TSH levels were correlated with response to treatment as determined by the change in HAM-D scores (p = 0.03, r = 0.648). There was a significant association between the percent changes in TSH values and the reduction in HAM-D scores in the reboxetine group (p = 0.03, r = −0.434). In the whole study group, female patients had lower values of basal T4 compared with men (p = 0.043), however percent changes of T4 did not differ between genders. In the treatment-responders significant increase in the reboxetine group and significant decrease in the sertraline group regarding the T4 values were found. We observed that various antidepressants had different effects on thyroid hormone levels and this could be attributed to the different mechanisms of actions of these antidepressants.

Research paper thumbnail of Addiction to topically used cyclopentolate hydrochloride: A case report

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2008

Research paper thumbnail of Oxidative–antioxidative systems and their relation with serum S100 B levels in patients with schizophrenia: Effects of short term antipsychotic treatment

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2007

Oxidative stress may be a contributing factor in the etiopathophysiology of schizophrenia, which ... more Oxidative stress may be a contributing factor in the etiopathophysiology of schizophrenia, which may be exacerbated by the treatment with antipsychotics with pro-oxidant properties. Increased levels of S100 B are associated with neurodegenerative disorders, including schizophrenia. The aim of the present study was to investigate the role of oxidative cell damage in the pathogenesis of schizophrenia. Forty patients who fully met the fourth Diagnostic and Statistical Manual of Mental Disorders criteria for schizophrenia and 35 healthy control subjects were included in the study. Serum S100 B level was determined to investigate brain damage. Plasma malondialdehyde (MDA) levels and susceptibility of red blood cell (RBC) to oxidation were determined to investigate the oxidative status and plasma vitamin E, vitamin C, serum total carotenoid levels and total antioxidant capacity and RBC superoxide dismutase (SOD) and whole blood glutathione peroxidase activities were measured to investigate the antioxidative defence before and after 6 weeks of antipsychotic treatment. Plasma MDA and serum S100 B levels and RBC-SOD activity were significantly higher in the schizophrenia group than those of the control group. Treatment did not modify any of the oxidative-antioxidative system parameters or serum S100 B levels. S100 B level was significantly higher in patients with negative symptoms than the patients with positive symptoms and the control subjects. S100 B levels were significantly reduced after 6 weeks of treatment in patients with negative symptoms. The results of the present study might support the oxidative cell injury hypothesis of the schizophrenia. Furthermore, the underlying mechanisms of the subgroups of schizophrenia might be different as suggested by the increased S100 B levels and its decrement after treatment in patients with negative symptoms.

Research paper thumbnail of Majör Depresif Bozuklukta Düzelmenin Öngörücüleri

Nöro Psikiyatri Arşivi, 2013

Ge liş ta ri hi/Re cei ved: 15.08.2011 Ka bul ta ri hi/Ac cep ted: 12.01.2012 © Nö rop si ki yat ... more Ge liş ta ri hi/Re cei ved: 15.08.2011 Ka bul ta ri hi/Ac cep ted: 12.01.2012 © Nö rop si ki yat ri Ar şi vi Der gi si, Ga le nos Ya yı ne vi ta ra f›n dan ba s›l m›fl t›r. / © Arc hi ves of Neu ropsy chi atry, pub lis hed by Ga le nos Pub lis hing ÖZET Amaç: Bu çalışmada antidepresan (AD) tedavi ile Majör Depresif Bozuklukta (MDB) düzelmenin öngörücülerinin araştırılması amaçlanmıştır. Yöntem: Bu çalışmanın örneklemi, MBD'de AD etkinliğini araştıran, 4 çalışmaya ait veri havuzundan oluşturulmuştur. Bu çalışmada 178 hasta, son vizit olan vizit 5'te düzelip düzelmediklerine göre 2 gruba ayrıldı. Böylelikle hastalar kullandıkları AD'den bağımsız olarak sosyodemografik ve klinik özellikleri açısından birbirleriyle karşılaştırıldı. Bulgular: Düzelen ve düzelmeyen hastalar arasında sosyodemografik ve hastalık özellikleri açısından herhangi bir fark bulunamamıştır. Beşinci vizitte düzelen hastaların düzelmeyenlere göre birinci vizitte daha düşük Hamilton Depresyon Derecelendirme Ölçeği (HAM-D), Montgomery-Asberg Depresyon Değerlendirme Ölçeği, Hamilton Anksiyete Değerlendirme Ölçeği ve Klinik Global Değerlendirme Ölçeği-Hastalığın Şiddeti değerleri ile daha yüksek Sosyal Uyum Kendini Değerlendirme Ölçeği (SUKDÖ) değeri gösterdikleri tespit edilmiştir. Tedavinin başındaki ölçek değerlerinin (HAM-D ve SUKDÖ) düzelememe üzerinde bir risk faktörü olup olmadıklarını belirlemek amacıyla oluşturulan lojistik regresyon modeli anlamlı bulunmuştur (χ2=22,692 p<0,001). Bu model için düzelememe değişkeninin doğru sınıflandırma oranı %66'dir. Modelde 1. vizit HAM-D ve SUKDÖ ölçek değerleri, istatistiksel olarak anlamlı risk faktörleridir (p<0,001). HAM-D değişken değeri artıkça düzelememe riski 1,095 (Odds oranı için %95 güven aralığı: 1,045-1,147) kat artarken, SUKDÖ değişken değerinin düşük olması ise riski 1,076 (Odds oranı için %95 güven aralığı: 1,042-1,114) kat artırır. Bu model aracılığıyla her bir birey için düzelememe olasılığı "p(Düzelememe)=1/[(1+exp(-0,093×V1HAM-D+0,075×V1SUKDÖ)]" eşitliği kullanılarak tahmin edilebilir. Sonuç: AD tedavi ile düzelmeyi öngörmekte başlangıçta kaydedilen depresyonun, anksiyetenin ve sosyal uyum bozukluğunun şiddet düzeyinin etkili olduğu saptanmıştır. (Nöropsikiyatri Arşivi 2013; 50: 122-129) Anah tar ke li me ler: Majör depresif bozukluk, düzelme, antidepresan Çıkar çatışması: Yazarlar bu makale ile ilgili olarak herhangi bir çıkar çatışması bildirmemişlerdir. ABS TRACT Background: We aimed to determine the predictors of remission in major depressive disorder (MDD) with antidepressant treatment (AT). Methods: The subjects were recruited from the databases of the previous four studies. 178 patients were separated in to two groups at the final visit regarding remission. The patients were analyzed in terms of sociodemographic and clinical features regardless of their AT. Results: The difference in sociodemographic and clinical features was insignificant between the groups. Remitted patients had lower scores on the Hamilton Depression Rating Scale (HDRS), Montgomery-Asberg Depression Scale, Hamilton Anxiety Rating Scale, and the Clinical Global Impression Scale compared to baseline whereas Social Adaptation Self-evaluation Scale (SASS) scores were higher. To evaluate the impact of basal scores of HDRS and SASS on non remission rates, logistic regression analysis was performed. The analysis result was significant (p<0.001). Valid classification rate was 66% for this model. For this model, the scores of HDRS and SASS at visit 1 are significant risk factors for non-remission (p<0.001). As the value of HDRS increases, the risk of nonremission increases 1.095 fold (Odds ratio 95%, confidence interval: 1.045-1.147), whereas as the value of SASS decreases the risk of non-remission increases 1,076 fold (Odds ratio 95%, confidence interval: 1.042-1.114). For each patient, non-remission possibility can be predicted by "p(non remission)=1/[(1+exp (-0,093×V1HDRS+0,075×V1SASS)]" equivalent via this model. Conclusion: The findings of the present study suggest that severe level of depression, anxiety and social maladaptation at baseline are more likely to predict remission.

Research paper thumbnail of Hyperprolactinemia and possibly related development of prolactinoma during amisulpride treatment; three cases

Journal of Psychopharmacology, 2008

Schizophrenia is a chronic and debilitating psychotic mental disorder that affects about 1% of th... more Schizophrenia is a chronic and debilitating psychotic mental disorder that affects about 1% of the world's population. Antipsychotic drugs are the mainstay of treatment in schizophrenia. Hyperprolactinemia, which is a common side effect of typical antipsychotics, is also associated with the use of some of the newer atypical agents. Antipsychotics may enhance prolactinoma growth as manifested by an increase in serum prolactin concentration. Prolactin-secreting pituitary adenomas possibly related with antipsychotics have been described in the literature. To our knowledge, this is the first series of cases showing a possible relation between pituitary adenomas and amisulpride treatment in patients with schizophrenia.

Research paper thumbnail of Pathological yawning in a patient with anxiety and chronic disease anaemia

Journal of Psychopharmacology, 2008

Yawning, frequent in daily life, is accepted as a complex arousal reflex. Excessive yawning may b... more Yawning, frequent in daily life, is accepted as a complex arousal reflex. Excessive yawning may be due to neurological, psychiatric, infectious, gastrointestinal or metabolic diseases. This reflex has also been associated with different selective serotonin reuptake inhibitors. We report a female patient, with excessive yawning, who was on selective serotonin reuptake inhibitor treatment with the diagnosis of generalised anxiety disorder. She was then found to have endometrial carcinoma. Her complaints of palpitation, shortness of breath and loss of energy might be explained by a psychiatric disease and/or anaemia. Previous anaemic periods and partial response of her psychiatric symptoms during last 3 years alerted us to think about an organic cause. Investigations for chronic disease anaemia resulted in diagnosis of endometrial carcinoma. This case is a good example showing misdiagnosis caused by medical stigmatisation.

Research paper thumbnail of Urticaria and angio-oedema due to ziprasidone

Journal of Psychopharmacology, 2006

Antipsychotic medications are commonLy associated with adverse cutaneous reactions (ACRs) in appr... more Antipsychotic medications are commonLy associated with adverse cutaneous reactions (ACRs) in approximately 5% of patients. Angio-oedema accompanying urticaria is one of the most serious ACRs. The 36-year-old female patient who was diagnosed with `Paranoid schizophrenia' 6 years ago, was commenced on ziprasidone 120 mg/day. On day 30 of the treatment, the patient presented urticarial papules and plaques all over the body and angio-oedema in the face. The patient was diagnosed as `Urticaria + Angio-oedema'. The development of ACRs after the initation of ziprasidone monotherapy, disappearance of lesions after the discontinuation of this antipsychotic, and positive intradermal skin test all suggests a possible causal relationship between ACRs and ziprasidone. To our knowledge, this is the first reported case of urticaria and angio-oedema due to ziprasidone monotherapy. Ziprasidone is a valid and effective choice amongst antipsychotic medications, but this case calls for caution ...