Lakhula - ntoni na? Okudambisa kunye lakhula

Isingqungquthela samhlanje sokuphila, ukuhamba okungapheliyo kolwazi olufunekayo ukuba umntu enze iinkqubo zemihla ngemihla, kunye nezinye izinto ezininzi, zikhokelela ekubeni umzimba kunye nesifo sengqondo asikwazi ukuma. Ukungazinzi kunye nokuxinezeleka, ukusebenza kakubi kunye nokunxibelelana, ngokuqhelekileyo ukunyanzeliswa, kwaye ngokuphindaphindiweyo kugxininiswe ngamachiza okanye ezinye izinto ezinamandla, ekugqibeleni zikhokelela kwizifo ezinzima ezifana nesifo esingapheliyo sokugula (CFS) kunye nokudandatheka okuhlukahlukeneyo. Ngokweziganeko zokuhlalutya kwezonyango, ukuxinezeleka kweminyaka engama-20 yale nkulungwane kuya kuphazamisa inani labagulayo kwiinkulungwane zekhulu le-20-izifo ezithatheleneyo nezifo zesimo senhliziyo. Ekulweni nokuphazamiseka kwengxaki, izidakamizwa ezahlukahlukeneyo zisetyenzisiweyo, zenziwe zombini ngesiseko sezinto zendalo kunye nokwenziwa. Iingxaki zokuxhatshazwa - yintoni na? Ziziphi na zona kwaye ezi ngonyango zingaphilisa ukudandatheka okanye zinciphise iimpawu zayo? Ziziphi iingenelo kunye nokuphazamiseka kwezi ziyobisi? Kule nqaku, siya kuzama ukuphendula le mibuzo kunye neminye imibuzo malunga neengcinezelo zentsholongwane, umphumo wokusetyenziswa kwazo kunye nemiphumo yokuthatha.

Yintoni na?

Njengoko igama libonisa, izidakamizwa (ezibizwa ngokuba yi-thymoleptics) ziziyobisi ze-psychotropic ezisebenzisana neempawu zokudakumba. Siyabulela ezinjalo iziyobisi, ukuxhalaba kunye nokuxinezeleka kwengqondo, ukunganakwa nokunyaniseka, ukulala ngenxa yokulala, kunciphise kakhulu kwaye kuphele ngokupheleleyo. Amachiza anxulumene neli qela ahlukeneyo kumabini kunye nokwakhiwa kwamakhemikhali, kunye nendlela yokwenza.

Usebenza njani?

Masibone, izidandlululo - into yintoni: ukutshatyalaliswa komzimba okanye ukunceda umntu ophelelwe ngumzimba. Makhe sijonge indlela ezi zisebenza ngayo. Ubomi bomntu buqulethe iindidi zeetoni ze-neurons, ezenza rhoqo utshintsho lwengcaciso phakathi kwabo. Ukufezekisa olo hlobo lwedluliselo lweenkcukacha, izinto ezizodwa eziphambili ziyimfuneko-i-neurotransmitters, zangena kwiifrikhthi zesikhokhethi kwi-space phakathi kwe-neurons. Abaphengululi banamhlanje bahlukanisa abadibanisi abangaphezu kwama-30, kodwa kuphela abathathu kubo banxulumene ngqo nophuhliso nenkqubela yokudandatheka: i-serotonin, i-norepinephrine (norepinephrine) kunye ne-dopamine. Ngokutsho kwedatha yocwaningo, ukudakumba kwenzeka xa kukho ukuhla kwexabiso elincinci kuma-neurotransmitter kwiindawo zokusebenzisana nge-neuronal. Isenzo se-anti-depressants injongo yokunyusa inani labalamli abayimfuneko kunye nokuqhelanisa ukulinganisela kwezinto eziphilayo.

Inxalenye ethile yembali

Ngaphambi kokuba siqale ukuqwalasela amaqela anamhlanje kunye neentlobo zezidandathelwano, siza kuxela ngokufutshane ngembali yokufumanisa kwabo.

Kuze kube phakathi kwekhulu lemashumi mabini, ukuxinezeleka kunye neemeko ezahlukeneyo ezinomdla kunye neempawu ezifanayo zaphathwa ngeendlela ezahlukeneyo zokulungisa izifo. "Ukuphakamisa imizwa" isetyenziswe ezininzi iintlobo zeemveliso, ezibandakanya i-caffeine, i-ginseng okanye abameli bama-opiates. "Uxolo" ulonwabo olwenziwe luvalo luye lwavavanywa ngeesalts ze-bromine okanye iziyobisi ezisekelwe kwisizaziso se-valerian. Kwakhona, iintlobo ezahlukeneyo ze-gymnastics kunye ne-physiotherapeutic iinkqubo zazisetyenziswa, ukuphumelela koko kwakungeyona nto ingabalulekanga.

Kwiminyaka eyi-50 yokuqala yekhulu le-20, isilwanyana "Prometazine" sidalwe, esasetyenziselwa okokuqala i-anesthesia ngexesha lokuhlinzwa. I-Pharmacologists zazama ukuqinisa ukukhusela nokunyanzeliswa kweliyeza, ngenxa yoko, ngo-1951, "i-Chlorpromazine" yafunyanwa ngokubanzi, esetyenziswa ngokubanzi kwiindlela zonyango zokunyangwa kwengxaki. Namhlanje eli chiza liyaziwa ngokuba yi "Aminazine".

Ekupheleni kweminyaka engamashumi ama-60 ekhulwini lokugqibela, oogqirha baseSwitzerland baphatha izigulane ngesifo sofuba babone umphumo ongathandekiyo wecandelo leziyobisi ezifana neProniazide. Izigulane ezazisifumanayo zikhulile. Kancinci, wayesetyenziswe kwisenzo sengqondo, njengoko wayebuthathaka kakhulu ekuncediseni isifo sofuba. Ngeli xesha elifanayo, umphandi waseJamani uRonald Kuhn ufumene isixhobo seMpramin.

Ukufunyanwa kwee-timoleptics zokuqala kukhokelela ekuphuhliseni okukhawulezileyo uphando lwezonyango kule ndawo kunye nokudala amatsha amachiza enjongo yokulwa neempawu kunye nezizathu zokuphazamiseka kwengxaki.

Udidi lwangoku

Ngokuxhomekeke kwimpembelelo yokusetyenziswa kwezidandathelwana kwizigulane ezidandathekileyo, zihlulwe njengolu hlobo lulandelayo:

Ukongezelela, kukho uluhlu olusekelwe kwindlela izenzo zokuxhatshazwayo ezichaphazelekayo zichaphazela ngayo iinkqubo zezinto eziphilayo ezinomzimba:

• I-TCA i-tricyclic timoanaleptics.
• I-MAOI-monoamine oxidase inhibitors:

- ingenakunyuswa (iTanylcipromin, iFenelzin);

- ukuguqulwa ("iPirazidol", "Moclobemide").

• IIPS - inhibitors yokuchithwa ngokukhethekileyo kwe-serotonin;
• IOSIN - inhibitors ye-reuptake ye-serotonin kunye ne-norepinephrine;
• I-NASSA-noradrenergic kunye ne-serotonergic anti-depressants.

Kukho nenani lezilwanyana ezixhatshazelisayo ezingenakucingelwa kuyo nawaphi na amaqela athetha.

I-TCAs: I- Tricyclic anti-depressants, yintoni na?

Amachiza eqela le-tricyclic, efana ne "Nortriptyline", "Imipramine" kunye ne "Amyltryptiline", lafumana igama labo ngenxa yendandatho yekhabhoni kathathu. Ezi zonyango ezixhatshazelisayo zisiza ukwandisa inani leenurotransmitter kwingqondo, njenge-norepinephrine (norepinephrine) kunye ne-serotonin (i-hormone yolonwabo). Oku kufezekiswa ngokunciphisa izinga lokusetyenziswa kwabo ngamaseli e-nerve-neurons.

Ngenxa yokuba kungekhona kuphela i-neurotransmitter eziyimfuneko ezikhutshwayo xa la mayeza athatyathwa, iziphumo ezininzi zecala ziyahluka. Ukuthatha izidakamizwa zeqela le-tricyclic kunokudala iziphumo ezilandelayo:

• Lethargy;
• Ukulala;
• I sihlunu;
• Umlomo omile;
• Ubuthathaka;
• Utywala;
• Ukwandisa izinga lentliziyo - i-pulse;
• Ukutyunjwa;
• Ukunciphisa i-potency kunye ne-libido;
• Ukuxhalabisa okanye ukuxhalabisa.

La mayeza aqhelekileyo axelwe oogqirha kwindawo yokuqala, kuba bezona zifundwa kakhulu kunye nemiphumo yokusetyenziswa kwazo ziyaziwa.

I-MAOI-monoamine oxidase inhibitors

Iyeza "Iproniazide", efunyenwe ngenye yeyokuqala, kunye namanye amayeza eleli qela, njenge "Izokaraksazid", "Tranilcipromin", ukukhusela impendulo ye-enzymatic ye-monoamine oxidase equle ekupheleni kwemizwa. Ngenxa yoko, i-neurotransmitters ejongene nomoya wethu, njenge-serotonin, tyramine kunye ne-norepinephrin, ayichithwanga, kodwa ngokuthe ngcembe iqokelela kwingqondo.

Ngokuqhelekileyo, i-MMAA i-anti-depressants imiselwe ukuba ixinzeleleke, okanye xa izidakamizwa zeqela le-tricyclic zingasondelanga kwaye azizange zibe neziphumo ezifunayo. Inzuzo yamachiza ale qela kukuba ayenzi mpe mbelelo enkulu, kodwa, ngokuchaseneyo, ivuselela iinkqubo zengqondo.

Njengamachiza e-tricyclic, i-MAOIs ayinayo impembelelo emfutshane kwimeko yomntu-umphumo weengcinezelo ezichasayo ziza emva kweeveki ezimbalwa emva kokuba ziqale ukuthatha.

Ngenxa yokuba ii- inhibitors ze-MAO zinemiphumo emibi kakhulu (kwaye zisebenzisana ngokulula namayeza okukhwehlela kunye nokubandayo kwaye anokukwazi ukunyusa ukwanda kwentsholongwane yegazi), nangenxa yokutya okunzima xa kuthathwa Ukubonelela ezinjalo iziyobisi ngokungaqhelekanga, xa ezinye iindlela zonyango azizange zincede.

Ukukhethwa kwe-inhibitors ye-selective ye-serotonin

Amaqela e-TCA kunye nee-MAOI ezicatshangelwe kuthi, ngokwenxalenye ininzi, izidakamizwa ezivulekileyo kunye nezifundo eziqhutywe kakuhle. Kodwa izizukulwana "ezidala" zokuxhatshazwa kancinci zitshintshwa ngokunyanisekileyo ngamachiza anje anamhlanje, isenzo esingavinjelwe ngabo bonke abalamli, kodwa kuphela ngeserotonin enye, ekuthintela ukubuyiswa kwayo kwakhona nge-neurons. Ngenxa yoko, ingqwalaselo yayo iyanda kwaye igalelo lonyango lufumaneka. IUPS iquka izidakamizwa zanamhlanje njenge "Fluoxetine", "Sertraline", "Zoloft", "I-Paroxetine" nabanye. Amachiza ale qela aneempembelelo ezimbalwa, kwaye ayichaphazeli umzimba womntu kakhulu.

Inhibitors ye-reuptake ye-serotonin kunye ne-norepinephrine

Ezi zizonyango ezitsha, ezi sele zikhankanywe kwisizukulwana sesithathu se-anti-depressants. Baqala ukuveliswa phakathi kwee-1990. Ezi zonyango ezifana ne "Tsymbalta", "Efferor" zithintela ukutshatyalaliswa kwe-serotonin kuphela, kodwa ne-noripinefrin, kodwa loo myeza "njengeVelbutrin" kunye ne "Zyban" inqanda ukubuya kwe-noradrenaline kunye ne-dopamine.

Iziphumo ezibi zeli qela leziyobisi zingaphantsi kunezo zabanye, kwaye zibonakaliswa zibuthathaka. Emva kokuthatha i-anti-depressants, ngokusekelwe kwii-inhibitors ezinjenge- "Duloxetine" kunye ne "Bupropion", kunokukho ukwanda kwisisindo kunye neentsholongwane ezincinci kwisigaba sezesondo.

I-Noradrenergic kunye ne-anti-depressants ethile ye-serotonergic - iNASSA

Elinye iqela lamanje lamanzi le-anti-depressant yi-NASSA, elinciphisa okanye liyeke ukutshatyalaliswa kwe-norepinephrine ngama-synapses weeseli zesisongela, ngokwandisa ukugxininiswa kwayo. Ezi zonyango ezifana ne "Remeron", "Lerivon", "Serzon" zivimbela i-receptors ye-serotonin.

Xa uthatha imishishini kweli qela, kukho imiphumo engathandekiyo emibi njengobungqingili, umlomo owomileyo, ukwanda kwondlo kunye nokufumana ubunzima obunxulumene. Ukupheliswa kweengcinezelo zeli qela kuqhubeka ngaphandle kweengxaki ezinzulu.

Ukongezelela kumaqela aphezulu angentla angama-antidepressants, kukho inani lezonyango ezingenakunikwa kuyo nayiphi na yazo. Ziyahluke kwizinto zombini kunye nokwenza isenzo. Oku, umzekelo, loo mveliso njengeBupropion, Hypericin, Tianeptine, Nefazodone kunye nabanye abaninzi.

Ezinye iindlela

Namhlanje, iingcali zangezinye izizwe zixhaphaza ukusebenzisa iziyobisi ezingathinteli i-neurotransmitters kunye neurotransmitters, kodwa imeko ye-endocrine izitho ezifana ne-adrenal gland, hypothalamus kunye ne-pituitary gland, ukwenzela unyango lweemeko ezixinzelelekileyo. Ezinye zezi zonyango, umzekelo, "Aminoglutetimide" kunye ne "Ketoconazole", vimba ukutyunjwa kwe-hormone cortisol, kodwa baneempembelelo ezininzi kwaye banefuthe elibi kwisimiso se- endocrine.

Kwinqanaba lesibili lisiko lokubandakanya iintshaba ze-antalarmin receptors, ezidibanisa iimpawu eziphathekayo ezithatha uxolo kunye nezidandlululo.

Ukongeza kwonyango lwemichiza yeemeko ezixinezelekileyo, iindlela ezifana ne-hypoxia ye-normobaric ne-plasmapheresis ngezikhathi ezithile, unyango olukhanyayo kunye nezinye ezininzi zisetyenziswe kaninzi, ezinceda ukunciphisa iimpawu kunye nokutyhafaza iimpawu.

Iinkonzo kunye neNgqungquthela

Abaninzi balabo bathatha i-anti-depressants bayavuma ukuba amayeza asebenzayo, ngakumbi xa athatyathwa ngexesha elifanayo kunye nekhosi yonyango eqhutywe yingcali. Kufuneka kukhunjulwe ukuba ezi ziyobisi, kunye nemilinganiselo yazo, zinokumiselwa kuphela ngugqirha, phantsi kolawulo lwazo kwaye kufuneka zithathwe. Ungalindelanga ukuphuculwa kwangoko kwimeko. Njengomthetho, ukuvakalelwa kwintembeko kunye nokulahlekelwa ngumdla ebomini, kunye nokunyaniseka, ukunganakwa nokudabuka kudlula iiveki ezi-3-4 emva kokuqala kokumiselwa ngokufanelekileyo.

Enye yeengxaki ezingenakucala kwezi zi yobisi ukurhoxiswa kwe-antidepressant syndrome, kubonakaliswe ngokukhawuleza okungalawulwayo kokungena kwabo.

Indlela yokusebenzisa ngokuchanekileyo?

1. Ukuba ufumene isigulo senhliziyo, isifo okanye isibindi, xela ugqirha wakho malunga nalo.

2. I-anti-depressants isenzo ngasinye, ngoko ingcali iza kukhetha izilwanyana ezifanelekileyo.

3. Kwezinye iimeko, elinye unyango alinakwanela, ugqirha unokumisela ukufumana amanyathelo amaninzi (uxolo kunye neengcinezelo, i-neuroleptics kunye nayiphi na i-anticonvulsants). Ngokusekelwe ekuxilongweni nasekulawuleni imeko yakho ye-somatic, oyingcali uya kukhetha izidakamizwa ezingancedisana kwaye zingabi nefuthe elibi kumzimba womntu.

4. Ungayeki ukuthatha izidakamizwa ezichasayo ngokukhawuleza kwaye ungakhange uxubushe ingcali, njengoko oku kunokunyusa inkxalabo yokudakumba kwaye kubangele iziganeko ezahlukahlukeneyo ezibangelwa ngumzimba.

5. Abantu abaninzi bacela ukuba kunokwenzeka yini ukusela izidakamizwa kunye notywala kunye kunye. Yonke imiyalelo kumayeza asho ukuba oku akuvumelekanga, kuba kungakhokelela kumonakalo omkhulu kwiinkqubo zeentlanzi, ukuya kwisiphumo esibulalayo.

Ingaba ihoxiswa okanye isifo somlutha?

Xa kwenzeka ukuba uthathe i-antidepressants ixesha elide uze ubeke ngokukhawuleza isizathu ngasinye, unokungahambi kakuhle, njengendlela yokuziphatha engazinzileyo, ukhathala okwenyukayo, intlungu yomzimba, isisu. Zonke ezi zimpawu zibizwa ngokuba yi-antidepressant withdrawal syndrome. Yingakho oogqirha bancomela kancane kancane ukunciphisa umthamo wezonyango ezithathwayo kwaye ukwenza oku phantsi kolawulo lweengcali. Abaqeqeshi kuphela baya kunceda ukususa iintozi ezingathandekiyo, ukuba bathathe i-standotonics efunekayo kunye nokulungiselela malunga nezityalo. Ukuba isicatshulwa sithathwe singalawulwa, kwaye oko kwamkelwa kwayo kwagqitywa ngokukhawuleza, ukuchithwa kwee-antidepressants kunokukhokelela ekuphazamiseni ukulala, ukuxhalabisa kunye neengxaki ezisuka kwinkqubo ye-cardiovascular system. Ukongeza, ezi zilandelayo zibonakaliswe:

• Ukoyika okungenangqiqo;
• Izimpawu ezifana ne-Influenza;
• Isihlunu, ukuhlanza;
• I-spasms kunye nentlungu kwisigxina sesisu;
• Ukulahleka kokulungelelaniswa kunye nosizi;
• Iingqungquthela;
• Ukugubha kweminye.

Endaweni yokugqiba

Ngelithini kunokwenziwa isigqibo malunga nokuba bomelele yaye anobungozi la machiza, yintoni na lakhula ukuba iziyobisi zale mihla ezinokwenza ukumelana noxinezeleko. Noko ke, ngaphambi kokuba uqale ukuthatha kubo, dibana ne oyingcali - zengqondo okanye psychoneurologist ngubani na bana phandle yeyiphi indlela esi sifo wena yintoni amayeza ukunceda ukumelana nayo.