Aim and Objective: Escitalopram (SCT) shows an antidepressant effect due to its mechanism of increasing the serotonin level by inhibiting the serotonin transporter protein (5HTT). 5HTT is encoded by solute carrier family 6 member 4 gene (SLC6A4) in the brain. Recognition of SCT plasma level of patients and pharmacodynamics of individuals during SCT treatment will increase the expected response to the treatment and reduce the adverse effects. This study aims to determine the effect of SLC6A4 promoter long/ short polymorphism and the SCT plasma level of patients on the response to treatment during the SCT drug therapy. Materials and Methods: Blood and plasma samples of 30 major depressive patients using 20 mg SCT for 8 weeks between the ages of 18 and 65 were analyzed to determine SCT plasma level and SLC6A4 promoter polymorphism. The treatment response level was determined by using the Hamilton Depression Rating Scale at patient files. Results: SCT plasma level of the nine patients with LL polymorphism was found to be in the range of 13.40–63.36 ng/mL. For 13 patients with LS polymorphism, SCT plasma level was found to be in the range of 2.93–57.48 ng/mL. For eight patients with SS polymorphism, the SCT plasma level was found to be in the range of 0.95–49.32 ng/mL. Conclusion: When the association between SCT plasma level and response to the drug treatment was examined, we had significant results to show that SCT level affected the response to treatment, especially in the LS group, as well as the SLC6A4 promoter variation. This study may lead to a more profound understanding of rational drug therapy as well as to a careful application of pharmacogenetics in psychiatry.

Transcranial Magnetic Stimulation (TMS) is not widely used in the world. Besides financial constraints like limited allocation of funds for psychiatric clinics, psychiatrists’ knowledge and attitudes regarding TMS may limit its widespread use. Therefore, this survey study aimed to examine the knowledge and attitudes of Turkish psychiatrists towards TMS. An online survey that was developed by the researchers containing 26 questions about physicians’ demographic data and their knowledge and attitudes towards TMS was sent to a closed e-mail group of psychiatrists and assistant psychiatrists. The study sample comprised 46 women and 61 men. Having knowledge about TMS statistically significantly affected participants’ approaches to accept TMS as a promising treatment, approve the spread of TMS as a treatment modality, desire to have more information about the mechanism of action of TMS (p=0.006; p=0.019 and p=0.013, respectively), whereas it didn’t statistically significantly affect their approaches to accept TMS as an effective treatment method, consider TMS as a misleading treatment for patients, use TMS only in the treatment of treatment-resistant depression patients (p=0.060, p=0.065, and p=0.136, respectively). Most of the psychiatrists who completed the survey in Turkey had a positive view of TMS and wanted to increase their knowledge. It may be appropriate to increase the number of presentations on TMS therapy at psychiatry meetings and encourage residents to make observations in clinics where TMS is administered, during psychiatric residency.

Progressive nonfluent aphasia is a slowly progressive degenerative disease characterized by atrophy in left hemisphere particularly frontotemporal. It is one of three subtypes of frontotemporal lobar degeneration (frontotemporal dementia). Unlike Alzheimer’s disease it begins between 45-65 years of age and occurs equally in both sexes usually. The reported youngest case was 21 years old. Atrophy is seen in the left hemisphere more in temporal lobe on magnetic resonance imaging. Approximately half of the cases have family history. In early it might confuse with depression and therefore diagnosis may be delayed. Brain magnetic resonance imaging is important for verification of diagnosis. In this paper, a case who early onset progressive nonfluent aphasia was mentioned.