Mankhwala Osokonezeka Maganizo ndi Zotsatira Zazovuta

Zamkati

• Kusankha ma serotonin reuptake inhibitors
• Zotsatira za SSRI
• Serotonin-norepinephrine reuptake inhibitors
• Zotsatira zoyipa za SNRI
• Tricyclic antidepressants
• Zotsatira za TCA
• Norepinephrine ndi dopamine reuptake inhibitors
• Zotsatira za NDRI
• Monoamine oxidase inhibitors
• Zotsatira zoyipa za MAOI
• Mankhwala owonjezera kapena owonjezera
• Mankhwala ena opatsirana pogonana

Chidule

Chithandizo cha vuto lalikulu lachisoni (chomwe chimadziwikanso kuti kukhumudwa kwakukulu, kukhumudwa kwamankhwala, kupsinjika kwa unipolar, kapena MDD) kumadalira munthuyo komanso kukula kwa matendawa. Komabe, madokotala nthawi zambiri amapeza zotsatira zabwino ngati mankhwala akuchipatala, monga antidepressants, ndi psychotherapy amagwiritsidwa ntchito limodzi.

Pakadali pano pali mankhwala opitilira awiri opanikizika omwe amapezeka.

Odwala matenda opatsirana amatha kuthana ndi kukhumudwa, koma palibe mankhwala amodzi omwe awonetsedwa kuti ndi othandiza kwambiri - zimatengera wodwalayo komanso momwe alili. Muyenera kumwa mankhwalawa pafupipafupi kwa milungu ingapo kuti muwone zotsatira ndikuwona zovuta zilizonse.

Nawa mankhwala omwe amaperekedwa pafupipafupi ndi zotulukapo zake.

Kusankha ma serotonin reuptake inhibitors

Njira yochiritsira kukhumudwa koyambirira imayamba ndi mankhwala a serotonin reuptake inhibitor (SSRI).

Ubongo ukapanda kupanga serotonin wokwanira, kapena sungagwiritse ntchito serotonin yolondola kale, kuchuluka kwa mankhwala muubongo kumatha kukhala kosafanana. SSRIs imagwira ntchito kusintha kuchuluka kwa serotonin muubongo.

Makamaka, ma SSRIs amaletsa kubwezeretsanso kwa serotonin. Mwa kulepheretsa kubwezeretsanso, ma neurotransmitters amatha kutumiza ndikulandila mauthenga amankhwala moyenera. Izi zikuganiziridwa kuti zimawonjezera mphamvu yolimbikitsira serotonin ndikusintha zizindikiritso zakukhumudwa.

Ma SSRI ambiri ndi awa:

• fluoxetine (Prozac)
• citalopram (Celexa)
• paroxetine (Paxil)
• mankhwala (Zoloft)
• escitalopram (Lexapro)
• fluvoxamine (Luvox)

Zotsatira za SSRI

Zotsatira zoyipa zomwe anthu omwe amagwiritsa ntchito ma SSRIs amakhala nazo ndi izi:

• Mavuto am'mimba, kuphatikizapo kutsegula m'mimba
• nseru
• pakamwa pouma
• kusakhazikika
• kupweteka mutu
• kusowa tulo kapena kusinza
• Kuchepetsa chilakolako chogonana komanso kuvutika kufikira chilakolako chogonana
• Kulephera kwa erectile
• kusokonezeka (jitteriness)

Serotonin-norepinephrine reuptake inhibitors

Serotonin-norepinephrine reuptake inhibitors (SNRIs) nthawi zina amatchedwa dual reuptake inhibitors. Amagwira ntchito poletsa kubwezeretsanso, kapena kubwezeretsanso, kwa serotonin ndi norepinephrine.

Ndi serotonin yowonjezera ndi norepinephrine imazungulira muubongo, kuchuluka kwa mankhwala muubongo kumatha kukhazikitsidwanso, ndipo ma neurotransmitters amalingaliridwa kuti amalumikizana bwino kwambiri. Izi zitha kusintha malingaliro ndikuthandizira kuthetsa zipsinjo.

Ma SNRI omwe amadziwika kwambiri ndi awa:

• venlafaxine (Effexor XR)
• desvenlafaxine (Pristiq)
• duloxetine (Cymbalta)

Zotsatira zoyipa za SNRI

Zotsatira zoyipa zomwe anthu omwe amagwiritsa ntchito SNRIs amakhala nazo ndi izi:

• thukuta lowonjezeka
• kuthamanga kwa magazi
• kugunda kwa mtima
• pakamwa pouma
• kuthamanga kwa mtima
• Mavuto am'mimba, makamaka kudzimbidwa
• kusintha kwa njala
• nseru
• chizungulire
• kusakhazikika
• mutu
• kusowa tulo kapena kusinza
• kuchepa kwa libido komanso kuvuta kufikira chiwonetsero
• kusokonezeka (jitteriness)

Tricyclic antidepressants

Tricyclic antidepressants (TCAs) adapangidwa m'ma 1950, ndipo anali m'gulu la mankhwala opatsirana akale omwe amagwiritsidwa ntchito kuthana ndi kukhumudwa.

Ma TCA amagwira ntchito poletsa kubwezeretsanso kwa noradrenaline ndi serotonin. Izi zitha kuthandiza thupi kupititsa patsogolo mapindu olimbikitsa kusintha kwa noradrenaline ndi serotonin yomwe imatulutsa mwachilengedwe, zomwe zimatha kusintha malingaliro ndikuchepetsa zovuta zakukhumudwa.

Madokotala ambiri amapereka ma TCA chifukwa amalingalira kuti ndi otetezeka ngati mankhwala atsopano.

Ma TCA omwe amadziwika kwambiri ndi awa:

• amitriptyline (Elavil)
• imipramine (Tofranil)
• doxepin (Sinequan)
• trimipramine (Surmontil)
• clomipramine (Anafranil)

Zotsatira za TCA

Zotsatira zoyipa zochokera m'gulu lino la antidepressants zimakhala zovuta kwambiri. Amuna amakonda kukhala ndi zovuta zochepa kuposa akazi.

Zotsatira zoyipa zomwe anthu omwe amagwiritsa ntchito ma TCA amakhala nazo ndi izi:

• kunenepa
• pakamwa pouma
• kusawona bwino
• Kusinza
• kugunda kwamtima msanga kapena kugunda kwamphamvu mosasinthasintha
• chisokonezo
• mavuto a chikhodzodzo, kuphatikizapo kuvuta kukodza
• kudzimbidwa
• kutaya chilakolako chogonana

Norepinephrine ndi dopamine reuptake inhibitors

Pakadali pano NDRI imodzi yokha ndi yomwe FDA imavomereza kukhumudwa.

• buproprion (Wellbutrin)

Zotsatira za NDRI

Zotsatira zoyipa zomwe anthu omwe amagwiritsa ntchito ma NDRI amapezeka ndi izi:

• khunyu, akamamwa kwambiri
• nkhawa
• kutulutsa mpweya
• manjenje
• kusokonezeka (jitteriness)
• kupsa mtima
• kugwedezeka
• kuvuta kugona
• kusakhazikika

Monoamine oxidase inhibitors

Monoamine oxidase inhibitors (MAOIs) ndi mankhwala omwe amalembedwa pokhapokha ngati mankhwala ndi mankhwala ena alephera.

MAOIs amalepheretsa ubongo kuti uwononge mankhwala a norepinephrine, serotonin, ndi dopamine. Izi zimathandiza kuti ubongo uzisunga mankhwalawa mopitirira muyeso, omwe atha kukulitsa kusunthika ndikusintha kulumikizana kwa ma neurotransmitter.

Ma MAI ofala kwambiri ndi awa:

• phenelzine (Nardil)
• selegiline (Emsam, Eldepryl, ndi Deprenyl)
• tranylcypromine (Zamasamba)
• isocarboxazid (Marplan)

Zotsatira zoyipa za MAOI

MAOIs amakhala ndi zotsatirapo zingapo, zambiri zomwe zimakhala zoyipa komanso zowopsa. MAOIs amakhalanso ndi mwayi wochita zinthu zowopsa ndi zakudya komanso mankhwala owonjezera.

Zotsatira zoyipa zomwe anthu omwe amagwiritsa ntchito MAOIs amakhala nazo ndi izi:

• Kugona masana
• kusowa tulo
• chizungulire
• kuthamanga kwa magazi
• pakamwa pouma
• manjenje
• kunenepa
• Kuchepetsa chilakolako chogonana kapena kuvutika kufikira zolaula
• Kulephera kwa erectile
• mavuto a chikhodzodzo, kuphatikizapo kuvuta kukodza

Mankhwala owonjezera kapena owonjezera

Kwa kukhumudwa kosagwirizana ndi mankhwala kapena kwa odwala omwe akupitilizabe kukhala ndi zizindikilo zosathetsedwa, mankhwala achiwiri amatha kuperekedwa.

Mankhwala owonjezerawa amagwiritsidwa ntchito pochiza matenda ena amisala ndipo atha kuphatikizira mankhwala othana ndi nkhawa, otonthoza, ndi ma antipsychotic.

Zitsanzo za antipsychotic zomwe zavomerezedwa ndi Food and Drug Administration (FDA) kuti zigwiritsidwe ntchito monga zowonjezera zowonjezera kukhumudwa ndizo:

• aripiprazole (Limbikitsani)
• quetiapine (Seroquel)
• Olanzapine (Zyprexa)

Zotsatira zoyipa za mankhwalawa atha kukhala ofanana ndi mankhwala ena opatsirana pogonana.

Mankhwala ena opatsirana pogonana

Mankhwala achilengedwe, kapena omwe sagwirizana ndi magulu ena aliwonse a mankhwala, amaphatikizapo mirtazapine (Remeron) ndi trazodone (Oleptro).

Zotsatira zoyipa za mankhwalawa ndi kuwodzera. Chifukwa mankhwala onsewa amatha kuyambitsa ulesi, nthawi zambiri amatengedwa usiku kuti ateteze chidwi ndi kuwunika.