Experts point out that the use of antidepressants without a doctor's advice to cope with exam stress or the stress of daily life can have many side effects and emphasize the importance of personalized treatment. They state that the patient's previous illnesses must be known in all kinds of drug treatment.
Psychiatry Specialist Prof. Dr. Sermin Kesebir from Üsküdar University NPISTANBUL Hospital drew attention to the harms of the increasing unconscious use of antidepressants.
Stating that they use antidepressants in mood disorders, major depressive disorder single episode and major depressive disorder and anxiety disorders, Prof. Dr. Sermin Kesebir said, "If the patient has these diagnoses, we usually start an antidepressant treatment. For a long time, we have theoretical information that antidepressants increase the risk of suicide or have some physical side effects that are not so innocent. But of course there are variables that need to be taken into account here. Apart from the diagnosis, there are the individual characteristics of the patient. By individual characteristics, we mean the age, gender and the presence of a concomitant general medical condition."
Personalized treatment, the most effective treatment
Pointing out the importance of personalized medication, Prof. Dr. Sermin Kesebir emphasized that the medication should be given in accordance with the characteristics of the individual and that personalized treatment is the most effective treatment. Prof. Dr. Sermin Kesebir stated that especially in antidepressant treatment, the dose of the drug must be adjusted in accordance with the individual's disease history, and noted that the dose of psychiatric drugs should be adjusted by looking at the patient's blood level.
Stating that in addition to the diagnosis of psychiatric disorder, the patient's physical disease history should be handled very carefully, Prof. Dr. Sermin Kesebir said, "The patient's past disease history must be known. How did the patient respond to drug treatment in this history? All details from febrile convulsions in infancy to whether the patient has an allergic condition must be learned. It should be known whether there is a chronic tonsillitis tonsil infection in childhood."
Family history gives important clues
Stating that family history is also very important after individual characteristics, Prof. Dr. Sermin Kesebir said: "Which physical and physical diseases are present in the family, is there any allergic condition in the family history, how is the response to medications, is there anything else to be done in terms of other examinations after these histories, the answers to the questions about whether there is any infection at that time must be obtained. There may not be a known history until then, but the metabolic and endocrine status at that time must be investigated. The first thing that comes to mind is to look at the thyroid. Is there a problem with the patient's glucose metabolism, how are the vitamin levels? The fluid electrolyte balance of the body must also be analyzed."
The speed at which the patient metabolizes the drug is important
Prof. Dr. Sermin Kesebir stated that pharmacogenetic characteristics should also be examined if a risky situation is observed in the patient's history and said, "It is necessary to examine whether the patient metabolizes a drug slowly or quickly. Drugs excreted from the liver and kidneys can cause different effects. In this context, it may be necessary to look at liver and kidney function tests. Individual characteristics and family history are our diagnostic and treatment options. These should be evaluated. This is not only for antidepressants, it should be a stage and evaluation that must be done before any medication is started."
The dose of the effective drug is determined from the blood sample
Üsküdar University Prof. Dr. S. Tuncel Özden Pharmacogenetics Laboratory Supervisor Specialist. Pharmacist. Selma Özilhan said that by looking at the drug blood levels of all drugs used in the field of psychiatry, they present a table to the physician regarding the effective dose range of the drug.
Özilhan stated that as a laboratory, they analyze approximately 60 drugs from a single blood level, inform the physician about the phenotype of individuals, and observe how individuals metabolize the drug through these tests. Accordingly, he said, they can determine the most appropriate dose to affect the patient.
Özilhan said they do this using advanced technology.
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