Antidepressant - kuyini? Zinhlungu futhi antidepressant

Modern "bebangalasa" ijubane zokuphila, kugeleza Imininingwane ukuthi umuntu kufanele ukusingatha nsukuzonke, kanye nabanye abaningi, iningi labo ezintweni ezingezinhle kuholele yokuthi umzimba nengqondo yini ongema. Insomnia nokucindezeleka, ukungasebenzi kanye zokuxhumana, ngokuvamile unganakwa, futhi ngokuvamile waminza out okwenziwa izidakamizwa noma nezinye izinto ezinamandla, luholele izifo ezinjalo eziyinkimbinkimbi, ezifana ukukhathala okungamahlalakhona syndrome (CFS) kanye nokucindezeleka ezahlukene. Ngokusho izibikezelo abahlaziyi zokucindezeleka yezokwelapha kuya 20 ngonyaka th Ngasekuqaleni kwaleli khulu leminyaka e inamba yezimo adlula abaholi kwekhulu lamashumi amabili - izifo ezithathelwanayo nezifo yisimiso senhliziyo nemithambo yegazi. Empini yokulwa iziyaluyalu bacindezeleke, izidakamizwa ezahlukene yibo bobabili esekelwe izingxenye zemvelo futhi zokwenziwa. Antidepressant - kuyini? Lokho abayikho kanye ngabe le mithi ukwelapha izinkinga zokucindezeleka noma senze lula izimpawu zayo kuphela? Yiziphi emihle nemibi imithi enjalo? Lesi sihloko zizozama ukuphendula le mibuzo kanye neminye ngomphumela antidepressant ukusetshenziswa kwabo kanye nemiphumela reception.

Kuyini lokhu?

Njengoba leli gama lisikisela, antidepressant (obizwa nangokuthi timoleptikov) - a izidakamizwa psychotropic ezisebenza ngokumelene izimpawu sokucindezeleka. Ngenxa yalaba izidakamizwa ukukhathazeka anda futhi ukucindezeleka ngokweqile ngokomzwelo, listlessness futhi ukucobeka, ukuqwasha kakhulu ziyancipha noma zinyamalale ngokuphelele. Ezibangelwa leli qembu izidakamizwa zihlukile kokubili isakhiwo sazo sekhemikhali kanye nokusungulwa, futhi lo mshini wezenzo.

Isebenza kanjani?

Asivume, anti-depressants - okungukuthi: ukubhujiswa kwayo emzimbeni noma ukusiza ishaye psyche womuntu. Ake sibheke le mithi zisebenza kanjani. Ubuchopho bomuntu siqukethe sebuningini izinzwa - amangqamuzana ezinzwa, njalo enza Ukwaziswa wengxoxo phakathi kwabo. Ukuze ukudluliswa kolwazi olunjalo ludinga ethize isithunywa izinto - neurotransmitters, engena ngokusebenzisa umqhewu esikhaleni izinhlaka zokuxhumana zobuchopho phakathi izinzwa. Abacwaningi banamuhla ukuhlonza neurotransmitters angaphezu kuka-30 ahlukene, kodwa ukuthuthukiswa kanye Yiqiniso zokucindezeleka babenesimo sengqondo "oqondile" ngezindawo ezintathu kuphela kwezine kubo: serotonin, noradrenaline (norepinephrine) kanye Dopamine. Ngokusho idatha ucwaningo, ukucindezeleka kwenzeka lapho ukuxhumana izinzwa emkhakheni kukhona ukwehliswa abalulekile ambalwa of neurotransmitters. Umthelela antidepressant kuhloswe kwandziswa kwelinani letikhungo balamuli olufanele kanye ukuzinza esele kwamakhemikhali ebuchosheni.

Umlando omncane

Ngaphambi kokuqhubeka kuhlolwe amaqembu owayephila kanye nezinhlobo antidepressant, chaza kafushane umlando ukutholakala kwawo.

Kuze phakathi nekhulu le-Athazeksesi, ukucindezeleka kanye nemibandela ahlukahlukene Neurotic nge nezimpawu ezifanayo babephathwa amalungiselelo zemithi engamakhambi ehlukahlukene. Ukuze "setha kwemizwa" basebenzisa izindlela ezihlukahlukene izingoma okuthakazelisayo, lapho zihlanganisa i-caffeine, ginseng noma abamele opiates. "Athobe" jitters wazama uxhumano lokudlulisa nosawoti noma imithi esekelwe valerian. Futhi sebenzisa izinhlobo ezahlukene umzimba kanye Physiotherapy ukwelashwa kabani ukusebenza ubelokhu kakhulu.

Ngasekuqaleni kwawo-50-yalolucwaningo zomuthi "Promethazine" sidalwe zenzeka ekhulwini lamashumi amabili, ekuqaleni ezisetshenziselwa izinzwa phakathi nokuhlinzwa. Pharmacologists baye bazama ukuthuthukisa inhibitory futhi umphumela inhibitory zomuthi, futhi umphumela waba ukuthi ngo-1951 wayethole "Chlorpromazine", eyayisetshenziswa kabanzi zokwelapha, ekwelapheni ukucindezeleka. Namuhla, le izidakamizwa ebizwa ngokuthi "Chlorpromazine" ezaziwayo.

Ngasekupheleni kwawo-60-yalolucwaningo udokotela Swiss leminyaka elidlule, iziguli lechivshimi ngesifo sofuba, wavelela ngumuntu engavamile side effect walesi izidakamizwa ngokuthi "Iproniazid". Iziguli abasitholayo, ekuphakamisile kwemizwelo. Kancane kancane ke zaqala ukusetshenziswa ngo umkhuba zengqondo njengesifo sofuba, wabasiza kancane kakhulu. Ngesikhathi umcwaningi German uRonald Kun wathola izidakamizwa "Imipramine".

Ukuvulwa kwe-timoleptikov kuqala kwaholela ekwakhekeni okusheshayo ucwaningo kwemithi kule ndawo futhi ukudalwa kwemithi emisha zokunqanda izimpawu kanye izimbangela zokucindezeleka.

ngezigaba yesimanje

Kuye onjani umphumela has ukusetshenziswa antidepressant ngokucindezeleka is e isiguli, bahlukene kanje:

Ngaphezu kwalokho, kukhona ngezigaba esekelwe kanjani umphumela antidepressant kuthinte izinqubo kwamakhemikhali emzimbeni womuntu:

• tricyclic antidepressant - timoanaleptiki tricyclic.
• MAOIs - Monoamine inhibitor oxidase:

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

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

• SSRI - abakhethayo serotonin reuptake inhibitor;
• IOZSIN - serotonin reuptake inhibitor futhi noradrenaline;
• NaSSAs - noradrenergic futhi ethize serotonergic antidepressant.

Futhi, kukhona izinhlobo eziningi zezidakamizwa antidepressant ukuthi ngeke kukhonjwe kunoma ala maqembu.

TCA: tricyclic antidepressant, kuyini na?

Izidakamizwa amaqembu tricyclic ezifana "Nortriptyline", "Imipramine" futhi "Amiltriptilin" lethiwa eyisisekelo kathathu carbon indandatho. Le mithi antidepressant ukusiza ukwandisa isibalo neurotransmitters ubuchopho ezifana norepinephrine (noradrenaline) kanye serotonin (i-hormone injabulo). Lokhu ibangelwa ekunciphiseni izinga ukusetshenziswa njengoba amangqamuzana ezinzwa e - izinzwa.

Ngenxa yokuthi ekwamukelweni mithi avimbelwe hhayi kuphela neurotransmitters kudingekile, kunezindlela eziningi ezahlukene engemihle. tricyclic antidepressant iqembu kungabangela imiphumela elandelayo uhlangothi:

• ukucobeka;
• ukozela;
• isicanucanu;
• nomlomo owomile;
• ngenxa yobuthakathaka;
• isiyezi;
• ukusheshisa ukushaya kwenhliziyo - ishayela;
• ukuqunjelwa;
• potency ephansi futhi libido;
• ukukhathazeka noma izinkathazo.

Le mithi ngokuvamile ebekwe udokotela kwasekuqaleni, ngoba kuyizinto wafunda kakhulu futhi imiphumela ngokusebenzisa kwawo baziwa.

MAOIs - Monoamine oxidase inhibitor

Ukulungiselela "Iproniazid" ukuvula ngomunye wabokuqala, kanye nezinye izidakamizwa yaleli qembu, njengokuthi "isocarboxazid," "tranylcypromine" zivimbela monoamine oxidase enzyme ukuphendula, eziqukethwe eziyimpumelelo emsipheni. Ngenxa yalokhu, i-neurotransmitters ukuthi banesibopho imizwa yethu, ezifana-serotonin, noradrenaline futhi tyramine, kungukuthi lubhidlike kancane olwenzekayo ebuchosheni.

I antidepressant ngokuvamile enqunyiwe, MAOIs ukucindezeleka atypical, noma lapho izidakamizwa iqembu tricyclic ongafikanga futhi akazange abe nomphumela oyifunayo. Buhle leli qembu izidakamizwa yokuthi abanayo nethonya amandla, futhi ngokuphambene nalokho, zishukumisa izinqubo engqondo.

Kanye izidakamizwa tricyclic, MAOIs kube namthelela esisheshayo womuntu - antidepressant ithonya iza emasontweni ambalwa emva kokuqala reception.

Ngenxa yokuthi mao inhibitor babe eminingi engemihle (futhi kalula ukuxubana izidakamizwa ukhwehlela futhi umkhuhlane, futhi kungaba avuse kokuphakama esisongela ukuphila wegazi) kodwa futhi ngenxa yokudla sasivumela kube lukhuni uma iqondiswa linqume izidakamizwa ezinjalo azivamile, lapho yingaba yini engakusiza ungazange kwasiza.

abakhethayo serotonin reuptake inhibitor

Sahlola iqembu TCAs futhi MAOIs - ke ikakhulukazi muva wavula kanye wafunda izidakamizwa. Kodwa isizukulwane "ubudala" ka antidepressant kancane kancane sithathelwe indawo izidakamizwa ezengeziwe yesimanje ukuthi uvimbele isenzo neurotransmitters, akubona bonke, kodwa kuphela olulodwa - serotonin, ekuvimbeleni reverse kombuso izinzwa zalo. Lokhu kwandisa okuhlushwa kunomphumela zokwelapha. Ukuze zihlanganisa ezifana ngemithi yanamuhla SSRI ezifana "fluoxetine", "sertraline", "Zoloft", "Paroxetine" nabanye. Kuleli qembu izidakamizwa waphawula ayinayo imiphumela eminingi engemihle, futhi abazi kakhulu kanjani umzimba womuntu.

Serotonin reuptake inhibitor futhi noradrenaline

Lena izidakamizwa kahle entsha, elingelakwaJuda eyesithathu antidepressant isizukulwane. Baqala esikhiqiza phakathi nawo-90-yalolucwaningo ka XX leminyaka. Kushaqwe izidakamizwa ezifana ne "Cymbalta", "Effexor" block le reuptake ka-serotonin akuyona kuphela, kodwa futhi noripinefrina, kodwa izidakamizwa ezifana "Wellbutrin" futhi "Zyban" ukuvimbela ukubuya norepinephrine futhi Dopamine.

Izidakamizwa-side effects kuleli qembu lincane kakhulu kunamanye, futhi eshiwo kunalokho wavuma. Emva kokuthola antidepressant, wadala ngesisekelo inhibitor ezifana "duloxetine" futhi "Bupropion", kungase kube ukwenyuka isisindo nokuphazamiseka okuhambisana ezincane ezingeni ngokobulili.

Noradrenergic futhi serotonergic ethize antidepressant - NaSSAs

Omunye amaqembu zangaleso NaSSA antidepressant izidakamizwa ukuthi ijubane noma ngisho ukumisa ukuthunjwa noradrenaline synapse of amangqamuzana ezinzwa, ngaleyo ndlela kwande lokuhlushwa yayo. izidakamizwa zakhe ezinjengethi, "Remeron" "Lerivon" "Serzon 'uyoyifeza Ukuvinjwa of serotonin receptor.

Imithi kuleli qembu kukhona omnene enjalo engemihle imiphumela efana ukozela, nomlomo owomile, isifiso yanda futhi ezihambisana isisindo somzimba. Khansela antidepressant yaleli qembu senzeka ngaphandle kwezinkinga ezinkulu.

Ngaphandle amaqembu eziyisisekelo antidepressant ngenhla, kukhona izinhlobo eziningi zezidakamizwa ukuthi ngeke kukhonjwe ukuba omunye wabo. Ahluke kokubili Ukwakheka kwamakhemikhali kanye mshini wezenzo. Lokhu, isibonelo, izidakamizwa ezifana "Bupropion", "Hypericin", "Tianeptine", "Nefazodone" kanye nabanye abaningi.

izindlela

Namuhla, ongoti angaphandle ngokwethukela kusetshenziswa kakhulu ekwelapheni ukucindezeleka imithi yokwelapha engiyisebenzisayo ethonya neurotransmitters hhayi neurotransmitters, kodwa isimo kohlelo endocrine, ezifana adrenal nezindlala, ngxenye futhi pituitary indlala. Ezinye zalezi izidakamizwa, njengokuthi "Aminoglutethimide" futhi "ketoconazole" zivimbela adrenal-hormone okuthiwa i-cortisol zamagama, kodwa eminingi engemihle futhi nemiphumela engemihle ku ohlelweni endocrine.

Iqembu lesibili ngokuvamile okubhekiselwa antalarmina abamelene yokwamukela sihlanganise izimfanelo ezinhle lapho babe zinhlungu futhi antidepressant.

Ngaphezu ukwelashwa kwemithi ithi futhi bacindezeleke, ziya ngokuya amasu esetshenziswa ezifana ngakanye hypoxia normobaric futhi plasmapheresis, Ukwelapha ngokukhanya, kanye nabanye abaningi ukuthi banciphise izimpawu eziwumphumela wokugula futhi amelioration izimpawu.

Pro ne con

Iningi labo wathatha antidepressant, uyavuma ukuthi imithi eminye esebenza ngempumelelo kakhulu, ikakhulukazi uma ezithathwe ngesikhathi esifanayo olwenziwa inkambo Uchwepheshe yokwelapha. Kufanele kukhunjulwe ukuthi le mithi kanye umthamo wabo angaqoka udokotela, ngaphansi kolawulo kabani futhi kufanele uwathatha. Ungalindeli ngcono osheshayo. Njengoba umthetho, nomuzwa wokungabi nathemba futhi ukungasathandi empilweni, kanye ukucobeka, abantu abaningi abasinaki futhi ukudabuka zidlule 3-4 amasonto ngemuva kokuqala ekuphathweni letindzala.

Omunye bokwenza enkulu le mithi iyona antidepressant ukuqedwa syndrome, esizibonakalisa nge ekunqanyulweni abukhali futhi engalawuliwe ukungena yabo.

Usifaka kanjani isicelo?

1. Uma ngabe sebethole isifo senhliziyo, izinso noma isifo sesibindi qiniseka ukuthi utshele udokotela wakho.

2. antidepressant isinyathelo ngamunye, ngakho onguchwepheshe ngeke ukhethe izidakamizwa ukuthi kufanelekile wena ngqo.

3. Kwezinye izimo, omunye umuthi akwanele, udokotela wakho angase akunikeze reception ngesikhathi esisodwa amaningi (zinhlungu futhi antidepressant, antipsychotics futhi yimuphi izidakamizwa anticonvulsant). Ngokusekelwe Ihlahlubo ukuqapha isimo sakho ukuphathwa kwabathintwayo, onguchwepheshe ngeke ukhethe izidakamizwa ukuthi uzokwazi umphelelisi nomunye futhi ngeke ibe nomthelela omubi umzimba womuntu.

4. Awukwazi ayeke ukuthatha imithi antidepressant ngokuzumayo futhi ngaphandle kokuxoxisana onguchwepheshe, njengoba lokhu zingase zibe zimbi inkambo ukucindezeleka futhi kubangele ezihlukahlukene ezingemnandi ukuphendula bokuphila.

5. Abantu abaningi ukubuza ukuthi kungenzeka ukuphuza antidepressant kanye notshwala ndawonye. Zonke imiyalelo izidakamizwa wabonisa ukuthi sebekubeke akwamukelekile neze, ngoba kungabangela umonakalo isimiso sezinzwa, noma ukufa.

ukuhoxiswa noma umlutha?

Kuleso simo, uma uthatha antidepressant isikhathi eside, bese, nganoma isiphi isizathu, yema, kungabangela ukungakhululeki, njenge-ukuziphatha engazinzile ngokomzwelo, ukukhathala, ukhwehlela nobuhlungu bomzimba, isiyezi. Zonke lezi zimpawu zaziwa njenge- antidepressant ukuqedwa syndrome. Yingakho odokotela batusa elokhu enciphisa umthamo imithi wathola futhi ukwenza kanjalo ngaphansi kokuqondisa ochwepheshe. ochwepheshe kuphela ingasiza ekudambiseni ukungakhululeki, njengoba sengike wacosha normotonics ezidingekayo futhi amalungiselelo ngesisekelo izitshalo. Uma izidakamizwa esithathwayo angalawuleki, bese nokuqokwa kwakhe kwaba isigubhukane ivalwe, kuhoxiswa ka antidepressant kungaholela ubuthongo thuthuva, ukukhathazeka yanda, futhi izinkinga esimiso senhliziyo nemithambo yegazi. Ngaphezu kwalokho, lezi zimpawu ezilandelayo kungenzeka:

• ukwesaba ongenangqondo;
• izimpawu zomkhuhlane;
• ukucanuzela kwenhliziyo, ukuhlanza,
• amajaqamba nobuhlungu pheshana emathunjini;
• ukulahlekelwa ukuhlobanisa izinto, futhi inzululwane;
• amaphupho amabi;
• esitho liqhaqhazela.

esikhundleni isiphetho

Kulokhu osekushiwo kumele kuphetfwe ngendlela eqinile futhi ngempela yingozi le mithi, iziphi antidepressant ukuthi kukhona ngemithi yanamuhla ezingaba babhekane nokucindezeleka. Nokho, ngaphambi kokuba uqale luwathathe, ubonane Uchwepheshe - wezifo zengqondo noma psychoneurologist abangakwazi ukuthola okuyinto uhlobo lesi sifo nokuthi yini imithi ukusiza ukubhekana naso.