So wo duruyɛfo akyerɛw wo nnuru a wɔde sa adwenemhaw? Anaasɛ obi a wunim no de saa aduru yi di dwuma? Ɛwom sɛ nsɛm pii wɔ ɔmanfo mu fa saa aduru yi ho de, nanso nnipa baahe na wonim sɛnea ɛka amemene no ne nea efi mu ba ankasa? Nnipa pii suro saa aduru yi, nanso nea enti a wosuro saa ne nimdeɛ a wonni. Enti, momma yɛnte eyi ase yiye na yɛnte ase pefee nnɛ, te sɛ nea yɛne yɛn adamfo bi rekasa.
Dɛn ne nnuru a ekum adwenemhaw yi?
Ɛwom sɛ wɔfrɛ saa nnuru yi ‘nnuru a ekum adwenemhaw’ de, nanso ɛnyɛ adwenemhaw, adwenemhaw a ɛma obi te nka sɛ ɔyɛ basaa kɛse ne anidaso a enni hɔ nko na wɔde sa. Wodii kan de nnuru yi bae wɔ 1950 mfe no mu. Ɛnnɛ, adwenemhaw akyi no, wɔapene nnuru yi so nso ama tebea horow te sɛ OCD (Obsessive-Compulsive Disorder), Social Phobia, Panic Disorder, GAD (Generalized Anxiety Disorder), ne PTSD (Posttraumatic Stress Disorder).
Nea ɛka ho no, ɛtɔ mmere bi a nnuruyɛfo betumi akyerɛw saa aduru yi ama tebea horow te sɛ ɛyaw a enni sabea, nna a wontumi nna, ne atiridiinini. Wɔfrɛ eyi sɛ ‘off-label’ a wɔde di dwuma. Eyi kyerɛ sɛ wonnya npenee aduru no so wɔ aban kwan so mma saa tebea no, nanso oduruyɛfo no gye di sɛ ɔyarefo no benya so mfaso.
Ɔkwan bɛn so na saa aduru yi ka yɛn amemene?
Sɛ yɛbɛka no tiawa a, nnuru yi yɛ adwuma denam nnuru bi a ɛwɔ yɛn amemene mu a ɛsakra no so. Yɛfrɛ saa nnuru yi neurotransmitters . Eyinom na ɛhyɛ nneɛma pii so, te sɛ yɛn adwene, yɛn nkate, nna, ne aduan ho akɔnnɔ.
Susuw ho saa kwan yi so. Ntini mu nkwammoaa a ɛwɔ yɛn amemene mu no de saa ‘abɔfo’ a wɔfrɛ wɔn neurotransmitters yi di dwuma de ne wɔn ho wɔn ho di nkitaho. Ntini mu nkwammoaa biako gyae ɔbɔfo yi, na ɛde nkrasɛm no kɔ nkwammoaa a edi hɔ no nkyɛn. Sɛ wɔde nkrasɛm no kɔ a, wɔde ɔbɔfo no san kɔ mfitiase nkwammoaa no mu ntɛm ara (wɔfrɛ eyi reuptake ).
Nea nnuru a ekum adwenemhaw yɛ titiriw ne sɛ ɛtwentwɛn saa a wɔsan gye no ase kakra. Afei saa ɔbɔfo no (sɛ nhwɛso no, serotonin) tra ntini mu nkwammoaa abien (synapse) ntam kwan no mu kyɛ. Afei ebetumi ayɛ adwuma akyɛ na ama yɛn adwene atu mpɔn.
Nokware ne sɛ, abenfo mpo nnim sɛnea nnuru yi yɛ adwuma 100%, efisɛ onipa amemene yɛ ade a ɛyɛ den yiye. Nanso nhwehwɛmu ada no adi sɛ wobetumi aboa ma wɔadi yare no ho sɛnkyerɛnne ahorow so.
Nnuru ahorow a wɔtaa de siw reuptake ano
Nnuru a wɔtaa kyerɛw ma a wɔde kum adwenemhaw no yɛ kuw yi dea mprempren. Wɔakyekyɛ eyinom mu ayɛ no ahorow atitiriw pii.
1. SSRIs (Nnuru a Wɔpaw a Ɛmma Serotonin a Wɔsan Fa Mu) .
Eyinom ne nnuru a edi kan a nnuruyɛfo taa kyerɛw ma. Sɛnea edin no kyerɛ no, eyinom de wɔn ani si neurotransmitter serotonin so pɔtee. Serotonin ho hia ma nneɛma te sɛ yɛn adwene, yɛn nneyɛe, ne yɛn nkae.
Sɛ wufi ase nom saa aduru yi wie a, ebetumi agye adapɛn pii, ɛtɔ mmere bi a ɛkɔ asram 2-3, ansa na woahu nea efi mu ba no nyinaa. Enti ɛho hia sɛ yenya abotare. Afei nso, nnyae saa aduru yi a wobɛnom mpofirim da a wo duruyɛfo nka ho afotu. Saa a wobɛyɛ no betumi ama woanya yare no ho sɛnkyerɛnne a ɛnyɛ dɛ (antidepressant discontinuation syndrome).
Serotonin Syndrome - Biribi a ɛsɛ sɛ wohaw wo ho wɔ ho!
Ɛtɔ mmere bi a, sɛ wonom nnuru afoforo a ɛma serotonin dodow kɔ soro te sɛ SSRI a, serotonin dodow a ɛwɔ amemene no mu no betumi akɔ soro a ɛho nhia. Eyi betumi ayɛ nea asiane wom.
| Serotonin Syndrome ho sɛnkyerɛnne a ɛtaa ba | |
|---|---|
| - dadwen, ahomegye a enni mu | - a woatrɛw mu |
| - a ɛyɛ yaw, ɔfe, yafunu a ɛyɛ yaw | - muscle twitching, a ɛyɛ den |
| - a wofifiri dodo, wo ho popo | - a etumi tu ntɛmntɛm fi ɔfã biako kɔ ɔfã foforo |
| Nsɛnkyerɛnne a emu yɛ den a ɛhwehwɛ sɛ wɔde obi kɔ ayaresabea ntɛm ara: | |
| - a ɛyɛ basaa anaasɛ adwenemhaw a emu yɛ den | - a ɛyɛ atiridiinini a ɛkorɔn |
| - Koma a ewo no ye ntɛmntɛm paa | - a ewo akisikuru |
| - a ewo mogya mmoroso | - a woyera wo nhumu |
Sɛ wowɔ saa sɛnkyerɛnne ahorow a emu yɛ den yi bi a, kɔ ayaresabea a ɛbɛn wo no Emergency Treatment Unit (ETU) ntɛm ara .
2. SNRIs (Nnuru a Ɛmma Serotonin-Norepinephrine a Wɔsan Nfa) .
Eyinom yɛ nnuru a ɛkɔ akyiri kakra a ɛbae wɔ SSRI ahorow no akyi. Wɔka ntini mu nkwaadɔm a ɛma obi nya ntini mu nkwaadɔm a wɔfrɛ no serotonin ne norepinephrine nyinaa . Norepinephrine ho hia ma yɛn adwene na yɛma yɛn ani da hɔ. Ɛno nti na ɛtɔ da bi a wɔde saa nnuru yi sa ɛyaw a enni sabea (e.g., asikreyare ntini mu yare, fibromyalgia).
- Nhwɛso ahorow a wɔtaa de di dwuma: Duloxetine (Cymbalta), Venlafaxine (Effexor) .
- Nneɛma bɔne a ɛtaa ba: akisikuru, ano a ɛyɛ mmerɛw, ɔbrɛ, nna a ɛyɛ den, adwenemhaw, fifiri.
3. NDRIs (Nnerema a Ɛmma Norepinephrine ne Dopamine a Wɔsan Fa Mu) .
Saa aduru yi ma ntini mu nkwaadɔm a ɛma nipadua no yɛ adwuma norepinephrine ne dopamine dodow kɔ soro . Dopamine ho hia ma yɛn anigye, nea ɛkanyan yɛn, ne yɛn adwene.
- Nhwɛso titiriw: Bupropion (Wellbutrin). Eyi yɛ aduru a ebetumi nso aboa wo ma woagyae sigaretnom.
- Hyɛ no nsow titiriw: Ɛwɔ nna mu nsunsuanso bɔne pii sen nnuru afoforo a ekum adwenemhaw. Nanso, ɛmfata nnipa a asiane wom sɛ wobenya akisikuru.
Ahorow afoforo, dedaw nanso ɛda so ara ho hia
Ɛwom sɛ mprempren wɔmfa nnuru yi nni dwuma kɛse de, nanso ebetumi ayɛ nea mfaso wɔ so kɛse ama nnipa binom a wɔnyɛ wɔn ade wɔ nnuru foforo ho. Nanso, ɛwɔ nsunsuanso bɔne pii.
Nnuru a wɔde kum adwenemhaw a ɛwɔ tricyclic ne tetracyclic (TCAs) .
Eyinom yɛ nnuru dedaw a wɔde adi dwuma fi 1950 mfe no mu. Ɛwom sɛ etu mpɔn te sɛ nnuru foforo de, nanso ɛwɔ nsunsuanso bɔne pii. Sɛ nhwɛso no, wobetumi ama obi ada, n’ano ayow, ne mu duru ayɛ kɛse, na asakra ne koma bɔ.
- Nhwɛso ahorow a wɔtaa de di dwuma: Amitriptyline, Nortriptyline, Clomipramine.
Nnuru a esiw monoamine oxidase ano (MAOIs) .
Eyinom nso yɛ nnuru a akyɛ paa na wɔntaa mfa nni dwuma. Sɛ wode eyinom redi dwuma a , ɛsɛ sɛ wohwɛ yiye paa wɔ nea wudi ho. Efisɛ sɛ wudi nnuan a amino acid ‘Tyramine’ wom (sɛ nhwɛso no, kyiisi a ayɛ dedaw, soya sauce, nam bi, nnuaba bi) a, wo mogya mmoroso betumi akɔ soro wɔ ɔkwan a ɛyɛ hu so. Afei nso, eyinom a wɔde ka nnuru afoforo a ekum adwenemhaw ho no yɛ nea asiane wom kɛse.
Ɛho hia yiye sɛ wobɛbɔ wo duruyɛfo amanneɛ wɔ nnuru, vitamin, anaa nhabannuru biara a worenom ho, efisɛ saa nnuru yi betumi adi nkitaho.
Nutraceuticals a wobetumi anom de aboa wɔ nnuruyɛ mu
Eyinom nyɛ nnuru, na mmom aduan a wɔde ka aduan ho anaa aduannuru a wɔde ma a ebetumi aboa wɔ ayaresa tebea horow bi mu. Wɔnkamfo nkyerɛ sɛ wɔmfa nni dwuma nkutoo mma adwenemhaw. Nanso, wobetumi de adi dwuma de aka ayaresa titiriw ho, sɛnea wo duruyɛfo tu fo no.
- SAMe (S-adenosyl-methionine): Nnuru a nipadua no yɛ a ɛboa ma wɔyɛ ntini mu nkwaadɔm.
- Omega-3 Fatty Acids: Eyinom a ɛwɔ mpataa ngo mu titiriw no betumi aboa ma amemene no mu ɔfe bi so atew.
- Vitamin D: Nhwehwɛmu kyerɛ sɛ abusuabɔ bi da vitamin yi a wonya fi owia hann mu a wonnya ne adwenemhaw ntam.
Nanso kae sɛ, ɛnyɛ papa sɛ wobɛfa eyinom sɛnea w’ankasa wopɛ. Wo ne wo duruyɛfo nkasa na fa di dwuma bere a ɔpene so nkutoo. Efisɛ ɛtɔ mmere bi a eyinom betumi ne nnuru afoforo a worenom no adi nkitaho.
Nkrasɛm a Wɔde Kɔ Fie
- Nnuru a ekum adwenemhaw yɛ nnuru bi a ɛsakra amemene mu nnuru (neurotransmitters) dwumadi.
- Ebetumi agye adapɛn anaa asram pii ansa na nnuru yi atumi ayɛ adwuma koraa, enti ɛho hia sɛ wunya abotare .
- Mfi ase da, sesa dodow a wode ma no, anaasɛ nnyae nnuru biara a wobɛnom mpofirim a wunnya wo duruyɛfo afotu. Saa a wobɛyɛ no betumi ayɛ nea asiane wom.
- Ka nnuru foforo biara, vitamin, anaa nhabannuru a wonom ho asɛm kyerɛ wo duruyɛfo.
- Sɛ sɛnkyerɛnne ahorow a emu yɛ den te sɛ adwenem naayɛ a emu yɛ den, atiridiinini kɛse, ne akisikuru ba a, kɔ ayaresabea Dwumadibea a Ɛhwɛ Ntɛmntɛm (ETU) ntɛm ara, efisɛ ebetumi ayɛ serotonin syndrome.
- Sɛ wowɔ aduru yi ho dadwen anaa ehu bi a, wo ne wo duruyɛfo nka ho asɛm pefee.
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