Imithi Yokucindezeleka Nemiphumela engemihle

-Delile

• I-serotonin reuptake inhibitors ekhethiwe
• Imiphumela emibi ye-SSRI
• ISerotonin-norepinephrine reuptake inhibitors
• Imiphumela emibi ye-SNRI
• I-Tricyclic antidepressants
• Imiphumela emibi ye-TCA
• I-Norepinephrine ne-dopamine reuptake inhibitors
• Imiphumela emibi ye-NDRI
• I-Monoamine oxidase inhibitors
• Imiphumela emibi ye-MAOI
• Imishanguzo yokwengeza noma yokwengeza
• Amanye ama-anti-depressants

Ukubuka konke

Ukwelashwa kwesifo sokucindezeleka okukhulu (okwaziwa nangokuthi ukucindezeleka okukhulu, ukucindezeleka komtholampilo, ukucindezeleka kwe-unipolar, noma i-MDD) kuncike kumuntu nobukhulu besifo. Kodwa-ke, odokotela bavame ukuthola imiphumela emihle kakhulu lapho yomibili imishanguzo kadokotela, njenge-anti-depressants, ne-psychotherapy isetshenziswa ngokuhlangana.

Njengamanje, kunemithi elwa nokudambisa ukucindezelwa engaphezu kweshumi nambili.

Ama-anti-depressants ayaphumelela ekwelapheni ukucindezeleka, kepha akukho muthi owodwa okhonjiswe ukuthi uphumelela kakhulu - kuncike ngokuphelele esigulini nasezimeni zazo. Kuzofanele uphuze umuthi njalo amasonto ambalwa ukuze ubone imiphumela futhi ubone noma yimiphi imiphumela emibi.

Nayi imishanguzo edonswa njalo yokulwa nokucindezelwa kanye nemiphumela yaso emibi kakhulu.

I-serotonin reuptake inhibitors ekhethiwe

Indlela ejwayelekile yokwelashwa kokucindezeleka iqala ngemithi kadokotela okhetha i-serotonin reuptake inhibitor (SSRI).

Lapho ubuchopho bungenzi i-serotonin eyanele, noma bungakwazi ukusebenzisa kahle i-serotonin ekhona, ibhalansi yamakhemikhali ebuchosheni ingahle ingalingani. Ama-SSRI asebenza ukushintsha izinga le-serotonin ebuchosheni.

Ngokuqondile, ama-SSRI avimba ukubuyiselwa kabusha kwe-serotonin. Ngokuvimba ukuvuselelwa kabusha, ama-neurotransmitters angathumela futhi athole imilayezo yamakhemikhali ngempumelelo. Lokhu kucatshangwa ukuthi kukhulisa imiphumela ekhulisa imizwa ye-serotonin futhi ithuthukise izimpawu zokucindezeleka.

Ama-SSRI ajwayelekile kakhulu afaka:

• i-fluoxetine (Prozac)
• I-citalopram (Celexa)
• i-paroxetine (Paxil)
• i-sertraline (Zoloft)
• i-escitalopram (Lexapro)
• i-fluvoxamine (Luvox)

Imiphumela emibi ye-SSRI

Imiphumela emibi ejwayelekile etholwa abantu abasebenzisa ama-SSRI ifaka phakathi:

• izinkinga zokugaya ukudla, kubandakanya nohudo
• isicanucanu
• umlomo owomile
• ukungahlaliseki
• ikhanda
• ukuqwasha noma ukozela
• ukunciphisa isifiso sobulili nobunzima bokufinyelela ku-orgasm
• ukungasebenzi kahle kwe-erectile
• ukuyaluza (jitteriness)

ISerotonin-norepinephrine reuptake inhibitors

I-Serotonin-norepinephrine reuptake inhibitors (i-SNRIs) kwesinye isikhathi ibizwa ngokuthi yi-dual reuptake inhibitors. Basebenza ngokuvimba ukutholwa kabusha, noma ukuphinda kwenziwe kabusha, kwe-serotonin ne-norepinephrine.

Nge-serotonin eyengeziwe ne-norepinephrine ejikeleza ebuchosheni, ibhalansi yamakhemikhali ebuchosheni ingahle isethwe kabusha, futhi ama-neurotransmitters kucatshangwa ukuthi axhumana kahle kakhulu. Lokhu kungathuthukisa imizwa futhi kusize ekunciphiseni izimpawu zokudangala.

Ama-SNRI anqunywa kakhulu afaka:

• i-venlafaxine (i-Effexor XR)
• desvenlafaxine (Pristiq)
• i-duloxetine (iCymbalta)

Imiphumela emibi ye-SNRI

Imiphumela emibi kakhulu etholwa abantu abasebenzisa ama-SNRI ifaka phakathi:

• ukujuluka okwandayo
• ukwanda komfutho wegazi
• ukushaya kwenhliziyo
• umlomo owomile
• ukushaya kwenhliziyo okusheshayo
• Izinkinga zokugaya ukudla, imvamisa ukuqunjelwa
• izinguquko ekudleni
• isicanucanu
• isiyezi
• ukungahlaliseki
• ikhanda
• ukuqwasha noma ukozela
• kwehle i-libido nobunzima bokufinyelela ku-orgasm
• ukuyaluza (jitteriness)

I-Tricyclic antidepressants

Ama-Tricyclic antidepressants (TCAs) asungulwa ngawo-1950s, futhi ayephakathi kwama-anti-depressants okuqala asetshenziselwa ukwelapha ukudangala.

Ama-TCA asebenza ngokuvimba ukubuyiselwa kabusha kwe-noradrenaline ne-serotonin. Lokhu kungasiza umzimba ukwelula izinzuzo zokukhuthaza imizwa ye-noradrenaline ne-serotonin ekhishwa ngokwemvelo, engathuthukisa imizwa futhi yehlise nemiphumela yokudangala.

Odokotela abaningi banikeza ama-TCA ngoba kucatshangwa ukuthi aphephe njengemithi emisha.

Ama-TCA ajwayelekile kakhulu afaka:

• i-amitriptyline (u-Elavil)
• imipramine (Tofranil)
• doxepin (Sinequan)
• i-trimipramine (iSurmontil)
• i-clomipramine (Anafranil)

Imiphumela emibi ye-TCA

Imiphumela emibi evela kulesi sigaba se-anti-depressants ivame ukuba nzima. Abesilisa bavame ukuzwa imiphumela emibi embalwa kunabesifazane.

Imiphumela emibi ejwayelekile etholwa abantu abasebenzisa ama-TCA ifaka phakathi:

• ukuzuza kwesisindo
• umlomo owomile
• ukungaboni kahle
• ukozela
• ukushaya kwenhliziyo okusheshayo noma ukushaya kwenhliziyo okungajwayelekile
• ukudideka
• Izinkinga zesinye, kufaka phakathi ubunzima bokuchama
• ukuqunjelwa
• ukulahlekelwa isifiso sobulili

I-Norepinephrine ne-dopamine reuptake inhibitors

Njengamanje i-NDRI eyodwa kuphela evunyelwe i-FDA yokudangala.

• i-buproprion (Wellbutrin)

Imiphumela emibi ye-NDRI

Imiphumela emibi ejwayelekile etholwa abantu abasebenzisa ama-NDRI ifaka:

• ukuquleka, lapho kuthathwa ngemithamo ephezulu
• ukukhathazeka
• i-hyperventilation
• uvalo
• ukuyaluza (jitteriness)
• ukucasuka
• eqhaqhazela
• inkathazo yokulala
• ukungahlaliseki

I-Monoamine oxidase inhibitors

I-Monoamine oxidase inhibitors (i-MAOIs) yimithi ejwayele ukubekwa kuphela uma eminye imishanguzo nokwelashwa kwehlulekile.

Ama-MAOIs avimbela ubuchopho ekuqhekekeni amakhemikhali i-norepinephrine, i-serotonin, ne-dopamine. Lokhu kuvumela ubuchopho ukuthi bugcine amazinga aphezulu ala makhemikhali, angahle akhulise imizwa futhi athuthukise ukuxhumana kwe-neurotransmitter.

Ama-MAOI ajwayelekile afaka:

• i-phenelzine (Nardil)
• i-selegiline (i-Emsam, i-Eldepryl, ne-Deprenyl)
• i-tranylcypromine (iParnate)
• isocarboxazid (Marplan)

Imiphumela emibi ye-MAOI

Ama-MAOI athambekele ekubeni nemiphumela engemihle eminingi, eminingi yayo emibi futhi eyingozi. Ama-MAOI futhi anethuba lokuxhumana okuyingozi nokudla kanye nemithi ethengiswayo.

Imiphumela emibi evame ukubonwa ngabantu abasebenzisa ama-MAOI ifaka phakathi:

• ukulala emini
• ukuqwasha
• isiyezi
• umfutho wegazi ophansi
• umlomo owomile
• uvalo
• ukuzuza kwesisindo
• ukunciphisa isifiso sobulili noma ubunzima bokufinyelela ku-orgasm
• ukungasebenzi kahle kwe-erectile
• Izinkinga zesinye, kufaka phakathi ubunzima bokuchama

Imishanguzo yokwengeza noma yokwengeza

Ngokucindezelwa okungazweli ekwelashweni noma kweziguli eziqhubeka nokuba nezimpawu ezingaxazululeki, kungabekwa umuthi wesibili.

Le mithi yokwengeza ngokuvamile isetshenziselwa ukwelapha ezinye izifo zempilo yengqondo futhi ingafaka imishanguzo yokulwa nokukhathazeka, okusimamisa imizwa, kanye nama-antipsychotic.

Izibonelo ze-antipsychotic ezivunyiwe yi-Food and Drug Administration (FDA) ukuze zisetshenziswe njengezindlela zokwengeza zokucindezeleka zifaka:

• i-aripiprazole (Hlanza)
• i-quetiapine (iSeroquel)
• i-olanzapine (Zyprexa)

Imiphumela emibi yale mithi eyengeziwe ingafana namanye ama-anti-depressants.

Amanye ama-anti-depressants

Imithi engajwayelekile, noma leyo engangeni kwezinye izigaba zemithi, ifaka i-mirtazapine (Remeron) ne-trazodone (i-Oleptro).

Umphumela oyinhloko wale mithi ukozela. Ngoba yomibili le mithi ingadala ukuthamba, imvamisa ithathwa ebusuku ukuvimbela ukunakwa kanye nezinkinga zokugxila.