Ukuxhatshazwa kwintsholongwane yesizukulwana esitsha. Iingxaki zokuxhatshazwayo: Yiyiphi enye ingcono? Ukuphononongwa koogqirha, amaxabiso

Namhlanje, ukudakumba ichaphazela abantu abadala kuphela, kodwa kananjalo abantwana nabafikisayo. Esi sifo kunye neendlela yokulwa ukuba bachitha ixesha elininzi Iingcali zophando kunye inani elikhulu amanqaku neencwadi. Ukuba translate with "yenzululwazi" kulwimi esiqhelekileyo, ukudakumba - kukuphelelwa amandla nomnqweno ukuze baphile. Iimpawu zesi sifo ukuba silale kwaye rhoqo ungatyhilekanga, ixhala nokudinwa, silale kunye moodiness.

Pharmacology Modern inikeza ukujongana nesi sifo sizukulwana yokugqibela yokunciphisa. Zingaphi ezizukulwaneni timoleptikov (eyaziwa njenge-arhente, ukubaleka nxamnye uxinzelelo) ezikhoyo namhlanje ukuba ngazo yaye zahluke enye kwenye, yintoni na indlela yesenzo yabo? Ezi kunye nezinye mibuzo iza kuqwalaselwa kwinqaku ocetywayo ukuze bakuthathele ingqalelo.

Yintoni lakhula?

Eli chiza, apho unako okudambisa iimpawu nokuzithintela kukudakumba. Indlela ephambili yemisebenzi ijolise ekulinganiseni umsebenzi zengqo- lobuchopho bomntu. iiseli zemithambo-luvo, amacandelo alo, ukunxibelelana ngokusisigxina kunye nabanye ngokusebenzisa izinto ezikhethekileyo - neurotransmitters. Ngokutsho ithiyori omnye, kuvela iingxaki edakumbisayo xa ebuchotsheni ngenxa yezizathu ezahlukeneyo, amazinga kakhulu zomlamli okanye ngomdla biogenic: dopamine, norepinephrine okanye serotonin. isizukulwana entsha lakhula, kwakunye nazo zonke engaphambili, sibe nemigaqo-amanyathelo okulungisa kwi kwiinkqubo kwemichiza ingqondo ngokuguqula uyondelelwano lwee- a ngomdla biogenic.

Yintoni injongo yawo?

Ngapha koko lakhula mihla ukunceda ukumelana iimpawu zokudakumba, ngokufuthi zisetyenziswa ukuphelisa iingxaki ezifana:

• iindidi iintlungu imvelaphi engaziwayo;
• yokudla okanye ubuthongo;
• fatigue kakhulu okanye ukulahleka amandla;
• novalo okanye ukuziva ombane DC;
• ezikwenza novalo okanye ixhala;
• iingxaki ukugxila okanye ukukhumbula.

generation lakhula

Phambi kokuba ucinge izizukulwana ezininzi ngayo iziyobisi nxamnye kukudakumba okudalwe namhlanje, simele sikhumbule ukuba lakhula esafunyanwa kuphela phakathi kwenkulungwane XX. Ukuza kuthi ga ngoku, ngokuxhomekeke kwixesha fyabo kunye ekuqaleni ukusetyenziswa practice kwezonyango, kwakunye nenyathelo of lakhula, oko wagqiba ukwabela izizukulwana ezine kula machiza.

Zezomntu izicwangciso sizukulwana sokuqala

Isizukulwana sokuqala, luvuliwe kwi-imi- 50 kwinkulungwane yokugqibela, emelwe tricyclic timoleptikov intshukumo elibujikele (TCAs). Ezi ziquka iziyobisi, "amitriptyline" (yeQela, lowo wokuqala uluntu) kunye nezakhi zayo, kwakunye "Nefazodone 'iziyobisi' Anafranil" yaye "Melipraminum". Ezi zinto baqhube uvimba norepinephrine reuptake, ukuze kwandiswe ukusebenza ingqalelo yayo. Noko ke, TCAs ukuvimbile kuphela norepinephrine (noradrenaline), kodwa onke amanye kuza neurotransmitters indlela yabo, nto leyo inani elikhulu zineziphumo ezibi kakhulu, ngokukodwa ezifana ukunyuka okukhulu uxinzelelo lwegazi kunye nokwanda izinga intliziyo. Iziyobisi kweli qela zezi kakhulu zinetyhefu, kwaye zibenze libanda, xa usebenzisa kubo liphezulu kakhulu, nto ke leyo ebangele ukuba kangaka encinane esetyenziswa ukunyanga uxinezeleko namhlanje.

Ngaphezu koko, isizukulwana yokuqala iquka azisetyenziswa namhlanje ziqulathe inhibitors lakho monoamine oxidase (Mao) iziyobisi - "Iproniazid", "tranylcypromine," "isocarboxazid". isenzo lwabo luxhomekeke inhibition lwe umsebenzi kwalapho zemithambo-luvo ingqondo, ngaleyo ndlela kwande yoxinaniso of serotonin kunye norepinephrine.

amachiza Second-generation

Isizukulwana yesibini, ngokungafaniyo yokuqala, kuba nefuthe ngakumbi uyakhetha, kodwa buthathaka phezu neurotransmitters kunye luvo ngokwabo. Oku kuquka tetracyclic ayibuyiseki (Mao-B) kwaye ingathityazwa (Mao-A) monoamine reuptake inhibitors, ezifana amalungiselelo thaca njenge "Lerivon", "Lyudiomil", "Pirazidol" kunye nabanye. Ngenxa yokuba kule ulwamkelo kwakukho iseti yeziphumo ebezingalindelekanga kunokuba kakhulu, kodwa ngenxa yokusebenzisana kunye namachiza ezahlukeneyo kunye neziphumo akucingeleki, iziyobisi eli qela zisetyenziswa kunqabile kakhulu. kunokuba nzima ezikhemisti ukufumana iqela lakhula, monoamine reuptake inhibitors. Kodwa kwezinye iimeko zifumaneka phantsi kwezinye amagama eemveliso. Ngoko ke, iingcali zithi, ukuba ichiza "Lyudiomil" - iyafana ipilisi "maprotiline" ixabiso, umenzi, kunye nezinye lizwe kuphela.

isizukulwana sesithathu

abaphandi Modern bafumanisa ukuba ubuchopho kwaye luvo bayabandakanyeka mediators ezingama-30, kodwa i "ubunini" ngokudandatheka omathathu: serotonin, dopamine kunye norepinephrine (noradrenaline). Besizukulwana sesithathu ziquka inhibitors serotonin reuptake uyakhetha (SSRIs) zimelwe lakhula mihla ezinjalo ezisetyenziswa ngokuqhelekileyo, amachiza "Zoloft", "citalopram", "prozac", "Tsipraleks", "paroxetine", "Pliz" kunye nabanye abaninzi. La machiza asithe abalamli azikho zonke, kodwa inye kuphela - serotonin. Xa amandla negalelo zingaphantsi iziyobisi-sizukulwana sokuqala, kodwa emibi ngaphantsi kakhulu ngaphezu kwayo nayiphi na ngaphambili. Onke amachiza SSRI zisebenza kakuhle kakhulu kwaye kufuneka azisebenzisele efanayo. Noko ke, ngamnye wethu umzimba uneempawu zawo ngamnye, nangenxa Inani labo kunye namandla iziphumo ebezingalindelekanga iya kwahluka kwimeko nganye. Oogqirha bathi zineziphumo ezibi kakhulu amachiza wesithathu-sizukulwana kukho sokulibala, isiyezi, isicaphucaphu nexhala.

Ingaba SSRIs luyabiza. Ngenxa yoko, abaninzi abamaziyo, kwaye isetyenziswa ngokubanzi medicament "citalopram" ixabiso ezikhemisti, ngokuxhomekeke lophawu, apho oveliswa, ziyahluka ukusuka engange 870 ukuya ku-2000.

Okwesine-generation yokunciphisa

Ezi amayeza ezithathwe ubalisa SIOZSiN Iqela (serotonin uyakhetha reuptake inhibitor kunye norepinephrine). Ezi isizukulwana entsha lakhula, njengoko iziyobisi "Cymbalta", "Milnacipran", "Remeron", "Effexor" ezithintela lokufakwa kunye norepinephrine, kunye serotonin. Iziyobisi "Zyban" yaye "Wellbutrin" musa basebenzisane serotonin, kunye dopamine, yaye babambelela norepinephrine. Development of the amayeza kungayanyaniswa kwiqela, yaqala kuphela yee-imi- 90 kwinkulungwane lokugqibela, yaye nyaka ngamnye kukho amachiza amatsha ngakumbi.

Oogqirha abakwazi ukuthetha eziqhitsini ukuba kweli qela kukho eyona anti-nokudakumba, injalo kumgaqo-siseko akunakwenzeka, njengoko ngenxa unyango iintlobo ezahlukeneyo edakumbisayo ulungiso ukuphazamiseka mazikhethwe ngamnye, kuthathelwa ingqalelo iimpawu yempilo yomguli ngamnye.

Popular timoleptiki lwangoku

Esazi ubunzulu nefuthe eli qela kweziyobisi kwi-nervous system, kufuneka kukhunjulwe ukuba bonke kunokwenzeka - kuzo ebezintle nezo zingentle - imiphumo inokuba ukubona yokungenelela uchwepheshe abaqeqeshiweyo kuphela - nogqirha. Kuthathelwa ingqalelo zonke iimpawu ngamnye nokuxilonga, lo ngowona Ugqirha kumisela kanye lakhula, nto leyo inokunceda ngcono kwimeko yakho ethile, kunye neziphumo ebezingalindelekanga encinci. Kwimeko xa uthatha yemithi unayo nayiphi na ingxaki, kuba ugqirha uyakwazi ukunyenyisa okanye ukutshintsha irejimeni yonyango. Namhlanje iingcali ezininzi sicebisa ukuba izigulane kunye nezigulo edakumbisayo amalungiselelo evela kwiqela inhibitors serotonin reuptake uyakhetha kunye nefuthe noradrenaline ngempumelelo ethe zaqinisekiswa practice. imithi ezifana "milnacipran" "Flux" ( "fluoxetine"), "duloxetine", "Velaksin" ( "venlafaxine") - le ziqhelekileyo kwaye isetyenziswa ngokubanzi lakhula isizukulwana lokugqibela. Cinga ethandwa unyango edakumbisayo ukuphazamiseka timoleptiki.

amayeza "Flukosetin"

Eli chiza yenye abameli yokuqala zeqela SSRI, luhlanganisa zombini yeQela kunye neziphumo ivuselela. Medicine "Flux", okwabizwa ngokuba anti-nokudakumba "Fluoxetine", inceda ukwehlisa ixhala kunye ukungakhululeki, ususa ukoyika kuphucula isimo. Ukusetyenziswa kakhulu ngempumelelo kwayo, ngokutsho yeengcali, psychotherapists, kwiimeko zokudakumba asthenic kunye bengenamdla kunye nokudakumba nezilwanyana ezohlukeneyo ubungozi likhoboka lento ethile. Oku wasebenzisa eli chiza xa unyango ngokudla. "Fluoxetine" bucala ukuba okokuqala ngo-1974 kwi-US, kwaye kule minyaka ilishumi idluleyo, waya kwindawo yokuqala ethengisela UK, nje phantsi igama elahlukileyo lorhwebo - lithetha "Prozac". ERashiya, eli yeza isetyenziswa ngokubanzi baseklinikhi ezininzi ibonisa ukuba omiselwe ukuba izigulane okanye generics kumazwe ezahlukeneyo depressive.

Drug "Paroxetine"

Le yeyona sinamandla kwimiphumo iqela elimele inhibitors uyakhetha, uyakhetha serotonin reuptake, ngokuqhelekileyo esetyenziswa ukunyanga ukuphazamiseka ixhala kunye nokudakumba. Namhlanje, iziyobisi, eyona nto asebenzayo apho paroxetine, entle kakhulu. Le ukulungiselela Russian "Adepress 'ukusuka' Veropharm" unyango "pliz" yi mveliso Croatian ka Pliva, iipilisi isiHungary "Reksetin" yi kaGidiyon Richter kunye nabanye abaninzi. Kungakhathaliseki ukuba nazyvatsya amayeza "Paroxetine", nokubuyekezwa kwayo zombini izigulane kunye amagqirha ukuba becala ezintle.

Drug "Wellbutrin"

Ngcono eyaziwa ngokuba yi "Zyban" okanye "NouSmok". Le esisebenza kuzo zonke zontathu iziyobisi na bupropion hydrochloride, igalelo ukunyuka kwimali dopamine kunye norepinephrine apha ebuchotsheni. Imithi nale esisebenza kuphela kumkhulula iimpawu zokudakumba, kodwa sincedisa ukoyisa iziphumo ngokweemvakalelo kwenicotine ukurhoxiswa. Eli chiza uphucula ovakalelwa kwandisa ukusebenza. Ingxelo evela kwabo ndalahla likhoboka inicotine ngokusebenzisa loo mithi "Wellbutrin", "NouSmok" yaye "Zyban", ukuthetha malunga ukusebenza aphezulu la machiza nexesha elongezelelweyo kwisithuba ukuyeka.

amayeza "Cymbalta"

Ukulungiselela le lakhula yesine-sizukulwana kukho inhibitors of reuptake of norepinephrine kunye serotonin, kwangaxeshanye wenza yaxhuzula kancane dopamine. Le into esebenzayo isiyobisi duloxetine has a kunokuba phezulu, xa kuthelekiswa namanye ngesantya inyathelo bucala. Ngokwembono koogqirha kunye nezigulane nempembelelo ecacileyo antidepressive lubonakala ekupheleni yokuqala - ekuqaleni kwiveki yesibini ka ulwamkelo. Ukongeza, le ichiza ukufana ezahlukeneyo amanyathelo kwaye lonke ixesha isicelo layo. Nakuba kunjalo, kukho iqela yezigulane, ngokubona ukuba isiphumo eli yeza ukuba kwenzeka, ukuba buthathaka kakhulu. Njengoko sele kukhankanyiwe, iimpawu ngamnye reactions kwemichiza badla kukhokelela ukuba ichiza othile emiselwe ngugqirha, akanako ukunika isiphumo kulindeleke.

Yimalini?

Namhlanje zicwadi kunzima ukuthetha malunga amaxabiso amachiza. Oku kungenxa yokuba imarike lwemali iyahlozinga kakhulu, kunye nemithi yokunciphisa entsha, ngokuba becala ukuza kuthi evela kubavelisi bezinye iintlanga, amaxabiso ezo zinikwe euro. Yiyo loo nto kule theyibhile ingezantsi ibonisa amaxabiso asezantsi kwaye ubuninzi ku engange, kuba nje ayikwazi avareji. Inxalenye iziyobisi bengangenanga ngaphambili wathengisa nokuba ngamaxabiso ubudala, lo gama bafikayo ayabiza kakhulu ngakumbi.

Ukuba Ukujonga itafile ngenyameko, uya kuphawula ukuba awunazo machiza-isizukulwana yesibini, ezizezi MAOIs (monoamine reuptake inhibitors). Oku impazamo. Eyona nto kukuba ezi lakhula ezininzi zineziphumo ezibi nokungasebenzisani ngeziyobisi ezininzi azinalo ngokoqobo kusetyenziswa kumazwe aseYurophu. I-US wayengazenzi kusetyenziswa amayeza "isocarboxazid" "Ugenelzin" yaye "tranylcypromine," yaye kwilizwe lethu - ichiza "Nialamide". Zonke amayeza ngasentla zifumaneka kuphela phantsi kweliso iingcali zempilo yengqondo.

Le tafile ibonisa ngokucacileyo ukuba "Classic" lakhula tricyclic ixabiso eziphantsi kakhulu amachiza amatsha na SSRI kunye SIOZSiN. Ngenxa yoko, ukuba ukuthetha malunga nokufumaneka aphezulu amayeza olusebenzayo bucala ukuze uninzi lwabantu musa ukuba. Noko ke, ugqirha kunokunceda ukukhetha ichiza ngaphantsi senani iimpawu ezifanayo, ebizwa ngokuba yi-generic.

Intsebenziswano kunye namanye amachiza

Lakhula angasebenzisana namanye amachiza, nkqu ezo zibonakala ngathi ukuba sibe ekhuselekileyo eziqhelekileyo. I esebenzayo kakhulu kule nkalo ezi timoanaleptiki tricyclic kunye monoamine oxidase inhibitors, kodwa amaqela amalungiselelo SSRIs kunye SIOZSiN ngenkankulu ukuba basebenzisane kunye namanye amayeza. Kuyo nayiphi na imeko, ukuba ugqirha imisela ukuba naziphi na amayeza nokudakumba, qiniseka ukuba ukufumanisa ukuba uyakwazi ukudibanisa yokwamkela yazo kunye nokusetyenziswa eminye imithi, izongezo zokutya, kunye neti kunye infusions esintu.

Utywala lakhula

Uyinqaba ngolu hlobo, kodwa ixesha elininzi abantu abafuna ukwamkelwa timoleptikov yezizathu ezahlukeneyo, cela kangaphi kunokwenzeka ukudibanisa indlela iziselo ezinxilisayo 'esinxilisayo' kunye namacwecwe kukudakumba. Ukuze uphendule lo mbuzo ulula: Ukuba ufuna ukuthatha umngcipheko yempilo yengqondo neyomzimba zabo, mhlawumbi ubomi, zama nto! Inyaniso yokuba utywala kunye anti-depressants kuba nefuthe elibi kwinkqubo luvo kunye ingqondo, yaye oku ingcinezelo kabini kunokukuchaphazela kakubi zombini i "Mission Umbindi Wolawulo", oko kukuthi, ingqondo kunye namacandelo kunye neenkqubo ingxelo kuye. Nokuba okanye ukudibanisa - isigqibo ukwamkela kwakho kuwe kuphela.

endaweni yesiphelo

Akukho mfuneko yokuba ukucinga "ibe" ngaphezulu, lakhula babe ngcono ngempumelelo ngakumbi. Ukuba nawe uvakalelwa ngaloo mini ngasinye siba nzima ngakumbi ukuphila ngaphezu kowangaphambili, amandla alisilingene nkqu izinto ezininzi elula ngemihla, dibana yincutshe! ugqirha wakho ukufumanisa imeko yakho kwaye amisele unyango kuyimfuneko, ukukhetha amayeza afanelekileyo kuwe. Oku ngeke kube anti-depressants. Arsenal Iyeza zanamhlanje kumba kakhulu: Iintlobo ezahlukeneyo Unyango, umzimba kunye lokugqojozwa, ubuchule ukuphefumla impilo yomzimba.