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Diyabetik Nöropatili Hastaların Nöropatik Ağrı ve Depresyon Tedavisinde, Antidepresan ve Antiepileptik Kullanımı: Bir Karşılaştırma Çalışması

Antiepileptic and Antidepressant Drugs in the Treatment of Neuropathic Pain and Depression of the Patients with Diabetic Neuropathy: A Comparative Study

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2011

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: The aim of this study is to investigate the effects of two antidepressants; amitryptline, venlafaxine XR, and two anticonvulsants lamotrigine, oxcarbazepine on pain and depression in diabetic neuropathy (DN). Material and methods: Following the visual analog scale (VAS), Short-McGill pain questionnaire (SMPQ) and Beck depression inventory (BDI) performance, patients with diabetic neuropathy were randomly treated with lamotrigine (2x50 mg/day), oxcarbazepine (2x300 mg/day), amitryptiline (25 mg/day), or venlafaxine XR (75 mg/day). Patients presented to 6 follow-up visits, within 15 days of intervals. VAS scores were re-measured in each follow-up visits, whereas SMPQ and BDI scores were performed at the end of the study. Results: There were statistically significant differences between the BDI and SMPQ scores of the all study groups before treatment and at the last follow-up visit (p<0.05).Initial VAS scores were similar in the study groups, whereas VAS scores in the day 15, 30 and 90 revealed statistically significant differences in all groups (p<0.05). Lamotrigine and oxcarbazepine were found as effective as amitryptiline and venlafaxine XR on depression. Conclusion: Similar efficacity of antiepileptic and antidepressants in the precence of painful DN and depression is important to contribute in personalization of the treatments and to increase the therapeutic options.
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Abstract (Original Language): 
Amaç: Bu çalışmada, diyabetik nöropati (DN) hastalarında antidepresan olan amitriptilin ve venlafaksin SR ile antiepileptik olan lamotirijin ve okskarbazepinin ağrı ve depresyon üzerindeki etkilerinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Diyabetik nöropati tanısı konmuş hastalara nöropatik ağrı değerlendirmesine yönelik vizüel analog skala (VAS) ve Short-McGill ağrı anketi (SMAA) ile birlikte depresyon değerlendirmesinde kullanılan Beck Depresyon Envanteri (BDE) uygulanmasını takiben, rastgele ve randomize bir şekilde lamotrijin (2x50 mg/gün), okskarbazepin (2x300 mg/gün), amitriptilin (25 mg/gün) ve venlafaksin SR (75 mg/gün) tedavi rejimlerinden biri başlanmıştır. Hastalar 15 günlük aralarla toplam 6 kez kontrole çağrılmış ve her kontrolde VAS skorları ölçülmüştür. 6. ve son kontrolde ise VAS’a ek olarak SMAA ve BDE skorları ölçülmüştür. Bulgular:Tüm gruplarda, tedavi öncesi ve tedavi sonrası son BDE ve SMAA değerleri arasında istatistiksel olarak anlamlı farklılık saptanmıştır (p<0.05). Başlangıç VAS skorları benzer olan tüm tedavi gruplarında, 15. ve 30. ve 90. günlerde yapılan değerlendirmelerde VAS skorlarının tüm gruplar arasında istatistiksel olarak anlamlı farklılık gösterdiği saptanmıştır (p<0.05). Sonuç olarak lamotirijin ve okskarbazepin depresyon üzerinde amitriptilin ve venlafaksin SR kadar etkili olduğu bulunmuştur. Sonuç: Ağrılı DN ve eşlik eden depresyon varlığında antiepileptik ve antidepresanların benzer etkili olmaları tedavi alternatiflerinin arttırılması ve tedavinin kişiselleştirilmesine katkıda bulunması açısından önemlidir.
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  • 3
149-154
  • Turkish

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