Stating that the diagnosis of the patient is important in the use of antidepressants, experts point out that the patient's history must be known. According to experts, not only for antidepressants but also for all kinds of medication, it is essential to know the patient's previous illnesses, individual characteristics, drug allergies and family history.
H.Ü., a high school sophomore in Antalya, was allegedly hospitalized due to the medication prescribed by the psychiatrist she went to for exam stress. The young girl, who suffered burns on her body, was diagnosed with a rare and serious condition called "Stevens Johnson Syndrome", in which the skin and mucous membranes react seriously to drugs or infections. While H.Ü.'s treatment continues in intensive care, the incident brought the correct use of antidepressants and antidepressants to the agenda.
Psychiatry Specialist Prof. Dr. Sermin Kesebir from Üsküdar University NPISTANBUL Hospital pointed out that the patient's past history should be taken into consideration when using antidepressants.
Individual characteristics should not be ignored
Stating that they use antidepressants in mood disorders, major depressive disorder single episode and major depressive disorder and anxiety disorders, Prof. Dr. Sermin Kesebir made the following evaluations:
"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. However, there are of course variables that need to be taken into account here. Apart from the diagnosis, there are individual characteristics. What do I mean by individual characteristics? The person's age, gender, the presence of an accompanying general medical condition."
History of physical illness should also be known
Prof. Dr. Sermin Kesebir stated that in addition to the diagnosis of a psychiatric disorder, a history of physical illness should be handled very carefully and said, "It should be learned whether there is a history of febrile convulsions in infancy or whether there is an allergic condition. It should be known whether there is a chronic tonsillitis tonsil infection in childhood. It is necessary to know the individual disease history in detail. How the patient responded to drug treatment in this history. How did the patient respond to some of the medications he/she had used before?"
Family diseases should also be learned
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."
Pharmacogenetic properties should be known
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 by using advanced technology.