Thola ama-Antipsychotic ahamba phambili wezingane

-Delile

• Uyemukelwa
• Ngabe I-Atypical Antipsychotic isebenza Kanjani futhi Ngubani Oyidingayo?
• Izimo Eziphathwa Nge-Atypical Antipsychotic
• Ischizophrenia
• Ukuphazamiseka KweBipolar
• I-Aripiprazole (Hlanza)
• I-Quetiapine (Seroquel)
• Olanzapine futhi Risperidone
• Izinkinga Zokuthuthuka Ezisabalele
• Izinkinga Zokuziphatha Eziphazamisayo
• Ukuphepha kwe-Atypical Antipsychotic
• Ukukhathazeka kokuphepha ngama-antipsychotic atypical ezinganeni nasebusheni
• Ukuzuza isisindo
• Izinkinga Zenhliziyo Nesifo Sikashukela
• Ukuziphatha kokuzibulala
• Eminye Imiphumela emibi
• Ukukhetha i-Atypical Antipsychotic Yezingane
• Ukukhuluma Nodokotela Wakho
• Sivivinye Kanjani Ama-Antipsychotic
• Ukwabelana ngalo Mbiko
• Mayelana NATHI
• Izinkomba

• Isifinyezo
• Umbiko Ogcwele

Imithi kadokotela ebizwa nge-antypychotic antipsychotic, efaka i-aripiprazole (Abilify), asenapine (Saphris), clozapine (Clozaril), iloperidone (Fanapt), olanzapine (Zyprexa), paliperidone (Invega), quetiapine (Seroquel), risperidone (Risperdone) (Geodon), banikwa izingane nentsha ukuthi zilaphe i-schizophrenia ne-bipolar disorder. Zisetshenziswa futhi ukuzama ukunciphisa ulaka, ukucasuka, nokuziphatha okuzilimazayo okuhambisana nokuphazamiseka okusakazekayo kokuthuthuka, kufaka phakathi i-autism ne-Asperger syndrome, nokuphazamiseka kokuziphatha okuphazamisayo. Kepha ukunikeza abantu abasha le mithi kuyimpikiswano ngoba abakafundiswanga kahle, futhi ukuphepha nokusebenza isikhathi eside kwezingane nentsha akwaziwa.

Ucwaningo olwenziwe kubantu abadala luthole ukuthi ama-antipsychotic atypical angadala imiphumela emibi kakhulu, ngakho-ke ukuphepha kwesikhathi eside kuyinkinga ethile ngokusetshenziswa kwabo ezinganeni. Ezinye zezinto ezikhathaza kakhulu zibandakanya ukunyakaza okungalawuleki nokudlidlizela okufana nesifo sikaParkinson (esaziwa njengezimpawu ze-extrapyramidal), ingozi eyandayo yesifo sikashukela, ukuzuza okukhulu kwesisindo, kanye namazinga aphezulu we-cholesterol ne-triglyceride. Izidakamizwa ze-antipsychotic nazo zingakhuphula ingozi yokufa ngaphambi kwesikhathi, ikakhulukazi ngenxa yokushaywa yimivimbo, kubantu abadala asebekhulile abanenkinga yokuwohloka komqondo. Lezi zingcuphe zifundwe ikakhulukazi kubantu abadala; imiphumela ezinganeni ayaziwa ngokugcwele ngalesi sikhathi.

Ngenxa yokushoda kobufakazi, asikwazi ukukhetha i-Best Buy antypychotic antoticychotic yezingane ezine-schizophrenia, i-bipolar disorder, izifo ezisakazekayo zentuthuko, noma ukuphazamiseka kokuziphatha okuphazamisayo. Esikhundleni salokho, abeluleki bethu bezokwelapha bancoma ukuthi abazali babhekisise ngokucophelela izingozi nezinzuzo ezingaba khona. Izingane ezinalezo zinkinga kufanele zithole ukwelashwa okuphelele, okubandakanya ukwelashwa kokuziphatha kwengqondo, ukuqeqeshwa kwabazali, nezinhlelo ezikhethekile zemfundo, kanye nanoma yiluphi uhlobo lokwelashwa kwezidakamizwa.

Ukunquma ukuthi usebenzise eyodwa yale mithi kufanele kwenziwe ngokubambisana nodokotela wengane yakho. Ukucatshangelwa okubalulekile kufaka izindleko, ezingaba mikhulu, imiphumela emibi engaba khona, nokuthi ngabe umuthi ukhonjisiwe ukuthi uyasebenza yini esimweni noma izimpawu ezivelele zengane yakho. Uma ingane yakho inesimo esivele sikhona-isibonelo, i-ADHD noma ingcindezi-kufanele uqiniseke ukuthi ziphathwa ngendlela efanele, ngoba lokhu kungathuthukisa izimpawu zengane yakho.

Lo mbiko ushicilelwe ngoMashi 2012.

Okuqukethwe

• Isigaba 1: Siyakwamukela
• Isigaba 2: Ngabe I-Atypical Antipsychotic isebenza Kanjani futhi Ngubani Oyidingayo?
• Isigaba 3: Ukuphepha kwe-Atypical Antipsychotic
• Isigaba 4: Ukukhetha i-Atypical Antipsychotic Yezingane
• Isigaba 5: Ukukhuluma Nodokotela Wakho
• Isigaba 6: Sivivinye Kanjani Ama-Antipsychotic
• Isigaba 7: Ukwabelana ngalo Mbiko
• Isigaba 8: Mayelana Nathi
• Isigaba 9: Izinkomba

Funda kabanzi

Uyemukelwa

Lo mbiko ugxile ekusetshenzisweni kwemithi kadokotela ebizwa nge-atypical antipsychotic yizingane nentsha, eneminyaka engu-18 nangaphansi. Ama-antipsychotic atypical asetshenziselwa ukwelapha i-schizophrenia kanye ne-bipolar disorder. Zibuye zisetshenziselwe ukuzama ukunciphisa ubudlova, ukucasulwa, ukuhoxa komphakathi / ukukhathala, nezinye izimpawu ezinganeni nentsha enezinkinga zokukhula ezisabalele, kubandakanya i-autism ne-Asperger syndrome, nokuphazamiseka kokuziphatha okuphazamisayo (kepha kufanele kuqashelwe ukuthi ama-antipsychotic atypical Siza izinkinga zokuxhumana eziyinhloko ze-autism nezinye izifo ezifanayo.)

Ukunikeza izingane nentsha imishanguzo yokulwa ne-psychotic kuyimpikiswano ngoba kunobufakazi obuncane mayelana nokuphepha noma ukusebenza kahle kula maqembu eminyaka.Okuningi kwalokho esikwaziyo kuvela ezifundweni zabantu abadala. Njengoba iThebula 1 likhombisa, ama-antipsychotic amaningi we-atypical awavunyelwe yi-Food and Drug Administration ukuthi asetshenziswe izingane. Kepha zingasetshenziswa ngokusemthethweni "ngaphandle kwelebula," okusho ukuthi umuthi ungabekwa ukwelapha isimo esingenayo imvume ye-FDA. (Okuningi ngalokhu esigabeni 2.)

Ngaphandle kokushoda kobufakazi, le mithi ivame ukunikezwa izingane nentsha. Lokhu kusizile ukwenza ama-antipsychotic e-atypical abe isigaba sesihlanu esithengisa kakhulu semithi e-U.S ngo-2010, kuthengiswa ama- $ 16.1 billion, ngokusho kwe-IMS Health.

I-Clozapine (Clozaril), eyatholakala e-U.S ngo-1989, yayiyi-antipsychotic yokuqala evunyelwe yi-FDA. Namuhla, kuvame ukunikezwa kuphela lapho ezinye izidakamizwa zehluleka ngoba kungadala ukuphazamiseka okukhulu kwegazi kwabanye abantu. Kwalandelwa amanye ama-antipsychotic atypical, kufaka phakathi i-aripiprazole (Abilify), asenapine (Saphris), iloperidone (Fanapt), olanzapine (Zyprexa), paliperidone (Invega), quetiapine (Seroquel), risperidone (Risperdal), ne-ziprasidone (Geodon) . (Bheka Ithebula 1.)

Ama-antipsychotic e-atypical angadala imiphumela emibi ekhathazayo, kufaka phakathi ukuqina kwemisipha, ukuhamba kancane nokuthuthumela okungazibandakanyi (okwaziwa njengezimpawu ze-extrapyramidal), ukuzuza okukhulu kwesisindo, ingozi eyengeziwe yohlobo lwesifo sikashukela sohlobo 2, namazinga aphezulu e-cholesterol. (Imiphumela emibi ibhalwe kuThebula 2.) Abantu abaningi abaqala ukuthatha eyodwa abayithathi isikhathi eside, noma ngabe yehlisa izimpawu zabo, ngoba abakwazi noma abafuni ukubekezelela imiphumela emibi.

Ukuphatha izingane ezinezinkinga zokukhula noma zokuziphatha kungaba yinselele kubazali nakodokotela. Ngoba kuncane kakhulu okwaziwayo ngokusetshenziswa kwama-antipsychotic e-atypical ezinganeni, futhi ngenxa yezinkinga ezihambisana nalokho kuphazamiseka, Imibiko Yabathengi I-Best Buy Izidakamizwa ayikukhuthazi izinketho ezithile zokwelashwa noma ikhethe i-Best Buy kulo mbiko okhethekile. Esikhundleni salokho, sihlola ucwaningo lwezokwelapha ukukusiza uqonde izinzuzo nezingozi zama-antipsychotic e-atypical ukuze unqume, nodokotela wengane yakho, ukuthi ayifanele yini ingane yakho.

Lo mbiko uyingxenye yephrojekthi Yemibiko Yabathengi ukukusiza ekutholeni imishanguzo ephephile, esebenzayo ekunika inani elifanele kakhulu ledola lakho lokunakekelwa kwezempilo. Ukuze ufunde kabanzi mayelana nephrojekthi nezinye izidakamizwa esizihlolele ezinye izifo nemibandela, iya ku-CRBestBuyDrugs.org.

Ithebula 1. Izidakamizwa ze-Atypical Antipsychotic Zilinganisiwe Kulo Mbiko
Igama elijwayelekile	Amagama omkhiqizo	Okujwayelekile kuyatholakala	Ukuvunyelwa kwe-FDA ezinganeni
I-Aripiprazole	Yenza amandla	Cha	Kuvunyelwe ukusetshenziswa yintsha ene-schizophrenia, intsha ene-bipolar disorder exutshwe noma iziqephu ze-manic, kanye nokucasuka okuhambisana ne-autism.
I-Asenapine	USafris	Cha	Cha
I-Clozapine	UClozaril Fazaclo	Yebo	Cha
Iloperidone	I-Fanapt	Cha	Cha
Olanzapine	Zyprexa I-Zyprexa Zydis	Cha *	Kuvunyelwe ukusetshenziswa yintsha ene-schizophrenia, kanye nentsha enesifo se-bipolar exutshwe noma iziqephu zomuntu.
I-Paliperidone	Invega	Cha	Cha
I-Quetiapine	ISeroquel I-Seroquel XR	Cha *	Kuvunyelwe ukusetshenziswa ekwelapheni izingane ezineziqephu ze-manic ku-bipolar disorder, kanye nentsha ene-schizophrenia.
I-Risperidone	I-Risperdal	Yebo	Kuvunyelwe ukusetshenziswa yintsha ene-schizophrenia, intsha enesifo se-bipolar exutshwe noma iziqephu ze-manic, kanye nokucasuka okuhambisana ne-autism.
I-Ziprasidone	UGeodon	Cha	Cha

* Ukuphathwa Kwezokudla Nezidakamizwa kunikeze imvume yokwesikhashana yomkhiqizo ojwayelekile kodwa akukho okutholakalayo ngalesi sikhathi.

Buyela phezulu Funda kabanzi Buyela ohlwini lokuqukethwe

Ngabe I-Atypical Antipsychotic isebenza Kanjani futhi Ngubani Oyidingayo?

Akwaziwa kahle ukuthi i-antipsychotic isebenza kanjani ukusiza ukukhulula izimpawu. Kepha esikwaziyo ukuthi zithinta amazinga amakhemikhali ebuchosheni abizwa ngama-neurotransmitters, adlala indima ebalulekile ekuziphatheni nasekuqondeni, kanye nokulala, imizwa, ukunaka, inkumbulo nokufunda. Lokhu kungaba yindlela abazinciphisa ngayo izimpawu zengqondo, njengokucabanga izinto ezingekho, ukukhohlisa, ukucabanga okungahlelekile, nokuphazamiseka ku-schizophrenia kanye ne-bipolar disorder. Futhi kungachaza ukuthi bangakunciphisa kanjani ubudlova, ukucasuka, nokuziphatha okuzilimazayo okuhambisana nokuphazamiseka okusakazekayo kokuthuthuka nokuphazamiseka kokuziphatha okuphazamisayo. Kepha kusuka ebufakazini obunqunyelwe obutholakalayo, kusengakacaci ukuthi bakwenza kahle kangakanani lokhu, nokuthi bahlala besebenza isikhathi eside yini.

Izimo Eziphathwa Nge-Atypical Antipsychotic

Iningi lezifundo ze-antipsychotic atypical zigxile ekwelapheni i-schizophrenia kanye ne-bipolar disorder. Eminye yezidakamizwa inemvume ye-FDA yokwelapha lezo zimo ezinganeni nasebusheni kanjalo nakubantu abadala. Kodwa futhi zisetshenziselwa "i-off-label," okusho ukuthi zinqunywe odokotela ukuphatha izimo ezingazange zivunyelwe i-FDA.

Ukunikezwa kwelebula ngaphandle kwelebula kuyinto ejwayelekile futhi esemthethweni, yize kungekho emthethweni ezinkampanini ezenza imithi ukukhuthaza imishanguzo yazo ukuthi ingasetshenziswanga ngaphandle kwelebula. Ukusetshenziswa okungekho kwelebula kwama-antipsychotic atypical ezinganeni kufaka ukwelashwa kwezifo ezisakazekayo zokuthuthuka, njenge-autism ne-Asperger syndrome, nokuphazamiseka kokuziphatha okuphazamisayo. (I-Aripiprazole ne-risperidone zivunyelwe kulabo abanezinkinga ze-autism-spectrum, kepha amanye ama-antipsychotic atypical awekho.)

Kuzo zonke izimo ezine-bipolar disorder, schizophrenia, ukuphazamiseka kokukhula okusakazekile, nokuphazamiseka kokuziphatha okuphazamisayo-ubufakazi obusekela ukusetshenziswa kwama-antipsychotic atypical ngabantu abasha bunqunyelwe kwizifundo ezimbalwa, zesikhashana esifushane, ngaphandle kobufakazi obuhle bekhwalithi ukusebenza ngempumelelo nokuphepha.

Sekukonke, ucwaningo ngokusetshenziswa kwama-antipsychotic atypical yizingane lubandakanye kuphela i-2,640 yazo. Cishe izingane eziyi-1 000 zazinenkinga yokuphazamiseka kwengqondo okuguquguqukayo, ezingama-600 zazinezinkinga zokukhula ezisabalele, ezingama-640 zazinezinkinga zokuziphatha eziphazamisayo, kanti ezingaphansi kwezingama-400 zaziba nesifo sokuphazamiseka kwengqondo.

Ibhokisi elisesigabeni 2 likhombisa ukuthi yimiphi imishanguzo efundwe ezinganeni, nokuthi iziphi izimo. Kuphela i-aripiprazole (Abilify), i-olanzapine (i-Zyprexa), i-quetiapine (i-Seroquel), ne-risperidone (i-Risperdal) ezifundwe ezinganeni ezine-bipolar disorder. Entsheni ene-new schizophrenia esanda kuqala, kuphela i-olanzapine (iZyprexa), i-quetiapine (iSeroquel), ne-risperidone (i-Risperdal). I-Aripiprazole (Abilify), i-olanzapine (i-Zyprexa), ne-risperidone (i-Risperdal) ifundwe ezinganeni ezinezinkinga zokukhula ezisabalele, kuyilapho kuphela i-risperidone (Risperdal) ifundwe ezinganeni ezinokuphazamiseka kokuziphatha okuphazamisayo.

Esimweni ngasinye salezi zingane, ubufakazi obuqhathanisa ngqo i-antipsychotic eyodwa kokunye bunqunyelwe ngokweqile noma abukho nhlobo. Ubufakazi benzuzo nokulimala bushiwo ngezansi ngesimo somuthi ngamunye.

Ischizophrenia

Akucaci ukuthi zingaki izingane ezihlushwa yi-schizophrenia ngoba lesi sifo asijwayele ukutholakala kuze kube yilapho sesikhulile, ngokusho kweNational Institute of Mental Health. ISchizophrenia itholakale ezinganeni ezineminyaka yobudala engu-5 kepha lokhu akuvamile. Abesilisa bavamise ukuzwa izimpawu zokuqala besezineminyaka eyevile kwengu-20 nasekuqaleni kweminyaka ephakathi kwengama-20; abesifazane bavame ukutholakala okokuqala eminyakeni engama-20 kuya kwengama-30.

Abantu abane-schizophrenia bahlushwa ukucabanga okuhlangene nokungenangqondo, kepha ngokungafani nenkolelo evamile, abanabo ubuntu obuningi. Bangase bahoxe, besabe, futhi baphazamiseke, bese behlangabezana nemibono nokukhohlisa. Futhi bangaba nobunzima obukhulu bokuxhuma kwabanye ngokomzwelo.

Abantu abaningi abane-schizophrenia baphila impilo enenjongo futhi basebenza kahle ngokwelashwa okufanele. Ucwaningo oluningi lwezidakamizwa ezilwa nokulwa nezengqondo lubhekise kubantu abadala abane-schizophrenia. Kutholakale ukuthi kusiza ukunciphisa izimpawu, kuthuthukise ikhwalithi yempilo, futhi kunciphise nethuba lokuthi umuntu azilimaze yena noma abanye. Kepha ucwaningo ngokusetshenziswa kwe-antipsychotic yintsha eye i-schizophrenia yayo esanda kutholakala ukuthi ilinganiselwe.

I-Atypical Antipsychotic Ifundelwe Izingane Nentsha, yi-Disorder
Igama Elijwayelekile	I gama le-brand	Ukuphazamiseka
		Izingane ezine-bipolar disorder	Intsha ene-schizophrenia esanda kuqala	Izingane ezinenkinga yokuziphatha ephazamisayo	Izingane ezinezinkinga zokukhula ezisabalele
I-Aripiprazole	Yenza amandla	& hlola;			& hlola;
Olanzapine	Zyprexa	& hlola;	& hlola;		& hlola;
I-Quetiapine	ISeroquel	& hlola;	& hlola;
I-Risperidone	I-Risperdal	& hlola;	& hlola;	& hlola;	& hlola;

& hlola; kukhombisa ukuthi lesi sidakamizwa sifundwe njengokwelashwa kwalesi sifo ezinganeni nase / noma kwentsha. I-Asenapine (Saphris), i-Clozpine (i-Clozaril), i-iloperidone (i-Fanapt), i-paliperidone, ne-ziprasidone (i-Geodon) azikho ohlwini ngoba azifundiswanga ezinganeni.

Ucwaningo lwabantu abadala lubonisa ukuthi cishe isigamu salabo abane-schizophrenia babhekana nokwehla okuphawulekayo ezimpawu zabo ngemuva kokuthatha i-antipsychotic. Ezinye izimpawu, njengokuxokozela, zingaba ngcono ezinsukwini ezimbalwa nje. Abanye, njengokukhohlisa nokubonwa izinto ezingekho emthethweni, kungathatha amasonto amane kuya kwayisithupha ukukhululeka. Ngenxa yalokhu, cishe wonke umuntu otholwe ene-schizophrenia uzothola umuthi olwa nokugula ngengqondo.

Kodwa ama-antipsychotic e-atypical awasebenzi kuwo wonke umuntu. Cishe amaphesenti angama-20 abantu abane-schizophrenia abatholi nzuzo kubo, kanti amanye amaphesenti angama-25 kuye kwangama-30 ahlangabezana nokwehliswa okuncane kwezimpawu.

Izifundo ezimbili ezincane eziqhathanisa ngqo umphumela wama-antipsychotic atypical asetshenziswa yintsha ene-schizophrenia ayitholanga umehluko omkhulu phakathi kwezidakamizwa ezihloliwe. I-Olanzapine (i-Zyprexa) ne-quetiapine (i-Seroquel) zibe nomthelela ofanayo ezimpawu ngemuva kwezinyanga eziyisithupha ocwaningweni oluncane kakhulu lwentsha eyayinezifo ezintsha ze-schizophrenia. I-Risperidone (i-Risperdal) ne-olanzapine (i-Zyprexa) iholele ekuthuthukisweni okufanayo kwezimpawu emasontweni ayisishiyagalombili.

Ukuphazamiseka KweBipolar

Iningi labantu abanesifo se-bipolar bavame ukunikezwa ukuxilongwa lapho sebeneminyaka eyevile kwengu-20 noma ekuqaleni kwawo-20. INational Institute of Mental Health ilinganisela ukuthi lesi sifo sithinta abangaphansi kwamaphesenti amathathu kwentsha, kodwa ukudlanga ngqo akukaziwa ngoba lesi sifo kunzima ukusithola ezinganeni. Lokhu kungenxa yokuthi izimpawu azicaci kangako ezinganeni kunabantu abadala, futhi zingadibana nezinye izimo zobuntwana, njenge-ADHD noma ukuphazamiseka kokuziphatha.

Izimpawu eziphawulekayo zokuphazamiseka kwe-bipolar ukushintsha okubukhali phakathi kwezimo eziphakeme kakhulu-noma i-mania-nezimo eziphansi kakhulu-noma ukucindezeleka. Ezimweni eziningi, lokho kukhathazeka ngokweqile kuhlala amasonto ambalwa. Imvamisa kukhona isikhathi esiphakathi nendawo esinemizwa "ejwayelekile". Kepha abanye abantu abane-bipolar disorder bangaba nezikhathi lapho izimpawu ze-mania kanye nokudangala kutholakala ngasikhathi sinye. Lezi zibizwa ngeziqephu “ezixubekile”.

Ama-antipsychotic e-Atypical ngokuvamile awasetshenziselwa ukwelapha ukuphazamiseka kwe-bipolar kuze kube yilapho abantu beqale bazama eminye imithi, kufaka phakathi i-lithium, i-divalproex, ne-carbamazepine.

Ucwaningo lwabantu abadala luthole ukuthi wonke ama-antipsychotic angasiza ekunciphiseni izimpawu ze-mania zesifo se-bipolar, ngamaphesenti angama-40 kuye kwangama-75 abantu ababhekana nokwehla kwezimpawu. Kepha kube nezifundo ezimbalwa ngomphumela wezidakamizwa kubantu abadala abane-bipolar disorder kune-schizophrenia, futhi zimbalwa kakhulu ezinganeni ezine-bipolar disorder.

Nakhu okwaziwa kuze kube manje:

I-Aripiprazole (Hlanza)

Kokunye ukuhlola, ukuphendula kwesikhashana okusho ukuthi amaphesenti angama-50 noma ukuncipha okukhulu kwezimpawu-kubonakale kumaphesenti angama-45 kuye kwangama-64 ezingane nentsha ethatha i-aripiprazole ngemuva kwamasonto amane okwelashwa uma kuqhathaniswa namaphesenti angama-26 athatha i-placebo. Ukuxolelwa-ukuxazululwa okuphelele kwezimpawu- kufinyelelwe kumaphesenti angama-25 kuye kwangama-72 ezingane ezithatha i-aripiprazole uma kuqhathaniswa namaphesenti ama-5 kuye kwangama-32 endaweni ye-placebo. Kepha ekugcineni kocwaningo, izingane ezithatha i-aripiprazole zilinganise izinga lazo lokuphila liphansi kunelalashwa nge-placebo.

I-Quetiapine (Seroquel)

Kokunye ukuhlola, amaphesenti angama-58 kuye kwangama-64 ezingane nentsha enezimpawu ze-mania akhombise impendulo ngemuva kwamasonto amathathu ekwelashwa nge-quetiapine uma kuqhathaniswa namaphesenti angama-37 athatha i-placebo. Ukuxolelwa kubonwe ngaphezulu kwengxenye abathathe i-quetiapine ngokuqhathaniswa namaphesenti angama-30 endaweni ye-placebo.

Ngenkathi i-quetiapine isetshenziswa nomunye umuthi, i-di-valproex, yintsha eneziqephu ezinzima ze-mania, amaphesenti angama-87 akhombise impendulo ngemuva kwamasonto ayisithupha uma kuqhathaniswa namaphesenti angama-53 athatha i-divalproex iyodwa. Kokunye ukuhlola okuqhathanisa i-quetiapine ne-divalproex kwentsha enesifo sokuphazamiseka kwengqondo okuguquguqukayo, zombili lezi zidakamizwa ziholele ekwenzeni ngcono impilo ekupheleni kwamasonto amane. Ukuthuthuka kubonakale emandleni abo okuhlalisana nabanye nokuphatha indlela abaziphethe ngayo, okudala ukuphazamiseka okumbalwa empilweni yomndeni. Futhi abazali balabo abaku-quetiapine bathe izingane zabo zisebenza kangcono esikoleni, emphakathini nasemfundweni, futhi bazizwa bengcono ngabo.

I-Quetiapine ayingcono kune-placebo uma kukhulunywa ngezikhathi zokudangala zokuphazamiseka kwengqondo okuguquguqukayo. Ocwaningweni lwentsha engama-32 enesiqephu sokucindezeleka esihambisana nesifo sokuphazamiseka kwengqondo okuguquguqukayo, i-quetiapine ayizange iholele ekuthuthukisweni kwezimpawu noma izinga elithuthukisiwe lokuxolelwa kulandela ukwelashwa amasonto ayisishiyagalombili uma kuqhathaniswa ne-placebo.

Olanzapine futhi Risperidone

Ucwaningo olulodwa oluncane luqhathanisa i-risperidone (Risperdal) ne-olanzapine (iZyprexa) ezinganeni ezingama-31 zasenkulisa ezine-bipolar disorder ezazikhombisa izimpawu zemania. Izidakamizwa zikhombise ukusebenza okufanayo ekuqedeni izimpawu kulandela ukwelashwa amasonto ayisishiyagalombili. Kudingeka isifundo esikhulu ukuqinisekisa lokho okutholakele.

Ucwaningo lwentsha enezimpawu ze-mania luthole ukuthi amaphesenti angama-59 kuye kwangama-63 abathathe i-risperidone (Risperdal) amasonto amathathu bathola impendulo uma kuqhathaniswa namaphesenti angama-26 athatha i-placebo. Ocwaningweni olufanayo ne-olanzapine (Zyprexa), amaphesenti angama-49 entsha ethatha le mithi ikhombise impendulo uma iqhathaniswa namaphesenti angama-22 athatha i-placebo. Zombili lezi zifundo zathola nokuthi i-risperidone ne-olanzapine kwaholela ekutheni iziguli eziningi zithole ukuxolelwa uma kuqhathaniswa ne-placebo.

Izinkinga Zokuthuthuka Ezisabalele

Izinkinga zokukhula ezisabalele zifaka phakathi ukuphazamiseka kwe-autism spectrum (i-autism ne-Asperger syndrome) kanye ne-Rett syndrome, ukuphazamiseka kokuhlukaniswa kwengane, kanye nokuphazamiseka kokukhula okugcwele (okuvame ukubizwa ngokuthi "isifo sokukhula esigcwele yonke indawo, hhayi lapho kuchazwe ngenye indlela").

Ngokwesilinganiso, eyodwa ezinganeni eziyi-110 e-U.S. Inohlobo oluthile lokuphazamiseka kwe-autistic, ngokusho kweCenters for Disease Control and Prevention. I-Autism, evame kakhulu kubafana kunamantombazane, ijwayele ukubonakala ngaphambi kweminyaka yobudala engu-3. Imbangela ayaziwa. Abantu abane-autism banenkinga ngamakhono okusebenzelana nabanye kanye nawokuxhumana, kanye nokuziphendulela ngokomzwelo, futhi ngokuvamile bakhombisa isimilo esivinjelwe nesiphindaphindayo sokuziphatha, imisebenzi, kanye nezintshisekelo.

Alikho ikhambi, kepha kunezindlela zokwelapha ezingasiza. Izinhlelo ezihleliwe zokufundisa noma zokuphila zansuku zonke ezigxile ekuthuthukiseni amakhono namasu wokuxhumana ajwayele ukusetshenziswa, kanye namasu okuphatha indlela yokuziphatha kanye nokwelashwa kokuziphatha kwengqondo. Ama-antipsychotic anqunyiwe, uma kunesidingo, ngenhloso yokwehlisa isimilo esiphazamisayo, kufaka phakathi ukungasebenzi kahle, ukungafisi, ulaka nokuziphatha okuzilimazayo. Eminye imishanguzo ingasetshenziswa ukwelapha ezinye izifo, njengokukhathazeka noma ukudangala.

Zimbalwa izifundo ezibheke ukusetshenziswa kwe-antipsychotic yizingane ezinalezi zinkinga. Ucwaningo olukhulu kunawo wonke, olwalubandakanya izingane eziyi-101 ezinenkinga yokuthuthuka okusakazeka yonke indawo, lwathola ukuthi amaphesenti angama-69 alabo abathatha i-risperidone (Risperdal) balinganiselwa ukuthi “bathuthuke kakhulu” ngemuva kokwelashwa amasonto ayisishiyagalombili uma kuqhathaniswa namaphesenti ayi-12 athatha i-placebo. I-Risperidone (i-Risperdal) ukuphela kwe-antipsychotic eye yafundwa ezinganeni zasenkulisa ezinesifo esandayo sokukhula, kepha ayitholakalanga ingcono kune-placebo.

Akucaci ukuthi izinzuzo ze-risperidone zihlala isikhathi eside yini. Ubufakazi obunqunyelwe bukhombisa ukuthi ngemuva kwezinyanga ezine zokwelashwa, amaphesenti ayi-10 ezingane ezibonisa ukuthuthuka azoyeka ukuthatha umuthi noma kungenxa yokuthi awusasebenzi noma aba nemiphumela engemihle. Lokhu kuholele ekubuyiseleni emuva-ukubuyela kwezimpawu ezingeni labo lokuqala-ngamaphesenti angama-63, kanti amaphesenti ayi-13 kuphela alabo abaqhubeka nokuphuza umuthi izinyanga ezimbili ezengeziwe baphinde babuyela emuva.

Ezifundweni ezimbili ezibandakanya izingane ezingama-316, labo abathathe i-aripiprazole (Abilify) babencane amathuba okuzilimaza noma babonise ulaka kwabanye uma kuqhathaniswa nalabo abathola i-placebo. Babengacasuki kangako, babe nokugqashuka okumbalwa okuncane, babe nezinguquko ezimbalwa zemizwa noma imizwelo ecindezelekile, futhi babengajwayele ukumemeza noma ukumemeza ngokungafanele.

Ubufakazi obulinganiselwe kakhulu buyatholakala ekusetshenzisweni kwe-olanzapine (Zyprexa) yizingane ezinezinkinga zokukhula ezisabalele. Zimbili kuphela izifundo ezithinta izingane ezingaphansi kwezingama-25 ezitholakalayo. Imiphumela ikhombisa ukuthi i-olanzapine iphakeme kune-placebo futhi ifana ne-anti-psychotic haloperidol (Haldol) endala. Kepha ngenxa yenani elincane kakhulu lezingane ezifundiwe, kudingeka izifundo ezinkudlwana ukuthola ukuthi ngabe lokho okutholakele kungasetshenziswa kabanzi kubantwana abanezinkinga zokukhula ezisabalele.

Izinkinga Zokuziphatha Eziphazamisayo

Ukuphazamiseka kokuziphatha okuphazamisayo kufaka phakathi ukuphikisana nokuphikisana nokuphikisana, ukungaziphathi kahle, nokuphazamiseka kokuziphatha okuphazamisayo (okuya ezincwadini zezokwelapha okuvame ukubizwa ngokuthi "ukuphazamiseka kokuziphatha okuphazamisayo, okungachaziwe ngenye indlela"). Isifo esiphikisayo esiphikisayo sivela cishe kumaphesenti ama-1 kuye kwayi-6 wentsha, futhi ukuphazamiseka kokuziphatha kwenzeka cishe kumaphesenti ama-1 kuye kwayi-4.

Izimpawu ezibonwe ezinganeni ezitholwe zinezinkinga zokuphikisana nokuphikisana zifaka ubutha, ukunganaki, nokudelela igunya. Kubonakala ngaphambi kweminyaka yobudala engu-8, futhi kuvame kakhulu kubafana. Kwezinye izimo, ukuqina kwezimpawu kungakhula ngokuguga futhi kube yisici sokuphazamiseka kokuziphatha. Izingane ezitholwe zinenkinga yokuziphatha ephazamisayo zivame ukukhombisa ukusilela / i-hyperactivity disorder (ADHD).

Izingane ezinokungaziphathi kahle zibonisa iphethini yolaka kubantu nasezilwaneni, ukucekelwa phansi kwempahla kanye / noma ukwebiwa kwempahla, nokunye ukwephulwa kwemithetho emibi, imvamisa ngaphandle kokuzisola. Ukuziphatha kokuphazamiseka kuvame ukutholakala ngaphambi kweminyaka yobudala eyi-16, futhi kuvame kakhulu kubafana. Kokubili ukuphikisana nokuphikisana nokuphikisana nokuziphatha kuhlotshaniswa nezinkinga ezinkulu ezisebenza ekhaya, esikoleni, futhi, kamuva nasemsebenzini. Izingane ezinenkinga yokuphikisana nokuphikisana zivame ukuhlangabezana nezinkinga zokuyala esikoleni, futhi zihlala zinezinkinga zomthetho njengabantu abadala.

Izingane ezinamaphethini wokuziphatha afanayo, kepha anzima kakhulu, uma kuqhathaniswa nalezo ezinokuphikisana nokuphikisana noma ukuphazamiseka kokuziphatha, zingatholwa zinokuphazamiseka kokuziphatha okuphazamisayo noma ukuphazamiseka kokuziphatha okuphazamisayo, okungachaziwe ngenye indlela. Izingane ezikulesi simo zikhombisa ubudlelwano phakathi kwabantu nobudlelwano bomndeni, kanye / noma nokuphazamiseka kokusebenza kwesikole.

Ukwelashwa okuyisisekelo kokuphazamiseka kokuziphatha okuphazamisayo kususelwe emndenini futhi kufaka phakathi ukuqeqeshwa kwabaphathi babazali. Ukwelashwa kwemithi kubhekwa njengokungezayo futhi kuhloswe ngezimpawu ezithile. Esinqumweni sokuqala umuthi, imvamisa kubalulekile ukuthi ubheke ezinye izimo ingane engaba nazo. Isibonelo, imishanguzo ye-ADHD ingaba wusizo uma ingane inezinkinga zokuziphatha eziphazamisayo kanye ne-ADHD. Ezinganeni ezinokuphazamiseka kokuziphatha, izinto zokuqinisa imizwa, njenge-lithium ne-valproate, zingasiza. Ama-antipsychotic anikezwe izingane ezinokuphazamiseka kokuziphatha okuphansi ukunciphisa ulaka oluhambisana nalezi zimo, kepha kufundwe kuphela ama-antipsychotic-risperidone ne-quetiapine ngalokhu kusetshenziswa. Ayikho imishanguzo elwa ne-antipsychotic evunyelwe yi-FDA ekwelapheni ukuphazamiseka kokuziphatha okuphazamisayo.

Ocwaningweni lwezingane ezinezimpawu zokuphazamiseka kokuziphatha eziphazamisayo, labo abathole i-risperidone bakhombise cishe isilinganiso esiphindwe kabili sezinga lokuziphatha ekuziphatheni okuyinkinga kunamasonto ayisithupha kuya kwayishumi okwelashwa uma kuqhathaniswa nalabo abathathe i-placebo. Cishe amaphesenti angama-27 ezingane eziqhubeke nokuthatha i-risperidone izinyanga eziyisithupha ziye zabuyela emuva uma kuqhathaniswa namaphesenti angama-42 ezingane ezingayitholanga imishanguzo, kepha izinga lokuthuthuka lehla kuwo womabili amaqembu.

Ocwaningweni lwentsha enezimpawu zokuziphatha eziphazamisayo ezidinga ukulaliswa esibhedlela, i-risperidone ithuthukise ukuhlolwa kwayo konke, ngamaphesenti angama-21 ahlolwe “njengokuphazamiseka okukhulu” noma kuqhathaniswa namaphesenti angama-84 athatha i-placebo.

I-Quetiapine (Seroquel) ayitholakalanga ukuthi iyasebenza ekuthuthukiseni isimilo esinolaka esihambisana nokuphazamiseka kokuziphatha. Ocwaningweni olukhona kuphela, i-quetiapine ibingcono kakhulu kune-placebo ekwehliseni ubudlwangudlwangu kanye nokungasebenzi kahle kwentsha enenkinga yokuziphatha nokuziphatha okunolaka okulingene. Enye yezingane eziyisishiyagalolunye (amaphesenti ayi-11) iyeke ukuthatha imishanguzo ngenxa ye-akathisia, umphumela ohlangothini owenza abantu bazizwe sengathi abakwazi ukuhlala bethule. I-Quetiapine yayiphakeme kune-placebo ezinyathelweni zomhlaba wonke zokwenza ngcono izimpawu nezinga lempilo.

Buyela phezulu Funda kabanzi Buyela ohlwini lokuqukethwe

Ukuphepha kwe-Atypical Antipsychotic

Ama-antipsychotic e-Atypical angadala imiphumela emibi kakhulu, enciphisa ukusebenza kwawo konke. (Bheka Ithebula 2, ngezansi.) Abantu abaningi abaqala ukuthatha elilodwa abalithathi isikhathi eside, noma ngabe kunciphisa izimpawu zabo, ngoba abakwazi noma abafuni ukubekezelela imiphumela emibi. Ngaphezu kwalokho, abantu abane-schizophrenia ne-bipolar disorder bathambekele kakhulu ekuyekiseni imishanguzo yabo ngenxa yesifo abanaso. Bangase bangaqondi ukuthi banesifo sengqondo, behluleka ukwamukela ukuthi bayazuza emithini, bakhohlwe ukuyiphuza, noma bayeke ukuyiphuza lapho izimpawu ezinzima kakhulu sezincipha.

Umphumela owodwa obucayi we-antipsychotic e-atypical ihlobene nokuhamba (i-extrapyramidal) -i-tics engalawuleki kanye nokuthuthumela okufana nesifo sika-Parkinson. Imiphumela emibi ye-Extrapyramidal ngokuvamile iyaphela lapho umuthi unqanyuliwe noma umthamo wehlisiwe. Kepha ukuphazamiseka kokuhamba okuthile okubizwa nge-tardive dyskinesia kungakhula ngokusetshenziswa isikhathi eside futhi kungaqhubeka noma ngabe isiguli siyekile ukuthatha i-antipsychotic.

Izidakamizwa ze-antypychotic ze-atypical nazo zidala eminye imiphumela emibi kakhulu, kufaka phakathi ingozi eyengeziwe yohlobo lwesifo sikashukela sohlobo 2, ukuzuza okukhulu kwesisindo, kanye namazinga aphezulu we-cholesterol kanye ne-triglyceride. Ngaphezu kwalokho, kutholakale ukuthi bakhulisa ubungozi bokufa ngaphambi kwesikhathi, ikakhulu ngenxa yokushaywa yimivimbo, kubantu abadala asebekhulile abanenkinga yokuwohloka komqondo. Lezi zingcuphe zifundwe ikakhulukazi kubantu abadala; imiphumela ezinganeni ayaziwa ngokugcwele ngalesi sikhathi.

Ithebula 2. Imiphumela engemihle ehlotshaniswa ne-Atypical Antipsychotic
Imiphumela emibi emincane kuya kokumaphakathi - Lezi zinganciphisa noma zinyamalale ngokuhamba kwesikhathi, noma zinciphiswe uma umthamo wehlisiwe. Bayasuka lapho umuthi umisiwe. Uhlu olungezansi lu-alfabhethi hhayi ngokulandelana kokubaluleka, ubunzima, noma imvamisa. Iningi labantu linemiphumela engaphezu kweyodwa yale miphumela. Kepha isipiliyoni, nobukhali bemiphumela emibi yehluka kakhulu kumuntu.
Ukunyakaza kwezitho zomzimba nokungajwayelekile, ukunyakaza kwemisipha, ukuthuthumela nokuqaqamba kwemisipha	Ukuqwasha
Ukuya esikhathini ngokungajwayelekile	Ukuminyanisa izindebe nokunyakaza kolimi okungavamile
Ukubona okufiphele	Ukuqina kwemisipha noma ubuthakathaka
Ukuqunjelwa	Ukushaya kwenhliziyo okusheshayo
Isiyezi ngokuma noma ukuhamba ngokushesha	Ukungahlaliseki
Umlomo owomile	Ukuhlalisa, ukozela
Ukweqa amathe ngokweqile	Ukungasebenzi ngokocansi
Ukuzizwa ulambile kakhulu kunokujwayelekile	Ukuqhuma kwesikhumba
Imiphumela emibi engaba yingozi - Lokhu kungadinga ukuyeka isidakamizwa noma ukushintshela kwesinye. Zivame ukubuyiselwa emuva, kepha kwezinye izimo, zingaba ngunaphakade, futhi, esimweni se-agranulocytosis, ngisho nokusongela impilo.
I-Agranulocytosis † - Ukwehluleka komnkantsha ukukhiqiza amaseli egazi amhlophe alwa nezifo, okungaholela ekuthelelekeni okunzima noma okubulalayo. Le ngozi ihlotshaniswa ikakhulukazi ne-clozapine, futhi ukuhlolwa kwegazi njalo kuyadingeka lapho uyithatha.
Izinguquko emzimbeni lokho kubangela ukungajwayelekile kukashukela egazini nezinye izinkinga, okungaholela ekutheni uthayiphe isifo sikashukela sohlobo lwesibili kanye nengozi enkulu yesifo senhliziyo nokushaywa unhlangothi kubantu abadala.
I-Myocarditis † - Ukuvuvukala kwemisipha yenhliziyo engabulala. Le ngozi ihlotshaniswa ngokuyinhloko ne-clozapine.
Ukuquleka † - Le ngozi ihlotshaniswa ngokuyinhloko ne-clozapine.
Ukuzuza okukhulu kwesisindo - Amaphesenti ayi-7 noma ukwanda okukhulu kwesisindo sangaphambi kokwelashwa (inani eliphelele lincike esisindweni sokuqala sengane). I-Clozapine ne-olanzapine zombili zibangela ukukhuluphala okukhulu kunamanye ama-antipsychotic.
I-Tardive dyskinesia - Ukunyakaza okungalawuleki komzimba okungafaka ukuthuthumela nokuqaqamba komzimba.

† Ihlotshaniswa ngokuyinhloko ne-clozapine; ukuhlolwa kwegazi njalo kuyadingeka lapho uyithatha.

Kukonke, amaphesenti angama-80 kuye kwangama-90 abantu abadala abathatha i-antipsychotic yanoma yiluphi uhlobo bazoba nomphumela owodwa ohlangothini; iningi lizoba nokuningi kokukodwa. Kulabo ababhekana nemiphumela emibi:

• Amaphesenti angama-20 kuye kwangama-30 azoba nomphumela omubi noma ongabekezeleleki futhi ayeke ukuphuza umuthi ezinsukwini, emasontweni, noma ezinyangeni ezimbalwa.
• Amaphesenti angama-35 kuye kwangama-45 azoyeka ukuthatha umuthi ezinyangeni eziyisithupha.
• Amaphesenti angama-65 kuya kwangama-80 azoyeka ukuthatha umuthi ezinyangeni eziyi-12 kuya kwezingu-18.

Ukukhathazeka kokuphepha ngama-antipsychotic atypical ezinganeni nasebusheni

Ngenxa yezifundo ezilinganiselwe zezingane nentsha, imiphumela emibi yama-antipsychotic atypical ayaziwa ngokuphelele. Iphrofayili yemiphumela eseceleni iyahlukahluka ngezidakamizwa, ngakho-ke lapho ucabangela eyodwa yengane yakho, izingozi zomuthi ngamunye othize kufanele zicatshangelwe ngokumelene nenzuzo engaba khona. Izingxenye ezilandelayo ukubuka konke kwemiphumela emibi etholakala ezifundweni ezibandakanya izingane nentsha.

Ukuzuza isisindo

Ukuzuza kwesisindo mhlawumbe kungumphumela ohlangothini ovame kakhulu ohlotshaniswa nama-antipsychotic atypical athathwe yizingane nentsha. I-Risperidone (i-Risperdal) enikezwa ngamanani aphansi, ngokwesibonelo, iholela ekutholeni kwesisindo esiphakathi kwamakhilogremu ama-4 ezinganeni ezinenkinga yokuthuthuka okugcwele noma ukuphazamiseka kokuziphatha okuphazamisayo uma kuqhathaniswa nalabo abanikezwa i-placebo. Akukacaci ukuthi lokhu kuzuza kwesisindo kuyaqina yini noma kuyaqhubeka nokwanda ngaphezu kwesikhathi esizayo. Ubufakazi bamanje bubonisa ukuqhubeka kwesisindo, ngokulinganiselwa kwamakhilogremu ama-4 kuye kwayi-12 ngonyaka owodwa kuze kufike kumakhilogremu ayi-18 ngemuva kweminyaka emibili.

Ukuzuza kwesisindo nakho kuyimiphumela emibi kakhulu ene-aripiprazole (Abilify). Kokunye ukuhlola, amaphesenti ayi-15 ezingane ezikuthathayo zithole ukukhuluphala okuphawulekayo (okungenani amaphesenti ayi-7 ngaphezulu kwesisindo sokuqala) ngaphezulu kwamasonto ayisishiyagalombili. Kwesinye isifundo, izingane ezingamaphesenti angama-32 zithole ukukhuluphala okuphawulekayo ngenkathi ziku-aripiprazole. Kuzo zombili lezi zifundo, izingane ezithatha i-placebo zithole ukukhuluphala okungatheni. Ukuthi ukuzuza kwesisindo okuhambisana ne-aripiprazole kuyaqhubeka isikhathi eside akucaci ngoba azikho izifundo zesikhathi eside zokuthola isisindo ngokwelashwa okuqhubekayo okutholakalayo.

I-Olanzapine (iZyprexa) nayo ihlotshaniswa nokuzuza kwesisindo, nezingane zithola amakhilogremu angu-7.5 kuye kwayi-9 ngaphezu kwamasonto ayisithupha kuya kwayishumi okwelashwa. Ucwaningo oluthile lwathola ukuthi izingxenye ezimbili kwezintathu zezingane zithole okungenani amaphesenti ayi-7 ngaphezulu kwesisindo sazo sokuqala. Njengasendabeni ye-aripiprazole (Abilify), izifundo zokuzuza kwesisindo ezinganeni eziqhubeka nokuthatha i-olanzapine isikhathi eside azitholakali.

Ithebula 3. Ukuzuza kwesisindo nge-Atypical Antipsychotic ezinganeni nasebusheni
Izidakamizwa	Ukuzuza kwesisindo ngamakhilogremu ngaphezu kwamaviki ayisithupha kuya kwayisishiyagalombili
	Ukukhubazeka Okugcwele Okuthuthukayo noma Ukuphazamiseka Kokuziphatha Okuphazamisayo	Ukuphazamiseka KweBipolar	Ischizophrenia
I-Aripiprazole (Hlanza)	3-4	<1	–
I-Olanzapine (Zyprexa)	7.5 kuye ku-9	7.4	–
I-Quetiapine (Seroquel)	–	3	4-5
I-Risperidone (Risperdal)	4	2	2

I-Quetiapine nayo ibanga ukuzuza kwesisindo. Isibonelo, ocwaningweni lwezingane ezineziqephu ezicindezelekile zesifo sokuphazamiseka kwengqondo okuguquguqukayo, labo abathole i-quetiapine bathole cishe amakhilogremu ama-3 ngaphezu kwalabo abathole i-placebo.

Izinkinga Zenhliziyo Nesifo Sikashukela

Ezinye izidakamizwa ze-antipsychotic zingakhuphula inani eliphelele le-cholesterol (i-LDL ne-triglycerides). Ngaphezu kwalokho, lezo zidakamizwa-ngaphandle kwe-aripiprazole (Abilify) - zingakhuphula ushukela wegazi, noma ezinye izimpawu zesifo sikashukela, kwezinye izingane, noma zenze ukulawula ushukela egazini kube kubi kulabo abanesifo sikashukela esivele sikhona.

Akunakwenzeka ukusho ukuthi ingakanani ingozi eyengeziwe yokwengeza kwezidakamizwa, noma uma umuthi owodwa mubi kakhulu kunomunye wezingane. Ngokuya ngezifundo ezishicilelwe, i-olanzapine (iZyprexa) ingadala ukwanda okukhulu kwamazinga e-cholesterol ezinganeni kunabantu abadala.

Ngenkathi amaphethini wesigqi senhliziyo (i-EKGs) ayejwayelekile, ucwaningo olulodwa lwabonisa ukwanda kwesikhashana kokushaya kwenhliziyo nge-risperidone phakathi namasonto amabili okuqala okwelashwa. Amazinga wenhliziyo yabahlanganyeli abuyele kokujwayelekile ngemuva kwamasonto amabili okwelashwa.

Ukuziphatha kokuzibulala

Ezifundweni zezingane ezithatha ama-antipsychotic e-atypical, bekukhona abambalwa abakhombise indlela yokuzibulala, kepha akunakwenzeka ukusho ukuthi ngabe lokhu kusho ukwanda noma ukwehla engcupheni yokuziphatha ukuzibulala, noma kungabi namthelela nhlobo.

Imithi yokwelashwa kwengqondo, efana nezidambisigciwane ezithile, itholakale ikhulisa le ngozi ezinganeni. Ngenxa yokuthi i-aripiprazole (Abilify) ne-quetiapine (Seroquel) yabelana ngomsebenzi ofanayo we-neurotransmitter ebuchosheni njengalezi zidambisi zengqondo, le mithi inesixwayiso esibi sokuthi ingandisa ingozi yokuzibulala nokuziphatha, yize ubufakazi bungacaci.

Kubantu abadala abane-schizophrenia, i-clozapine (i-Clozaril, i-Fazaclo ODT) ukuphela komuthi we-antipsychotic otholakele ukunciphisa ingozi yokuzibulala noma ukuzibulala. Lokhu akuzange kufundwe ezinganeni.

Eminye Imiphumela emibi

Izifundo ze-risperidone (Risperdal) zithole amanani aphansi eminye imiphumela emibi, kepha lokhu kungahle kube ngenxa yemithamo ephansi esetshenzisiwe, nokulandela okufishane. Ukunyakaza kwezitho zomzimba nokungajwayelekile komzimba (izimpawu ze-extrapyramidal), bekungajwayelekile ezivivinyweni zesikhashana, kepha kubikwa kaningi kuneziguli ezithatha i-placebo.

I-Risperidone yaziwa ngokubangela amazinga akhuphukayo we-hormone prolactin, esiza ekukhiqizeni ubisi lwebele ngemuva kokukhulelwa. Kwabesifazane nabesilisa abangakhulelwe, ukwanda kweprolactin kungaholela ekukhuliseni amabele nezinkinga zomsebenzi wezocansi. Ucwaningo lwezingane luthole ukuthi i-risperidone ikhuphule amazinga e-prolactin, kepha akekho owakhombisa izimpawu noma izimpawu njengokukhuliswa kwebele. Akucaci ukuthi, ngokuhamba kwesikhathi, amazinga e-prolactin ahlala ephakeme noma abuyela kokujwayelekile.

Eminye imiphumela emibi ebonwa kaningi nge-aripiprazole (Abilify) kune-placebo ifaka ukulala, ukuvuza amathe, ukuthuthumela, isicanucanu noma ukuhlanza. Ukunyakaza okungavamile kwezingalo, imilenze, noma umzimba nakho kwabonakala kaningi ezinganeni ezithatha i-aripiprazole. Ukuqhubeka nokufunda kuyadingeka ukuthola ukuthi ngabe le miphumela engemihle iyaxazululeka, ihlale ingaguquguquki, noma ibe yimbi ngokuhamba kwesikhathi ngokwelashwa okuqhubekayo.

Ocwaningweni lokusetshenziswa kwequetiapine (Seroquel) ekwelapheni intsha enenkinga yokuziphatha, amaphesenti ayi-11 alabo abathatha imishanguzo bema ngenxa ye-akathisia, isimo lapho umuntu ezizwa engenakho ukuthula, njengokungathi abakwazi ukuhlala bethule. Ngaphandle kwalokho, lesi sidakamizwa sabekezelelwa kahle.

Eminye imiphumela emibi ebikwe yizingane ezithatha i-olanzapine ifaka phakathi i-sedation nokwanda kwesifiso sokudla.

Sekukonke, imiphumela emibi ibikwa kaningi nge-olanzapine (Zyprexa) kune-quetiapine (Seroquel) noma i-risperidone (Risperdal). Ukuba namandla kwakukhona kakhulu ezigulini ezelashwa nge-olanzapine uma kuqhathaniswa ne-quetiapine, futhi ukukhathala kwakuvame kakhulu nge-olanzapine uma kuqhathaniswa ne-risperidone. Kepha ezinye iziguli ezithatha i-risperidone zibike umphumela ohlobene nokunyakaza uma kuqhathaniswa nalezo ezithatha i-olanzapine.

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Ukukhetha i-Atypical Antipsychotic Yezingane

Ngenxa yobufakazi obuncane bokusetshenziswa kwama-antipsychotic ezingqondo ezinganeni nasebusheni, kunzima ukunquma ukusebenza nokuphepha kwabo okwesikhashana. Futhi akukho okwaziwayo ngokuphepha nokusebenza kwabo isikhathi eside ngoba izifundo ezibandakanya abantu abasha bezincane futhi zifushane ngesikhathi.

Ngakho-ke asikwazi ukukhetha i-Best Buy atypical antipsychotic ezosetshenziswa yizingane nentsha ene-schizophrenia, i-bipolar disorder, izifo ezisakazekayo zentuthuko, noma ukuphazamiseka kokuziphatha okuphazamisayo. Esikhundleni salokho, abeluleki bethu bezokwelapha bancoma ukuthi abazali bahlolisise izingozi nezinzuzo. Uhlelo lokwelashwa oluphelele lwezingane ezinalezi zinkinga kufanele lubandakanye ukwelashwa kokuziphatha kwengqondo, ukuqeqeshwa kwabazali kanye nezinhlelo ezikhethekile zemfundo, kanye nanoma yiluphi uhlobo lokwelashwa kwezidakamizwa.

Ukuthatha isinqumo sokusebenzisa noma iyiphi yale mithi nhlobo, futhi uma kunjalo, yimuphi, okufanele wenziwe ngokubambisana nodokotela wengane yakho futhi kufanele kusekelwe ezintweni ezibalulekile ezimbalwa. Isibonelo, yiziphi izimpawu zomntwana wakho eziphawuleka kakhulu, ezicindezelayo noma ezonakalisa amandla akhe? Ngabe lezi zimpawu zitholwe yimishanguzo yokulwisa ingqondo? Ingabe izinzuzo zanele noma zibalulekile kuwe nasenganeni yakho?

Kufanele futhi ubheke nezindleko zomuthi, ezingaba zinkulu. Futhi ubuyekeze imiphumela emibi yesidakamizwa ngokuya ngomlando wezempilo wengane yakho ukuze uqiniseke ukuthi kufanelekile. Le mithi ifundwe ngokunganele ezinganeni maqondana nemiphumela engemihle, ngakho-ke kuzodingeka futhi ubheke nobufakazi obuvela ezifundweni zabantu abadala.

Uma ingane yakho inesimo esivele sikhona - ngokwesibonelo, i-ADHD noma ukucindezeleka - kufanele uqiniseke ukuthi ziyelashwa. Lokhu kungathuthukisa izimpawu zengane yakho. Ngokuphazamiseka kwe-bipolar, kunezinye, izidakamizwa ezicwaningwe kahle ezitholakalayo, njenge-lithium, i-divalproex, ne-carbamazepine, okufanele izanywe kuqala ngaphambi kokucubungula ama-antipsychotic e-atypical.

Uma uthatha isinqumo sokunikeza ingane yakho i-antipsychotic, siphakamisa ukuthi usebenzise umthamo ophansi kakhulu wokunciphisa amathuba okuba nemiphumela engemihle. Futhi qiniseka ukuthi ingane yakho ihlolwa futhi ngezikhathi ezithile ngudokotela ukuthola ukuthi ngabe umuthi usasiza futhi uyadingeka yini.

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Ukukhuluma Nodokotela Wakho

Imininingwane esiyethula lapha ayihloselwe ukuthi ithathe isikhundla sokwahlulela kukadokotela. Kepha siyethemba ukuthi kuzokusiza wena nodokotela wengane yakho ukunquma ukuthi ngabe i-antipsychotic ifanele yini.

Khumbula ukuthi abantu abaningi bayanqikaza ukuxoxa ngezindleko zemithi nodokotela wabo, nokuthi ucwaningo luthole ukuthi odokotela abajwayele ukubheka intengo lapho beyalela umuthi. Ngaphandle kokuthi uyikhuphule, udokotela wakho angacabanga ukuthi izindleko akuyona into kuwe.

Abantu abaningi (kufaka phakathi odokotela) bacabanga ukuthi imishanguzo emisha ingcono. Yize lokho kungukucabanga kwemvelo ukukwenza, akusilo iqiniso ngempela. Ucwaningo luhlala luthola ukuthi imishanguzo eminingi emidala ilungile futhi kwezinye izimo ingcono kunemithi emisha. Cabanga ngabo “njengabazamile nabayiqiniso,” ikakhulukazi uma kukhulunywa ngerekhodi labo lezokuphepha. Izidakamizwa ezintsha azikahlangabezani nesikhathi, futhi nezinkinga ezingalindelekile zingenza futhi zikhule uma sezifikile emakethe.

Vele, eminye imishanguzo emisha kadokotela iyasebenza kakhulu futhi iphephe kakhulu. Khuluma nodokotela wakho ngama-pluses nama-minus wemithi emisha uma kuqhathaniswa nemithi emidala, kubandakanya nemithi ejwayelekile.

Imithi kadokotela iya “generic” lapho amalungelo obunikazi enkampani kuyo ephela, imvamisa ngemuva kweminyaka eyi-12 kuye kwengu-15. Ngaleso sikhathi, ezinye izinkampani zingenza futhi zithengise umuthi.

Ama-generic abiza kancane kunemithi emisha enegama lomkhiqizo, kepha akuzona izidakamizwa ezisezingeni eliphansi. Ngempela, ama-generic amaningi ahlala elusizo eminyakeni eminingi ngemuva kokumakethwa okokuqala. Yingakho ngaphezu kwamaphesenti angama-60 kuyo yonke imiyalo e-U.S. Namuhla ibhalelwe ama-generics.

Olunye udaba olubalulekile ongakhuluma ngalo nodokotela wakho ukugcina irekhodi lemithi oyiphuzayo. Kunezizathu eziningana zalokhu:

• Okokuqala, uma ubona odokotela abaningana, ngamunye angahle angazi ngomuthi abanye abawunikeze.
• Okwesibili, njengoba abantu behluka ekuphenduleni kwabo emithini, kuvamile ukuthi odokotela namuhla banikeze amaningana ngaphambi kokuthola okusebenza kahle noma okuhle kakhulu.
• Okwesithathu, abantu abaningi bathatha imishanguzo eminingana kadokotela, imishanguzo engabhaliswanga, nezithako zokudla ngasikhathi sinye. Bangasebenzisana ngezindlela ezinganciphisa inzuzo oyithola kumuthi noma zibe yingozi.
• Ekugcineni, amagama emithi kadokotela-ejwayelekile kanye ne-brand-kaningi kunzima ukuyibiza futhi uyikhumbule.

Kuzo zonke lezo zizathu, kubalulekile ukugcina uhlu olubhaliwe lwazo zonke izidakamizwa nezithasiselo ozithathayo, futhi ukuzibuyekeza ngezikhathi ezithile nodokotela bakho.

Futhi qiniseka njalo ukuthi uyawuqonda umthamo womuthi obekelwe wona nokuthi mangaki amaphilisi okulindeleke ukuthi uwadle usuku ngalunye. Udokotela wakho kufanele akutshele lolu lwazi. Uma ugcwalisa incwadi ekhemisi noma uma uyithola ngeposi, hlola ukuthi umthamo kanye nenombolo yamaphilisi ngosuku esitsheni sephilisi iyafana yini nodokotela okutshele yona.

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Sivivinye Kanjani Ama-Antipsychotic

Ukuhlola kwethu kusekelwe ekubuyekezweni okuzimele kwesayensi kobufakazi bokusebenza, ukuphepha, kanye nemiphumela emibi ye-antipsychotic.Ithimba lodokotela nabaphenyi e-Oregon Health & Science University Evidence-Based Practice Center lenze lolu cwaningo njengengxenye yeDrug Effectiveness Review Project, noma i-DERP. I-DERP iyisinyathelo sokuqala sohlobo lwayo lokuhlola ukusebenza ngempumelelo nokuphepha kwamakhulu emithi kadokotela.

Isifinyezo sokuhlaziywa kwe-DERP kwama-antipsychotic kwakha isisekelo salo mbiko. Umxhumanisi wemibiko yabathengi i-Best Buy Drugs futhi uyilungu lethimba labacwaningi elizinze e-Oregon, elingenayo intshisekelo yezezimali kunoma iyiphi inkampani yezemithi noma umkhiqizo.

Ukubuyekezwa okugcwele kwe-DERP kwama-antipsychotic kuyatholakala ku- //derp.ohsu.edu/about/final-documentdisplay.cfm. (Lona ngumbhalo omude nobuchwepheshe obhalelwe odokotela.)

Indlela Yabathengi Ibika Izindlela Ezinhle Zokuthenga Izidakamizwa ichazwe ngokuningiliziwe esigabeni Sezindlela kuCRBestBuyDrugs.org.

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Ukwabelana ngalo Mbiko

Lo mbiko onelungelo lobunikazi ungalandwa mahhala, ushicilelwe kabusha, futhi usatshalaliswe ukuze usetshenziselwe ukwenza okungekhona okwezentengiso ngaphandle kwemvume evela Kumibiko Yabathengi & kuzungezisweR; inqobo nje uma kukhonjwe ngokusobala ukuthi Imibiko Yabathengi Izidakamizwa Ezingcono Kakhulu. ™ Sikhuthaza ukusatshalaliswa kwayo kabanzi futhi ngenhloso yokwazisa abathengi. Kepha Imibiko Yabathengi ayigunyazi ukusetshenziswa kwegama layo noma okokusebenza ngezinhloso zokuthengisa, ukumaketha, noma ukuphromotha. Noma iyiphi inhlangano ethanda ukusatshalaliswa kabanzi kwalo mbiko kufanele ithumele i-imeyili [email protected]. Imibiko Yabathengi I-Best Buy Drugs ™ iyimpahla ephawulwe ngokuhweba ye-Consumers Union. Zonke izingcaphuno ezivela kokuqukethwe kufanele zikhombe Imibiko Yabathengi i-Best Buy Drugs ™ njengomthombo.

© 2012 Abathengi Union of U.S. Inc.

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Mayelana NATHI

Inyunyana yabathengi, umshicileli wemibiko yabathengi & circledR; umagazini, uyinhlangano ezimele futhi engenzi nzuzo inhloso yayo kusukela ngo-1936 bekungukunikeza abathengi ulwazi olungachemile ngezimpahla nezinsizakalo kanye nokwenza imakethe efanelekile. Iwebhusayithi yi-www.CRBestBuyDrugs.org. Iwebhusayithi yalo magazini yiConsumerReports.org.

Lezi zinto zokwenziwa zenziwa zatholakala ngoxhaso oluvela kuHulumeni Wombuso Jikelele Wabathengi kanye noHlelo Olunikezwayo Lwemali Yesibonelelo, oluxhaswe ngokuxazululwa kwabantu abaningi ngezimangalo zokukhwabanisa kwabathengi maqondana nokumakethwa kwemithi kadokotela iNeurontin.

I-Engelberg Foundation inikeze isibonelelo esikhulu sokuxhasa ukwakhiwa kwephrojekthi kusuka ngo-2004 kuya ku-2007. Ukuxhaswa okwengeziwe kokuqala kwavela kuNational Library of Medicine, okuyingxenye yeNational Institutes of Health. Incazelo eningiliziwe yephrojekthi iyatholakala ku-CRBestBuyDrugs.org.

Silandele inqubo yokuhlela enzima ukuqinisekisa ukuthi imininingwane ekulo mbiko nakuwebhusayithi Yokubika Komthengi Iwebhusayithi Engcono Kakhulu Yezidakamizwa inembile futhi ichaza imikhuba yemitholampilo eyamukelwa ngokuvamile. Uma sithola iphutha noma saziswa kwenye sizolilungisa ngokushesha okukhulu. Kepha Imibiko Yabathengi kanye nababhali bayo, abahleli, abashicileli, abanikezeli bamalayisense, kanye nabahlinzeki abakwazi ukubhekana namaphutha ezokwelapha noma ukweqiwa, noma eminye imiphumela ekusetshenzisweni kolwazi olukulesi siza. Sicela ubheke esivumelwaneni sethu somsebenzisi ku-CRBestBuyDrugs.org ukuthola eminye imininingwane.

Imibiko Yabathengi Izidakamizwa Ezithengwa Kakhulu akumele zibhekwe njengokungena esikhundleni sokubonisana nodokotela noma nodokotela wezempilo. Lo mbiko kanye nemininingwane kuCRBestBuyDrugs.org inikezwe ukuthuthukisa ukuxhumana nodokotela wakho kunokukufaka esikhundleni.

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Izinkomba

1. Izinhlelo zokusebenza J, Winkler J, Jandrisevits MD, Izinhlelo zokusebenza J, Winkler J, Jandrisevits MD. Ukuphazamiseka kwe-bipolar: izimpawu nokwelashwa ezinganeni nasebusheni. Umhlengikazi wezingane. 2008; 34 (1): 84-8.
2. U-Arango C, uRobles O, uParellada M, uFraguas D, uRuiz-Sancho A, uMedina O, uZabala A, uBombin I, uMoreno D. Olanzapine ngokuqhathaniswa ne-quetiapine ebusheni obunesiqephu sokuqala se-psychotic. I-Eur Child Adolesc Psychiatry. U-2009; 18 (7): 418-28.
3. UBarzman DH, iLungu lePhalamende leDelBello, i-Adler CM, iStanford KE, iStrakowski SM. Ukusebenza nokubekezeleleka kwe-quetiapine kuqhathaniswa ne-divalproex ekwelapheni ukungacabangi kanye nolaka olusebenzayo ezinganeni ezine-bipolar disorder ezenzeka ngokuhlanganyela kanye nokuphazamiseka kokuziphatha okuphazamisayo. Ijenali yePsychopharmacology Yezingane Nentsha. 2006; 16 (6): 665-70.
4. Izikhungo Zokulawulwa Kwezifo. Ukuqhamuka kwe-Autism Spectrum Disorders-Autism and Networks Monitoring Network, United States, 2006. MMWR. U-2009; 58 (SS10): 1-20.
5. UCorrell CU, uManu P, u-Olshanskiy V, uNapolitano B, uKane JM, uMalhotra AK. Ingozi ye-Cardiometabolic yemithi yesizukulwane sesibili ye-antipsychotic ngesikhathi sokuqala ukusetshenziswa ezinganeni nasebusheni. Ijenali ye-American Medical Association. 28 Okthoba 2009. 302 (16): 1765-1773.
6. ICummings CM, iFristad MA, iCummings CM, iFristad MA. Isifo se-bipolar yengane: Ukuqashelwa ekunakekelweni okuyisisekelo. I-Curr Opin Pediatr. 2008; 20 (5): 560-5.
7. Ukuthola i-RI, McNamara NK, i-Branicky LA, i-Schluchter MD, i-Lemon E, i-Blumer JL. Ucwaningo lwendiza elingaboni kabili lwe-risperidone ekwelapheni ukuphazamiseka kokuziphatha. Ijenali yeAmerican Academy of Child & Adolescent Psychiatry. 2000; 39 (4): 509-16.
8. Ukuthola i-RL, i-Nyilas M, i-Forbes RA, i-McQuade RD, i-Jin N, i-Iwamoto T, i-Ivanova S, i-Carson WH, i-Chang K. Ukwelashwa okunamandla kwe-bipolar I disorder yabantwana, isiqephu somuntu noma esixubekile, nge-aripiprazole: I-randomized, double blind, isifundo esilawulwa yi-placebo. Ijenali ye-Clinical Psychiatry. 2009; 70 (10): 1441-51.
9. UGoldstein BI. Isifo se-bipolar yengane: Kungaphezu kwenkinga yomsindo. Izifo zezingane. 2010; 125 (6): 1283-5.
10. UHaas M, iLungu lePhalamende leDelbello, uPandina G, uKushner S, uVan Hove I, u-Augustyns I, uQuiroz J, uKusumakar V. Risperidone ekwelapheni i-mania ebukhali ezinganeni nasebusheni abane-bipolar disorder: I-placebo-elawulwa ngokungahleliwe, eyimpumputhe, funda. Ukuphazamiseka KweBipolar. 2009; 11 (7): 687-700.
11. UHazell P, Williams R, Hazell P, Williams R. Ukubuyekezwa kokuhlela: Imibono eshintshayo ngenkinga yentsha ye-bipolar kanye nesifo esithuthukayo sokuthuthuka. ICurr Opin Psychiatry. 2008; 21 (4): 328-31.
12. Luby J, Mrakotsky C, Stalets MM, Belden A, Heffelfinger A, Williams M, Spitznagel E. Risperidone ezinganeni zasenkulisa ezinenkinga ye-autistic spectrum: Uphenyo lokuphepha nokusebenza kahle. Ijenali yePsychopharmacology Yezingane Nentsha. 2006; 16 (5): 575-87.
13. UMaglione M, et al. Ukusetshenziswa okungekho kwelebula kwama-Antipyychotic Atypical: Isibuyekezo. Ukubuyekezwa Kokusebenza Ngokuqhathanisa Nombolo 43. (Ilungiswe yiSouthern California / RAND Evidence-based PracticeCenter ngaphansi Kwenkontileka No. HHSA290-2007-10062-1.) AHRQ Publication No. 11- EHC087-EF. I-Rockville, MD: I-Agency for Healthcare Research kanye neKhwalithi. Septhemba 2011.
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16. Isikhungo Sikazwelonke Sezempilo Yengqondo. Ukuphazamiseka kwe-bipolar phakathi kwezingane. Kutholakala ku-imh.nih.gov/ statistics / 1bipolar_child.shtml. Kufinyelelwe ngoMashi 10, 20011.
17. Isikhungo Sikazwelonke Sezempilo Yengqondo. Ischizophrenia. Kutholakala ku-imh.nih.gov/statistics/ 1SCHIZ.shtml. Kufinyelelwe ngoMashi 10, 20011.
18. Amayunithi Wocwaningo ku-Pediatric Psychopharmacology Autism Network. Ukwelashwa kwe-Risperidone yokuphazamiseka kwe-autistic: Izinzuzo zesikhathi eside nokuyekiswa kwempumputhe ngemuva kwezinyanga eziyi-6. Ijenali yaseMelika Yezokwelapha. 2005; 162 (7): 1361-9.
19. USeeman P. Ama-antipsychotic e-Atypical: Indlela yokwenza. Ngabe uJ Psychiatry. 2002 Febhuwari; 47 (1): 27-38.
20. USnyder R, Turgay A, Aman M, Binder C, Fisman S, Carroll A. Imiphumela ye-risperidone ekuziphatheni nasekuphazamisekeni kokuziphatha kokuphazamiseka ezinganeni ezinama-IQ aphezulu. Ijenali yeAmerican Academy of Child & Adolescent Psychiatry. 2002; 41 (9): 1026-36.

Buyela phezulu Funda kabanzi

Qaphela: Uma ibhokisi lentengo liqukethe ifayela le- , lokho kukhombisa ukuthi umthamo walowo muthi kungenzeka utholakale ngezindleko eziphansi zenyanga ngezinhlelo zesaphulelo ezinikezwa yizitolo ezinkulu zamaketanga. Isibonelo, uKroger, Sam's Club, Target, kanye neWalmart banikela ngemithi ekhethiwe ejwayelekile yemithi ejwayelekile ngo- $ 4 noma izinyanga ezintathu ukunikezwa ngo- $ 10. Ezinye izitolo zamaketanga, njenge-Costco, i-CVS, i-Kmart, ne-Walgreens, zinikela ngezinhlelo ezifanayo. Ezinye izinhlelo zinemikhawulo noma imali yobulungu, ngakho-ke hlola imininingwane ngokucophelela ngemikhawulo futhi uqiniseke ukuthi umuthi wakho umboziwe.

Nciphisa uhlu lwakho

• Izincomo zokuthenga okuhamba phambili kuphela
• Okujwayelekile kuphela
• Ukutholakala kohlelo lwezindleko eziphansi njalo ngenyanga
• Igama lomkhiqizo kuphela
• Ukuqina kuphela
• Ama-Spasms kuphela
• OTC kuphela
• Rx kuphela