Ðe nèkpɔnɛ be yele yeƒe ŋutilã ʋuʋum le yeƒe lɔlɔ̃nu mea? Mina míaƒo nu tso Tardive Dyskinesia ŋu!

Ðe nèsena le ɖokuiwò me ɣeaɖewoɣi be yeƒe ŋutilã ƒe akpa aɖewo, abe alɔ alo afɔ ene, alo mo ƒe dzedzeme, le ʋuʋum le mɔ si dzi womate ŋu aɖu o nu ko? Alo ɖe ame aɖe si nènya la va kpɔ dzesi wɔnuku siawo le atike aɖewo nono vɔ megbea? Ne èse nu ma tɔgbe kpɔ la, ekema nɔnɔme si ŋu míaƒo nu tsoe egbea, si woyɔna be Tardive Dyskinesia, anye nu vevi aɖe na wò. Togbɔ be enye nya didi vie hã la, mina míase nusi wònye gɔme ko.

Nukae nye Tardive Dyskinesia?

Kpuie ko la, Tardive Dyskinesia (TD) nye ahɔhɔ̃mekawo ƒe dɔléle, alo dzesiwo ƒe ƒuƒoƒo, si me wò ŋutilã ƒe lãmekawo ʋãna le lɔlɔ̃nu faa me, eye màte ŋu aɖu wo dzi o. Abe asi ƒe ʋuʋu alo mo ƒe dzedzeme si trɔna kpata ene.

Nusi koŋ gbɔ nɔnɔme sia tsoe nye atike aɖewo zazã ɣeyiɣi didi na tagbɔdɔléle, vevietɔ dzidzime gbãtɔ ƒe atike siwo wua tagbɔdɔléle (neuroleptics). Ke hã, menye atike siawo koe ate ŋu ahe esia vɛ o. Atike bubu aɖewo hã ate ŋu ahe esia vɛ.

Nya "Tardive" gɔmee nye "heheɖemegbe" alo "tsi megbe." "Dyskinesia" fia le lɔlɔ̃nu faa me, si fia be lãmekawo ƒe ʋuʋu si dzi womeɖu o. Eyata le nɔnɔme sia me la, ʋuʋu siawo siwo melɔ̃na o la dona ne èdze atike aɖe nono gɔme hena ɣeyiɣi aɖe, ɣeaɖewoɣi ƒe geɖe. Gake ɣeaɖewoɣi la, nɔnɔme sia ate ŋu ado mo ɖa le atikeawo nono ɣeyiɣi kpui aɖe megbe gɔ̃ hã. Nɔnɔme sia ate ŋu adzɔ ɖe amesiwo xɔ wu ƒe 65 koŋ dzi, ne wozã atike la ɣeyiɣi kpui aɖe gɔ̃ hã.

Aleke gbegbee nɔnɔme sia bɔe?

Numekulawo gblɔ be ne mede ɖeke o la, amesiwo noa dzidzime gbãtɔ ƒe tagbɔdɔlékuiwutikewo dometɔ 20% ya teti xɔa tardive dyskinesia. Womesrɔ̃ nu tso alesi tututu nɔnɔme sia dzɔna le atike ƒomevi bubuwo ŋu o, eyata esesẽ be woagblɔ xexlẽme si sɔ.

Nukae nye Tardive Dyskinesia ƒe dzesiwo?

Tardive dyskinesia ate ŋu ana ʋuʋu le teƒe siawo tɔgbe si dzi màte ŋu aɖu o:

• Lãmetsi siwo le wò mo
• Aɖe
• Kɔ
• Lãmetsi siwo le akɔta
• Abɔ kple afɔwo

Mo ƒe ʋuʋu le lɔlɔ̃nu faa me:

• Nuyi ƒoƒo alo nu mimi ƒe ʋuʋu.
• Modzakaɖeɖe alo mo ʋuʋu le susu aɖeke manɔmee.
• Aɖe dodo alo aɖe tete ɖe ŋgonu.
• Ʋuɖuɖu ƒe ʋuʋu.
• Ŋgonu siwo le ʋuʋum.
• Ŋku ƒe ʋuʋu kabakaba / blepharospasm. Bu alesi wòado dziku na wòe ne èyi edzi le ŋku ʋuʋum ko ŋu kpɔ.

Ʋuʋu bubu siwo womewɔna le lɔlɔ̃nu faa me o:

• Asibidɛwo ƒe ʋuʋu enuenu, abe piano ƒoƒo ene.
• Wò akɔta tutu alo eʋuʋu.
• Azɔlizɔzɔ kple azɔlizɔzɔ si le abe dadi ene.
• Ŋutete manɔanyi be woanɔ anyi kpoo, seselelãme si nɔa ame me ɣesiaɣi be yemeɖea dzi ɖi o (akathisia). Esia ate ŋu anye nuteƒekpɔkpɔ si me dziɖeleameƒo le ŋutɔ.

Dzesi siawo ate ŋu anɔ bɔbɔe ŋutɔ eye womate ŋu ade dzesii kura na ame aɖewo o, gake le ame bubuwo gome la, woate ŋu asẽ ale gbegbe be woate ŋu akpɔ ŋusẽ ɖe gbesiagbedɔwo dzi ale gbegbe be womate ŋu awɔe o .

Ðɔktawo ate ŋu azã nya siawo tɔgbe atsɔ aɖɔ dzesi siawo:

• Dystonia: Lãmetsiwo ƒe tete si dzi womeɖu o.
• Myoclonus: Lãmetsi aɖe ƒe ʋuʋu kpata, ɣeyiɣi kpui aɖe.
• Buccolingual stereotypy: Ʋuʋu si wogbugbɔ gblɔna si me nu kple aɖe le.
• Tics: Lãmetsiwo ƒe tete nye numame, vevietɔ le mo.

Nukawoe hea Tardive Dyskinesia vɛ?

Numekulawo menya nusi tututu hea esia vɛ o. Ke hã, susu vevitɔ enye be ate ŋu atso atike siwo woyɔna be ``dopamine antagonists`` siwo xea mɔ na ahɔhɔ̃mekawo ƒe dɔlékuiwutike ``dopamine`` ƒe xɔlawo le ahɔhɔ̃a me zazã gbɔ. Esia ate ŋu adzɔ ne èno atike siawo hena ɣeyiɣi kpui aɖe alo ɣeyiɣi didi aɖe. Gake afɔkua lolona wu ne èno wo ɣeyiɣi didi. Ɣeaɖewoɣi la, TD ate ŋu adzɔ ne wodzudzɔ atike siawo, tɔtrɔ le atikeawo ƒe agbɔsɔsɔme ŋu, alo ɖe edzi gɔ̃ hã.

Bu eŋu kpɔ be ne èno atike siwo xea mɔ na dopamine xɔlawo ɣeyiɣi didi la, dopamine xɔla siwo le ahɔhɔ̃a me (vevietɔ esiwo le ahɔhɔ̃a ƒe akpa aɖe si kpena ɖe ame ŋu be wòaɖu ʋuʋu dzi) va sea nu gɔme wu. Wosusu be dopamine ƒe agbɔsɔsɔ fũ alo lãmenugbagbevi siwo xɔa dɔlékuiwo ƒe seselelãme fũ akpa gbɔe ʋuʋu sia si dzi womeɖu o la tso.

Tsɔ kpe ɖe dopamine ŋu la, wosusu be ahɔhɔ̃meka bubuwo abe serotonin, acetylcholine, kple GABA ene hã kpɔa gome le eme. Esia ate ŋu anye nusitae TD tsoa atike bubu siwo menye tagbɔdɔlékuiwutikewo o gbɔ ɣeaɖewoɣi.

Atike kawoe hea Tardive Dyskinesia vɛ?

Atike siwo gbɔna zazã ate ŋu ahe tardive dyskinesia vɛ:

• Tagbɔdɔlékuiwutikewo / ahɔhɔ̃mekawo ƒe dɔmawɔmawɔ nyuie: Esiawoe nye nu vevitɔ si gbɔ wòtsona.
• Metoclopramide alo atike bubu siwo tsia ʋuʋudedi nu.
• Blanuilélenutsitike aɖewo .

Ƒã ŋutɔ la, atike siawo hã ate ŋu ahe TD vɛ:

• Lithium si woyɔna be lithium.
• Atike siwo wozãna tsɔ tsia alɔ̃madɔmadɔ nu.
• Atike siwo wua histamine, vevietɔ hydroxyzine.
• Asrãtikewo nye atike siwo wonana na asrãdɔ.

Tagbɔdɔlékuiwutikewo kple TD

Tagbɔdɔlélewo abe tagbɔdɔléle ene koŋue wozãna tsɔ daa tagbɔdɔlélawo (neuroleptics). Atike siawoe nye nusiwo hea TD vɛ wu.

Wosusu be dzidzime gbãtɔ ("si bɔ") ƒe tagbɔdɔlékuiwutikewo ate ŋu ahe TD vɛ wu dzidzime evelia ("atypical") ƒe tagbɔdɔlékuiwutikewo.

Dzidzime gbãtɔ ƒe tagbɔdɔlékuiwutikewo ƒe kpɔɖeŋu aɖewo:

• Chlorpromazine `(Klolopromazine)`
• Fluphenazine `(Fluphenazine)`
• Haloperidol `(Haloperidol)`
• Perphenazine `(Perphenazine)`
• Prochlorperazine `(Proklorperazine)`
• Thioridazine `(Thioridazine)`
• Trifluoperazine `(Trifluoperazine)`

Metoclopramide kple tardive dyskinesia

Metoclopramide nye atike si wozãna tsɔ daa chronic acid reflux (GERD), si nye dɔgbo ƒe dɔléle sesẽ aɖe. Wozãnɛ hã tsɔ daa dɔgbo ƒe dɔléle si do ƒome kple suklidɔ.

Kadodo sẽŋu aɖe le metoclopramide kple TD dome. Nusiwo ate ŋu ana woaxɔ TD le atike sia ta dometɔ aɖewoe nye:

• Ƒe 65 alo esi wu nenema xɔxɔ.
• Nyɔnu nyenye.
• Suklidɔ ƒe amesinɔnɔ.
• Metoclopramide nono kwasiɖa 12 alo esi wu nenema.

Blanuilélenutsitikewo kple TD

Wozãa blanuilélenutsitikewo tsɔ daa nɔnɔmewo abe blanuiléle, dzimaɖitsitsi, kple nuteɖeamedzi ƒe dɔléle ene. Atike siawo ate ŋu ahe TD vɛ na amesiwo xɔ wu ƒe 65. Esia le alea elabena ahɔhɔ̃a trɔna ne ame tsi. Zi geɖe la, esia mebɔ kura o wu TD si atike siwo wua tagbɔdɔléle hena vɛ.

Blanuilélenutsitike siwo gbɔna la do ƒome kple `(TD)`:

• Trazodone (esia nye serotonin ƒe tɔtrɔ).
• Amitriptyline, clomipramine, kple doxepin (esiawo nye blanuilélenutsitike siwo wozãna zi etɔ̃).
• Fluoxetine kple sertraline (esiawo nye SSRI-tikewo).
• Phenelzine kple rasagiline (esiawo nye MAOI).
• Wogblɔ be selegiline (si hã nye MAOI) do ƒome kple TD ne wozãe kple levodopa.

Lithium kple TD

Lithium nye atike si wozãna tsɔ daa tagbɔdɔléle. Edo ƒome kple TD hã. Gake ne èno lithium kpe ɖe tagbɔdɔlékuiwutike ŋu la, afɔku si le eme be nàxɔ TD la lolo wu sã.

Atike siwo wozãna tsɔ tsia alɔ̃madɔmadɔ nu kple TD

Wozãa atike siwo wua alɔ̃madɔmadɔ tsɔ xea mɔ na alɔ̃madɔmadɔ heɖua wo dzi. Carbamazepine kple lamotrigine do ƒome kple TD, gake womehea TD vɛ boo o. Wogblɔ be phenytoin hã do ƒome kple TD.

Atike siwo wua histamine kple TD

Antihistamines kpena ɖe ame ŋu le nulɔdɔ ƒe dzesiwo me. Wogblɔ be hydroxyzine, vevietɔ, do ƒome kple TD ne wozãe ɣeyiɣi didi.

Ame siwo xɔ wu ƒe 65 siwo zã phenothiazines (atike siwo wozãna tsɔ tsia tagbɔdɔléle nu) tsã la ate ŋu axɔ TD ne wole hydroxyzine nom.

Asrãtikewo kple TD

Asrãtikewo abe chloroquine kple amodiaquine ene do ƒome kple TD.

Nukawoe nye afɔku siwo le Tardive Dyskinesia xɔxɔ me?

Nu aɖewo ate ŋu ana afɔku si le asiwò be nàxɔ tardive dyskinesia nadzi ɖe edzi. Wo dometɔ aɖewoe nye:

• Ƒe: Amesiwo xɔ wu ƒe 40 ate ŋu axɔ TD. Ame siwo xɔ wu ƒe 65 koŋue le afɔku me le tɔtrɔ siwo vaa lãmekawo ƒe dɔwɔwɔ me siwo dzɔna ne wole tsitsim ta.
• Ŋutsu alo nyɔnu nyenye: Nyɔnuwo ate ŋu axɔ TD wu. Nyɔnu siwo tsi dzinukpɔkpɔ megbe siwo noa tagbɔdɔlékuiwutikewo abe ƒe ɖeka ene la ate ŋu axɔ TD ƒe afɔku 30%.
• Ameƒomevinyenye: Numekuku aɖewo ɖee fia be Amerikatɔ ameyibɔwo ate ŋu axɔ TD wu yevuwo. Azɔ hã, amesiwo tso Filipino kple Asiatɔwo mexɔa TD o wu amesiwo tso Caucasus. (Ehiã be woagawɔ numekuku bubuwo le nutoa me be woakpɔ alesi esia ku ɖe Sri Lanka ŋui.)
• Tagbɔdɔléle: Ame siwo ŋu tagbɔdɔléle le ate ŋu ase veve ɖe TD nu wu ame bubuwo ne wole atike siwo tsia tagbɔdɔléle nu zãm.

Numekulawo le nu srɔ̃m tso domenyiŋusẽfianu siwo dzia TD xɔxɔ ƒe afɔkua ɖe edzi alo ɖea edzi hã ŋu fifia.

Nukawoe nye kuxi siwo ate ŋu ado tso Tardive Dyskinesia me?

Ʋuʋu si dzi womeɖu o si tardive dyskinesia hena vɛ ate ŋu ana ame ƒe dzi nadze eme ŋutɔ. Ate ŋu akpɔ ŋusẽ ɖe wò hadome kple seselelãme ƒe nyonyo hã dzi. Esia ate ŋu akpɔ ŋusẽ gã aɖe ɖe wò susu ƒe lãmesẽ dzi. Ate ŋu ana gbesiagbedɔwo wɔwɔ hã nasesẽ.

Zi geɖe la, TD menye dɔléle si wua ame o. Gake la,Ƒã ŋutɔ la, ne TD va nu sẽ eye wògblẽ nu le lãkusi (afisi gbeɖiɖikawo le - lãkusi ƒe ʋuʋu) kple lãkusi (lãmeka si kpena ɖe ŋuwò nègbɔa ya) ŋu la, ate ŋu ana gbɔgbɔ nasesẽ eye wòade wò agbe afɔku me.

Aleke wokpɔa Tardive Dyskinesia ƒe dɔlélea?

Wò ɖɔkta abia nya tso wò dzesiwo, atikewɔwɔ ŋutinya, kple atikewo zazã ŋu. Wò ɖɔkta ate ŋu asusui be tardive dyskinesia (TD) ne èle atike si wonya be ehea tardive dyskinesia vɛ la zãm. Woawɔ ŋutilãmedɔ kple ahɔhɔ̃mekawo dodokpɔ. Woate ŋu aɖo wò ɖe eŋutinunyala bibi aɖe hã, abe ahɔhɔ̃ŋutinunyala, ʋuʋu ƒe kuxiwo ŋuti nunyala, alo tagbɔdɔdala ene.

Ðɔktawo zãa Diagnostic and Statistical Manual of Mental Disorders (DSM-5) tsɔ dea dzesi tardive dyskinesia. DSM-5 gblɔ be hafi woakpɔe be tardive dyskinesia le dɔlélea ŋu la, ele be dzesiawo nanɔ anyi ɣleti ɖeka ya teti le atikeawo zazã vɔ megbe. Ne èxɔ ƒe 40 alo esi mede nenema o la, ele be nànɔ atike zãm ɣleti etɔ̃ ya teti, alo ne èxɔ ƒe 40 kple edzivɔ la, ele be nànɔ atike zãm ɣleti ɖeka.

Wò ɖɔkta ate ŋu aɖe gbe be woawɔ dodokpɔ bubuwo atsɔ aɖo kpe TD dzi alo atsɔ aɖe dɔléle bubu siwo ƒe dzesiwo sɔ kple wo nɔewo, abe Huntington ƒe dɔléle ene, ɖa. Esiawo ate ŋu anye dodokpɔ siwo wowɔna le nudokpɔƒe kple nɔnɔmetatawo dodokpɔ, abe ahɔhɔ̃a ƒe CT-dɔdamɔnu alo MRI ene. Gake zi geɖe la, TD nyea dɔléle si wokpɔna le kɔdzi. Esia fia be ɖɔktawo nɔa te ɖe atikewɔwɔ ŋutinya deto kple ŋutilãmedɔdada tsitotsito dzi kpɔa dɔlélea, eye womewɔa dodokpɔ bubu aɖeke kpee o.

Nukae nye Tardive Dyskinesia ƒe atikewo?

Numekuku siwo wowɔ tso tardive dyskinesia dzi kpɔkpɔ ŋu ɖee fia be nu vovovowo do tso eme. Numekuku aɖewo ɖee fia be dzesiawo nyona ɖe edzi ne woɖe tagbɔdɔlékuiwutikewo ƒe agbɔsɔsɔ dzi kpɔtɔ alo wodzudzɔ. Bubuwo ɖenɛ fiana be vovototo aɖeke mele wo dome o.

Wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàdzudzɔ atike si le wò TD hem vɛ, ne anya wɔ. Nublanuitɔe la, esia manya wɔ ɣesiaɣi o. Esia le alea elabena ne wodzudzɔ atikeawo zazã ate ŋu agblẽ nu le nɔnɔme si gbɔ atikea nɔ dzi ɖum la ŋu.

Ne èxɔ TD esime nèle dzidzime gbãtɔ ƒe tagbɔdɔlékuiwutike nom la, wò ɖɔkta ate ŋu atrɔ wò ɖe dzidzime evelia ƒe tagbɔdɔlékuiwutike zãm.

Le tagbɔdɔlékuiwutikewo dzudzɔ alo wo tɔtrɔ ɖeɖeɖa megbe la, kpeɖodzi sẽŋutɔ kekeake le TD dada ŋu fifia na atikewo ƒe hatsotso aɖe si woyɔna be VMAT inhibitors. Fifia wokpɔe be deutetrabenazine kple valbenazine le dedie eye wowɔa dɔ nyuie. Ne TD si sɔ gbɔ va ɖo esi nu sẽ si le ŋusẽ kpɔm ɖe wò agbenɔnɔ dzi le ŋuwò la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàzã atike siawo.

Ðe woate ŋu ada Tardive Dyskinesiaa? (Ðe woate ŋu atrɔea?)

Nublanuitɔe la, tardive dyskinesia ƒe akpa gãtɔ nɔa anyi didi, si fia be enɔa anyi didi. Togbɔ be atikewo ate ŋu akpe ɖe ame ŋu wòaɖu dzesiawo dzi hã la, womate ŋu ada dɔlélea keŋkeŋ alo atrɔe o.

Nukae wòle be makpɔ mɔ na ne Tardive Dyskinesia le ŋunye?

Tardive dyskinesia mekpɔa ŋusẽ ɖe amesiame dzi le mɔ ɖeka nu o. Dzesiawo ate ŋu atso esiwo nu mesẽ o dzi va ɖo esiwo nu sẽ dzi. Azɔ hã, togbɔ be atikewɔwɔ kpena ɖe ame aɖewo ŋu woɖua woƒe dzesiwo dzi hã la, ɖewohĩ mawɔe na ame bubuwo o. Wò ɖɔkta awɔ dɔ kpli wò be nàdi atikewɔwɔmɔnu nyuitɔ kekeake. Woate ŋu ana nàkpɔ nusi nàkpɔ mɔ na la nyuie.

Ðe woate ŋu axe mɔ ɖe Tardive Dyskinesia nua?

Tardive dyskinesia nye nɔnɔme si me nyagblɔɖi sesẽ. Menye amesiame si noa atike aɖewoe axɔe o.

Ne afɔku aɖewo le ŋuwò siwo ana nàxɔ nɔnɔme sia bɔbɔe la, ke ƒo nu kple wò ɖɔkta. Àte ŋu axe mɔ ɖe tardive dyskinesia nu to atike bubu zazã me. Be nàɖe TD xɔxɔ ƒe afɔkua dzi akpɔtɔ la, wò ɖɔkta aŋlɔ tagbɔdɔlékuiwutike si wɔa dɔ nyuie wu la na wò hena ɣeyiɣi kpuitɔ kekeake.

Ne èle atike aɖe si wonya be ehea TD vɛ zãm la, ƒo nu kple wò ɖɔkta tso dodokpɔ wɔwɔ edziedzi hena ʋuʋu ƒe kuxiwo ŋu. TD ƒe dzesiwo kpɔkpɔ kaba ate ŋu akpe ɖe wo ŋu woaɖe woƒe sesẽ dzi akpɔtɔ. Anyo wu be woawɔ dodokpɔ siawo le ɣleti etɔ̃ va ɖo ade me tso esime wodze atike si ate ŋu ahe TD vɛ gɔme.

Aleke mawɔ akpɔ ɖokuinye dzi ne Tardive Dyskinesia le ŋunye?

Wò ɖɔkta awɔ dɔ kpli wò atrɔ asi le wò atikewɔwɔ ƒe ɖoɖoa ŋu alesi wòhiãe. Afɔɖeɖe bubu aɖewo siwo nàte ŋu awɔ atsɔ akpɔ TD gbɔe nye esi:

• Na wò ɖɔkta nawɔ dzesiwo ƒe dodokpɔ edziedzi le ɣleti etɔ̃ va ɖo ade ɖesiaɖe me.
• Wɔ wò dzesiwo ŋuti nuŋlɔɖi. Ne dzesi yeyewo dze le ŋuwò la, na wò ɖɔkta nanya.
• Te beléle na ɖokuiwò, si me kamedede hã le. Kamedede ate ŋu akpe ɖe ame ŋu wòaɖe ʋuʋu ƒe dzesi aɖewo dzi akpɔtɔ.
• Ðo dze kple wò ɖɔkta tso wò gbesiagbedɔwo kple agbenɔnɔ ƒe nyonyome ŋu.
• Ne TD le ŋusẽ kpɔm ɖe wò susu kple hadome lãmesẽ dzi la, di kpekpeɖeŋu tso susumedɔléle ŋuti aɖaŋuɖola gbɔ .

Ɣekaɣie wòle be mayi xɔ si me wowɔa dɔ kpata le?

Ne gbɔgbɔ sesẽ na wò le tardive dyskinesia ta la, ƒo ka na 911 (ƒe 1990 le Sri Lanka) enumake alo yi xɔ si te ɖe ŋuwò si kpɔa nudzɔdzɔ kpatawo gbɔ.

Mlɔeba la, nusiwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Tardive dyskinesia (TD) gblẽa nu le amewo ŋu le mɔ vovovowo nu. Le ame aɖewo gome la, ate ŋu akpɔ ŋusẽ ɖe woƒe agbenɔnɔ ƒe nyonyome dzi vevie. Gake ɖo ŋku edzi be wò ɖɔkta awɔ dɔ kpli wò atsɔ alé ŋku ɖe wò TD ŋu ahakpɔ edzi. Woate ŋu akafu atikewɔwɔ ƒe ɖoɖo aɖe ahatrɔ asi le eŋu wòasɔ ɖe wò nuhiahiãwo nu, eye woaɖo aɖaŋu le ɖokuiwò dzi kpɔkpɔ ƒe mɔnu siwo ate ŋu akpe ɖe ŋuwò ŋu. Mègadzudzɔ wò atikewo nono alo atrɔ atikeawo ƒe agbɔsɔsɔme gbeɖe wò ɖɔkta ƒe aɖaŋuɖoɖo manɔmee o. Ƒo nu kple wò ɖɔkta tso nyabiase alo nu siwo ŋu nètsi dzi ɖo ŋu.

` Tardive dyskinesia, ʋuʋu le lɔlɔ̃nu faa me, atikewo ƒe nugbegblẽ le ame ŋu, tagbɔdɔlékuiwutikewo, ahɔhɔ̃mekawo ƒe dɔléle, dopamine, VMAT mɔxenuwo