Alper Evrensel

Üsküdar University · Department of Psychiatry

Fecal microbiota transplantation has a 1700-year history. This forgotten treatment method has been put into use again during the last 50 years. The interest in microbiota-gut-brain axis and fecal microbiota transplantation is rapidly increasing. New evidence is obtained in the etiopathogenesis of neuropsychiatric disorders. There is a large number...

The gut microbiota is essential to human health and the immune system and plays a major role in the bidirectional communication between the gut and the brain. Based on evidence, the gut microbiota is associated with metabolic disorders such as obesity, diabetes mellitus and neuropsychiatric disorders such as schizophrenia, autistic disorders, anxie...

Cognitive scientists have tried to explain the neural mechanisms of unconscious mental states such as coma, epileptic seizures, and anesthesia-induced unconsciousness. However these types of unconscious states are different from the psychoanalytic unconscious. In this review, we aim to present our hypothesis about the neural correlates underlying p...

The relationship between intestinal microbiota and the brain has been the focus of attention of the scientific world in recent years; >90% of the articles discussing the microbiome have been published only recently. 1 There is a strong and bidirectional relationship between the brain and the gut. Gut bacteria communicate with the intestinal epithel...

Microorganisms’ flora, which colonize in many parts of our body, stand out as one of the most important components for a healthy life. This microbial organization called microbiome lives in integration with the body as a single and whole organ/system. Perhaps, the human first encounters the microbial activity it carries through the immune system. T...

Collectivity, referred as the drive to be and stay together with the other beings, serves as a basic tool for survival and reproduction. Thus, it should be considered a basic instinct. In the first part of this article, we are describing the basic mechanisms of collectivity: (1) the collectivity instinct, (2) social trust, (3) inter- and intragroup...

Here, we report the third case with mildly elevated CA 15-3 and CEA tumor markers related to prolonged sertraline use.

Human beings exist in a biological and social system from a micro to a macro level, by means of “collectivity”, a dynamic collaboration that they have established together with the elements in that system in a way to complement each other and realize a common goal. Many neuroscientific concepts used today to explain neuronal processes from which me...

Suicidal cases are criminal cases that either should be prevented or be investigated forensically after occurring. One of the aims of our study is that arrange the bacterial flora-one of the biological factors-in the gut to reduce suicide cases. In our study, we compared the bacterias which are based in the gut flora of suicidal death with the cont...

Major depressive disorder is the most common neuropsychiatric disorder affecting millions of people worldwide, with severe consequences and causing the greatest loss of workforce. The monoamine hypothesis is still valid in explaining the etiopathogenesis of depression. Current treatment approaches aim to change the monoamine levels in the synaptic...

Depression is a very common disease with increasing incidence resulting from complex interactions of genetic, environmental, and immunological processes. To this day, the etiopathogenesis and treatment of depression unfortunately seem to be stuck in the synaptic gap. Despite highly potent antidepressants, the treatment rate cannot reach 100%, the t...

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...

The human body can be considered a superorganism in which it's eukaryotic cells and prokaryotic microorganisms coexist. Almost every organ system of the body lives a symbiotic life with these commensal bacteria. Intestinal microbiota has an important role in shaping, organizing and maintaining mental functions from as early as the intrauterine peri...

Objective: It is essential for the patient health that the physician reaches the data that will help with proper drug treatment in cases when Therapeutic Drug Monitoring (TDM) can not be applied. This study aims at examining the change on the plasma levels related to three antidepressants including to escitalopram (S-CT), fluoxetine (FLU), and sert...

Introduction There has long been a need for diagnostic, theragnostic, and prognostic biomarkers for psychiatric disorders. Biomarkers help reduce ambiguity and arbitrariness and increase objectivity. In this context, many candidates for hormonal, immunological, serological, and neuroimaging markers have been proposed, but none of these marker candi...

Introduction: Eating disorders are one of the most prevalent psychiatric disorders and have become a growing problem nowadays. Research shows that eating disorders are mostly widespread in industrialized societies where beauty is associated with thinness. This study investigates the relationships between eating attitudes, body image and depression...

Electroencephalography (EEG) signals are known to be nonstationary and often multicomponent signals containing information about the condition of the brain. Since the EEG signal has a complex, nonlinear, nonstationary, and highly random behavior, numerous linear feature extraction methods related to the short-time windowing technique do not satisfy...

Anxiety disorders are a complex set of illnesses in which genetic factors, particularly stress, play a role in the etiopathogenesis. In recent years, inflammation and intestinal microbiota have also been included in this complex network of relationships. The functions associated with tryptophan catabolism and serotonin biosynthesis have long been a...

Introduction. Over the past decade, evidence that supports the relationship between intestinal microbiota and the brain has been obtained. Ageing, stress, nutrition and medicines can alter the composition of bacteria in the intestinal microbiota. This condition, called dysbiosis, can be repaired through prebiotics, probiotics or fecal microbiota tr...

Psychobiotics are live bacteria that directly and indirectly produce positive effects on neuronal functions by colonizing into the intestinal flora. Preliminary studies, although in limited numbers, have found that these bacteria have anxiolytic and antidepressant activities. No research has yet been published on the antipsychotic efficacy of psych...

Psychiatric diseases are the manifestations that result from the individual's genetic structure, physiology, immunology and ways of coping with environmental stressors. The current psychiatric diagnostic systems do not include any systematic characterization in regard to neurobiological processes that reveal the clinical picture in individuals who...

The current diagnostic classification systems in psychiatry have been developed primarily for evidence-based clinical decision making with both categorical and dimensional approaches having their own advantages and disadvantages. Efforts have been made to improve these classification systems, and we are now at the point where we must expand beyond...

The search for rational treatment of neuropsychiatric disorders began with the discovery of chlorpromazine in 1951 and continues to evolve. Day by day, new details of the intestinal microbiota–brain axis are coming to light. As the role of microbiota in the etiopathogenesis of neuropsychiatric disorders is more clearly understood, microbiota-based...

A large number of evidence have been obtained regarding the relationship between gut microbiota and the brain during the last decade. Absence of gut microbiota or changes in the bacterial composition can cause significant results in body and brain functions. Aging, stress, nutrition, and medications like antibiotics may change the intestinal microb...

The aim of this study was to screen for the comorbidity of compulsive buying disorder with psychiatric disorders and associated sociodemographic variables. One hundred and ninety-six volunteering psychiatric patients attending Üsküdar University Outpatient Psychiatry Clinic formed the study sample. Compulsive buying disorder (CBD) was screened with...

Introduction: Comorbidity of migraine and mood disorders has long been recognized. Most of the studies have focused on the relationship between migraine and major depression with only few studies suggesting a special association between migraine and bipolar spectrum disorders. We aimed to evaluate the prevalence of bipolar disorder in migraine pati...

The effect of childhood traumas in adulthood psychopathology is considerable. There are studies indicating that there is cause and effect relation between adulthood aggression and childhood traumas. However, in Turkey, there are few studies on this subject. The results of these studies are controversial in some aspects. This research was designed t...

Therapeutic Drug Monitoring (TDM) is used to determine the concentration of drug in plasma/serum to adjust the dose of therapeutic drug. Selective and sensitive analytical methods are used to determine drug and metabolite levels for the successful application of TDM. The aim of the study was to develop and validate using LC‐MS/MS to analyse quantit...

Background: Studies on the effects of microorganisms living in the guts of human health and the etiopathogenesis of diseases, especially psychiatric disorders, have rapidly increased in recent years. According to the results of these studies, evidence has been found that there is direct and indirect (immune system) interaction between the microbiot...

Paroxetine is a commonly used serotonin-reuptake inhibitor for the treatment of various psychiatric disorders. Available literature is sparse with cases of paresthesia that occur during withdrawal of paroxetine, there are fewer reports of paresthesia during the initiation. Here we report a case of panic disorder who experienced tingling of the tong...

Bipolar affective disorder (BD) diagnosis and initiation of appropriate treatment are often delayed, and this is associated with poorer outcomes, such as rapid cycling or cognitive decline. Therefore, identifying certain warning signs of a probable successive episode during the inter-episode phase is important for early intervention. We present the...

Alcohol and substance addiction is a growing problem all over the world. Also, studies on understanding the causes of addiction as well as the treatment continue. Alcohol and substance addiction have genetic, environmental and psychological causes. The leading psychological cause is anxiety disorders. There are only a few studies in the literature...

Contrary to the general belief, a fetus is not sterile. Gut microbiota becomes colonized to the fetus in the intrauterine period. Microorganisms play a very significant role in the development of the immune system and the brain of the fetus. There is a bidirectional symbiotic relationship between gut microbiota and the body. This interaction is det...

This paper is an effort to describe, in neuroscientific terms, one of the most ambiguous concepts of the universe-the soul. Previous efforts to understand what the soul is and where it may exist have accepted the soul as a subjective and individual entity. We will make two additions to this view: (1) The soul is a result of uninhibited mental activ...

Objectives Psychological outcomes of aesthetic surgical procedures like hair transplantation are mostly positive including decreased anxiety, depression and social phobia and increased general well-being, self-efficacy and self-esteem. However, some patients may suffer from post-surgical depression and post-surgical increased suicide rates have bee...

Introduction Sjogren's syndrome (SS) is a common autoimmune disorder that is characterized by chronic inflammation of lachrymal and salivary glands. The well-known clinical manifestations of SS are dry eyes and dry mouth. However, the disease may first present itself with psychiatric symptoms, such as depressed mood, agitation or irritability. Obj...

Escitalopram is a commonly used antidepressant. Antidepres-sants are safe for short-term use. However, prolonged use can cause side effects with previously undetected clinical risks. 1) We report a case of a patient in whom levels of carcinoembry-onic antigen (CEA) in blood increased greatly while using es-citalopram but decreased after the drug wa...

Meningiomas are mostly benign tumors of the meninges that may stay clinically silent or present first with psychiatric symptoms only. We present a case of medial cranial fossa meningioma that was first diagnosed as mixed anxiety disorder with dissociative symptoms and vertigo. In light of the intact neurological and vestibular system examination, o...

Background: Mirtazapine is a tetracyclic antidepressant that enhances both noradrenergic and serotonergic transmission. The most common cause of papilledema is increased intracranial pressure due to brain tumor. Also it may occur as a result of idiopathic intracranial hypertension (IIH, pseudo tumor cerebri). Moreover, papilledema may also develop...

Paroxetine is one of the selective serotonin reuptake inhibitor antidepressant drugs. Galactorrhea can be seen during antidepressant treatments. There are a few reports in literature on paroxetine use and related prolactin level changes. We present a case that was receiving paroxetine in whom despite low blood levels of the drug, hyperprolactinemia...

Pregabalin and gabapentin, it's pharmacological like drug are new generation antiepileptic drugs. They show their effects through voltage-gated calcium channels. Sedation and cognitive dysfunction are among their side effects. There are some investigations shows that pregabalin and gabapentin may help to quit smoking. In this article two patients a...

Gut microbiota is essential to human health, playing a major and important role in the bidirectional communication between the gut and the brain. There is significant evidence linking gut microbiota and metabolic disorders such as obesity, diabetes and neuropsychiatric disorders such as schizophrenia, autism, anxiety, depression. New studies show m...

Aripiprazole is an atypical antipsychotic agent which has partial agonistic effect on dopamine D2 and D3 receptor. It is effective in the treatment of schizophrenia and bipolar disorder. Due to its partial agonistic effect, hyperactivity of dopamine may occur in the mesolimbic pathway. In the literature, there are few case reports about pathologica...

There are few researches about the average length of stay of inpatients in psychiatric clinics and costs of their treatment. In addition, these are unknown in Gülhane Military Medical Academy (GMMA) and military hospitals. In this study, it is aimed to determine the average length of staying at hospital according to their diagnosis and the frequenc...

zet Huzursuz bacak sendromu, nörolojik bir hareket bozukluğudur. Ek psikiyatrik belirtiler, hastalığın sonucu olarak ortaya çıkabilir. Ayrıca başka patolojilere veya ilaçlara bağlı olarak da meydana gelebilir. Pramipeksol, huzursuz bacak sendromu tedavisinde kullanılan bir dopamin agonistidir ve mezokortikolimbik dopaminerjik uyarıma bağlı psikotik...

Gabapentin, one of the antiepileptics, shows its effects via voltage-gated calcium channels. Sedation and mood elevation are among its side effects. The positive effects of antiepileptics such as valproate and carbamazepine as mood stabilizers have raised the hope that other antiepileptics may as well be efficacious in the treatment of mood disorde...

A 24-year-man presented to the neurology department with sudden onset headache. No neurological deficits, signs of raised intracranial tension or meningeal irritation were found. Also, no medication was started prior to the headache. The patient had experienced similar episodes of headaches for the past 3 years, which were not relieved with analgae...

Herpes zoster is a secondary reactivation of primary contagious varicella-zoster virus in the dorsal root ganglia. While thoracic zona is common, cervical dermatomal zona is a rare segmental complication of herpes zoster and can be easily misdiagnosed as other diseases. This article describes a patient with initial neuralgia without dermatomal lesi...

Objective: Antidepressants may increase serum prolactin levels. The purpose of the study is to explore the effects of six months of venlafaxine intake on the serum prolactin level of patients with major depressive disorders. Methods: Seventy-eight patients with major depressive disorders, who had applied to the psychiatry clinics consecutively, par...

Objective: Antidepressant drugs may lead to sexual dysfunction. It was aimed to research the effect of a 6-month intake of venlafaxine on sexual function during the treatment of patients with major depressive disorder. Methods: Forty-eight major depressive disorder cases who had been admitted to the psychiatry clinic consecutively were included in...

Introduction: Aggression is one of the leading clinical characteristics of antisocial personality disorder (APD). Studies aiming to clarify and control the biological basis of aggression are ongoing. Thyroid hormones have been indicated to play a role in the development of aggression. The aim of this study was to examine the level of aggression an...

Three years ago, a 55-year-old man, a teacher, was involuntarily brought to our outpatient psychiatry clinic by his wife. He had agreed to be examined because of his wife's divorce request. He had no symptoms and no insight about his condition during the examination. According to his wife, he had started to spend more time on the computer using soc...

Obsessions are repetitive thoughts, phantasies and opinion which cannot be removed from people's mind. In the literature various types of obsessions and compulsions were defined. The main function of the compulsions is to reduce disturbing thoughts and instincts. Sexual dysfunctions are common in obsessive compulsive disorder. Patients can effort t...

zet Olfaktör referans sendromu, kişinin vücudundan kötü koku yaydığı ısrarlı ve yanlış inancı ile seyre-den bir bozukluktur. Sınıflandırma sistemlerinde sanrısal bozukluk başlığı altında yer almaktadır. Bu bozuklukta görülen düşünce bozukluğunun obsesyonel mi yoksa sanrısal mı olduğu konusunda tartışmalar sürmektedir. Etiyopatogenezi henüz aydınlat...

zet Yüz tanıma, sosyal ilişki ve benlik gelişimi arasında bir bağlantı vardır. İnsanın yüz tanımayı dil işlevinde olduğu gibi önemli ve karmaşık bir dizge üzerinden gerçekleştirmesinin bir nedeni olmalı-dır. İnsanların birbirilerini yüzlerinden tanımaları, dostu düşmanı yüz üzerinden ayırmaları, bütün dostluklarını yüz üzerinden kurmaları onun dış...

Bağırsak mikrobiyotası beyin ve bağırsak arasında karşılıklı bir ilişki oluşturarak insan sağlığı üzerin-de temel ve önemli bir rol oynar. Obesite, diyabet gibi metabolik hastalıklar ve şizofreni, otizm, anksiyete, depresyon gibi neuropsikiyatrik bozukluklarla bağırsak mikrobiyotası arasında bağlantı olduğuna ilişkin güçlü kanıtlar vardır. Yeni ara...

Pedophilia, even though rare, is a disorder that requires further examination due to accompanying social, medical, ethical and legal problems. It is not clear that pedophilia is an impulse control disorder or not. There is controversy regarding sentence reduction. Since it is a rare disorder the knowledge is limited. There are different opinions ab...

Objective: Etiopathogenesis of attention deficit hyperactivity disorder (ADHD) has not been elucidated. It has been thought that environmental and genetic factors played a role in it. Perinatal fetal traumas might cause minimal brain damage. Being a first born child is a risk factor in term of exposure to birth traumas. There are few studies which...