Chilichonse Chimene Muyenera Kudziwa Zokhudza Kupanikizika Kwa Mtima Kumene Kumayambitsa Kulemera

Zamkati

• 1. Tricyclic antidepressants
• 2. Mankhwala ena a monoamine oxidase inhibitors (MAOIs)
• 3. Kugwiritsa ntchito zida zina za serotonin reuptake inhibitors (SSRIs) kwa nthawi yayitali
• 4. Mankhwala ena opatsirana pogonana
• Ma anti-depressants omwe sangayambitse kunenepa
• Kutenga

Chidule

Kulemera ndi vuto lomwe lingachitike chifukwa cha mankhwala osokoneza bongo. Ngakhale kuti munthu aliyense amayankha mosiyanasiyana mankhwalawa, mankhwalawa akhoza kupangitsa kuti muchepetse panthawi yomwe mumalandira.

1. Tricyclic antidepressants

Tricyclic antidepressants, omwe amadziwikanso kuti cyclic antidepressants kapena TCAs, atha kubweretsa kunenepa. Mankhwalawa ndi awa:

• amitriptyline (Elavil)
• chomera
• desipramine (Norpramin)
• doxepin (Adapin)
• imipramine (Tofranil-PM)
• nortriptyline (Pamelor)
• chojambula (Vivactil)
• trimipramine (Surmontil)

Ma TCA anali ena mwa mankhwala oyamba omwe adavomerezedwa kuthana ndi kukhumudwa. Sakupatsidwanso pafupipafupi chifukwa chithandizo chatsopano chimayambitsa zovuta zochepa.

Kunenepa kunalinso chifukwa chofala chomwe anthu amasiya kulandira chithandizo ndi mitundu iyi ya antidepressants, malinga ndi kafukufuku wa 1984.

Komabe, ma TCA amatha kukhala othandiza kwa anthu omwe samayankha mitundu ina ya mankhwala opatsirana, ngakhale atakhala ndi zovuta zina zosafunikira.

2. Mankhwala ena a monoamine oxidase inhibitors (MAOIs)

Monoamine oxidase inhibitors (MAOIs) anali gulu loyamba la mankhwala opatsirana pogonana omwe adapangidwa. MAOIs omwe amachititsa kulemera ndi awa:

• phenelzine (Nardil)
• isocarboxazid (Marplan)
• tranylcypromine (Zamasamba)

Madokotala amapatsa MAOIs nthawi zambiri pamene mankhwala ena opatsirana sagwira ntchito chifukwa cha zovuta zina komanso chitetezo. Mwa ma MAO atatu omwe atchulidwa pamwambapa, phenelzine ndiye omwe angayambitse kunenepa, malinga ndi 1988.

Komabe, kukhazikitsidwa kwatsopano kwa MAOI kotchedwa selegiline (Emsam) kwawonetsedwa kuti kumapangitsa kuti muchepetse thupi mukamalandira chithandizo. Emsam ndi mankhwala opatsirana omwe amagwiritsidwa ntchito pakhungu ndi chigamba.

3. Kugwiritsa ntchito zida zina za serotonin reuptake inhibitors (SSRIs) kwa nthawi yayitali

SSRIs ndi omwe amadziwika kuti ndi mankhwala osokoneza bongo. Kugwiritsa ntchito ma SSRIs kwa nthawi yayitali kumatha kupangitsa kunenepa:

• paroxetine (Paxil, Pexeva, Brisdelle)
• mankhwala (Zoloft)
• fluoxetine (Prozac)
• citalopram (Celexa)

Ngakhale ma SSRI ena amagwirizanitsidwa ndi kuchepa thupi poyamba, kugwiritsa ntchito ma SSRIs kwakanthawi kambiri kumalumikizidwa ndi kunenepa. Kugwiritsa ntchito nthawi yayitali kumatengedwa ngati chithandizo chomwe chimatenga nthawi yayitali kuposa miyezi isanu ndi umodzi.

Mwa ma SSRIs omwe atchulidwa pamwambapa, paroxetine nthawi zambiri imagwirizanitsidwa ndi kunenepa ndi kugwiritsa ntchito kwakanthawi komanso kwakanthawi.

4. Mankhwala ena opatsirana pogonana

Mirtazapine (Remeron) ndi wotsutsana ndi noradrenergic, womwe ndi mtundu wa antidepressant antypical. Mankhwalawa akhala akuwonjezera kunenepa komanso kukulitsa chilakolako kuposa mankhwala ena.

Mirtazapine sizimapangitsa anthu kunenepa poyerekeza ndi ma TCA.

Sizimakhalanso ndi zovuta zina zambiri monga mankhwala ena opatsirana. Komabe, zitha kuyambitsa:

• nseru
• kusanza
• Kulephera kugonana

Ma anti-depressants omwe sangayambitse kunenepa

Mankhwala ena opatsirana pogonana amathandizidwa ndi kunenepa pang'ono ngati zovuta zina. Mankhwalawa amaphatikizapo:

• escitalopram (Lexapro, Cipralex), SSRI
• duloxetine (Cymbalta), serotonin-norepinephrine reuptake inhibitor (SNRI), itha kuyambitsa kunenepa pang'ono ndi
• bupropion (Wellbutrin, Forfivo, ndi Aplenzin), wodwala matenda opatsirana
• nefazodone (Serzone), wotsutsana ndi serotonin komanso reuptake inhibitor
• venlafaxine (Effexor) ndi venlafaxine ER (Effexor XR), onse omwe ndi SNRIs
• desvenlafaxine (Pristiq), SNRI
• levomilnacipran (Fetzima), SNRI
• vilazodone (Viibryd), mankhwala opatsirana pogonana a serotonergic
• vortioxetine (Trintellix), mankhwala osokoneza bongo
• selegiline (Emsam), MAOI atsopano omwe mumagwiritsa ntchito khungu lanu, lomwe lingayambitse zovuta zochepa kuposa MAO omwe amatengedwa pakamwa

Kunenepa sikucheperanso kuchitika ndi ma SSRI otsatirawa akagwiritsidwa ntchito kwa miyezi yosachepera isanu ndi umodzi:

• mankhwala (Zoloft)
• fluoxetine (Prozac)
• citalopram (Celexa)

Kutenga

Sikuti aliyense amene amamwa mankhwala opanikizika amalemera. Anthu ena amachepetsa thupi.

Akatswiri amatsindika kuti kuda nkhawa ndi kunenepa sikuyenera kutengera kusankha kwa anthu opsinjika maganizo kwa anthu ambiri. Palinso zovuta zina ndi zinthu zofunika kuziganizira mukamasankha mankhwala opatsirana.

Mukayamba kunenepa mukamamwa mankhwala opanikizika, mankhwalawa sangakhale omwe amachititsa kuti muchepetse. Kusangalala mukamamwa mankhwala opanikizika, mwachitsanzo, kumatha kukulitsa chilakolako chanu, kumabweretsa kunenepa.

Osasiya kumwa mankhwalawa nthawi yomweyo ngakhale mutakhala wonenepa pang'ono. Muyenera kugwira ntchito ndi dokotala wanu kuti mupeze mankhwala opatsirana omwe amathandiza pazizindikiro zanu zapanikizika ndipo sizimabweretsa zovuta zina zosafunikira. Izi zingatenge chipiriro pang'ono.

Dokotala wanu amathanso kukupatsani malangizo othandizira kupewa kunenepa mukamamwa mankhwala opatsirana.