1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi

Temel, Mustafa Kemal

doi:10.5336/mdethic.2018-63817

1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi

M. Kemal TEMEL (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Tıp Tarihi ve Etik Ana Bilim Dalı, İstanbul, Türkiye)

Türkiye Klinikleri Tıp Etiği-Hukuku Tarihi Dergisi

14 1

Yıl: 2019 Cilt: 27 Sayı: 2 Sayfa Aralığı: 89 - 102 Metin Dili: Türkçe DOI: 10.5336/mdethic.2018-63817 İndeks Tarihi: 03-06-2020

1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi

Öz:

Bugün, farklı farmasötik sınıflardan çeşitli antidepresif ajanlar klinik depresyon tedavisinde başarıyla kullanılmaktadır.Ne var ki Türkçe tıp literatüründe bu ilaçların güncel klinik kullanım ve sonuçlarına dair bol miktardayayın bulunmasına karşın, bunların tarihi klinik gelişim sürecini kökenlere inerek, teferruatla bildirençalışmalar çok azdır. Bu araştırmada, literatürdeki bu boşluğun dolduruluşuna katkıda bulunmak amaçlanmıştır.Araştırmada, antidepresif ajanların kısmen etki mekanizmalarına kısmen de kimyasal yapılarına göre düzenlenmişolan klasik tasnifi izlenmiştir. PubMed ve ScienceDirect gibi veri tabanlarının ve çeşitli bilimsel dergilerin arşivlerininretrospektif taranışı ile her bir farmasötik alt sınıfın başlangıcını teşkil eden prototipik antidepresanınkeşfi; tarihi olay örgüsüne, ilgili tıbbi figürlere ve orijinal klinik araştırma sonuçlarına dair ilk elden bilimsel yayınlarüzerinden işlenmiştir. Antidepresif psikofarmakoterapi tarihindeki dönüm noktaları üzerinde durulmuş,başlıca ilaç sınıfları (monoamin oksidaz inhibitörleri, trisiklik ve tetrasiklik ajanlar ve monoaminerjik geri alıminhibitörleri) arasında bağlantılar kurulmuş ve yerine göre analojiler yapılmış ya da farklılıklar vurgulanmıştır.Varılan başlıca bir sonuç, antidepresif psikofarmakoterapi tarihinde tesadüfi gözlem eseri (“ilk kuşak/klasik”) ajanlardanrasyonel dizaynla ilaç üretimine (“ikinci kuşak” antidepresanlara) geçişin interdisipliner iş birliğine borçluolunan gelişmelerle mümkün olmuş olduğudur: Çeşitli bilimsel branşlardan kişilerce monoaminerjik konsantrasyonhipotezinin ortaya atılışı, monoamin oksidaz-A ve -B enzimlerinin keşfi, floresans mikroskopiye dayananhistokimyasal görüntüleme yönteminin geliştirilişi, antidepresif ajanların etki mekanizmalarının sistematik invitro ve in vivo tetkikatla aydınlatılışı ve de antihistaminikler gibi mevcut kimyasalların ya da yeni maddelerinklinik çalışmalarla antidepresif potansiyelleri bakımından sınanışı gibi aşamalardan geçilerek, sonunda bugünmajör depresif bozukluk tedavisinde başvurulan birincil ilaçlar olan monoaminerjik geri alım inhibitörlerine ulaşılmıştır.

Anahtar Kelime:

The 1950s and Antidepressive Psychopharmacotherapy: History and Classification of Clinical Antidepressants from Their Prototypes to Today

Öz:

Various antidepressive agents from different pharmaceutical classes are used successfully to treat depression today. Despite their well-documented clinical use and outcomes, however, the Turkish medical literature appears to lack studies dilating upon their historical development with reference to the origins and key events. Aimed at contributing to filling this gap, this study was built on the classical classification of antidepressive agents based partly on mechanism of action and chemical structure. PubMed, ScienceDirect, and various journal archives were reviewed retrospectively concerning the discovery of each agent that prototyped the pharmaceutical subclass investigated, with a focus on the timeline events, medical figures, and original clinical research results. The milestones in the history of antidepressive psychopharmacotherapy were highlighted, with connection and comparison between the main drug classes (monoamine oxidase inhibitors, tricyclics and tetracyclics, and monoaminergic reuptake inhibitors) through analogies and distinctions identified when appropriate. A main conclusion was that the consequential transition from the serendipitously obtained (“first-generation/classical”) agents to rationally designed drug production (the “second-generation” antidepressants) was achieved by developments brought about by interdisciplinary collaboration. Production of the MRIs, pharmaceutics used primarily in treating major depressive disorder today, was processed through various stages by various scientific contributors propounding the monoaminergic concentration hypothesis, discovering the monoamine oxidase-A and -B enzymes, developing the histochemical visualization methodology by fluorescence microscopy, elucidating mechanisms of action of antidepressive agents through in vitro and in vivo investigation, and testing the existing chemicals such as antihistamines or new derivatives in clinical studies for their antidepressive potentials.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Temel M (2019). 1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi. , 89 - 102. 10.5336/mdethic.2018-63817
Chicago	Temel Mustafa Kemal 1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi. (2019): 89 - 102. 10.5336/mdethic.2018-63817
MLA	Temel Mustafa Kemal 1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi. , 2019, ss.89 - 102. 10.5336/mdethic.2018-63817
AMA	Temel M 1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi. . 2019; 89 - 102. 10.5336/mdethic.2018-63817
Vancouver	Temel M 1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi. . 2019; 89 - 102. 10.5336/mdethic.2018-63817
IEEE	Temel M "1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi." , ss.89 - 102, 2019. 10.5336/mdethic.2018-63817
ISNAD	Temel, Mustafa Kemal. "1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi". (2019), 89-102. https://doi.org/10.5336/mdethic.2018-63817

APA	Temel M (2019). 1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi. Türkiye Klinikleri Tıp Etiği-Hukuku Tarihi Dergisi, 27(2), 89 - 102. 10.5336/mdethic.2018-63817
Chicago	Temel Mustafa Kemal 1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi. Türkiye Klinikleri Tıp Etiği-Hukuku Tarihi Dergisi 27, no.2 (2019): 89 - 102. 10.5336/mdethic.2018-63817
MLA	Temel Mustafa Kemal 1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi. Türkiye Klinikleri Tıp Etiği-Hukuku Tarihi Dergisi, vol.27, no.2, 2019, ss.89 - 102. 10.5336/mdethic.2018-63817
AMA	Temel M 1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi. Türkiye Klinikleri Tıp Etiği-Hukuku Tarihi Dergisi. 2019; 27(2): 89 - 102. 10.5336/mdethic.2018-63817
Vancouver	Temel M 1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi. Türkiye Klinikleri Tıp Etiği-Hukuku Tarihi Dergisi. 2019; 27(2): 89 - 102. 10.5336/mdethic.2018-63817
IEEE	Temel M "1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi." Türkiye Klinikleri Tıp Etiği-Hukuku Tarihi Dergisi, 27, ss.89 - 102, 2019. 10.5336/mdethic.2018-63817
ISNAD	Temel, Mustafa Kemal. "1950'li Yıllar ve Antidepresif Psikofarmakoterapi: Prototiplerinden Bugüne Klinik Antidepresanların Tasnif ve Tarihi". Türkiye Klinikleri Tıp Etiği-Hukuku Tarihi Dergisi 27/2 (2019), 89-102. https://doi.org/10.5336/mdethic.2018-63817