Antidepressants - ndichiyani? Asamakhale ndi nkhawa ndiponso antidepressants

Modern "popemphera" mayendedwe a moyo, ndi wosatha mtsinje wa mudziwe kuti munthu ayenera kusamalira tsiku ndi tsiku, komanso ena ambiri, ambiri a iwo zinthu zoipa kutsogolera chakuti thupi ndi maganizo sungakhale. Kusowa tulo ndi nkhawa, wonongeka ndi kulankhulana, kawirikawiri saidziŵa, ndipo nthawi zambiri anaposa ndi mankhwala kapena zinthu zina zimene, kudzabadwira matenda osiyanasiyana, monga kumva kutopa matenda (CFS) ndi maganizo osiyana. Malinga ndi Zoneneratu wa akatswiri a maganizo mankhwala kwa 20 chaka TH zaka zino chiwerengero cha milandu kuposa atsogoleri a mazana makumi awiri - matenda opatsirana ndi matenda a dongosolo mtima. Mu kulimbana ndi matenda a maganizo, mankhwala osiyanasiyana ndi onse zochokera zigawo zikuluzikulu zachilengedwe ndi kupanga. Antidepressants - ndichiyani? Kodi iwo ali ndi ngati mankhwala kuchiza maganizo kapena okha atsogolere zizindikiro zake? Kodi ubwino ndi kuipa kwa mankhwala chiyani? Nkhaniyi itithandiza yesani kuyankha mafunso awa ndi zina za zotsatira antidepressant ntchito zawo ndi zotsatira za phwando.

Ndi chiyani icho?

Monga dzina lake likunenera, antidepressants (wochedwanso timoleptikov) - ndi mankhwala psychotropic kuti kulimbana zizindikiro maganizo. Chifukwa cha mankhwala awa kuchuluka nkhawa ndipo amaika maganizo nkhawa, listlessness ndi ulesi tulo kwambiri yafupika kapena kwathunthu kutha. Choikidwa gulu la mankhwala zosiyana onse mu dongosolo mankhwala ndi zikuchokera, ndi limagwirira ntchito mwakhama.

Kodi ntchito?

Dziwani izi, odana depressants - ndiko: kuwonongedwa kwa thupi kapena kuthandiza wapabanja psyche anthu. Tiyeni tione mmene mankhwala ntchito. Ubongo wa munthu imakhala ndi kuchuluka kwa manyuroni - maselo mitsempha, nthawi zonse kuchita kuwombola zambiri pakati pawo. Pakuti kufala kwa mauthenga amenewa amafuna yeniyeni Mtumiki zinthu - timene, ozama mwa kudula mu malo synaptic pakati manyuroni. Ofufuza amakono kudziwa kuposa 30 timene osiyana, koma chitukuko ndi Inde maganizo ndi "mwachindunji" maganizo atatu okha a iwo: serotonin, noradrenaline (norepinephrine) ndi dopamine. Malinga ndi kafukufuku kafukufuku, maganizo kumachitika pamene mogwirizana kwa manyuroni m'munda pali kwambiri kachulukidwe kuchepetsa timene. Mmene antidepressants umalimbana kuwonjezera chiwerengero cha nkhoswe zogwirizana ndi normalization wa bwino amuzolengedwa ubongo.

A mbiri pang'ono

Akuyendera ku kulingalira magulu ndi chi mitundu ya antidepressants, mwachidule kufotokoza mbiri ya anatulukira.

Mpaka cha m'ma makumi awiri, maganizo ndi zikhalidwe zosiyanasiyana neurotic ndi zizindikiro zofanana ankapatsidwa kukonzekera a zitsamba. "Amaika maganizo" ntchito zosiyanasiyana nyimbo zosangalatsa, imene monga tiyi kapena khofi, ginseng oyimirira opiates. "Anatontholetsa" jitters anayesa salt bromine kapena mankhwala zochokera valerian. Komanso ntchito zosiyanasiyana zokambirana komanso mankhwala physiotherapy amene mogwira wakhala otsika kwambiri.

Kumayambiriro 50 ntchentche wa mankhwala "Promethazine" analengedwa ndi mazana makumi awiri, poyamba ntchito mankhwala ochititsa dzanzi pa opaleshoni. Pharmacologists ndayesera kumapangitsanso ochepetsera ndi mmene ochepetsera mankhwala, ndi chifukwa chakuti ndi 1951 adalandira "Chlorpromazine", umene ankagwiritsa ntchito yochizira matenda, matenda a maganizo. Lero, mankhwala chikudziwika ngati "Chlorpromazine".

Cha m'ma 60 ntchentche a dokotala Swiss atumwi wotsiriza, odwala lechivshimi ndi TB, zinali zodzaza ndi chochititsa mbali zotsatira za mankhwala monga "Iproniazid". Odwala kulandira izo, ali kukwezeka maganizo. Pang'onopang'ono izo zinayamba kugwiritsidwa ntchito mu mchitidwe Psychiatric monga TB, anathandiza pang'ono kwambiri. Pa nthawi yomweyo German kafukufuku Ronald Kun anapeza mankhwala "Imipramine".

Kutsegula kwa timoleptikov woyamba unabala mofulumira kafukufuku pharmacological m'dera limeneli ndi chilengedwe cha mankhwala atsopano kulimbana ndi zizindikiro ndi zimayambitsa kuvutika maganizo.

Gawo zamakono

Malinga wotani athandiza ntchito antidepressants pa maganizo ali wodwala, iwo zidzasankhidwa motere:

Komanso, pali gulu zochokera mmene zotsatira za antidepressants bwanji njira amuzolengedwa mu thupi:

• Tricyclic antidepressants - tricyclic timoanaleptiki.
• MAOIs - Monoamine oxidase zoletsa:

- sizingasinthe ( "tranylcypromine," "phenelzine");

- kusintha ( "Pirazidol", "Moclobemide").

• SSRI - kusankha serotonin reuptake zoletsa;
• IOZSIN - serotonin reuptake zoletsa ndi noradrenaline;
• NaSSAs - noradrenergic mosabisa serotonergic antidepressants.

Komanso, pali mankhwala antidepressant kuti sangathe zimachitika aliyense mwa magulu amenewa.

TCA: tricyclic antidepressants, ndichiyani?

Mankhwala magulu tricyclic monga "Nortriptyline", "Imipramine" ndi "Amiltriptilin" nalo dzina lake kuchokera amabweretsera patatu mpweya mphete. Mankhwalawa antidepressant kuthandiza kuonjezera chiwerengero cha timene ubongo monga norepinephrine (noradrenaline) ndi serotonin (timadzi wa Mtendere). Izi zimatheka ndi kuchepetsa mlingo wa mowa wa maselo mitsempha - manyuroni.

Chifukwa chakuti pa chiphaso cha mankhwala awa ali oletsedwa osati zofunika timene, pali zotsatira zosiyanasiyana mbali. antidepressants Tricyclic gulu angayambitse zotsatira mavuto:

• mphwayi;
• kusinza;
• nseru;
• youma pakamwa;
• kufooka;
• chizungulire;
• mathamangitsidwe wa mlingo mtima - zimachitika;
• kudzimbidwa;
• m'munsi potency ndi libido;
• nkhawa kapena nkhawa.

Mankhwalawa kawirikawiri zotchulidwa dokotala mu malo oyamba, popeza kwambiri kuphunzira ndi zotsatira za ntchito zawo zimadziwika bwino.

MAOIs - Monoamine oxidase zoletsa

Kukonzekera "Iproniazid" kutsegula oyamba, komanso mankhwala ena a gulu ili, monga "isocarboxazid," "tranylcypromine" ziletsa monoamine oxidase enzyme anachita, ali molekezera mitsempha. Chifukwa ichi, timene kuti ali ndi udindo maganizo athu, monga serotonin, noradrenaline ndi tyramine, si unagwa ndipo pang'onopang'ono amasonkhana mu ubongo.

The antidepressants zambiri zotchulidwa, MAOIs kwa maganizo atypical, kapena pamene mankhwala tricyclic gulu sanabwere ndipo analibe zotsatira ankafuna. Ubwino wa gulu la mankhwala ndi chakuti iwo alibe chikoka kwakukulu, ndi M'malo mwake, yotithandiza njira maganizo.

Komanso mankhwala tricyclic, MAOIs ndi ndekuti mofulumira umunthu - antidepressants chikoka akubwera masabata angapo pambuyo chiyambi cha phwando.

Chifukwa chakuti Mao zoletsa ndi zotsatira zambiri mbali (ndi mosavuta anatani ndi mankhwala chifuwa ndi chimfine, ndipo kungakhale moyo pachiswe kukwezedwa kwa magazi) komanso chifukwa cha zakudya mwachilungamo okhwima pamene kutumikiridwa mankhwala mankhwala kawirikawiri, pamene mankhwala ena sanathandize.

kusankha serotonin zoletsa reuptake

Takambirana gulu la TCAs ndi MAOIs - izo makamaka posachedwapa anatsegula komanso kuphunzira mankhwala. Koma "lakale" m'badwo wa antidepressants pang'onopang'ono m'malo ndi mankhwala zambiri zamakono kuti ndigwire ntchito ya timene, osati onse, koma limodzi - serotonin, kuteteza takeover ake n'zosiyana manyuroni. Zimenezi ndende ndipo limachita achire. Kuti Zina ano SSRI mankhwala monga "fluoxetine", "sertraline", "Zoloft", "Paroxetine" ndi ena. Mu gulu ili la mankhwala taonera zotsatira ochepa mbali, ndipo osati mochuluka bwanji thupi.

zoletsa Serotonin reuptake ndi noradrenaline

Izi ndi mwachilungamo mankhwala atsopano, umene uli ku antidepressants m'badwo wachitatu. Iwo anayamba kubala m'ma 90 ntchentche wa XX atumwi. Mankhwala monga "Cymbalta", "Effexor" chipika reuptake wa serotonin si, komanso noripinefrina, koma mankhwala monga "Wellbutrin" ndi "Zyban" kupewa adzabwerenso norepinephrine ndi dopamine.

Zotsatira zoyipazi mankhwala gulu n'chochepa kwambiri kuposa zina, ndipo anasonyeza m'malo ofooka. Atalandira antidepressants, analengedwa pa maziko a zoletsa monga "duloxetine" ndi "Bupropion", pangakhale kuwonjezeka mu kulemera ndi kukanika yaing'ono dera kugonana.

Noradrenergic ndi serotonergic yeniyeni antidepressants - NaSSAs

Wina wa magulu n'zosamveka NaSSA antidepressant mankhwala amene amachepetsa kapumidwe kapenanso ngakhale kuletsa adani a noradrenaline synapses maselo mitsempha, potero kuwonjezeka ndende zake. mankhwala monga "Remeron" "Lerivon" "Serzon" kugwira Letsani wa serotonin zolandilira.

Mankhwala mu gulu ili pali zotsatira ofatsa ngati zosasangalatsa mbali monga kugona, pakamwa youma, kuchuluka kudya ndi kugwirizana kunenepa. Kuletsa antidepressants wa gulu izi zimachitika popanda vuto lalikulu.

Kuwonjezera magulu zofunika antidepressants pamwamba, pali mankhwala amene sangathe zimachitika mmodzi wa iwo. Iwo amasiyana onse mipweya ndi limagwirira ntchito mwakhama. Mwachitsanzo, mankhwala monga "Bupropion", "Hypericin", "Tianeptine", "Nefazodone" ndi ena ambiri.

njira zina

Lero, akatswiri achilendo ambiri ntchito zochizira maganizo mankhwala amene amakhudza timene osati timene, koma pa chikhalidwe cha dongosolo endocrine, monga adrenal zopangitsa, ubongo imene imalamulira kutentha ndi pituitary England. Ena mwa mankhwala, monga "Aminoglutethimide" ndi "ketoconazole" ziletsa adrenal timadzi tochepa kaphatikizidwe, koma ali ndi zotsatira zambiri mbali ndi kukhala mavuto obwera pa dongosolo endocrine.

Gulu lachiwiri nthawi anatchula antalarmina cholandilira muzikangana kuphatikiza makhalidwe abwino amene asamakhale ndi nkhawa ndiponso antidepressants.

Kuwonjezera mankhwala pharmacological wa limati maganizo ayamba njira ntchito monga likukulira normobaric hypoxia ndi plasmapheresis mankhwala kuwala, komanso ena ambiri kuchepetsa zizindikiro ndi amelioration zizindikiro.

Ovomereza ndi okana

Anthu ambiri amene anatenga antidepressants, amavomereza kuti mankhwala othandiza kwambiri, makamaka ngati amwedwa pa nthawi yomweyo wochitidwa ndi njira katswiri wa mankhwala. Tiyenera kukumbukira kuti mankhwala awa ndi mlingo awo agwire dokotala, pansi pa ulamuliro amene ndi kuwatenga iwo. Musayembekezere kusintha yomweyo. Monga ulamuliro, kupanda chiyembekezo ndi imfa ya chidwi mu moyo, komanso ulesi, mphwayi ndi chisoni kudutsa masabata 3-4 pambuyo chiyambi cha utsogoleli zokhudza zonse.

Mmodzi wa kuipa kwambiri mankhwala awa ndi antidepressant discontinuation syndrome, amene kumaonekera ndi kuchotsa lakuthwa, kusalankhula kulowa awo.

Kodi ntchito?

1. Ngati inu anapezeka ndi matenda a mtima, impso kapena matenda chiwindi sindilephera dokotala.

2. Antidepressants zinthu payekha, kotero katswiri adzakhala kusankha mankhwala ndi oyenera makamaka kwa inu.

3. Nthawi zina mankhwala wina sikokwanira, dokotala anu angakupatseni munthawi yomweyo phwando angapo (asamakhale ndi nkhawa ndiponso antidepressants, antipsychotics ndi mankhwala aliwonse anticonvulsant). Kuchokera pa matenda ndi kuyan'anila chikhalidwe chanu somatic, katswiri adzakhala kusankha mankhwala kuti adzatha azigwirizana ndi sadzakhala kungasokoneze pa thupi la munthu.

4. Inu simungakhoze kusiya kumwa mankhwala antidepressant mwadzidzidzi ndipo popanda kufunsa katswiri, izi kumawonjezera Inde maganizo ndi mavuto osiyanasiyana zosasangalatsa anachita thupi.

5. Anthu ambiri amafunsa ngati n'zotheka kumwa antidepressants ndi mowa limodzi. malangizo onse mankhwala anasonyeza kuti m'gulu zosavomerezeka, chifukwa angathe kuwononga kwambiri wamanjenje dongosolo, kapena imfa.

achire kapena osokoneza?

Zikatero, ngati inu kutenga antidepressants kwa nthawi yaitali, ndiyeno pazifukwa zosiyanasiyana, anaima mwadzidzidzi, zingachititse kusapeza, monga khalidwe maganizo osakhazikika, kutopa, zopweteka minofu, chizungulire. Zizindikiro zonsezi limatchedwa antidepressant syndrome discontinuation. N'chifukwa chake madokotala amalangiza pang'onopang'ono kuchepetsa mlingo wa mankhwala analandira ndiponso kutero kuyang'aniridwa ndi akatswiri. akatswiri Only angathandize kuthetsa kusapeza, m'mene anatenga normotonics zofunika ndi kukonzekera pa maziko a zomera. Ngati mankhwala akutengedwa mosatonthozeka, kenako udindo wake anali mwadzidzidzi itatha, ngati Kulipira antidepressants zingachititse kuti chisokonezo tulo, kuchuluka nkhawa, ndi mavuto ndi dongosolo la mtima. Komanso, zizindikiro izi zingachitike:

• wodzikweza mantha;
• chimfine zizindikiro;
• nseru, kusanza;
• omangana ndi ululu thirakiti m'mimba;
• imfa ya kuyenda, ndipo vertigo;
• kutulo;
• nthambi kugwedeza.

m'malo mapeto

Kuyambira takambiranazi Ndizachidziwikire za mmene amphamvu ndi woopsa kwambiri mankhwala, kodi antidepressants kuti mankhwala amakono akhoza maganizo. Komabe, musanayambe kuwatengera, kukaonana ndi katswiri - zamaganizo kapena psychoneurologist amene akhoza kulingalira zomwe mtundu wa matenda ndi inu ndi zimene mankhwala kuthandiza kupirira izo.