Isizukulwane yakamuva anti-depressants. Antidepressant: Yikuphi okungcono? Izibuyekezo odokotela amanani

Namuhla, ukucindezeleka kuthinta abadala nje kuphela kodwa futhi izingane nentsha. Lesi sifo nezindlela zokulwa ke nikela eziningi Ochwepheshe ucwaningo futhi inani elikhulu izihloko kanye nezincwadi. Uma sihumusha nge "ngokwesayensi" olimini abavamile, ukucindezeleka - iyona siphelelwe amandla nesifiso sokuphila. Izimpawu zalesi sifo yilabo ukucobeka kanye njalo endaweni embi kwemizwelo, ukukhathazeka kanye ukukhathala, ukucobeka kanye moodiness.

kwemithi Modern inikeza ukubhekana nalesi sifo isizukulwane wokugcina antidepressant. Indlela izizukulwane timoleptikov (owaziwa nangokuthi amanxusa, egijima ngokumelene ukucindezeleka) eziningi ezikhona namuhla ukuthi enifana futhi ihluke nomunye, yini lo mshini wezenzo zabo? Le mibuzo kanye neminye iyophendulwa kule sihloko okuphakanyiswe ukunakwa kwakho.

Yiziphi antidepressant?

Lesi sidakamizwa, okuyothi kungadambisa izimpawu ngisho ukuvimbela ukucindezeleka. Mshini eyinhloko esenzweni kuhloswe ukulungisa ukusebenza kwamakhemikhali ebuchosheni bomuntu. Njengoba amangqamuzana ezinzwa e, izingxenye zalo, ukuxhumana unomphela nomunye ngokusebenzisa izinto ezikhethekile - neurotransmitters. Ngokusho kwenye ithiyori, kuphakama iziyaluyalu bacindezeleke lapho ubuchopho ngenxa yezizathu ezihlukahlukene, amazinga kakhulu ziyancipha soMlamuli noma Amine biogenic: Dopamine, norepinephrine noma le-serotonin. isizukulwane yakamuva antidepressant, kanye bonke abanhliziyo langaphambilini, abe umqondo futhi izinyathelo zokulungisa ebuchosheni izinqubo kwamakhemikhali ngokushintsha lokuhlushwa i-Amine biogenic.

Yiziphi bona?

Ngaphandle ukuthi antidepressant yesimanje kokusisiza ukuba sibhekane nesimo ne izimpawu zokucindezeleka, ngokuvamile asetshenziselwa ukuqeda izinkinga ezifana:

• ezihlukahlukene engaziwa imvelaphi ubuhlungu;
• yokuphazamiseka kwemikhuba yokudla noma ukulala;
• ukukhathala ezinzima noma ukulahleka amandla;
• uvalo noma imizwa DC voltage;
• izikhathi zokudakwa wokuba novalo noma ixhala ukukhathazeka;
• izinkinga ukugxilisa ingqondo noma ukukhumbula.

isizukulwane antidepressant

Ngaphambi kokuba ucabangele izizukulwane eziningi kanjani izidakamizwa ngokumelene ukucindezeleka adalwe namuhla, kumelwe sikhumbule ukuthi antidepressant Kwatholakala kuphela phakathi nekhulu XX. Kuze kube manje, kuye ngokuthi yisiphi isikhathi kokusunguliwe nokuqala ukusetshenziswa e umkhuba emtholampilo, kanye isenzo antidepressant, unquma ukwaba izizukulwane ezine le mithi.

Umuntu unamasu isizukulwane sokuqala

Isizukulwane sokuqala, evulekile 50-yalolucwaningo kwekhulu elidlule, emelelwe tricyclic timoleptikov isinyathelo eyindilinga (TCAs). Lezi zihlanganisa izidakamizwa, "amitriptyline" (antidepressant, ungowokuqala omphakathi) nemikhiqizo yalo, kanye "Nefazodone" izidakamizwa "Anafranil" futhi "Melipraminum". Lezi zinto zehlela uyenzele ivimbela norepinephrine reuptake, ngaleyo ndlela kwande lokuhlushwa yayo. Nokho, TCAs ivinjiwe norepinephrine hhayi kuphela (noradrenaline), kodwa futhi wonke amanye sondela bo dlela neurotransmitters, okuholela inani elikhulu engemihle imiphumela, ikakhulukazi ezifana waba ukwanda okukhulu kwezincwadi blood pressure kanye kwenhliziyo. Izidakamizwa kuleli qembu abasakwazi anobuthi, kanye amathuba ukweqisa izidakamizwa lapho uzisebenzisa kakhulu, yingakho basuke ngakho kancane esetshenziswa ekwelashweni zokucindezeleka namuhla.

Ngaphezu kwalokho, isizukulwane sokuqala zibandakanya ayisetshenziswa namuhla aqukethe inhibitor engelapheki ka monoamine oxidase (mao) izidakamizwa - "Iproniazid", "tranylcypromine," "isocarboxazid". Isenzo sabo kusekelwe okusithiyayo of umsebenzi kwalapho izinzwa ubuchopho, ngaleyo ndlela kwande lokuhlushwa serotonin futhi norepinephrine.

izidakamizwa lesibili isizukulwane

Isizukulwane sesibili, ngokungafani lokuqala, kunomphumela ngokhetha kakhudlwana, kodwa buthaka ku neurotransmitters futhi izinzwa ngokwabo. Kuhlanganisa tetracyclic engelapheki (Mao-B) futhi esethola (Mao-A) monoamine reuptake inhibitor, amalungiselelo anjalo "njengamadoda Lerivon", "Lyudiomil", "Pirazidol" nabanye. Ngenxa yokuthi edilini lomshado kwakukhona iqoqo kunalokho nemiphumela emibi, kodwa futhi ngenxa ukuxhumana izidakamizwa eziningi nemiphumela ezingalindelekile, izidakamizwa yaleli qembu asetshenziswa kakhulu kuyaqabukela. Pharmacy kunalokho nzima ukuthola iqembu antidepressant, monoamine reuptake inhibitor. Kodwa kwezinye izimo ziseZwini ngaphansi amanye amagama brand. Ngakho, ochwepheshe bathi, ukuthi lesi sidakamizwa "Lyudiomil" - kuyafana iphilisi "maprotiline" intengo, umakhi, futhi elinye izwe kuphela.

isizukulwane sesithathu

abaphenyi Modern wathola ukuthi ebuchosheni futhi isimiso sezinzwa ezihilelekile balamuli abanye 30, kodwa kuze kube "ubunikazi" zokucindezeleka womathathu: serotonin, Dopamine futhi norepinephrine (noradrenaline). Isizukulwane sesithathu zihlanganisa abakhethayo serotonin reuptake inhibitor (SSRIs) emelelwa antidepressant ezifana yesimanje evame ukusetshenziswa, izidakamizwa "Zoloft", "citalopram", "Prozac", "Tsipraleks", "paroxetine", "Pliz" kanye nabanye abaningi. Le mithi ukuvimba balamuli akuzona zonke, kodwa munye kuphela - serotonin. Ngu amandla umthelela ziphansi yale mithi-lokuqala isizukulwane, kodwa side effects babe ngokuphawulekayo esingaphansi imuphi omunye ngaphambili. Yonke imithi SSRI kuphumelela kakhulu futhi kufanele ibekezelelwe efanayo. Nokho, ngamunye wethu umzimba has izici zayo siqu ngabanye, futhi ngenxa yokuthi isibalo sabo namandla imiphumela emibi kuzohluka esimweni ngasinye. Odokotela bathi ezivamile ezingemnandi komzimba izidakamizwa oyisizukulwane sesithathu kukhona ukuqwasha, isiyezi, isicanucanu nokukhathazeka.

Ingabe SSRIs ngempela eqolo. Ngakho, a kahle owaziwa futhi esetshenziswa kabanzi nomuthi "citalopram" Inani Pharmacy, kuncike brand, ngo ukuthi likhiqizwa ngaluphi, ziyahlukahluka kusuka ruble 870 kuya ku-2000.

Oyisizukulwane sesine antidepressant

Lezi imithi kuthathwe uyalandisa SIOZSiN iqembu (abakhethayo serotonin reuptake inhibitor kanye norepinephrine). Lawa isizukulwane yakamuva antidepressant, njengoba izidakamizwa "Cymbalta", "Milnacipran", "Remeron", "Effexor" ukuthi ukuvimba bamba futhi norepinephrine, futhi le-serotonin. Izidakamizwa "Zyban" futhi "Wellbutrin" musa uxhumana serotonin, futhi Dopamine, futhi norepinephrine imisiwe. Ukuthuthukisa imithi ezibangelwa iqembu, waqala maphakathi nawo-90-yalolucwaningo kwekhulu elidlule, futhi njalo ngonyaka zikhona izidakamizwa amasha.

Odokotela alinakusho ngokungagunci ukuthi kuleli qembu kukhona okungcono elwa nokudangala, kuba isimiso nzima, ukwelapha izinhlobo ezahlukene futhi bacindezeleke amakhambi iziyaluyalu akhethiwe ngamunye, kucatshangelwa izici zempilo nesineke ngamunye.

Popular timoleptiki yesimanje

Eqaphela ukubaluleka kwalesi umthelela leli qembu izidakamizwa nesimiso sezinzwa, kumelwe kukhunjulwe ukuthi zonke kungenzeka - okuhle nokubi - nemiphumela ongabikezela futhi iwukudambisa kuphela uchwepheshe oqeqeshiwe - udokotela. Ikhumbula zonke izici ngamunye kanye ukuxilonga, kuba Udokotela angakwazi uqoke ncamashi antidepressant, okuyinto can usizo olungcono kakhulu esimweni sakho, ne sakugcina side effects. Esimeni lapho imithi kukhona izinkinga, kuba udokotela ungalungisa noma ukushintsha uhlobo lwemithi yokwelapha. Namuhla odokotela abaningi batusa ukuba iziguli ezinokuphazamiseka bacindezeleke amalungiselelo kusukela iqembu abakhethayo serotonin reuptake inhibitor futhi noradrenaline nomthelela ngempumelelo okuyinto sekuqinisekisiwe practice. ukuthaka imithi ngendlela zakhe ezinjengethi, "milnacipran" "Flux" ( "fluoxetine"), "duloxetine", "Velaksin" ( "venlafaxine") - ezivamile futhi asetshenziswa kabanzi zinyanga isizukulwane antidepressant. Cabanga ethandwa kakhulu ekwelapheni bacindezeleke iziyaluyalu timoleptiki.

"Flukosetin" imithi

Lesi sidakamizwa ingenye abameleli lokuqala iqembu SSRI, ke ihlanganisa kokubili antidepressant nemiphumela ivuselela. Medicine "Flux", eyaziwa nangokuthi elwa nokudangala "Fluoxetine", kuyasiza ekunciphiseni ukukhathazeka nokucindezeleka kususa kwesaba futhi kuthuthukisa nemizwelo. Ukusetshenziswa ngempumelelo ngokugcwele, ngokuvumelana odokotela, psychotherapists, ezimweni zokucindezeleka asthenic ngokunganaki futhi ukucindezeleka kobukhulu kanye disorder esilawulayo-kuphoqeleke obuhlukahlukene. Kwakuvamise lokhu izidakamizwa ekwelapheni ngokudla. "Fluoxetine" Antidepressant eyabhaliswa okokuqala ngo-1974 e-US, futhi kule minyaka eyishumi eyedlule, waya endaweni yokuqala yokuthengisa e-UK, nje ngaphansi ezahlukene egameni lendawo yokuhweba noma - kusho "Prozac". ERussia, lokhu umuthi esetshenziswa kabanzi futhi odokotela abaningi basikisela ukuthi ezinqunyiwe iziguli noma imithi ejwayelekile uthi ahlukahlukene futhi bacindezeleke.

Izidakamizwa "Paroxetine"

Lena onamandla kunayo imiphumela yeqembu ummeleli we inhibitor abakhethayo, abakhethayo serotonin reuptake, ngokuvamile esetshenziswa ekwelashweni yokukhathazeka nokucindezeleka. Namuhla, izidakamizwa, isithako esebenzayo okuyinto paroxetine, pretty okuningi. Lokhu ukulungiselela Russian "Adepress" kusukela "Veropharm ngaleli" khambi "pliz" amafemu Croatian ka Pliva, amaphilisi Hungarian "Reksetin" by Gédéon Richter nabanye abaningi. Kungakhathaliseki ukuthi nazyvatsya imithi "Paroxetine", ukubuyekezwa ngakho kokubili iziguli nodokotela ingxenye enkulu omuhle.

Izidakamizwa "Wellbutrin"

Kungcono eyaziwa ngokuthi "Zyban" noma "NouSmok". Isithako asebenzayo azo zonke izidakamizwa ezintathu kuyinto bupropion hydrochloride, sandla ukwanda ngenani Dopamine futhi norepinephrine ebuchosheni. Imithi nale isithako hhayi kuphela udambise ukucindezeleka, kodwa futhi usizo lokunqoba nemiphumela engokomzwelo yokuthi i-nicotine zokuqaleka. Lesi sidakamizwa ngcono isimo futhi kwandisa ukusebenza kahle. Izimpendulo ezivela kulabo ngiyilahle umlutha kagwayi ngokusebenzisa izidakamizwa ezifana "Wellbutrin", "NouSmok" futhi "Zyban", ukhuluma ngani kusebenta okusezingeni eliphezulu le mithi esikhathini ukuyeka.

"Cymbalta" imithi

Ukulungiswa kohlelo antidepressant oyisizukulwane sesine kukhona inhibitors ka reuptake ka norepinephrine futhi serotonin, kanyekanye enifeza kokuquleka kancane Dopamine. Umuthi ketshezi esebenzayo duloxetine has a high kunalokho, uma iqhathaniswa nezinye antidepressant isinyathelo isivinini. Ngokombono kokubili odokotela kanye neziguli nomphumela ecacile antidepressive livezwa ekupheleni lokuqala - ekuqaleni kwesonto reception yesibili. Ngaphezu kwalokho, lokhu izidakamizwa ukufana ezahlukene isinyathelo futhi kulo lonke isikhathi sokusebenza kwawo. Nokho, kukhona iqembu iziguli, ngokubona ukuthi umphumela walesi imithi uma kwenzeka, obuthakathaka kakhulu. Njengoba sekushiwo, izinto ezenza umuntu ukusabela kwamakhemikhali ngokuvamile iholela yokuthi umuthi othize udokotela, ngeke likwazi ukunikeza umphumela kulindeleke.

Kungakanani?

Namuhla kunzima ngempela ukukhuluma ngezidakamizwa amanani. Lokhu kungenxa yokuthi emakethe lwemali ingahlalisekanga kakhulu kanye nemithi yokunciphisa ukucindezeleka amasha, ingxenye enkulu kufika kithi evela abakhiqizi angaphandle, amanani entengo inikeziwe euro. Yingakho kule Lithebula lelingentasi likhombisa lokutawugcilwa amanani ubuncane kanti esiphezulu in ruble, ngoba imane nje ayikho alinganiswe. Ingxenye izidakamizwa ukuthi afakwe ngaphambili idayiswa ngisho ngamanani ubudala, kuyilapho abantu abafikayo ibiza kakhulu.

Uma ubheka etafuleni ngokucophelela, uzophawula ukuthi awunazo izidakamizwa lesibili isizukulwane, okungukuthi MAOIs (monoamine reuptake inhibitor). Leli akulona iphutha. Into wukuthi lezi antidepressant Ziningi ezingemnandi side effects kanye ukungavumelani ne izidakamizwa eziningi kungukuthi cishe esetshenziswa emazweni ase-European. I-US kuyaqabukela asetshenziswa imithi "isocarboxazid" "Ugenelzin" futhi "tranylcypromine," futhi ezweni lethu - isidakamizwa "Nialamide". Konke imithi ngenhla iyatholakala kuphela ngaphansi kokuqondisa ochwepheshe kwempilo yengqondo.

Leli thebula libonisa ngokucacile ukuthi "zakudala" tricyclic antidepressant intengo aphansi ukwedlula izidakamizwa entsha ye kukhona SSRI futhi SIOZSiN. Ngakho, ukukhuluma ukutholakala eliphezulu imithi ngempumelelo antidepressant ngoba iningi labantu akudingeki obakhathalelayo. Nokho, udokotela kungasiza ukukhetha izidakamizwa engabizi nge izakhiwo efanayo, okuthiwa ejwayelekile.

Ukuxhumana nezinye izidakamizwa

Antidepressant bangahlanganyela nezinye izidakamizwa, ngisho nalabo ezibonakala sibe ephephile ajwayelekile. I asebenzayo kakhulu kule nenhlonipho timoanaleptiki tricyclic futhi monoamine oxidase inhibitor, kodwa amalungiselelo amaqembu SSRIs futhi SIOZSiN neze uxhumana neminye imithi. Kunoma yikuphi, uma udokotela ekunika nawe oyiphuzayo ukucindezeleka, qiniseka ukuze uthole ukuthi ungakwazi ukuhlanganisa reception zabo nokusetshenziswa neminye imithi, Izithako zokudla, ngisho zezinkambi kanye infusions ngezindleko zemithi engamakhambi.

Utshwala kanye nemithi yokunciphisa ukucindezeleka

Njengabangaqondakali njengoba kuzwakala, kodwa abantu abaningi abadinga yokuvuma timoleptikov yezizathu ezihlukahlukene, cela kuba kangaki kungenzeka ukuhlanganisa indlela uphuzo "oludakayo 'kanye amaphilisi sokucindezeleka. Ukuze siphendule lo mbuzo ulula: uma ufuna ukuthatha ingozi empilweni yabo engokwengqondo nengokomzimba, futhi mhlawumbe ukuphila, kuzame! Iqiniso lokuthi utshwala anti-depressants nethonya elibi kakhulu isimiso sezinzwa nobuchopho, futhi lokhu ingcindezi double ezingapheli zingayilimaza kokubili "Mission Control Centre", ie ngobuchopho kwezitho izinhlelo sokubika kuye. Noma cha ukuhlanganisa - isinqumo ukwamukela wena kuphela.

esikhundleni isiphetho

Akubalulekile ukuba bakwazi ukucabanga nokuthola "ibe" phezu kwa-, antidepressant kangcono futhi kuphumelele kangcono. Uma unomuzwa wokuthi usuku ngalunye kuba nzima nakakhulu ukuphila kwalowo odlule, amandla akwanele ngisho nezindaba ezilula kakhulu futhi evamile, uthintane onguchwepheshe! Udokotela wakho ungakwazi ukuxilonga nesimo sakho futhi linqume ukwelashwa ezidingekayo, ngokukhetha imithi ezifanele kakhulu kuwe. Ngeke nje kuphela kube anti-depressants. Arsenal imithi yanamuhla ngempela ebanzi: izinhlobo ezahlukene ukwelashwa kwengqondo, umsebenzi kanye ukutshopa, amasu ukuphefumula futhi ukuze athole ukwelashwa komzimba.