Ungayisebenzisa ngokweqile i-anti-depressants?

-Delile

• Yimiphi imithamo ejwayelekile ebekiwe nebulalayo?
• Ama-TCA
• Ama-SSRIs
• Ama-SNRIs
• Ama-MAOIs
• Ukuvimbela ukuzibulala
  
• Ziyini izimpawu nezimpawu zokudlula ngokweqile?
• Izimpawu ezimnene
• Izimpawu ezinzima
• Isifo se-Serotonin
• Imiphumela emibi ye-anti-depressant
• Okufanele ukwenze uma usola ukweqisa ngokweqile
• Ukuphathwa ngokweqile kuphathwa kanjani?
• Okubalulekile

Ingabe ukweqisa ngokweqile kungenzeka?

Yebo, kungenzeka ukuthi weqe ngokweqile kunoma yiluphi uhlobo lwe-antidepressant, ikakhulukazi uma ithathwa nezinye izidakamizwa noma imishanguzo.

Ama-anti-depressants yimithi kadokotela esetshenziselwa ukwelapha izimpawu zokudangala, ubuhlungu obungapheli nezinye izifo zemizwa. Kuthiwa basebenza ngokwandisa amazinga amakhemikhali athile - i-serotonin ne-dopamine - ebuchosheni.

Kunezinhlobo eziningana ze-anti-depressants ezitholakalayo, kufaka phakathi:

• ama-tricyclic antidepressants (TCAs), njenge-amitriptyline ne-imipramine (Tofranil)
• i-monoamine oxidase inhibitors (MAOIs), njenge-isocarboxazid (Marplan) ne-phenelzine (Nardil)
• i-serotonin reuptake inhibitors ekhethiwe(Ama-SSRIs), kufaka phakathi i-fluoxetine (i-Prozac), i-sertraline (i-Zoloft), ne-escitalopram (i-Lexapro)
• i-serotonin-norepinephrine reuptake inhibitors(Ama-SNRIs), njenge-duloxetine (iCymbalta) ne-venlafaxine (i-Effexor XR)
• izidakamizwa zokulwa nokucindezela, kufaka phakathi i-bupropion (Wellbutrin) ne-vortioxetine (Trintellix)

Ukweqiwa ngokweqile kwe-TCA kukhonjiswe ukuthi kunemiphumela ebulala kakhulu kune-MAOI, SSRI, noma i-SNRI overdoses.

Yimiphi imithamo ejwayelekile ebekiwe nebulalayo?

Umthamo obulalayo we-anti-depressant uncike ezintweni eziningi, kufaka phakathi:

• uhlobo lwe-antidepressant
• umzimba wakho uwugaya kanjani umuthi
• isisindo sakho
• iminyaka yakho
• uma unezimo esezikhona, njengenhliziyo, izinso, noma isimo sesibindi
• uma uthathe i-anti-depressant ngotshwala noma ezinye izidakamizwa (kufaka phakathi ezinye izidambisi-mkhuba)

Ama-TCA

Uma kuqhathaniswa nezinye izinhlobo zama-anti-depressants, ama-tricyclic antidepressants (TCAs) aholela enanini eliphakeme kakhulu lokudlula ngokweqile okubulalayo.

Umthamo ojwayelekile wansuku zonke we-TCA amitriptyline uphakathi kwama-milligram angama-40 kuya kwayi-100 (mg). Umthamo ojwayelekile we-imipramine uphakathi kuka-75 no-150 mg ngosuku. Ngokuya kokunye ukubuyekezwa kwe-2007 kwedatha yesikhungo sikashevu sase-U.S, izimpawu ezisongela impilo zivame ukubonwa ngemithamo emikhulu kune-1,000 mg. Kwisilingo esisodwa somtholampilo, umthamo obulala kakhulu we-imipramine wawuyi-200 mg nje.

Abaphenyi bancoma ukwelashwa okuphuthumayo kunoma ngubani othathe umthamo we-desipramine, nortriptyline, noma i-trimipramine enkulu kuno-2.5 ​​mg ngekhilogremu (kg) wesisindo. Kumuntu onesisindo esingama-70 kg (cishe ama-154 amakhilogremu), lokhu kuhumusha cishe ku-175 mg. Kuwo wonke amanye ama-TCA, kunconywa ukwelashwa okuphuthumayo ngemithamo emikhulu kuno-5 mg / kg. Kumuntu onesisindo esingama-70 kg, lokhu kuhumusha cishe kuma-350 mg.

Ama-SSRIs

Ama-serotonin reuptake inhibitors akhethiwe (ama-SSRIs) yiwona-antidepressants ajwayele ukubekwa ngoba ajwayele ukuba nemiphumela engemihle embalwa. Uma kuthathwe yedwa, ukweqisa izidakamizwa kwe-SSRI akuvamile ukubulala.

Umthamo ojwayelekile we-SSRI fluoxetine (Prozac) uphakathi kuka-20 no-80 mg ngosuku. Umthamo ongaphansi kuka-520 mg we-fluoxetine uhlotshaniswe nomphumela obulalayo, kodwa kukhona kothile othatha amagremu ayi-8 e-fluoxetine futhi alulame.

Ingozi yobuthi kanye nokufa iphezulu kakhulu lapho umthamo ophakeme we-SSRI uthathwa ngotshwala noma ezinye izidakamizwa.

Ama-SNRIs

I-Serotonin-norepinephrine reuptake inhibitors (i-SNRIs) ithathwa njengeinobuthi obuncane kunama-TCA, kepha inobuthi kakhulu kune-SSRIs.

Umthamo ojwayelekile we-SNRI venlafaxine uphakathi kuka-75 no-225 mg ngosuku, uthathwa ngemithamo emibili noma emithathu ehlukanisiwe. Imiphumela yesifo sobuthakathaka ibonwe ngamanani aphansi njengokufika ku-2,000 mg (2 g).

Noma kunjalo, iningi le-overdoses ye-SNRI ayibulali, noma kumazinga aphezulu. Izimo eziningi zokudlula ngokweqile zibandakanya izidakamizwa ezingaphezu kwesisodwa.

Ama-MAOIs

I-Monoamine oxidase inhibitors (i-MAOIs) ikilasi elidala lama-anti-depressants futhi ayisasetshenziswa njengabaningi. Izimo eziningi zobuthi be-MAOI zenzeka lapho imithamo emikhulu ithathwa kanye notshwala noma ezinye izidakamizwa.

Izimpawu ezinzima zokudlula ngokweqile zingenzeka uma uthatha okungaphezu kwesisindo somzimba wakho. Ukufa ngokweqile kwe-MAOI, kepha lokhu kungenzeka ngoba akusabekiwe kabanzi ngenxa yokuxhumana kwabo okuningi.

Ukuvimbela ukuzibulala

1. Uma ucabanga ukuthi othile usengozini ngokushesha yokuzilimaza noma ukulimaza omunye umuntu:
2. • Shayela ku-911 noma inombolo yakho ephuthumayo yasendaweni.
3. • Hlala nalo muntu kuze kufike usizo.
4. • Susa noma yiziphi izibhamu, imimese, imishanguzo, noma ezinye izinto ezingadala ingozi.
5. • Lalela, kodwa ungahluleli, uphikise, usongele noma umemeze.
6. Uma wena noma omunye umuntu omaziyo ecabanga ukuzibulala, thola usizo enhlekeleleni noma ku-hotline yokuvimbela ukuzibulala. Zama i-National Suicide Prevention Lifeline ku-800-273-8255.

Ziyini izimpawu nezimpawu zokudlula ngokweqile?

Ukweqisa izidakamizwa kuma-anti-depressants kungadala izimpawu ezimnene nezimbi. Kwezinye izimo, ukufa kungenzeka.

Izimpawu zakho zizoncika ku:

• ungakanani umuthi owuthathile
• uzwela kangakanani emithini
• noma ngabe uyithathile imithi ngokuhlangana nezinye izidakamizwa

Izimpawu ezimnene

Ezimweni ezimnene, ungahlangabezana:

• abafundi abahlanzekile
• ukudideka
• ikhanda
• ukozela
• umlomo owomile
• imfiva
• ukungaboni kahle
• umfutho wegazi ophakeme
• isicanucanu nokuhlanza

Izimpawu ezinzima

Ezimweni ezinzima, ungahlangabezana:

• ukusangana
• isilinganiso senhliziyo esisheshayo ngendlela engajwayelekile (tachycardia)
• isithuthwane
• ukuthuthumela
• umfutho wegazi ophansi (hypotension)
• ikhoma
• ukuboshwa kwenhliziyo
• ukucindezeleka kokuphefumula
• ukufa

Isifo se-Serotonin

Abantu abadlula ngokweqile kuma-anti-depressants nabo bangathola i-serotonin syndrome. I-Serotonin syndrome ukusabela kabi kwezidakamizwa okubi kakhulu okwenzeka lapho i-serotonin eningi yakha emzimbeni wakho.

I-Serotonin syndrome ingadala:

• isicanucanu
• ukuhlanza
• isifo sohudo
• amajaqamba esiswini
• ukudideka
• ukukhathazeka
• ukushaya kwenhliziyo okungajwayelekile (arrhythmia)
• izinguquko kumfutho wegazi
• ukudlikizela
• ikhoma
• ukufa

Imiphumela emibi ye-anti-depressant

Njengemithi eminingi, ama-anti-depressants angadala imiphumela emibi emincane noma ngomthamo ophansi. Imiphumela emibi kakhulu ifaka phakathi:

• ikhanda
• uvalo
• isifo sohudo
• ukulahlekelwa isifiso sokudla
• inkathazo yokulala
• umlomo owomile
• ukuqunjelwa
• ukuzuza kwesisindo
• isiyezi
• ukushayela ucansi okuphansi

Imiphumela engemihle ingahle ingakhululeki ekuqaleni, kepha ngokuvamile iyathuthuka ngokuhamba kwesikhathi. Uma uhlangabezana nale miphumela engemihle ngenkathi uthatha umthamo wakho obekiwe, akusho ukuthi weqise ngokweqile.

Kodwa kusamele utshele udokotela wakho nganoma yimiphi imiphumela emibi obhekene nayo. Ngokuya ngobukhulu besifo sakho, udokotela wakho angafuna ukunciphisa umthamo wakho noma akushintshele emithini ehlukile.

Okufanele ukwenze uma usola ukweqisa ngokweqile

Uma usola ukuthi ukweqisa ngokweqile kwenzeke, funa ukunakekelwa kwezimo eziphuthumayo ngokushesha. Akufanele ulinde kuze kube yilapho izimpawu zakho ziba nzima kakhulu. Izinhlobo ezithile ze-anti-depressants, ikakhulukazi ama-MAOIs, kungenzeka zingabangeli izimpawu ezinzima kuze kube ngamahora angama-24 ngemuva kokusebenzisa ngokweqile.

E-United States, ungaxhumana neNational Capital Poison Center ku-1-800-222-1222 bese ulinda eminye imiyalelo.

Uma izimpawu ziba nzima, shayela abezimo eziphuthumayo zangakini. Zama ukuhlala uzolile futhi ugcine umzimba wakho upholile ngenkathi ulinde abasebenzi bezimo eziphuthumayo ukuthi bafike.

Ukuphathwa ngokweqile kuphathwa kanjani?

Endabeni yokweqisa ngokweqile, abasebenzi bezimo eziphuthumayo bazokuhambisa esibhedlela noma egumbini labezimo eziphuthumayo.

Unganikezwa amalahle acushiwe ngenkathi usendleleni. Lokhu kungasiza ukumunca umuthi futhi kunciphise ezinye zezimpawu zakho.

Lapho ufika esibhedlela noma egumbini lezimo eziphuthumayo, udokotela wakho angase asishaye isisu sakho ukuze asuse noma imuphi umuthi osele. Uma uthukuthele noma udangele, bangasebenzisa ama-benzodiazepines ukukudambisa.

Uma ukhombisa izimpawu ze-serotonin syndrome, zingaphinde zinikeze imithi yokuvimba i-serotonin. Uketshezi olufakwa emithanjeni (IV) kungadingeka futhi ukugcwalisa izakhi zomzimba ezibalulekile nokuvimbela ukoma.

Lapho izimpawu zakho sezidlulile, kungadingeka ukuthi uhlale esibhedlela ukuze ubhekwe.

Okubalulekile

Lapho nje umuthi oweqile usuphumile ohlelweni lwakho, cishe uzolulama ngokugcwele.

Ama-anti-depressants kufanele athathwe kuphela ngaphansi kokuqondisa kwezokwelapha. Akufanele neze uthathe okungaphezu komthamo wakho onqunyiwe, futhi akufanele ulungise le dose ngaphandle kwemvume kadokotela wakho.

Ukusebenzisa ama-anti-depressants ngaphandle kwencwadi kadokotela noma ukuwaxuba nezinye izidakamizwa kungaba yingozi enkulu. Awusoze waqiniseka ukuthi ungasebenzisana kanjani ne-chemistry yomzimba wakho ngamunye noma imiphi eminye imithi noma izidakamizwa oziphuzayo.

Uma ukhetha ukusebenzisa ama-anti-depressants ngokuzilibazisa noma uwaxube nezinye izinto zokuzilibazisa, gcina udokotela wakho enolwazi. Bangakusiza uqonde ubungozi bakho bokuxhumana nokudlula ngokweqile, kanye nokubuka noma yiziphi izinguquko empilweni yakho yonke.