Esrar Kullanymyna Ba?ly Geli?en Amotivasyonel Sendrom: Testosteron Ekleme Tedavisiyle Belirtileri Düzelen Bir Olgu Sunumu

Amotivational Syndrome Caused by Cannabis Use: A Case Who Improved with Additional Testosterone Combination Treatment

Özet

Esrar, cannabis sativa adly bitkinin tohumlaryndan vekurutulmu? yapraklaryndan elde edilir, keyif verici etkisinedeniyle dünyada yaygyn olarak kullanylmaktadyr.Yapylan epidemiyolojik çaly?malarda, en az bir kez esrarkullanymy ülkeler arasynda büyük farklylyklar göstermektedir. Yngiltere'de %41, Danimarka %17, Macaristan %6,Türkiye'de %1.2-4 kullanym oranlary belirlenmi?tir. Esrarkullanym bozukluklarynyn, klinik synyflandyrylmasy vetedavisiyle ilgili bir çok çaly?ma yapylmy?tyr. Esrar kullanymyna ba?ly geli?en amotivasyonel sendrom ise klinikolarak az bilinmekte ve tedavisi ile ilgili günümüzde çokaz klinik çaly?ma bulunmaktadyr. Amotivasyonelsendrom, kronik esrar kullanymy ile ortaya çykan; enerjideazalma, motivasyon dü?üklü?ü, sosyal etkile?imsizlik,duygulanymda küntle?me, amaca yönelik aktivitelerdeazalma, zayyf muhakeme, konsantrasyon eksikli?i, bellekkusuru gibi bili?sel ve duygusal fonksiyonlarda bozulmayla seyreden bir sendromdur. Yapylan çaly?malarda, kronik esrar kullanym bozuklu?uolanlarda, motivasyon dü?üklü?ü, enerji azly?y gibi amotivasyonel sendrom klinik belirtileri %16-21 oranyndagörülmekte buna ra?men amotivasyonel sendrom, aztany konulan, ayrycy tanysy ve tedavisi konusunda çok azçaly?malaryn oldu?u bir klinik tablo olarak kar?ymyza çykmaktadyr. Tedavisinde, öncelikle altta yatan nedeninortadan kaldyrylmasy, esrar kullanymy varsa byrakylmasyönerilmektedir. Bu yazyda, kronik esrar kullanymy sonucuamtoivasyonel sendrom geli?en bir olguda, testosteronekleme tedavisiyle, klinik belirtilerinde düzelme gözlenenbir olgu sunulmaktadyr

Abstract

Cannabis which is obtained from seeds and dried leavesof the cannabis sativa plant is widely used in the worlddue to its recreational effect. Epidemiological studieswere suggested huge differences among countries interms of using cannabis at least once. The percentiles ofuse for countries were determined as 41% in England,17% in Denmark, 6% in Hungary, and 1.2-4% in Turkey.Lots of studies about cannabis use disorders, clinicalclassification, and treatment were conducted. However,amotivational syndrome caused by cannabis use is notonly a clinically less known phenomenon but also wehave limited clinical experience about this syndrome.Amotivational syndrome is a syndrome which is causedby cannabis use and which goes along with the cognitiveand emotional dysfunctions such as decrease in energyand motivation, lack of social interaction, apathy,decrease in goal-oriented activities, poor judgement,lack of concentration, and memory problems. In studies,it was shown that clinical symptoms of motivational syndrome such as decrease in motivation and energy in 1621% of people with cannabis use disorder was observedbut motivational syndrome emerges as a clinical phenomenon which has been diagnosed less and we have afew studies about definitive diagnosis and treatment.For treatment, it is recommended that underlying problem should be eliminated and that cannabis use shouldbe stopped.. In this article, a case which had amotivational syndrome caused by cannabis use and which hada recovery in clinical symptoms with the treatment ofadding testosterone