Kuenda pane antidepressants: Yekutangisa gwara kune mhedzisiro

Zvinodhaka Info

Kana iwe, seni, uchitambura kubva pakati nepakati kusvika pakuora mwoyo kukuru, kusagadzikana kusingaperi, kana kunyangwe bipolar kusagadzikana, zvinogona kunge mupi wako wezvekurapa akakunyorera mushonga unodzvinyirira. Ini ndinogona kukuudza kubva pane zvakaitika kuti iyi mishonga inogona kushandura hupenyu. Pamwe pamwe nehurukuro yekurapa, mishonga yekudzvinyirira inogona kubata zviratidzo zvinokutadzisa kurarama hupenyu hwakazara. Vanogona kukusunungura kubva kusuruvara kwakadzika, kutya, kutsamwa, uye zvimwe zvakawanda zviratidzo zvinokanganisa basa, chikoro, uye hukama hwehukama.

Kune makirasi akati wandei emishonga inodzvinyirira, uye ese anoshanda nenzira dzakasiyana. Asi chinhu chimwe chavanofanana ndechekuti vanochinja kuvapo kwemamwe makemikari muuropi hwako. Ichi chinhu chakanaka, munzira dzakawanda, sezvo zvichibatsira kurapa kushushikana kwako kana kushushikana. Asi semishonga yese, inogona kukonzeresa mhedzisiro.

Chikwata chevarapi uye vemishonga vakabatsira kuumba iri gwara rakazara remishonga yekudzvinyirira uye mhedzisiro yemishonga yekudzvinyirira.

Ndeapi marudzi eanodzvinyirira?

Mishonga yekudzvinyirira mishonga yekurapa inobata zviratidzo zvekuora mwoyo, kumwe kushushikana kwekushushikana, mwaka kusagadzikana kusagadzikana, uye dysthymia (kana kupfava kusingaperi kushushikana). Ose anoshanda nekugadzirisa kusaenzana kwemakemikari emaurotransmitter muuropi ayo anofambidzana neshanduko yemanzwiro uye maitiro.

Vakasiyana antidepressants vanonangana akasiyana maurotransmitter muhuropi uye huta system, anodaro Justin Hall, MD, chiremba wezvepfungwa Spectrum Maitiro Ehutano muAnnapolis, Maryland. Serotonin ndiyo inowanzo tarisirwa neurotransmitter iyo yanga ichibatanidzwa nekushushikana uye kushushikana.

Serotonin yakanangwa nekuti ndiyo neurotransmitter iyo inonyanya kufambidzana nekushushikana. Iyi kemikari ine akasiyana siyana mabasa mumuviri wemunhu . Vanachiremba vazhinji nevanhuwo zvavo vanozviti kemikari inofara, nekuti inozivikanwa kuwedzera mufaro uye nemanzwiro ehupenyu. Asi zvinogona zvakare kukanganisa kugaya kwako, ura, kufamba, ndangariro, kurara, uye zvimwe zvinhu zvakawanda.

Iwo makirasi eanodzvinyirira zvinodhaka anosanganisira:

• Kusarudza serotonin reuptake inhibitor (SSRI)
• Serotonin-norepinephrine reuptake inhibitor (SNRI)
• Tricyclic antidepressant (TCA)
• Monoamine oxidase inhibitor (MAOI)
• Serotonin anopikisa uye reuptake inhibitor (SARI)
• Atypical antidepressant

Imwe yeaya makirasi, uye kunyangwe mishonga iri mukati mawo, inokanganisa huwandu hweanosiyana-siyana maurotransmitter kune imwe nhanho, anodaro Alam Hallan, Pharm.D., Director wefamasi yeGuelph General Hospital muOntario, Canada

Neichi chikonzero, vese varwere vanoda yakasarudzika chirongwa chekurapa. Mumiriri akanakisa kune mumwe murwere ndizvo zvinoshanda zvakanyanya kwavari, Dr. Hallan anodaro. Vazhinji varwere kazhinji vanotanga neSSRIs kana SNRIs. Kana vakasapindura kumishonga iyi, saka vanogona kuyedza maCAA kana atypicals. MAOIs akachengeterwa makesi asinganyanye nekuda kwekumwe kusangana kwakanyanya.

Inosarudza serotonin reuptake inhibitors (SSRIs) uye Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Zvese SSRIs uye SNRIs inorayirwa kuti irape kushushikana uye zvimwe kusagadzikana kwekushushikana. Ivo vanoshanda nekutarisa makemikari muuropi hwako anonzi maurotransmitter. Kana huropi hwako huchitumira mameseji kubva kune imwe sero kuenda kune imwe, sekunzwa kufara nezvenhau idzi, kana bhaisikopo iri rinosetsa, iwo mameseji anofamba nerubatsiro rwemaurotransmitter.

SSRIs inotarisa neurotransmitter inonzi serotonin, uye SNRIs inotarisana neserotonin uye norepinephrine. Kazhinji, apo uropi hwako hunotumira mameseji kubva kune imwe neuron kuenda kune imwe, iye anotumira anoburitsa zvishoma yetiurotransmitter kutakura iwo meseji, ipapo inodzosera zvakare iyo neurotransmitter mushure mekunge meseji yaunzwa.

SSRI antidepressants inoshanda nekuvhara iyo reabsorption (kana reuptake) yeserotonin muuropi yako, mushure mekunge yaendesa ayo anofara mameseji. Naizvozvo, huropi hwako huchave hune serotonin yakawanda inowanika kuendesa akawanda anofara mameseji. Iyo inowanzo gadzirirwa antidepressants, SSRIs inoonekwa seinonyanya kushanda pamwe neayo mashoma mashoma mhedzisiro. Mimwe mienzaniso inosanganisira Celexa (citalopram), Lexapro (escitalopram), Paxil (paroxetine), Prozac (fluoxetine) uye Zoloft (sertraline).

Saizvozvowo, SNRIs inowedzera iwo mazinga eese serotonin uye norepinephrine muuropi hwako.

Norepinephrine imwe yeurotransmitter inoita basa mukudzikamisa mamiriro. Mimwe mienzaniso yeSNRI inosanganisira Cymbalta (duloxetine), Effexor (venlafaxine), uye Pristiq (desvenlafaxine).

Tricyclic antidepressants (TCAs)

Tricyclic (kana tetracyclic) mishonga yekudzvinyirira mamwe emamwe ekutanga antidepressant akagadzirwa. Izvo zvakanaka zvinobudirira, asi zvinouyawo nemimwe migumisiro, saka zvinonyanya kuchinjwa nemishonga mitsva kunze kwekunge SSRIs kana SNRIs dzisingashande.

Cyclic antidepressants zvakare anovharira iyo reuptake yeiyo neurotransmitters serotonin uye norepinephrine, ichiwedzera iwo mazinga emakemikari maviri aya muuropi. Nekudaro, maCAA anogona kukanganisa mamwe maurotransmitter zvakare, ndosaka vaine yakawanda yakawanda mhedzisiro. Mienzaniso yeCAA inosanganisira amitriptyline uye amoxapine.

Monoamine oxidase inhibitors (MAOIs)

Kufanana nevamwe, monoamine oxidase inhibitors (MAOIs) shanda nekukanganisa maurotransmitter. Kunyanya, MAOIs anokanganisa dopamine, serotonin, uye norepinephrine, ayo pamwe chete anozivikanwa se monoamines. Kune zvakare kemikari iri muuropi inonzi monoamine oxidase, inobvisa iwo maurotransmitter. MAOIs anoshanda nekudzivirira monoamine oxidase, nekudaro achibvumidza akawanda eaya maurotransmitter kuti agare muuropi.

Aya aive ekutanga antidepressant, akagadzirwa muma1950. Vakanga vachishanda pakurapa kusagadzikana kukuru kwekushungurudzika. Nekudaro, semaCAA, vanouya nemhedzisiro yakawanda. Kune huwandu hwekudyidzana kwezvinodhaka zvine njodzi pakati peMAOI nemimwe mishonga, zvichiita kuti zvive zvakaoma kurapa vanhu vane matambudziko ehutano hwepfungwa pamwe nemamwe mamiriro ekurapa. Mimwe mienzaniso inosanganisira Nardil (phenelzine) uye Marplan (isocarboxazid).

Serotonin anopikisa uye reuptake inhibitors (SARIs)

Serotonin anopikisa uye reuptake inhibitors (SARIs) FDA-inogamuchirwa semishonga inodzvinyirira, asi inowanzo shandiswa off-label semubatsiro wekurara. Kufanana neSSRIs, vanoshanda nekudzivirira serotonin reuptake. Asi ivo vanoitawo sevadzivisi, vachivhiringidza imwe serotonin receptor inonzi 5HT2a, iyo inovharira mashandiro eproteni yekuendesa serotonin.

Mimwe mienzaniso yeSARIs inosanganisira Desyrel (trazodone) uye Serzone (nefazodone).

Atypical antidepressants

Atypical antidepressants zvakangofanana nezvavanonzwika-kwete zvakajairika. Izvi zvinoreva kuti ivo havakwani mune chero emamwe makirasi eanodzvinyirira, uye vanoshanda munzira dzakasiyana. Kunyangwe pasina nzira yekupfupisa mashandiro emishonga iyi, zvinokwana kutaura kuti ese anoshandura magadzirirwo emamwe maurotransmitter muuropi hwako, kusanganisira dopamine, serotonin, uye / kana norepinephrine. Mimwe mienzaniso yeatypical antidepressants ndeye Wellbutrin (bupropion) uye Remeron (mirtazapine).

Kunzwisisa mhedzisiro yemhedzisiro yekudzvinyirira

Kunyange paine huwandu hwakasiyana hwemhedzisiro inokanganisa mishonga yekudzvinyirira, izvi ndizvo zvakajairika.

• Kurera huremu kana kuwana
• Zvinetso zvepabonde, kusanganisira kurasikirwa kwechido chepabonde, kusagadzikana kwe erectile, nevamwe
• Kusarara
• Kukotsira
• Kuneta
• Kutemwa nemusoro
• Nausea
• Muromo wakaoma
• Kuona kwakashata
• Kuzvimbirwa
• Dzungu
• Kusagadzikana
• Kushatirwa
• Kufunganya
• Kusarongeka kwemoyo

Pamusoro peizvi, kune marefu- uye mapfupi-kwenguva mhedzisiro mhedzisiro yemishonga inodzvinyirira.

Yakareba-nguva mhedzisiro mhedzisiro yeanodzvinyirira

Kunyangwe akawanda antidepressant mhedzisiro mhedzisiro iri pfupi-pfupi, pane mashoma anogara kwenguva yakareba-izvi zvakashata mhedzisiro ndezvekuwandisa uye zvinogona kazhinji kutarisirwa nenzira dzinoverengeka, zvakatsanangurwa pazasi. Izvo zvinogona kuve zvenguva refu mhedzisiro mhedzisiro zvinosanganisira uremu shanduko, matambudziko epabonde, kushaya hope, kukotsira, uye kuneta.

Kurera huremu

Chikonzero chekuwedzera huremu uchitora mishonga yekudzvinyirira kwenguva refu hachina kujeka. Zvinogona kuti varwere vakambodya zvishoma pavakange vakaora mwoyo vakasangana nehavi yavo vachidzoka nehurapi, Dr. Hallan vanoratidza, kana mishonga inogona kukonzera shanduko mumetabolism yavo. Muzviitiko zvakawanda, inosvika pamazana mashanu emapaunzi kana zvakadaro pagore.

Zvimwe zvidzidzo zvekurapa zvakaratidza kuti kushandiswa kwenguva refu kweanodzvinyirira kunogona kuwedzera njodzi yako yezvirwere zvine chekuita nekurema, senge mhando 2 chirwere cheshuga .

Kana kugadzirisa iyi divi mhedzisiro nedhayeti uye kurovedza muviri kusingashande, Dr. Hallan anokurudzira kuyedza mushonga mutsva. Yese mishonga iyi inoshanda zvakasiyana muvanhu vakasiyana, saka mumwe mushonga ungangokonzeresa mhedzisiro kune wese munhu, kunyangwe kana zvichizivikanwa kazhinji zvichikonzeresa mhedzisiro yacho.

Zvirwere zvepabonde

Zvepabonde mhedzisiro mhedzisiro inowanzo kuve yakajairika mhedzisiro mhedzisiro iyo inogona kutungamira kune vanhu kumisa yavo mishonga kunyangwe ivo vari kuita zvakanaka pamushonga, Dr. Hall anodaro.

Muchokwadi, yakawanda sehafu yevarwere vese vanotora SSRIs vanogona kusangana nemimwe mhedzisiro pabonde, kusanganisira kudzikira kwekutyaira pabonde, kudzikira kwekugona kuve nehurume, kuoma kwechikadzi, kana kusagadzikana kwe erectile.

Nepo mimwe mhedzisiro iri yehupenyu hwepfupi, iyi mhedzisiro yepabonde inogona kuenderera munguva yese murwere achitora mishonga yekudzvinyirira. Zvisinei, havafaniri kunge vachikanganisa kana kuva nenjodzi. Kana zvichinetsa kusvika paunosarudza kusatora mushonga, Dr. Hall anokurudzira kutaura nachiremba wako nezvekudzora muyero, kutora mushonga pane imwe nguva yezuva, kana kuchinjira kumushonga wakasiyana.

Zvinetso zvekurara

Kusiyanisa kubva pamushonga kuenda kuchinodhaka uye murwere kusvika murwere, akawanda anodzvinyirira anokonzera kunetseka nekurara-kungave kushaya hope kana kutsimwaira. Kana iwe ukaona izvi divi mhedzisiro, Dr. Hall anokurudzira kuronga nguva yako mishonga zvinoenderana nemabatiro ainoita hope dzako: Kana yako antidepressant ichikuita kuti uve nekukotsira, tora usati warara. Kana zvikakugonesa kumuka, tora mangwanani. Kazhinji, kumuka kana kurara mhedzisiro yechirwere ichi kuchapera mushure memaawa akati wandei.

Ipfupi-temu mhedzisiro mhedzisiro yeanodzvinyirira

Nepo vanhu vazhinji vari chiratidzo chakasununguka pane mishonga yekudzvinyirira, hazvisi zvisina kujairika kuwana mhedzisiro-pfupi mhedzisiro mhedzisiro inogara mazuva mashoma kana mavhiki mashoma. Izvi zvinogona kusanganisira kusvotwa, kutemwa nemusoro, kuoma muromo, kusaona zvakanaka, kuzvimbirwa, uye kutsamwa kana kutsamwa.

Nausea

Nausea inoitika munenge makumi maviri neshanu muzana evanodzvinyirira varwere. Inowanzo tanga nekukurumidza mushure mekutanga kurapwa uye inoderera mushure memasvondo maviri kana matatu. Zvisinei, inoenderera mberi mukurapwa mune chingangoita chetatu chevanhu ivavo. Nausea inowanzozivikanwa ne venlafaxine uye SSRIs pane neatypicals senge bupropion, mirtazapine, kana reboxetine. Iyo inogona yakajairika kutarisirwa nekutora ako meds padumbu rakazara.

Kutemwa nemusoro

Chidzidzo chakaburitswa mumagazini Clinical Therapeutics vakaona kuti kutemwa nemusoro kwaive kwakanyanya kuitika kune vanhu zviuru makumi mana avo vachangotanga kutora mishonga yekudzvinyirira. Vaya vakatora maCAA nemaSSRIs vaiwanzoita kupfuura avo vakatora SNRIs kana bupropion kuti varwadziwe nemusoro. Nekudaro, vanhu vazhinji vanoita kuvaka kushivirira kweiyi mhedzisiro, uye vanoenda mushure menguva pfupi.

Muromo wakaoma

Kusangana muromo wakaoma ? Izvi zvinogona kunge zviri nekuti mishonga inodzivisa kwenguva pfupi kugadzirwa kwemate. TCAs dzinowanzo kukonzera mukanwa wakaoma kupfuura SSRIs.

Dr. Hallan vanokurudzira kuyamwa mazaya echando, kutora sips yemvura, kutsenga chingamu, kushandisa mindi, kana kukwesha mazino.

Matambudziko ekuona

Vanhu vane chiratidzo chisina kujeka vanozvitsanangura sekushaikwa kwekupinza kana kujekesa kune kwavo kuona. Kuona kwakashata kunowanzoitika kumaTCA. Vanhu vanogona zvakare kunzwa kupisa, kuchenesa, uye kutsvuka kweziso, kana kunzwisa tsitsi muziso. Uye zvakare, vamwe vanhu vanoti maziso avo anonyanya kuona chiedza.

Kana iwe uri kutora antidepressants uye iwe uchinge waona kusajeka kuona, tanga wawana ziso bvunzo kutonga kunze mamwe matambudziko ekuona. Iwe unogona zvakare kuedza kushandisa madonhwe eziso uye humidifier kudzikisira maziso ako. Taura nemupi wako nezvekushandura dhizaini yako kana iyi divi mhedzisiro ichiramba ichidarika kwemavhiki mashoma.

Kuzvimbirwa

Iyo neurotransmitter serotonin ine akati wandei mabasa kunze kwekuita kuti unzwe uchifara - inogona kukanganisa mafambiro ako, zvakare, nekuti serotonin irimo mumatumbu ako. Dzimwe nguva, mamwe maSSRI uye maCAA anogona kukonzera kupatira munguva pfupi. Varwere vanogona kuzvibata nekushandisa laxatives, kunwa yakawanda mvura, uye kudya yakawanda fiber.

Dzungu

Dzungu rinowanzoitika nemaCAA uye MAOI pane mamwe makirasi ekudzvinyirira. Icho chikonzero ma meds aya dzimwe nguva anokonzera dzungu ndechekuti anogona kudzikisa yako BP. Dr. Hall vanokurudzira kutora mishonga yako panguva yekurara kuti ubatsire kudzora iyi mhedzisiro.

Kushatirwa kana kushushikana

Zvese kugumbuka uye kushushikana zvakangoitika zvisingawanzo mhedzisiro mhedzisiro yekudzvinyirira, asi zvinoitika mune diki nhamba yevarwere. Icho chikonzero chingangove chakabatana neserotonin. Sezvatatoonekwa, mashoma maserotonin muuropi anogona kutungamira mukushushikana nekushushikana, ndosaka mishonga iyi yese ichishanda kuwedzera mazinga eserotonin neimwe nzira. Mumazuva ekutanga ekurapwa, muviri wako uri kushanda kugadzirisa ako maserotonin mazinga, izvo zvinoita kuti vachinje. Izvi zvinogona kukonzera kupfupika kwekuwedzera kwekushushikana kana kusagadzikana. Sezvo maserotonin ako mazinga paanowedzera kusimba, izvi zviratidzo zvinofanirwa kudzikira.

Side maitiro	SSRI	SNRI	TCA	MAOI	SARI	Wellbutrin	Remeron
Kurera huremu	X		X	X	X		X
Kusagadzikana pabonde	X	X	X	X	X
Zvinetso zvekurara	X	X	X	X	X	X	X
Nausea	X	X	X	X	X	X	X
Kutemwa nemusoro	X	X	X	X	X	X	X
Muromo wakaoma	X	X	X	X	X	X	X
Matambudziko ekuona	X	X	X	X	X	X	X
Kuzvimbirwa		X	X	X	X	X	X
Dzungu	X	X	X	X	X	X	X
Kushatirwa	X	X	X	X	X		X
Kufunganya	X	X	X	X		X	X
Kuwedzera kudikitira		X	X	X		X
Urine kuchengetedza		X	X	X
Kuderera kweropa		X	X	X	X

Yakakomba mhedzisiro mhedzisiro yeanodzvinyirira

Parizvino, zvese zvakajairika mhedzisiro yatakambokurukura haina kukuvadza, kunyangwe kana zvichinetsa. Kune, zvisinei, mashoma mashoma asingawanzo, asi zvakare akaipisisa, mhedzisiro mhedzisiro inogona kuitika kana uchitora mishonga yekudzvinyirira. Zvinosanganisira kuzviuraya, serotonin syndrome, uye hyponatremia.

Neraki, iyi mhedzisiro ine njodzi haina kujairika, uye njodzi dzakanyanya mumwedzi wekutanga wekurapa.

Pfungwa dzekuzviuraya

Kune mazhinji acho, mishonga yekudzvinyirira inobatsira kudzikisa zvese zviratidzo zvekushushikana, kusanganisira kuzviuraya. Zvisinei, vashoma vevarwere vanotambura-kazhinji vechidiki vakuru-vanowana njodzi yakakura yekuwedzera kuzviuraya mazano.

Sekureva kwaDr. Hallan, izvi zvinongoitika mune chaiwo mamiriro. Semuenzaniso, munhu akashungurudzika zvakanyanya uyo asina kudzidziswa anogona kunge achifunga kuzviuraya. Asi kushushikana kwake zviratidzo zvinomuchengetedza kubva pakuita pane idzodzo pfungwa nekuti izvo zvinomuita kuti anzwe kuneta kwakanyanya uye kupera simba. Kana angotanga kurapwa, simba rake nekuneta zvinogona kuvandudza zvakaringana kumupa simba rekutevera pane ake mazano ekuzviuraya.

Kuti udzivise iyi divi mhedzisiro, iwe unofanirwa kugovana chero pfungwa dzekuzviuraya dzawakave nadzo nemupi wako wezvehutano usati watanga kurapwa.

Serotonin chirwere

Serotonin syndrome chirwere chinotyisidzira hupenyu chinoitika mune vashoma kwazvo varwere, anodaro Dr. Hallan. Iyi imwe njodzi kune avo vari pane inopfuura imwe mishonga yeserotonergic. Boka rezviratidzo zvinosanganisira kushushikana, kubvunda, kutuka, uye hyperthermia. Kutora zvimwe zvinowedzera, saSt.John's Wort, kunogona kuwedzera njodzi yemamiriro aya.

Kana iwe ukawana izvi zviratidzo paunenge uchitora antidipressant, tsvaga rubatsiro rwechiremba nekukasira. Vacharega ako meds, vape zvinodzosera mumiririri, uye vanobatsira kudzora zviratidzo zvako.

Hyponatremia

Hyponatremia ndeimwe ngozi parutivi mhedzisiro uye inoonekwa mune vangangoita 1 mu2000 varwere vanotora SSRIs, Dr. Hallan anotsanangura. Achitaura nezvekushayikwa kwesodium muropa, hyponatremia inofungidzirwa kuve nekuda kwekuwedzera kugadzirwa kweiyo diuretic hormone, izvo zvinoita kuti muviri uchengete mvura yakawanda, nokudaro uchidiridzira huwandu hwesodium mumuviri, anodaro. Varwere, kunyanya varwere vakuru, vari panjodzi vanofanirwa kuongororwa vachishandisa bvunzo bhu.

Antidepressant kubvisa zviratidzo

Kunze kwekunge iwe uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchirangana nawo. Kurega kwevanodzvinyirira kunogona kukonzera zviratidzo zvekuregera, senge:

• Kufunganya
• Kushaya hope kana hope dzakajeka
• Musoro uchirira
• Kutemwa nemusoro
• Dzungu
• Kuneta
• Zviratidzo zvakaita sefuru
• Nausea
• Kushatirwa

Kana iwe uchifanira kurega kushandisa antidepressants, kana kutochinja yako dosi, zvakakosha kuti iwe utaure nemupi wako wekutanga. Iye kana iye anogona kukupa iwe chirongwa chekuzvimisa pachezvako kubva pamushonga kuitira kuti iwe ugone kudzora ekudzoka zviratidzo.