Tek doz bupropion kullanımına bağlı akut distoni: Bir olgu sunumu
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Tarih
2015
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AVES Yayıncılık
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bupropiyon SR, sigara bırakma tedavisi için Food and Drug Administration ve Avrupa Birliğinde onay alm ış nikotin dışı önemli bir farmakolojik seçenektir. Ayrıca majör depresyon tedavisinde kullanılan bupropiyon, noradrenalin ve dopamin geri alım inhibitörü olarak etki gösteren ajanlardan biridir. Tütün bağımlılığında dopamin ödüllendirme yolağını bloke ederek ve noradrenalin yolağına bağlı olarak ortaya çıkan yoksunluk belirtilerini azaltarak etki ettiği düşünülmektedir. Biz burada ilk doz bupropion SR aldıktan sonra akut distoni gelişen bir majör depresyon ve komorbid nikotin bağımlılığı olgusunu sunmayı amaçladık. Otuz iki yaşındaki erkek hastaya majör depresyon ve komorbid nikotin bağımlılığı tanısı konuldu. Hastada ek psikiyatrik ve psikiyatri dışı bir hastalık yoktu. Kullandığı herhangi bir ilaç yoktu. Hastaya bupropiyon 300 mg/gün başlandı. Hasta aldığı ilk doz 300 mg bupropiondan sonra boynunda kasılma hissi, dilini sürekli ağız dışında tutma ve tükürüğünü yutamama yakınmalarıyla acil servise başvurdu. Rutin laboratuvar testleri normal bulundu ve nörolojik muayenede akut distoni dışında bir patolojik bulgu saptanmadı. Klinik tablo bupropiyona bağlı akut distoni olarak değerlendirildi. Hastaya 5 mg biperiden i.m. yapıldı ve belirtiler düzeldi. Hastanın 24 saat sonraki muayenesinde distoni belirtileri yoktu. Bupropiyon kullanım ında görü- len yan etkiler uykusuzluk, baş ağrısı ve ağız kuruluğu, döküntü, bulantı, uykusuzluk, aşırı terleme, kulak çınlaması, hipertansiyon şeklinde sıralanabilir. Bupropiyonla ilişkili olarak literatürde hipomani, akut psikoz, görsel halüsinayon gibi psikiyatrik tablolarla beraber distoni, hiponatremi, hipokalemi, trombotik trombositopenik purpura gibi bazı farklı psikiyatri dışı genel tıbbi tablolar bildirilmiştir.
Bupropion is an important pharmacologic agent similar to nicotine in the treatment of smoking cessation approved by Food and Drug Administration and European Union. Also, bupropion is an agent in the treatment of major depression as noradrenaline and dopamine reuptake inhibitor. In nicotine addiction, it is thought that it affects by blocking the dopamine reward pathway and decreasing the withdrawal symptoms related with noradrenaline path- way. We aimed to present a case with major depression and nicotine addiction developing acute dystonia with use of bupropion. Thirty-two year-old male, was diagnosed as having major depression and comorbid nicotine addiction. He did not have either another psychiatric problems or another medical disease and also he had not been using any kind of medicine. He was started to have 300 mg/day bupropion. The day after having first dose of 300 mg bupropion, he had some kind of pseudoesthesias which caused sense of his neck being shorten, holding his tongue out of his mouth, and not swallowing his saliva so he was taken to emergency. Evaluations and routine testing were observed normal ranges and there were not determined any pathologic issues out of acute dystonia during the neurologic examination. Clinical table showed that acute dystonia related to bupropion. His symptoms were getting better after he was given 5 mg biperiden as i.m. Finally, it was observed that there were not any dystonia symp- toms after 24 hours of his check. Side effects of bupropion include insomnia, headache, dry mouth, eruption, nausea, excessive sweating, tinnitus and hypertension. Psychiatric problems including hypomania, acute psychosis, visual hallucinations and dystonia, hyponatremia, hypokalemia, and thrombotic thrombocytopenic purpura also reported as side effects of bupropion use in literature.
Bupropion is an important pharmacologic agent similar to nicotine in the treatment of smoking cessation approved by Food and Drug Administration and European Union. Also, bupropion is an agent in the treatment of major depression as noradrenaline and dopamine reuptake inhibitor. In nicotine addiction, it is thought that it affects by blocking the dopamine reward pathway and decreasing the withdrawal symptoms related with noradrenaline path- way. We aimed to present a case with major depression and nicotine addiction developing acute dystonia with use of bupropion. Thirty-two year-old male, was diagnosed as having major depression and comorbid nicotine addiction. He did not have either another psychiatric problems or another medical disease and also he had not been using any kind of medicine. He was started to have 300 mg/day bupropion. The day after having first dose of 300 mg bupropion, he had some kind of pseudoesthesias which caused sense of his neck being shorten, holding his tongue out of his mouth, and not swallowing his saliva so he was taken to emergency. Evaluations and routine testing were observed normal ranges and there were not determined any pathologic issues out of acute dystonia during the neurologic examination. Clinical table showed that acute dystonia related to bupropion. His symptoms were getting better after he was given 5 mg biperiden as i.m. Finally, it was observed that there were not any dystonia symp- toms after 24 hours of his check. Side effects of bupropion include insomnia, headache, dry mouth, eruption, nausea, excessive sweating, tinnitus and hypertension. Psychiatric problems including hypomania, acute psychosis, visual hallucinations and dystonia, hyponatremia, hypokalemia, and thrombotic thrombocytopenic purpura also reported as side effects of bupropion use in literature.
Açıklama
Anahtar Kelimeler
Akut distoni, Bupropiyon, Depresyon, Acute dystonia, Bupropion, Depression
Kaynak
Anadolu Psikiyatri Dergisi
WoS Q Değeri
Q4
Scopus Q Değeri
Q4
Cilt
16
Sayı
3
Künye
Demir, S., Atlı, A., Güneş, M., Çatı, S., Akıl, E., Çetinkaya, N. ve diğerleri. (2015). Tek doz bupropion kullanımına bağlı akut distoni: Bir olgu sunumu. Anadolu Psikiyatri Dergisi, 16(3), 227-229.
