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"Antidepresanlardan uzak durun" uyarısı Uzmanlar, günümüzde depresyon görülme sıklığının en temel sebebinin antidepresan kullanımı olduğunu ileri sürüyorlar. takvim.com.tr Giriş Tarihi : 07 Mart 2019 , 11:15 Güncelleme Tarihi : 07 Mart 2019 , 11:15
Antidepresanların etkinliğine ilişkin meta-analizi uluslararası arenada büyük tartışma yaratan Harvard Üniversitesi Tıp Fakültesi Plasebo Çalışmaları ve Terapötik Karşılaşım Programı Müdür Yardımcısı Prof. Dr. Irving Kirsch, bu yıl dördüncüsü düzenlenen Ulusal Psikofarmakoloji Kongresi için geldiği Antalya'nın Belek beldesinde, antidepresan ilaç tedavisi ve riskleriyle ilgili açıklamalarda bulundu.
Antidepresanların ciddi riskler taşıdığını ileri süren Kirsch, günümüzde depresyonun en önemli nedeninin de yoğun kullanılan antidepresan ilaçları nedeniyle depresyonun sürekli nüks etmesi olduğunu savundu.
Kirsch, antidepresanlar ve placebo (fiziksel, kimyasal ya da farmakolojik bir etkisi olmayan, ancak verildiği ya da uygulandığı kişiye böyle bir etkisi olduğu söylenen madde ya da işlem) arasındaki farkı ortaya koymak amacıyla yaptığı araştırmaya kadar, antidepresanların tedavi edici etkisine inandığını söyledi.
Araştırma nedeniyle Amerikan Gıda ve İlaç Dairesinden (FDA) aldığı verileri incelediğinde hayatının en büyük sürpriziyle karşılaştığını belirten Kirsch, antidepresanlarla ilgili çalışmaların yüzde 40'ının yayımlanmadığını ve yayımlanmayan bu çalışmalarda antidepresanların yüzde 88 oranında depresyon tedavisine ciddi katkı sağlamadığının gösterildiğini kaydetti.
Yaptığı araştırmalarda placebonun, antidepresanların sağladığı etkinin yüzde 82'sini sağladığını ortaya koyduğunu vurgulayan Kirsch, ''Buna karşın antidepresanlar 24 yaşın altındaki gençlerde ve çocuklarda intihar riskini yüzde 62, yetişkinlerde inme riskini yüzde 50-60, hamileliğin ilk üç ayındaki kullanımda ise kadınların otistik bebek sahip olması riskini yüzde 280 oranında arttırıyor. Ayrıca ölümlere neden olan her şeye de ciddi oranda katkısı var'' dedi.
-Depresyon nedeni antidepresan- İlaç firmalarının yıllarca antidepresanlarla ilgili bilgileri sakladıklarını savunan Kirsch, ''Doktorlar bu riskleri bilmeyince hastalar da bilemedi. Kimse farkında olmayınca da 'antidepresanlar iyidir' denilerek bir jenerasyon bu hapları kulandı ve hala etkisi sürüyor'' dedi.
Antidepresan ile tedavinin hiçbir faydası olmadığını iddia eden Kirsch, şunları söyledi:
''Risk var getiri yok. Plasebo ve antidepresan kullanımını karşılaştırdığınızda klinik olarak ciddi bir farktan bahsetmek mümkün değil. Antidepresanlar çözüm sunmakta çok sıkıntılı olduğu gibi çok ciddi riskler de taşıyorlar.
Antidepresan kullanımı depresyonun sonraki yıllarda tekrarlama riskinin yüzde 113-280 arttırıyor. 4-8 hafta gibi kısa kullanımlarda bile depresyonun tekrarlaması riskini arttırıyor. Günümüzde depresyon görülme sıklığının en temel sebebi antidepresan kullanımı. Çünkü ilaç kullandığınızda depresyon sürekli tekrarlıyor.''
-''Antidepresan en son çare''- İnsanların kendilerini kötü ve çaresiz hissedebileceklerini, intiharı düşünebileceklerini belirten Kirsch, buna karşın antidepresanların çözüm olmadığını kaydetti.
Kirsch, ''Bol bol egzersiz yapın. İşe yaramazsa terapiye gidin, akapunktur ya da meditasyon deneyin. Hiçbiri işe yaramazsa, depresyon tedavisinde ilaç en son çaredir'' diye konuştu.
Depresyon tedavisinde psikoterapinin etkisinin uzun vadede çok daha fazla fayda sağladığını ifade eden Kirsch, antidepresanların taşıdıkları risklerin ortaya çıkmasıyla birlikte İngiltere'de depresyon tedavisiyle bağlantılı olarak yapılan ve önerilen tedavi çözümlerinde bu tedavinin ön plana çıktığını kaydetti.
Kirsch, ''İngiltere'de şu anda 10 bin psikoterapi uzmanı yetiştirilmeye çalışılıyor. Bu rakama ulaşılırsa ciddi şekilde ilaçlardan uzak terapi yöntemleriyle depresyon tedavisi söz konusu olabilecek'' diye konuştu.
-''Haftada 3 gün egzersiz antidepresanla aynı etkiyi yaratıyor''- Egzersiz yapmanın depresyon tedavisi için antidepresanlardan çok daha iyi bir tedavi olduğunu dile getiren Kirsch, ''Haftada 3 gün egzersiz antidepresanla aynı etkiyi gösteriyor'' dedi.
Antidepresanla egzersizin kombine edildiği çalışmalardan da bahseden Kirsch, depresyon tedavisi gören kişilerin bir kısmına 4 ay boyunca sadece antidepresan, bir kısmına sadece egzersiz, bir kısmına ise hem ilaç hem egzersiz verilerek izlendiğini söyledi. Kirsch, sadece egzersiz yapan grupta depresyonun tekrarlama riskinin yüzde 8, ilaç alan grupta ise yüzde 40 bulunduğuna dikkati çekerek, hem ilaç alan hem de egzersiz yapan grupta bu oranın yüzde 31 olduğunu kaydetti.
Kirsch, araştırmanın, antidepresanların egzersizin iyi etkilerini de ortadan kaldırdığını da gösterdiğini sözlerine ekledi.
Hull ve Connecticut Üniversitesi Onursal Profesörü de olan Kirsch'in plasebo etkileri, antidepresan ilaç tedavisi, hipnoz ve telkin üzerine 10 kitabı, 200'den fazla bilimsel dergide yayınlanmış makalesi ve kitap bölümleri bulunuyor.