Browsing by Author "Tunçtürk, Mustafa"

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Electroconvulsive therapy or clozapine for adolescents with treatment-resistant schizophrenia: An explorative analysis on symptom dimensions
(Taylor & Francis Ltd, 2022-12-27) Tunçtürk, Mustafa; Ermis, Çağatay; Büyüktaşkın, Dicle; Turan, Serkan; Sağlam, Yeşim; Alarslan, Sezen; Güler, Duru; Sut, Ekin; Unutmaz, Güldal; Güzel, Ayse Beste; Canbek, Ozge Atay; Inal, Neslihan; Karacetin, Gul; Hazell, Philip; TURAN, SERKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk ve Ergen Psikiyatrisi Anabilim Dalı.; 0000-0002-6548-0629 ; AFO-6356-2022
ObjectiveThis study sought to compare pre-intervention patient characteristics and post-intervention outcomes in a naturalistic sample of adolescent inpatients with treatment-resistant psychotic symptoms who received either electroconvulsive therapy (ECT) or clozapine.MethodsData of adolescents with schizophrenia/schizoaffective disorder receiving ECT or clozapine were retrospectively collected from two tertiary-care psychiatry-teaching university hospitals. Subscale scores of the Positive and Negative Symptom Scale (PANSS) factors were calculated according to the five-factor solution. Baseline demographics, illness characteristics, and post-intervention outcomes were compared.ResultsThere was no significant difference between patients receiving ECT (n = 13) and clozapine (n = 66) in terms of age, sex, and the duration of hospital stay. The ECT group more commonly had higher overall illness and aggression severity. Smoking was less frequent in the clozapine group. Baseline resistance/excitement symptom severity was significantly higher in the ECT group, while positive, negative, affect, disorganisation, and total symptom scores were not. Both interventions provided a significant reduction in PANSS scores with large effect sizes.ConclusionBoth ECT and clozapine yielded high effectiveness rates in adolescents with treatment-resistant schizophrenia/schizoaffective disorder. Youth receiving ECT were generally more activated than those who received clozapine.
Index depressive episode and antidepressant exposure were associated with illness characteristics of pediatric bipolar disorder
(Wiley, 2021-05-31) İnal, Neslihan; Ermiş, Çağatay; Koç, Doğukan; Aksoy, Sena; Karaçetin, Gül; Tunçtürk, Mustafa; Eray, Şafak; Karabina, Berna; Akça, Ömer Faruk; Özgül, Dilek; Kılıç, Birim Günay; Uytun, Merve Çikili; Beşenek, Mert; Kavurma, Canem; Bilaç, Öznur; Gökçen, Cem; Topal, Zehra; Yazıcı, İpek Percinel; Sapmaz, Şermin Yalın; Özyurt, Gonca; Diler, Rasim Somer; ERAY ÇAMLI, ŞAFAK; KARABİNA, BERNA; 0000-0002-4847-7751; AAG-8101-2021; FBB-9411-2022
Objective Pediatric bipolar disorder (PBD) is a serious, recurrent disorder leading to severe functional impairment. As a first mood episode, index episode could affect the long-term course of the illness. This study aimed to investigate the clinical characteristics of youth with PBD from our multicenter, nationwide, naturalistic follow-up samples and to identify (i) the effects of index mood episode and (ii) the effect of previous antidepressant treatments on the age at mania onset of PBD. Method The study sample consisted of 271 youth with BD-I followed by the child and adolescent psychiatry clinics of seven different university hospitals and three research state hospitals, representing six geographic regions across Turkey. All diagnoses were made according to structured interviews, and all data were retrospectively obtained from clinical records by the clinicians. Results When patients with index depressive/mixed episodes (IDE, n=129) and patients with index (hypo)manic episodes (IME, n=142) were compared, the total number of mood episodes and rapid cycling feature were significantly higher in the IDE group than in the IME group. The Cox regression analysis adjusted for sociodemographic and illness characteristics revealed female adolescents in the IDE group treated with antidepressants were more likely to have an earlier onset of mania (hazard ratio=2.03, 95% confidence interval=1.31-3.12, p=0.001). Conclusion This is the first large-scale nationwide follow-up study in Turkey that indicated prior antidepressant treatments were associated with an earlier onset of mania in youth, particularly in adolescent females. Larger prospective studies are needed to identify neurodevelopmental processes underlying PBD and initiate prevention approaches.
Selective serotonin reuptake inhibitors and manic switch: A pharmacovigilance and pharmacodynamical study
(Elsevier, 2021-10-16) Çıray, R. Oğulcan; Halaç, Eren; Turan, Serkan; Tunçtürk, Mustafa; Özbek, Mutlu; Ermiş, Çağatay; TURAN, SERKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk ve Ergen Psikiyatrisi Anabilim Dalı.; 0000-0002-6548-0629; HKE-9636-2023; AFO-6356-2022
Background: There is still no approved mechanism of manic switch in bipolar disorder, yet many selective serotonin reuptake inhibitors were accused for this important adverse event. Therefore, we aimed to investigate to estimate SSRI' s risk for reporting mania and elevated mood using FEARS database and investigate receptor mechanisms involved.Methods: Mania and relevant side effects approved by FDA were screened in this dataset from the first quarter of 2004 to the third quarter of 2020. Disproportionality analysis were performed to estimate reporting odds ratio (ROR) and linear regressions were conducted to investigate relationship between ROR and Ki values. Receptor occupancy ratios were calculated from in vitro receptor binding profiles. The pharmacodynamical profile was extracted from the International Union of Basic and Clinical Pharmacology and the British Pharmacology Society dataset. Child and adolescent population was also investigated separately.Results: The analysis showed that the odds of a spontaneous report of mania in the FAERS database involving an SSRI were higher than the odds that such a report involved other types of drugs (ROR: 5.324 [CI: 3.773; 7.514]). The largest effect size in this estimation was found in fluvoxamine (ROR: 13.957 [CI: 10.391; 18.747]). Significant effects were found in regression analysis for Ki values of H1 and M1 receptors on ROR. Receptor occupation was not found to have an effect on ROR.Conclusion: Lower degress of Ki values on M1 and H1 may be plausible pharmacological mechanism. Further pharmacological data and clinical assessments may be important to validate this safety signal.