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Antiepileptik kullanımıyla ilişkili intihar girişimiyle sonuçlanmış bir epileptik psikoz vakası

A case of epileptic psychosis culminating in attempted suicide related to the use of antiepileptic

Journal Name:

  • Smyrna Tıp Dergisi

Publication Year:

  • 2012

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Abstract (2. Language): 
Psychosis is seen in approximately 5.4% of epileptic patients, a rate which is eight times that of the normal population. The commonest type of seizure seen with epileptic psychosis is complex partial seizure which is resistant to treatment. It has been suggested that 2% of epileptic psychosis cases are related to the use of Lamotrigine, and suicidal thoughts have been reported in 0.43-1.84% of patients using antiepileptic drugs. In this article, a 45-year-old woman, who had been taking antiepileptic treatment for fifteen years, and who had idiopathic epilepsy with resistant generalised tonic-clonic seizures, was presented. Valproic acid and later Carbamazepine failed to bring her seizures under control, and in the past year, after the use of Lamotrigine was started, her seizure type changed to complex partial seizure. During the course of treatment with 250mg/day of Lamotrigine, monitoring by magnetic rezonans imaging, and checking that her electroencephalography was within normal limits, indications of psychosis began to be observed. The patient began to hear voices ordering her to kill herself, after which she made an attempt at suicide in which she made lateral cuts to both wrists and her neck. It was decided that this attack, which began after a change in antiepileptic medication, was epileptic psychosis related to Lamotrigine. Her antiepileptic treatment was changed and antipsychotic treatment was begun. This case is presented with the aim of making known and discussing this rare attempted suicide in an epilepsy patient using Lamotrigine, and the severe consequences of psychosis related to the drug
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Abstract (Original Language): 
Psikoz, epileptik hastaların yaklaşık %5,4’ünde gözlenir ve bu oran normal populasyondan sekiz kat daha fazladır. Epileptik psikozda en sık görülen nöbet tipi; tedaviye dirençli kompleks parsiyel nöbetlerdir. Epileptik psikoz vakalarının %2’sinin Lamotrigine kullanımına bağlı olduğu düşünülmektedir ve antiepileptik ilaç kullanan hastaların %0,43-1,84’ünde intihar düşünceleri rapor ediliştir. Bu makalede 45 yaşında, onbeş yıldır antiepileptik tedavi alan ve idiopatik epilepsi ile birlikte dirençli generalize tonik-klonik kasılmaları olan kadın hasta sunulmuştur. Valproik asit ve ardından kullanılan Karbamezapin nöbetlerini kontrol altına almada yetersiz kalmış, ve son yıl içerisinde kullanılmaya başlanan Lamotrigine sonrası nöbetleri kompleks parsiyel şekle dönmüştür. 250 mg/gün dozunda sürdürülen Lamotrigine tedavisi sırasında; magnetik rezonans görüntülemesi ve elektroensefalografi kontrolları normal sınırlarda olan hastada, psikoz gözlenmeye başlandı. Hasta, kendini öldürmesi gerektiğine dair sesler duymaya başlamasından sonra, her iki el bileği ve boynuna yaptığı kesilerle intihar girişiminde bulundu. Bu atağın, epileptik tedavideki değişim sonrası Lamotrigine kullanımına bağlı gelişen epileptik psikoza bağlı olduğu düşünüldü. Antiepileptik tedavisi değiştirildi ve antipsikotik tedavi başlandı. Bu makale, Lamotrigine kullanan hastalarda nadirde olsa ortaya çıkabilecek intihar girişimlerinin ve bu ilaca bağlı psikozun ciddi sonuçlarının bilinmesi ve tartışılması amacıyla sunulmuştur
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  • 2
32-35
  • Turkish

REFERENCES

References: 

1. Elliott B, Joyce E, Shorvon S. Delusions, illusions and
hallucinations in epilepsy: 2. Complex phenomena and
psychosis. Epilepsiy Research 2009; 85: 172-186.
2. Wade FJ, Dang CV, Nelson L, Wasserberger J.
Emergent complications of the newer anticonvulsants.
The journal of emergency medicine 2010; 38(2):231-
237.
3. Bilgiç A, Yılmaz S, Tıraş S, Deda G, Kılıç ZE. Bir
grup epilepsili çocukta depresyon ve anksiyete belirti
düzeyi ve ilişkili faktörler. Turk Psikiyatri Dergisi
2006; 17:165-172.
4. Swinkels WAM, Kuyk J, Dyck V, Spinhoven C.
Psychiatric comorbidity in epilepsy. Epilepsy &
Behavior 2005; 7:37–50.
5. Rezaki M. Şizofreni nörobiyolojisine kısa bir bakış.
Klinik Psikiyatri 1998; 1:31-34.
6. Flugel D, Toole A, Thompsona PJ, Koepp MJ,
Cercignani M. A neuropsychological study of patients
with temporal lobe epilepsy and chronic interictal
psychosis. Epilepsy Research 2006; 71:117–128.
7. Adachia N, Harac T, Oanad Y, Matsuurae M, Okubof
Y, Akanumab N, et al.. Difference in age of onset of
psychosis between epilepsy and schizophrenia.
Epilepsy Research 2008; 78:201-206.
8. Nadkarni S, Arnedo V, Devinsky O. Psychosis in
epilepsy patients. Epilepsia 2007; 48:17–19.
9. Alper K, Kuzniecky R,Vorkas AK, Patel JG, Carrelli
A, Starner K. Postictal psychosis in partial epilepsy: A
Case–Control Study. Ann Neurol 2008; 63:602–610.
10. Tadokoro Y, Oshima T, Kanemato K. Interictal
psychoses in comparison with schizophrenia- A
prospective study. Epilepsia 2007; 48:2345–2351.
11. Falip M, Carren M, Donaire A, Maestro I, Pintor L,
Bargallo N. Postictal psychosis: A retrospective study
in patients with refractory temporal lobe epilepsy. Seizure
2009; 18:145-149.
12. VanCott A, Cramer JA, Copeland LA, Zeber JE,
Steinman MA, Dersh JJ. Suicide related behaviors in
older patients with new anti-epileptic drug use: data
from the VA hospital system. BMC Medicine 2010;
8:2-7.
13. Ziemba KS, O’Carroll CB, Drazkowski JF,
Wingerchuk DM, Hoffman-Snyder C, Wellik KE, et al.
Do antiepileptic drugs increase the risk of suicidality in
adult patients with epilepsy?: a critically appraised
topic. Neurologist 2010; 16(5):325-328.
14. Olesen BJ, Hansen PR, Erdal J, Abildström SZ, Weeke
P, Fosböl EL, et al. Antiepileptic drugs and risk of
suicide: a nationwide study. Pharmacoepidemiol Drug
Saf 2010; 19(5):518-524.
15. Brandt C, Fueratsch N, Boehme V, Kramme C,
Pieridou M, Villagran A, et al. Development of
psychosis in patients with epilepsy treated with
lamotrigine: Report of six cases and review of the
literature. Epilepsy Behav 2007; 11(1):133-139.
16. FDA. Statistical Review and Evaluation. Antiepileptic
Drugs and Suicidality. FDA CDER. May 2008.
http://www.fda.gov/ohrms/dockets/ac/08/briefing/2008
-4372 b1-01-FDA.pdf (22 Temmuz 2009’da erişilmiştir).
İletişim:
Dr. Hava Özlem Dede
Mustafa Kemal Üniversitesi Tıp Fakültesi
Nöroloji Anabilim Dalı Hatay-Türkiye
Tel: +90.505.2869346
e-mail: havaozlemdede@hotmail.com

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