Njira Zophatikizira za Kukhumudwa

Zamkati

• Udindo Wa Mankhwala
• Odwala Opanikizika
• Mankhwala oletsa antipsychotic
• L-Triiodothyronine
• Zolimbikitsa
• Therapy Yophatikiza monga Chithandizo Cha Mzere Woyamba

Ngati muli ndi vuto lalikulu la kukhumudwa (MDD), mwina mwakhala mukumwa mankhwalawa. Mankhwala osakanikirana ndi mtundu wa mankhwala omwe madotolo ambiri komanso akatswiri azamisala akhala akugwiritsa ntchito kwambiri pazaka khumi zapitazi.

Udindo Wa Mankhwala

Mpaka posachedwa, madokotala amapereka mankhwala ochepetsa nkhawa kuchokera mgulu limodzi lokha la mankhwala, kamodzi. Izi zimatchedwa monotherapy. Ngati mankhwalawa alephera, atha kuyesa mankhwala ena mgululi, kapena kusinthiratu ku gulu lina la antidepressants.

Kafukufuku tsopano akuwonetsa kuti kumwa mankhwala opatsirana pogonana m'makalasi angapo kungakhale njira yabwino kwambiri yochizira MDD. Kafukufuku wina adapeza kuti kugwiritsa ntchito njira yophatikizira pachizindikiro choyamba cha MDD kumatha kuonjezera mwayi wokhululukidwa.

Odwala Opanikizika

Payekha, bupropion ndi yothandiza pochiza MDD, koma itha kugwiritsidwanso ntchito limodzi ndi mankhwala ena ovuta kuthana nawo. M'malo mwake, bupropion ndi imodzi mwamankhwala omwe amagwiritsidwa ntchito kwambiri kuphatikiza mankhwala. Nthawi zambiri amagwiritsidwa ntchito ndi ma serotonin reuptake inhibitors (SSRIs) osankhidwa ndi serotonin- norepinephrine reuptake inhibitors (SNRIs). Nthawi zambiri amalekerera bwino anthu omwe adakumana ndi zovuta zina kuchokera kumankhwala ena opatsirana. Ikhozanso kuthana ndi zovuta zina zokhudzana ndi kugonana (kuchepa kwa libido, anorgasmia) yokhudzana ndi ma SSRIs ndi SNRIs odziwika.

Kwa anthu omwe akusowa kudya komanso kusowa tulo, mirtazapine ikhoza kukhala njira. Zotsatira zake zoyipa kwambiri ndikulemera komanso kukhala pansi. Komabe, mirtazapine sanaphunzire mozama ngati mankhwala osakaniza.

Mankhwala oletsa antipsychotic

Kafukufuku akuwonetsa kuti pakhoza kukhala phindu pothana ndi zotsalira mwa anthu omwe amatenga ma SSRI ndi ma antipsychotic, monga aripiprazole. Zotsatira zoyipa zomwe zimadza chifukwa cha mankhwalawa, monga kunenepa, kunjenjemera kwa minofu, ndi kusokonezeka kwa kagayidwe kachakudya, ziyenera kuganiziridwa mosamala chifukwa zitha kupititsa patsogolo kapena kukulitsa zizindikilo zina za kukhumudwa.

L-Triiodothyronine

Madokotala ena amagwiritsa ntchito L-Triiodothyronine (T3) pophatikizira ndi tricyclic antidepressants (TCAs) ndi monoamine oxidase inhibitors (MAOIs). Malingaliro ofufuzira T3 ndiyabwino kufulumizitsa kuyankha kwakuthupi kuchipatala kuposa kuwonjezera mwayi womwe munthu angalowerere.

Zolimbikitsa

D-amphetamine (Dexedrine) ndi methylphenidate (Ritalin) ndizomwe zimathandizira kuthana ndi kukhumudwa. Zitha kugwiritsidwa ntchito ngati monotherapy, koma zitha kugwiritsidwanso ntchito pophatikiza ndi mankhwala ochepetsa nkhawa. Zimathandiza kwambiri pamene zotsatira zomwe mukufuna ndizoyankha mwachangu. Odwala omwe afooka, kapena omwe ali ndi vuto la comorbid (monga sitiroko) kapena matenda azachipatala, atha kukhala oyenera kuphatikiza izi.

Therapy Yophatikiza monga Chithandizo Cha Mzere Woyamba

Kuchita bwino kwa chithandizo cha monotherapy ndikotsika, chifukwa chake ofufuza ambiri ndi madotolo amakhulupirira kuti njira yoyamba komanso yabwino kwambiri yochizira MDD ndi mankhwala osakanikirana. Komabe, madokotala ambiri ayamba kuchiza ndi mankhwala amodzi.

Musanapange chisankho chamankhwala, ipatseni nthawi yogwira ntchito. Pambuyo poyeserera (nthawi zambiri pafupifupi 2 mpaka 4 masabata), ngati simukuwonetsa yankho lokwanira, adotolo angafune kusintha mankhwala kapena kuwonjezera mankhwala owonjezera kuti awone ngati kuphatikiza kumathandizira dongosolo lanu lothandizira.