Imibuzo engu-6 Ongayibuza Udokotela Wakho Uma Izimpawu Zakho Ze-MDD Zingathuthukisi

-Delile

• 1. Ngabe ngiphuza umuthi wami ngendlela efanele?
• 2. Ngingumuthi ofanele?
• 3. Ngabe ngithatha umthamo ofanele?
• 4. Yiziphi ezinye izindlela zami zokwelashwa?
• 5. Ngabe ezinye izindaba zingadala izimpawu zami?
• 6. Ingabe uqinisekile ukuthi ngicindezelekile?

Ama-anti-depressants asebenza kahle ekulawuleni izimpawu ezinenkinga enkulu yokudangala (MDD). Kodwa-ke ingxenye eyodwa kwezintathu kuphela yabantu ezothola ukukhululeka okwanele ezimpawu zabo ngomuthi wokuqala abazama ngawo. Mayelana nabantu abane-MDD ngeke bathole ukukhululeka okuphelele ku-antidepressant, noma ngabe bathatha muphi ekuqaleni. Abanye bazobangcono okwesikhashana, kepha ekugcineni, izimpawu zabo zingabuya.

Uma uhlangabezana nezinto ezinjengokudabuka, ukulala kabi, nokuzethemba okuphansi nemithi akusizi, sekuyisikhathi sokukhuluma nodokotela wakho ngezinye izinketho. Nayi imibuzo eyisithupha yokukuholela engxoxweni futhi ikufake endleleni efanele yokwelashwa.

1. Ngabe ngiphuza umuthi wami ngendlela efanele?

Kuze kube uhhafu wabantu abaphila nokudangala abayithathi imishanguzo yabo yokulwa nokudangala ngendlela udokotela wabo abayalele ngayo - noma nhlobo. Ukweqa amanani kungathinta ukuthi isebenza kanjani imithi.

Uma ungakakwenzi lokho vele, dlula imiyalo yokufaka nomthamo nodokotela wakho ukuze uqiniseke ukuthi udla umuthi ngendlela efanele. Ungalokothi uyeke ukuthatha imithi yakho ngokungazelelwe noma ngaphandle kokubonisana nodokotela wakho. Uma imiphumela emibi ikukhathaza, buza udokotela wakho ukuthi ungashintshela kumthamo ophansi, noma komunye umuthi onemiphumela emibi embalwa.

2. Ngingumuthi ofanele?

Izinhlobo eziningi zemithi elwa nokudangala zivunyelwe ukwelapha i-MDD. Kungenzeka ukuthi udokotela wakho ukuqale nge-serotonin reuptake inhibitor ekhethiwe (SSRI) efana ne-fluoxetine (Prozac) noma i-paroxetine (Paxil).

Ezinye izinketho zifaka:

• i-serotonin-norepinephrine
  ama-reuptake inhibitors (ama-SNRIs) afana ne-duloxetine (Cymbalta) ne-venlafaxine (i-Effexor
  I-XR)
• izidakamizwa zokulwa nokucindezela
  njenge-bupropion (Wellbutrin) ne-mirtazapine (Remeron)
• umabhebhana
  imishanguzo efana ne-nortriptyline (Pamelor) ne-desipramine (Norpramin)

Ukuthola umuthi okusebenzelayo kungathatha ukulinga nephutha elithile. Uma umuthi wokuqala owuzamayo ungakusizi ngemuva kwamasonto ambalwa, udokotela wakho angakushintshela kwenye i-anti-depressant. Yiba nesineke, ngoba kungathatha amasonto amathathu noma amane ukuthi umuthi wakho uqale ukusebenza. Kwezinye izimo, kungathatha amasonto ayi-8 ngaphambi kokubona izinguquko kumzwelo wakho.

Enye indlela udokotela wakho angakufanisa ngayo nomuthi ofanele ukuhlolwa kwe-cytochrome P450 (CYP450). Lokhu kuhlolwa kubheka ukuhlukahluka okuthile kofuzo okuthinta ukuthi umzimba wakho uzicubungula kanjani izidakamizwa zokulwa nokucindezeleka. Lokhu kungasiza udokotela wakho ukuthi anqume ukuthi imiphi imishanguzo engacutshungulwa kangcono ngumzimba wakho, okuholele ekutheni kube nemiphumela engemihle embalwa nokusebenza okuthuthukile.

3. Ngabe ngithatha umthamo ofanele?

Udokotela wakho angakuqala ngomthamo ophansi we-antidepressant ukubona ukuthi kuyasebenza yini. Uma kungenjalo, bazokwengeza kancane umthamo. Umgomo ukukunika imithi eyanele yokuqeda izimpawu zakho, ngaphandle kokubanga imiphumela emibi.

4. Yiziphi ezinye izindlela zami zokwelashwa?

Imithi elwa nokudangala akuyona ukuphela kwendlela yokwelashwa ye-MDD. Ungazama futhi ukwelashwa kwengqondo okufana nokwelashwa kokuziphatha kwengqondo (CBT). Nge-CBT, usebenza nomeluleki okusiza ekuboneni izindlela zokucabanga eziyingozi futhi uthole izindlela eziphumelela kakhulu zokubhekana nezinselelo empilweni yakho. uthola ukuthi inhlanganisela yemithi kanye ne-CBT isebenza kangcono kwizimpawu zokucindezeleka kunendlela yokwelashwa kuphela.

I-Vagus nerve stimulation (VNS) kungenye indlela odokotela abasebenzisa ngayo ukucindezeleka lapho ama-anti-depressants engasebenzi. Ku-VNS, ucingo luxhunywe eceleni kwe-vagus nerve egijima isuka ngemuva kwentamo yakho iye ebuchosheni bakho. Inamathele entweni efana ne-pacemaker edlulisa imizwa kagesi ebuchosheni bakho ukukhulula izimpawu zokucindezeleka.

Ngokucindezeleka okukhulu, i-electroconvulsive therapy (ECT) nayo iyindlela. Lokhu akuyona "ukwelashwa kokushaqeka" okufanayo okwake kwanikezwa iziguli ezindaweni zokukhosela ngengqondo. I-ECT iyindlela yokwelashwa ephephile nephumelelayo yokudangala esebenzisa imisinga kagesi emnene ukuzama ukushintsha amakhemikhali obuchopho.

5. Ngabe ezinye izindaba zingadala izimpawu zami?

Kunezici eziningi ezingadabukisa izimpawu zokucindezeleka. Kungenzeka ukuthi enye into eyenzekayo empilweni yakho ikwenza ube lusizi, futhi imithi iyodwa ayenele ukuxazulula inkinga.

Cabanga ngalezi ezinye izinto ezingadala isimo esidabukisayo:

• isiphithiphithi sempilo yakamuva,
  njengokulahlekelwa othandekayo, ukuthatha umhlalaphansi, ukuthatha isinyathelo esikhulu, noma isehlukaniso
• isizungu sokuphila
  yedwa noma ukungabi nokuxhumana okwanele nomphakathi
• ushukela ophezulu, osetshenzisiwe
  ukudla
• ukuzivocavoca umzimba okuncane kakhulu
• ukucindezeleka okukhulu okuvela ku-
  umsebenzi onzima noma ubudlelwane obungenampilo
• ukusetshenziswa kwezidakamizwa noma kotshwala

6. Ingabe uqinisekile ukuthi ngicindezelekile?

Uma uzame ama-anti-depressants amaningana futhi engasebenzi, kungenzeka ukuthi esinye isimo sezokwelapha noma isidakamizwa osisebenzisayo yisizathu sokuthi uhlangabezana nezimpawu ze-MDD.

Izimo ezingadala izimpawu ezifana nokudana zihlanganisa:

• okweqile noma
  i-thyroid engasebenzi (i-hypothyroidism noma i-hyperthyroidism)
• ukuhluleka kwenhliziyo
• lupus
• Isifo seLyme
• isifo sikashukela
• ukuwohloka komqondo
• i-multiple sclerosis (MS)
• unhlangothi
• Isifo sikaParkinson
• ubuhlungu obungapheli
• i-anemia
• ukuvimbela ukuphefumula kokulala
  (OSA)
• ukusetshenziswa kabi kwezidakamizwa
• ukukhathazeka

Izidakamizwa ezingadala izimpawu ezicindezelayo zifaka:

• kudambisa izinhlungu ze-opioid
• imishanguzo yomfutho wegazi ophakeme
• ama-corticosteroids
• amaphilisi okuvimbela inzalo
• izidambisi

Uma umuthi ubangela izimpawu zakho, ukushintshela kwesinye isidakamizwa kungasiza.

Kungenzeka futhi ukuthi unesinye isimo sempilo yengqondo, njengesifo se-bipolar. Uma kunjalo, kuzodingeka uxoxe nodokotela wakho ngezinye izindlela zokwelashwa. Ukuphazamiseka kwe-bipolar nezinye izimo zempilo yengqondo kudinga ukwelashwa okuhlukile kwi-MDD.