Anahtar Kelimeler
dikkat eksikliği ve hiperaktivite bozukluğu
çocuk
ergen
farmakoterapi
Öz
Guanfacin uzatılmış salım (XR), çocuk ve ergenlerde dikkat eksikliği ve hiperaktivite bozukluğunun (DEHB) tedavisinde giderek daha fazla önem kazanan stimülan dışı bir farmakoterapi seçeneği olarak öne çıkmaktadır. Randomize kontrollü araştırmalar ve uzun süreli gözlemsel çalışmalar, ilacın hem tek başına kullanımında hem de psikostimülan tedavilere eklenmesi halinde belirgin klinik iyileşmeler sağladığını ortaya koymaktadır. Seçici α2A-adrenerjik reseptör agonizması yoluyla prefrontal korteksteki sinir ağlarını düzenleyerek yürütücü işlevleri ve davranışsal kontrolü desteklediği düşünülmektedir. Tedavinin erken döneminde sedasyon sık gözlenmekle birlikte, genellikle zaman içinde azalma eğilimi gösterir ve bazı olgularda uyku sürekliliği üzerinde ek yararlar bildirilmiştir. Ayrıca, bilişsel performans üzerinde belirgin olumsuz bir etkisinin bulunmadığı ve semptom kontrolünü bozmadığı gösterilmiştir. Türkiye’de Arislow® ve Guago® ticari isimleriyle ruhsatlı olarak bulunan Guanfacin XR, uluslararası kılavuzlarda stimülan dışı tedavi seçenekleri arasında yer almakla birlikte, yerel klinik veriler hâlen sınırlıdır. Çeşitli popülasyonlarda uzun vadeli etkinliği ve güvenlik profilini daha ayrıntılı olarak aydınlatmak için devam eden araştırmalara ihtiyaç vardır. Ayrıca, Türkiye'deki sağlık hizmetleri sağlayıcıları arasında farkındalığın artırılması ve eğitimlerin yaygınlaştırılması, klinik ortamlarda kullanımını artıracaktır.
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