Imithi Yokuhlanganiswa Yokudangala

-Delile

• Indima Yemithi
• Ama-anti-depressants we-Atypical
• Ama-antipsychotic
• L-Triiodothyronine
• Izikhuthazi
• Ukwelashwa Kokuhlanganiswa Njengendlela Yokwelashwa Kokuqala

Uma unenkinga enkulu yokudangala (MDD), kungenzeka ukuthi usuvele uthathe okungenani i-anti-depressant eyodwa. Ukwelashwa kwezinhlanganisela kuyindlela yokwelashwa odokotela abaningi nodokotela bengqondo abebelokhu beyisebenzisa kakhulu eminyakeni eyishumi edlule.

Indima Yemithi

Kuze kube muva nje, odokotela banikeze umuthi we-anti-depressant ovela esigabeni esisodwa kuphela semithi, esisodwa ngasikhathi sinye. Lokhu kubizwa ngokuthi yi-monotherapy. Uma lowo muthi uhlulekile, bangazama omunye umuthi ngaphakathi kwalelo banga, noma bashintshele kwelinye ikilasi lama-anti-depressants ngokuphelele.

Ucwaningo manje luphakamisa ukuthi ukuthatha imishanguzo yokulwa nokudangala kusuka emakilasini amaningi kungaba yindlela engcono kakhulu yokwelapha i-MDD. Olunye ucwaningo luthole ukuthi ukusebenzisa indlela yokuhlanganisa kusibonakaliso sokuqala se-MDD kungahle kabili amathuba okuxolelwa.

Ama-anti-depressants we-Atypical

Ngokwayo, i-bupropion iyasebenza kakhulu ekwelapheni i-MDD, kepha ingasetshenziswa futhi ngokubambisana neminye imithi ekucindezelekeni okunzima ukwelashwa. Eqinisweni, i-bupropion ingenye yemithi yokwelapha yokuhlanganiswa esetshenziswa kakhulu. Ihlala isetshenziswa nge-serotonin reuptake inhibitors ekhethiwe (i-SSRIs) kanye ne-serotonin- norepinephrine reuptake inhibitors (SNRIs). Ngokuvamile kubekezelelwa kahle kubantu abake babhekana nemiphumela emibi kakhulu evela kweminye imishanguzo yokulwa nengcindezi. Kungakhulula neminye imiphumela emibi yezocansi (kwehle i-libido, i-anorgasmia) ehlotshaniswa nama-SSRIs adumile kanye nama-SNRIs.

Kubantu ababhekene nokulahlekelwa isifiso sokudla nokuqwasha, i-mirtazapine ingaba inketho. Imiphumela yakhona emibi kakhulu ukuzuza isisindo nokuqina. Kodwa-ke, i-mirtazapine ayikaze ifundwe ngokujula njengomuthi oyinhlanganisela.

Ama-antipsychotic

Ucwaningo lubonisa ukuthi kungaba khona inzuzo ethile ekwelapheni izimpawu ezisele kubantu abathatha ama-SSRI ngama-antipsychotic, njenge-aripiprazole. Imiphumela emibi engaba khona ehlotshaniswa nale mithi, njengokuzuza kwesisindo, ukuqhaqhazela kwemisipha, nokuphazamiseka komzimba, kufanele ibhekwe ngokucophelela njengoba ingaqhubeka noma yenze ezinye izimpawu zokucindezeleka zibe zimbi.

L-Triiodothyronine

Abanye odokotela basebenzisa i-L-Triiodothyronine (T3) ekwelashweni okuhlangene ne-tricyclic antidepressants (TCAs) kanye ne-monoamine oxidase inhibitors (MAOIs). Iziphakamiso zocwaningo i-T3 ingcono ekusheshiseni impendulo yomzimba ekwelashweni kunokukhulisa amathuba okuthi umuntu angene ekuxolelweni.

Izikhuthazi

I-D-amphetamine (Dexedrine) ne-methylphenidate (Ritalin) yizikhuthazi ezisetshenziselwa ukwelapha ukudangala. Zingasetshenziswa njenge-monotherapy, kepha zingasetshenziswa futhi ekwelashweni okuhlangene nemithi elwa nokudangala. Ziwusizo kakhulu lapho umphumela oyifunayo uyimpendulo esheshayo. Iziguli ezikhubazekile, noma lezo ezinezimo ezi-comorbid (njenge-stroke) noma izifo ezingamahlalakhona zezokwelapha, kungaba ngabaqokelwe okuhle kule nhlanganisela.

Ukwelashwa Kokuhlanganiswa Njengendlela Yokwelashwa Kokuqala

Izinga lempumelelo yokwelashwa kwe-monotherapy liphansi kakhulu, ngakho-ke abacwaningi nodokotela abaningi bakholelwa ukuthi indlela yokuqala futhi engcono kakhulu yokwelapha i-MDD izindlela zokwelapha ezihlanganisiwe. Noma kunjalo, odokotela abaningi bazoqala ukwelapha ngomuthi owodwa wokulwa nengcindezi.

Ngaphambi kokwenza isinqumo ngomuthi, yinike isikhathi sokusebenza. Ngemuva kwesikhathi sesilingo (imvamisa cishe amasonto ama-2 kuye kwayi-4), uma ungakhombisi impendulo eyanele, udokotela wakho angafisa ukushintsha imishanguzo noma engeze umuthi owengeziwe ukuze abone ukuthi inhlanganisela isiza uhlelo lwakho lwezokwelapha luphumelele.