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September 3, 2007 THE NEW YORK
TIMES http://www.nytimes.com/2007/09/03/business/03drug.html?_r=1&n=Top/News/Business/Companies/Lilly,%20Eli,%20&%20Company&oref=slogin
In
a clinical trial of about 200 patients, an experimental drug from Eli Lilly reduced schizophrenia
symptoms without the serious side effects of current treatments, according to a
paper published yesterday in the journal Nature Medicine.
The
drug must still be evaluated on many more patients to test for the possibility
of side effects that have not yet emerged, and it is at least three to four
years from completing regulatory review.
But
schizophrenia researchers said the trial’s results were surprising and
impressive, especially since the drug works in a different way from existing
antipsychotic medicines, all of which have serious side effects, including
substantial weight gain and tremors.
Lilly
will begin a larger clinical trial for the drug this month. If that trial
confirms the results seen so far, the new drug could mark a breakthrough in the
treatment of schizophrenia — and open the way to a broad new class of
treatments for the disease. Schizophrenia, a devastating mental illness
that affects 1 percent of adults, or about 2.5 million in the United States,
usually begins in the late teens or 20s and is marked by psychotic delusions as
well as social withdrawal and cognitive impairment.
“This
is potentially one giant step forward for patients,” said Dr. Jeffrey
Lieberman, chairman of the psychiatry
department at Columbia and the lead investigator on a federally sponsored
clinical trial of schizophrenia medicines. “This drug may turn out to be not
just a comparably good antipsychotic agent, but a better antipsychotic agent.”
Dr.
Lieberman has not been involved with the development of the medicine and does
not receive any payments or consulting fees from Lilly.
The
new drug also has the potential to be a blockbuster for Lilly. Medicines for
schizophrenia and bipolar
disorder are the fourth-best selling class of medicines in the United
States, with sales of $12 billion in the United States and $18 billion
worldwide last year.
The
troubled history of Zyprexa, another antipsychotic medicine from Lilly, will
lead regulators and psychiatrists
to scrutinize the new medicine closely for hidden dangers, Dr. Lieberman said.
When it introduced Zyprexa in 1996, Lilly hailed it as a breakthrough with
fewer side effects than older drugs. But Zyprexa causes severe weight gain, and
the American Diabetes Association has linked it to diabetes.
Internal Lilly documents show that the company played down Zyprexa’s side
effects, worrying they would hurt sales.
Despite
that history, psychiatrists will be eager to see whether the new Lilly medicine
works, since the existing drugs are of limited help for many patients. Existing
schizophrenia medicines, whether older drugs such as Thorazine or newer
medicines like Zyprexa, all work by blocking the brain’s dopamine receptors.
But
the new Lilly drug does not directly affect dopamine. Instead, it modulates
brain activity through a different set of receptors. As a result, it has the
potential to be the first truly novel treatment for schizophrenia since
Thorazine was introduced 1954, Dr. Lieberman and other researchers said.
Lilly’s new drug — which does not have
a name yet and is referred to as LY2140023 — emerged from almost two
decades of research by Dr. Darryle D. Schoepp, a toxicologist and
pharmacologist who joined Lilly in 1988.
For
decades, psychiatrists have known that users of PCP, a street drug sometimes
called angel dust, have symptoms nearly identical to those of people with
schizophrenia. By the 1980s, scientists had discovered that PCP blocked brain
receptors that are triggered by an amino acid called glutamate. This led some
companies and scientists to study ways to stimulate glutamate receptors as a
treatment for schizophrenia.
But
the brain has many different kinds of glutamate receptors, and figuring out how
to stimulate or block them in medically beneficial ways has proved complicated.
Instead of focusing on the receptors blocked by PCP, Dr. Schoepp concentrated
on modulating the action of glutamate receptors in the brain’s prefrontal
cortex, an area responsible for personality and learning.
“This
is a system that is so fundamental to the function of your brain that it is quite
powerful,” said Dr. Schoepp.
But
because drugs that blocked dopamine had been the only successful schizophrenia
treatments, many researchers viewed the glutamate pathway as
unlikely to produce useful medicines, said Dr. P. Jeffrey Conn, director of the
Vanderbilt University
drug discovery program and an expert on glutamate research.
Dr.
Schoepp deserved praise for persuading Lilly to invest in a field that appeared
to be a long shot, Dr. Conn said, adding, “He locked in very early.”
As
a result, Lilly appears to have a multiyear lead over its competitors in
glutamate drugs, Dr. Conn said. Dr. Schoepp left Lilly in March to become
the head of neuroscience research for Merck. Dr. Schoepp and
Dr. Steven Paul, the president of Lilly Research Laboratories, both said that
his departure would not hurt the development of Lilly’s new medicine
Dr.
Joseph T. Coyle, a professor of psychiatry and neuroscience at Harvard Medical
School, said the Lilly trial validated the theory that modulating glutamate
receptors might control the symptoms of schizophrenia. Even if this drug fails
in later trials, companies and scientists are likely to pursue glutamate
research more aggressively, he said.
“When
you see a company that comes up with something that’s completely different,
completely out of the box, that attracts attention,” Dr. Coyle said.
Existing
drugs are reasonably good at treating the hallucinations and delusions of
schizophrenia. But they are far less effective at treating the so-called
negative symptoms of the disease — the lack of motivation and
emotion that leave many patients unable to work or have normal social
relationships. The side effects of existing medicines, which affect nearly
all patients, are also severe. Older drugs like Thorazine often cause tics and
movement disorders, while newer medicines typically have fewer effects on
movement but can cause weight gain and other metabolic changes.
In
the clinical trial whose results were reported yesterday, LY2140023 had none
of those side effects and appeared to work about as well as Zyprexa at reducing
symptoms. In the trial, which was conducted in Russia from August 2005 to
June 2006, patients were given the experimental drug, Zyprexa or a placebo.
About 100 patients received the experimental medicine.
For
the drug to be approved, Lilly will need to replicate the results in larger
trials. This month, Lilly will begin a trial with 870 patients to determine
the most effective dose of the drug. That trial is expected to be complete in
January 2009, and if it is successful Lilly will probably start a large
Phase III trial that could cover at least 2,000 patients.
“We
have to confirm safety and efficacy with multiple studies,” Dr. Paul of Lilly
said. He said he did not want to offer a prediction of when Lilly might ask the
FDA Food and
Drug Administration for approval. But he said Lilly intended to develop the
drug aggressively.
“We
are very actively working on this target and related targets because we believe
that this mechanism is now validated,” he said.
SIZOFRENIDE GORULEN INTAHARLARA MEYILLI DAVRANISLARI ONLEYEBILECEK/
TEDAVI EDEBILECEK OLAN ANTIPSIKOTIK
ILAC ONAYLANDI- December 20, 2002, Friday The
New York Times-Anti-Psychotic Approved To Treat Suicidal Behavior
By ERICA GOODE (NYT) 692 words
Late Edition - Final , Section
A , Page 30 , Column 5
LEAD PARAGRAPH - Clozapine,
one of a new generation of anti-psychotic drugs, has become the first
psychiatric medication to win federal approval as a treatment for suicidal
behavior.
The Food and Drug
Administration announced yesterday that the agency had approved the drug for
treating recurrent suicidal thoughts or suicide attempts in patients with
schizophrenia, a devastating illness that afflicts 1 of 100 Americans. Yazinin kalani 2.95 dolara satin alinabilir gazetden.
Yazi ozetle soyle diyor;…
Sizofrenide genler faktor olabilir http://www.nytimes.com/2002/12/13/national/13GENE.html
Gene May Play a Role in Schizophrenia-By
NICHOLAS WADE
The long search for a gene that
helps cause schizophrenia may at last be bearing fruit after many false starts
and disappointments, scientists are reporting.
An errant gene first implicated
among schizophrenic patients in Iceland has now turned up in a survey of
Scottish patients, too, giving a clear confirmation of the earlier result.
The gene may be involved in
remodeling the connections that brain cells make with one another, called
synapses. Many of the Icelandic and Scottish patients have the same variant
pattern in the gene, supporting the idea that when the gene does not work as
designed, wrongly formed nerve-to-nerve wiring accumulates in the brain, giving
rise to schizophrenia.
Not all schizophrenics carry
the variant and many people carry it without a problem, an expected pattern in
diseases caused by several genes. But in both populations, inheriting the
variant form of the gene appears to double the risk of schizophrenia.
The finding, if correct, would
bolster the strategy followed by Decode Genetics, a company based in Reykjavik
that is using the Icelandic population to search for the genetic roots of
common diseases like cancer, diabetes, heart disease and Parkinson's. The
schizophrenia-related gene is one of the first it has found.
Dr. Kari Stefansson, a former
Harvard neuropathologist who is the company's chief executive, said Decode and
its partner, the drug company Roche, were developing new drugs to counteract
the aberrant gene's effects but could not say when any would be ready for
clinical testing.
The variant form of the gene in
Icelanders was reported in July this year by Decode Genetics. But many
scientists have grown skeptical of claims about a schizophrenia gene because
some have not been confirmed by later studies.
In the current issue of The
American Journal of Human Genetics, Dr. Hreinn Stefansson (no relation to Kari
Stefansson), with colleagues at Decode Genetics and in Scotland, reports that
the same variant is common among Scottish schizophrenics.
Dr. Kenneth Kendler, a
psychiatric geneticist at Virginia Commonwealth University, said the
replication was "impressively robust" and that "it all looks
very good." Another schizophrenia expert, Dr. Ann Pulver of Johns Hopkins
University, called the new data "pretty convincing" and "really
nice evidence to support the original finding."
Speaking from a conference on
mind drugs in Puerto Rico, Dr. Kari Stefansson said other researchers had
recently found the same variant in German, Welsh and American schizophrenics.
The gene at issue is called
neuregulin-1. It makes a signaling protein that influences the receptivity of
brain cells to several types of neurotransmitters, the chemicals that convey
messages between nerve cells. Dr. Stefansson said neuregulin-1 may govern the
process by which the synapses are made and unmade in response to the brain's
experiences.
A defect in neuregulin-1, he
suggested, might lead to an accumulation of wrongly formed synapses, accounting
for the progressive nature of the disease. It might also explain why
environmental factors as well as heredity contribute to schizophrenia, as shown
by the fact that if one identical twin has the disease the other has only a 30
to 50 percent chance of developing it.
Dr. Stefansson said he had a
considerable emotional investment in the disease because his elder brother has
schizophrenia.
The variation discovered by
Decode Genetics is a set of seven genetic differences that spans the beginning
of the neuregulin gene, which is located on the eighth of the 23 pairs of human
chromosomes. Dr. Stefansson said he guessed that the seven changes might in
some unexplained way be altering the amount of protein the gene could produce.
Recently another gene possibly
related to schizophrenia-related gene was discovered on chromosome 6 by Dr.
Kendler and colleagues among Irish patients. The gene, known as dysbindin, may
represent a different way of causing schizophrenia.
Alternatively, both dysbindin,
neuregulin-1, and perhaps other genes yet to be discovered may all operate in
the same task or pathway, so that a defect in any one of them could cause
schizophrenia. If the disease has a single cause, it should be much easier to
find treatments that work for all schizophrenics.
Dr. Kendler said the progress
with the two genes "induces a bit more optimism in a field that has had
some difficult times."
|
BEYINDEN FOTOGRAFLAR SIZOFRENIDE ERKEN TESHISE YARDIM EDEBILIR-http://www.nytimes.com/2002/12/11/health/11BRAI.html Brain Imaging May Detect Schizophrenia in
Early Stages-By ERICA GOODE Scientists have known for some time that
people who suffer from schizophrenia show abnormalities in the structure of
their brains. But in a new study, researchers for the
first time have detected similar abnormalities in brain scans of people who
were considered at high risk for schizophrenia or other psychotic illnesses
but who did not yet have full-blown symptoms. Those abnormalities, the study
found, became even more marked once the illness was diagnosed. The subjects
in the study who went on to develop psychoses had less gray matter in brain
areas involved in attention and higher mental processes like planning,
emotion and memory, the researchers found. Experts said the study's results, reported
yesterday in an online version of The Lancet, the medical journal, offered
the possibility that imaging techniques might eventually be used to predict
who will develop schizophrenia, a devastating illness that affects more than
2.8 million Americans. Doctors could then offer treatment while the disease
was still in its earliest stages, possibly preventing further damage to the
brain. But Dr. Christos Pantelis, an associate
professor of psychiatry at the University of Melbourne and the lead author of
the report, cautioned that much more research was needed before magnetic
resonance imaging, the method used in the study, could serve as a diagnostic
tool for individual people with schizophrenia. "I think it's still too early to say
how helpful it will be," Dr. Pantelis said. Still, other researchers called the study's
findings exciting and said that the areas of the brain in which the
abnormalities were found would now be an active focus for study. "This is a terrific first step,"
said Dr. Paul Thompson, a professor of neurology at the University of
California at Los Angeles and an expert on brain imaging and schizophrenia. Dr. Herbert Y. Meltzer, a professor of
psychiatry at Vanderbilt University and an expert on schizophrenia, said,
"It proves that the psychosis is almost a late stage in the evolution of
the disease process." He added, "The key message is that this
is a neurodevelopmental disorder and that changes in memory, learning,
attention and executive decision-making precede the experience of the
psychosis." People who suffer from schizophrenia
typically experience auditory hallucinations and have blunted emotional
responses and difficulty with activities that require planning or other
higher-level processes. Some studies have suggested that the earlier
the illness is treated with antipsychotic drugs the better the prognosis. At
least two research groups, one led by Dr. Patrick McGorry, an author of the
Lancet report, and another at Yale, are conducting studies in which young people
who are experiencing some symptoms but have not yet developed schizophrenia
are treated with antipsychotic drugs. But the studies have been controversial
because it is not yet clear which symptoms predict later illness. In the new study, the researchers used
magnetic resonance imaging to scan the brains of 75 people who were deemed
"at high risk" for psychosis because they had a strong family
history of severe mental illness or had other risk factors, including
transient or mild symptoms of mental disturbance or a decline in mental
functioning. Over the next 12 months, 23 of the subjects
developed a full-blown psychosis and 52 did not fall ill, the researchers
found. A comparison of the brain scans from the two
groups revealed significant differences in the volume of gray matter in areas
of the frontal and temporal lobes and the cingulate gyrus. All three regions
have been linked to schizophrenia by previous research, Dr. Pantelis said. When the researchers conducted additional
brain scans on some subjects who developed psychoses, they found further
reductions in gray matter not seen in the scans taken before the illnesses
were diagnosed. http://query.nytimes.com/gst/abstract.html?res=FB0712F939550C778CDDAE0894DA404482&fta=y
Schizophrenia May Be Tied To 2 Genes, Research Finds -National Desk | July 4,
2002, Thursday Schizophrenia May Be Tied To 2 Genes,
Research Finds By NICHOLAS WADE (NYT) 1067 words Late Edition - Final , Section A , Page 11 ,
Column 5 ABSTRACT - Study of 270 Irish families, each
with several schizophrenic members, suggests to researchers that mutuation of
gene known as dysbindin may be involved in disease; separately, mutations of
gene called neuregulin-1, located on different chromosome, are found to be
highly correlated with schizophrenia in about 15 percent of Icelandic
patients; geneticists believe many different mutated genes contribute to
schizophrenia (M) Not;yaziyi NYTimes’dan satin alabilirisniz. http://www.msnbc.com/news/558493.asp#BODY Son arastirmaya gore babanin gec yasta
cocuk sahibi olmasi,cocukta sizofreni riskini arttirmaktadir. April 12 — Children fathered by older men run
a much higher risk of developing schizophrenia, researchers said Thursday in
a finding that provides strong evidence that men, like women, have a
“biological clock” when it comes to having children………… http://www.nytimes.com/2001/04/12/health/12DADS.html April 12, 2001 Father's Age Linked to Risk of
Schizophrenia-By ERICA GOODE The risk of having a child with
schizophrenia may increase with a father's advancing age, researchers
reported yesterday. The researchers, who examined the
relationship between the fathers' ages and schizophrenia among 87,907
Israelis born from 1964 through 1976, found that the older the father, the
more likely he was to have a child who suffered from schizophrenia, a
devastating mental illness. Men who were 45 through 49, for example,
were twice as likely to have offspring with schizophrenia or a related
disorder as were men under 25, the researchers found. The overall risk of having
a child with the illness, however, remained small. "The finding is a very strong
association of schizophrenia risk and father's age," said Dr. Delores
Malaspina, an associate professor of clinical psychiatry at the Columbia
University College of Physicians and Surgeons and the lead author of the
report, which appears in this month's issue of the journal Archives of
General Psychiatry. Other scientists were more skeptical. They
noted that confirmation through other studies was needed before such a link
could be said to be established, and they cautioned that in the history of
schizophrenia research, many apparent associations had eventually proved
spurious or impossible to replicate. If the results of the study hold up to
scrutiny, Dr. Malaspina said, "The next question is, `What might explain
that finding?' " One possibility, the researchers argue in their report,
is that some cases of schizophrenia are a result of genetic abnormalities in
sperm cells that become more likely as a man ages. Stem cells in the testicles divide
throughout a man's life in a process that leads to the production of sperm.
Each cell division carries the chance for copying errors in reproducing the
DNA. By the age of 40, research suggests, about 660 such divisions have taken
place. Genetic mutations can also occur from exposure to radiation or
chemicals over a man's life. In contrast, the divisions of cells that
produce a woman's eggs occur only before birth. A number of physical illnesses and birth
defects have been linked to genetic mutations during sperm production in
older fathers, including Apert syndrome, a rare congenital deformity of the
skull, fingers and toes, and achondroplasia, the most common form of
dwarfism. Some cases of schizophrenia, the researchers
suggested, might be associated with similar mutations. The illness runs in families, and is known
to have a strong genetic component, though efforts to identify the specific
gene or genes that predispose a person to schizophrenia have so far been
inconclusive. The disease affects 1 of every 100 Americans and is more common
in men. Full-blown symptoms often first appear in late adolescence or early
adulthood. In some cases, people who do not have a
family history of schizophrenia also develop the illness. Dr. Malaspina said
that the findings of her study "suggest that relevant mutations are
there" in such sporadic cases "as well as in familial cases." Dr. James F. Crow, a professor emeritus of
genetics at the University of Wisconsin, said, "I think this is very strong
evidence for a mutation component to schizophrenia, but it's quite an open
question as to how much of a component." But other scientists cautioned that other
explanations beside spontaneous genetic mutation could also account for the
study's results. For example, said Dr. Ann Pulver, director
of the epidemiology and genetics program in psychiatry at Johns Hopkins
University, "It may be that the fathers of schizophrenics have unusual
characteristics that delay reproduction." "I think this is an interesting
contribution to the epidemiological literature, that paternal age may be a
risk factor for a subgroup of schizophrenic patients," Dr. Pulver said.
"And it may be that advanced paternal age is associated with a mutation.
But that is a hypothesis and one would need to test it. In the study, Dr. Malaspina and her
colleagues took advantage of the Jerusalem Perinatal Study, a research
archive that includes information about all births in one area of Jerusalem.
Records from the study were correlated with those of a national registry of
psychiatric illness kept by the Israeli government. The researchers found that in 1,337 people admitted to
psychiatric hospitals before 1998, the fathers' ages were strongly associated
with a diagnosis of schizophrenia or a related disorder. The risk of
schizophrenia increased steadily with the father's increasing age. Advancing
age of the fathers, the investigators reported, accounted for 26 percent of
the cases of schizophrenia in the study; for fathers over 50, two out of
every three cases of the illness could be attributed to the father's age. http://abcnews.go.com/onair/2020/2020_000225_schizophrenia_feature.html
|
http://www.abcnews.go.com/onair/2020/2020_000225_schizophrenia_feature.html
25 Subat 2000 de, WABC TV 20/20 de
“Inside a Tortured Mind-The Voices Within” (Iskence edilen Aklin
Icinden, Icindeki sesler) adli programda ilk defa “TIPTA
ONEMLI GELISME “ haberiyle Virtuel Sizofreni Halusinasyon aleti (TLF;ABD Janssen Customer Action
Center at 1-800-JANSSEN den) tanitilmistir
ve asagidaki deneme asamasindaki
ses halusinasyonlarini yok edebilecek beyne manyetik stimulasyon uygulamasi,TMS
anlatilmistir. Asagidaki transkriptle,TV izlerken tutulan notlarin
karisimidir.
“Sizofreni hala bilinmeyenlerle dolu,sebebi
bilinmeyen bir mechul beyin hastaligidir . Doktorlar hastalarin niye halusinasyonlar
ve paranoya yasadiklarini
bilemiyorlar.Hatta niye dehset verici halusinasyonlarin onlari
etkiledigini,neden % 25 si olmayan garip,urkutucu seyler goruyorlar,% 60 si ise
sesler duyuyorlar bunu da bilmiyorlar.Uzmanlar ses olarak duyulan halusinasyonlarin
genelde daha tehlikeli oldugunu cunku sozle konusarak verilen mesajlarin
sizofreni kurbanlarinin kendilerine zarar vermelerine yol acan davranislara
neden oldugunu,cok azinda da siddete sebep oldugunu bildiriyorlar.Her 10
kisiden biri intahar ederler. Hastalik kadin vee rkekleri esit sekilde
etkilemektedir.Kadinlar cogunlukla 20 li ve 30lu yaslarda sizofreni hastasi
olurken,erkeklerde tipik olarak12-14 lu yaslar ve erken yirmili yaslarda
sizofreni gorulmektedir. Dr.Ralph Hoffman Yale psikiyatri Enstitusunun direktor
vekilidir ve sizofreni uzmanidir.Hastalarinin cogunun bu olmayan ama onlarin
beyinlerinde kesinlikle duyduklari sesleri bloke etmek icin,yok etmek
icin,duymamak icin basarisizca caba sarfedislerine tanik
olmustur.”Akillarina,beyinlerine ve hayatlarina el koyuyor bu
hastalik,istenmeyen mudahale gibi…Bir hastamdan mektup aldim, sizofreniye “BEYNIN
.AKLIN SUREKLI TECAVUZ EDILMESIDIR ” diyor Dr.Hoffman.Peki bu
garip seyleri gormek ve dehset verici sesleri duymak nasil birseydir? Doktorlar
uzun yillardir bu hastaligi tarif eden,karakterize eden parcalanmis dusunceleri
anlamaga cebellestirler.Ama doktorlar sizofreni olmadiklarindan,sadece
hastalarinin tarif ettigi seyleri hayal edebiliyorlardi.AMA SIMDI GERCEKTEN SIZOFRENI HASTALARININ AKLINDA,BEYNINDE
OLUP BITENLERI GORMESI,DUYMASI,ANLAMASI MUMKUN UZMANLARIN.
Virtuel realite denen teknikle, Janssen Farmokoloji sirketi
sizofreni hastasinin duydugu ve gordugu halusinasyonlari simule/taklit eden bir
alet gelistirdi.
Bu aleti takiyorsunuz ve aynen sizofrenili bir hastanin 24
saat,haftalarca,aylarca,yillarca katlanmak zorunda kaldigi beynindeki kotu
sesler ve goruntulerle siz de 1-2 dakika icin de olsa tanisiyorsunuz-bu
goruntuler ornek olarak ekranda da gosterildi,sesler de verildi. Janssen firmasi animasyonlu virtuel senaryoya “Onlarin
Yerinde Olsaniz” adini vermis . Alet oyle yapilmis ki,kullanan kisi
sizofreni hastalarinin normal bir karsilikli konusma yaparken, halusinasyon
goruntu ve diger seslerle mucadelesini anlatiyor size.Bu gozlugu takan kisi
sizofreni hastasinin hayatinin ne kadar zor ve inanilmaz dikkat dagitici
oldugunu anliyor.Janssen bu virtuel aleti bir tek sebepten dolayi yapmis-
doktorlarin ve aile uyelerinin, sizofrenili hastadaki inanilmaz felaket zor
yasamlarini,stresi anlamalarina yardimci olmak icin.
Sizofrenili kisiler her an kafalarinin icinde konusan,kotu,
onlara emirler veren, cogunlukla kendilerine zarar vermelerini emreden
inanilmaz kotu bir veya birden cok fazla sesler duymaktadirlar.Bunlara
inanilmaz dikkat cekici,urkutucu,korkunc goruntuler de eslik etmektedir.Ve bu
sesler ilaclarla bazen kismen
susturulabilmekteyse de her hastada degisik neticeler elde edilmektedir,
tamamen yok edilememektedir-surekli hortlamaktadirlar.Ustelik bu sesler (bazen
tek ses,cogunlukla da birden fazla ses) gittikce daha cok gurultu yaparlar ve
goruntulerdeki renkler ve carpikliklar da ise karisinca ;sizofrenili kisi
karsisindakini,sizi dahi duyamayabilir-cunku dikkatini dagitan,sizi duymamasina
sebep olan inanilmaz cok dikkat dagitici faktor vardir beyninde ve hicbir seye
konsantre olamaz dogal olarak !Ustelik gozunun onundeki ve beynindeki
goruntuler de surekli degiskendir,var olmayan seyler gorebilir;yataginin
altinda yilan, bogazinda fare, sizin alninizda goz, pencerede vahsi bir hayvan,
uzayan gariplesmis sekiller/insanlar , cilgin renkler vs gibi.Hastalarin halusinasyonlarinin % 25 si goruntu, % 65 si ise
duyulan seslerdir.Sikinti veren, en kotusu ve kisinin kendisi icin daha
tehlikeli olan ise duyulan seslerdir cunku “kendini yarala,ise yaramazsin,
oldur, assagiliksin” gibi cok agir tahrik edici ve surekli olmesini emreden
seslerdir bunlar.Ve de bunlar simdilik bilebildigimiz kadariyla
beyindeki fiziksel,kimyevi dengelerdeki degisikliklerin sonucunda ortaya
cikmaktadir.Yani kanser,diyabet,kalp gibi bir beyin hastaligidir sizofreni.Ve
beyinde bu hastalik neticesinde acimasiz bir kisa devreler trajedisi
yasanmaktadir.Yale Universitesindeki bu
arastirmaya ayrica asagidaki 3 hasta da katildilar ve bu bilgiler onlarin
yasadiklarindan ve doktorun anlattiklarindan ozetlenmistir.Mesela bu aletteki
goruntu ile edinilen tecrubenin aynen kendi yasadiklarinin benzeri oldugunu
soyleyen erkek hasta 14 yasindan beri sizofreni hastasiymis.Ilk defa bir gun “radyo
dinlerken,araya giren bir sesin direkt kendisiyle konusmaga baslamasiyla”
ilk defa bu seslerle tanistigini anlatti.Simdi yeni ilac Risperidon ile duyma
ve goruntu halusinasyonlari simdilik tamamen yok olmus ve de New York’ta “City
Voices” gazetesini cikariyormus simdi.Ama her hastada ilaclarla ayni neticeler alinamiyabiliyormus. Donald
ise 38 yasina kadar basarili bir kimya arastirmacisiymis ve aniden
hastalanmis.Kafasinin icindeki ses devamli”Hic bir ise yaramazsin,oldur kendini
‘diyormus hala.Ailesi ayni masada yemek yerken,Donald’in baska seslerle konusmasina
alistik diyorlar.Bu sesler ve goruntuler nedeniyle hastalarin 24 saat,omur boyu
dunyalari kararmaktadir.Onun icin de sizofreni hastalarin kisisel
trajedisidir.
Ilaclarla tedavi edilerek sizofrenideki sikca
gorulen paranoya ve deluzyonlari regule etmek,minimuma indirmekte etkili
olunmustur.Goruntuler ve sesler icinse genellikle ,ilac tedavisi en iyi
sekliyle, ancak gecici cozum olabilmektedir halen.
ABD de
agir sekilde hasta olan 2.5 milyon sizofreni hastasinin, dortte birinde ise ilaclar duyduklari
sesleri ve gordukleri halusinasyonlari yok edememistir hala.Goruntu
halusinasyonlari icin ilaclar tek tedavidir ama simdi duyulan sesleri tedavi
edebilecek Yale Psikiyatri Enstitusunde Dr.Hoffman tarafindan yonetilen yeni
metodla tedavi yaklasimi vardir.
Hoffman ve ekibi “Transcranial Magnetic
Stimulation=TMS” denen yeni yontemi test ettiler.Bu yontem beynin sol tarafinda
konusmayi aktive eden bolgeye kisa manyetik stimulasyonlar gondermek
seklindedir.Bazi bilimsel bulgulara gore bu bolgenin duyulan seslerle ilgili
oldugu anlasilmaktadir, ve Hoffman ve ekibi de bu bolgeye fokus oldular TMS
ile. Hoffman bu deneme mahiyetindeki islemi 12 hastaya uyguladi.Bunlara 4 gunde
40 dakika TMS uygulandi.12 hastadan 8 zinde basarili sonuc alindi-bazilarinda hemen
etkisi goruldu,bazilari ise gunlerce stimule edildiklerinde netice alindi.Bu
yeni TMs uygulamasinin ise yaradigini anlamalari kolaydi cunku aniden
hastalarin iclerindeki ses sustu.
HOFFMAN TMS IN HALA DENEME ASAMASINDA
OLDUGUNU SOYLUYOR.Eger uzun donemde etkili olacagi ispatlanirsa,TMS
yuzbinlerce ses halusinasyonlarindan ceken sizofreni hastasina ilacsiz
tedavi alternatifi olabilir .”
Onumuzdeki yakin gelecekte yeni arastirma sonuclari
aciklanincaya kadar, simdilik tek careleri ise hastaya cevap verecek en uygun
ilaci ve en uygun dozu bularak, surekli omur boyu ilac tedavisi ve terapiler
uygulanmasidir-bu uzunca zaman alabilmektedir.Yale Universitesi psikiyatri
bolumu direktoru Dr.Hoffman’in anlattigina gore, ILACLA SES HALUSINASYONU
TEDAVISINE ALTERNATIF OLABILECEK
arastirma safhasindaki TMS aleti http://info.med.yale.edu/psych/clinics/rTMS.html ile yapilan ilacsiz deneylere
bu 3 hasta da da katilmaktaymislar.Beynin sol
tarafindaki konusmayi aktive eden,harekete geciren noktaya 4 gunde 40 titresim
,stimulasyoon veriliyor (herkesde degisik uygulaniyor) ve hastada halusinasyon
azaliyor veya yok olabiliyormus.Bir hastada 3 ay sonra yeniden baslamis
sesler.Simdi tekrar beynini stimule ediyorlar.Eger arastirma
neticelenirse,kesinlesirse hastalara yeni umitler dogacak.VE DE EN ONEMLISI;
UMIT
VERICI BU HABERLERIN BIR BASLANGIC OLDUGUNU VE SIZOFRENININ
TEDAVISINDE,ONLENMESINDE ONUMUZDEKI 10 YILDA COK BUYUK GELISMELER ORTAYA
CIKACAGINI SOYLEDILER. 26 Subat
2000