Ua ʻike anei ʻoe i kahi lāʻau lapaʻau ʻē aʻe (SNRI) no nā keiki me ADHD?

Ke haʻi aku kāu kauka iā ʻoe ua loaʻa i kāu keiki ka ADHD ( Attention Deficit Hyperactivity Disorder), ʻo ʻoe, ma ke ʻano he makua, ua piha paha i nā nīnau a me nā hopohopo. Loaʻa paha iā ʻoe nā manaʻo like ʻole e pili ana i nā lāʻau lapaʻau e hāʻawi ʻia i kāu keiki a me ko lākou mau hopena ʻaoʻao. ʻO ka maʻamau, ʻo nā lāʻau hoʻoulu ka koho mua no ka ADHD. Akā, ʻaʻole hana kēia mau lāʻau no kēlā me kēia keiki. Makaʻu kekahi mau mākua e hāʻawi i kā lākou keiki i kēia mau lāʻau. No laila, inā ʻoe e noʻonoʻo ana i kahi koho ʻaʻole hoʻoulu, hiki i kāu kauka ke kuhikuhi i kahi ʻano lāʻau i kapa ʻia ʻo SNRI. I kēia lā, e kamaʻilio kākou e pili ana i ke ʻano o kēia mau SNRI a pehea lākou e hana ai.

He aha nā SNRI?

I ka ʻōlelo maʻalahi, ʻo SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) kahi ʻano lāʻau lapaʻau i hoʻohana ʻia e mālama i ke kaumaha. Hana lākou ma ka hoʻonui ʻana i nā pae o ʻelua mau ʻelele kemika i loko o ko mākou lolo. Kāhea mākou i kēia mau ʻelele he neurotransmitters. ʻO kēia mau kemika ʻelua he serotonin a me norepinephrine.

ʻAʻole i ʻae kūhelu ʻia kēia lāʻau lapaʻau e ka FDA (Food and Drug Administration) e mālama i ka ADHD. Eia nō naʻe, inā manaʻo nā kauka he kūpono loa ia a he kōkua no ka mea maʻi, hiki iā lākou ke kuhikuhi i kēia lāʻau lapaʻau 'off-label', ʻo ia hoʻi no kahi maʻi ʻē aʻe ma mua o ke kūlana i ʻae ʻia. He hana maʻamau kēia i waena o nā kauka ma Sri Lanka a puni ka honua.

Ua manaʻo ʻia kēia ʻano lāʻau lapaʻau SNRI hou he palekana a he emi nā hopena ʻaoʻao ma mua o nā antidepressants tricyclic (TCAs) i hoʻohana mua ʻia.

ʻElua ʻano nui o nā SNRI i hoʻāʻo ʻia no nā keiki me ADHD:

1. Duloxetine: Ua ʻae ʻia kēia e mālama i ke kaumaha a me ka hopohopo i nā pākeke. Eia kekahi, hoʻohana ʻia kēia lāʻau lapaʻau e mālama i ka hopohopo i nā keiki ma luna o 7 mau makahiki a me ke ʻano ʻeha o ka fibromyalgia.

2. Venlafaxine: He lāʻau lapaʻau kēia i ʻae ʻia e mālama i ke kaumaha a me ka hopohopo i nā pākeke. ʻOiai ʻaʻole i ʻae ʻia no nā keiki ma lalo o 18 a i ʻole no ADHD, kuhikuhi pinepine nā kauka iā ia 'off-label'.

Pehea e kōkua ai nā SNRI i ka poʻe me ADHD?

E noʻonoʻo e kamaʻilio ana nā ʻaʻalolo i loko o ko kākou lolo kekahi i kekahi. ʻO nā mea e kōkua ana i kēia kamaʻilio ʻana, ʻo ia hoʻi, ke kaʻana like ʻana o nā leka, ʻo ia nā neurotransmitters a mākou i ʻōlelo ai ma mua. Manaʻo nā kauka he pilikia ko nā keiki me ADHD me ka hana ʻana o nā ʻelele dopamine a me norepinephrine. Ua ʻike ʻia kekahi mau noiʻi e pili pū ana ka serotonin.

Hoʻonui nā lāʻau hoʻoulu i nā pae dopamine i loko o ka lolo. Hoʻonui nā lāʻau SNRI i nā pae serotonin a me norepinephrine. Ke hoʻonui ʻia kēia mau kemika, ʻoi aku ka maikaʻi o ka kamaʻilio ʻana, a i ʻole ka hoʻololi ʻana i nā leka, ma waena o nā hunaola nerve i loko o ka lolo.

Nā mea e pono ai ke ʻike i ka wā e hoʻohana ai i kēia lāʻau lapaʻau

Inā kuhikuhi ke kauka o kāu keiki i kahi SNRI, e hoʻomaka pinepine lākou me kahi mahele haʻahaʻa loa . A laila, i loko o kekahi mau pule, e hoʻonui mālie lākou i ka mahele a hiki i ka loaʻa ʻana o ke keiki i ka mahele e kūpono loa iā lākou. Hiki ke hala i 2 a 4 mau pule e ʻike ai i ka hopena piha o kēia lāʻau lapaʻau. No laila, mai hopohopo a ʻōlelo, "ʻAʻole au i hoʻomaka e lawe i kēia." He mea nui e hoʻomanawanui.

Loaʻa kēia mau lāʻau lapaʻau i ke ʻano pila a i ʻole capsule. Inā pilikia kāu keiki i ka ale ʻana i nā pila, hiki ke kuʻi ʻia kekahi mau lāʻau lapaʻau a hoʻohui ʻia i loko o kahi mea e like me ka applesauce. E kamaʻilio me kāu kauka e pili ana i kēia.

He mea nui loa ka makaʻala i nā hopena ʻaoʻao e hiki mai ana o ka lawe ʻana i kēia lāʻau lapaʻau a me nā hōʻailona e hiki mai ana inā ʻoe e hoʻōki koke i ka lawe ʻana.

Pehea ka maikaʻi o nā SNRI no ka ADHD?

He mea kēia e pono ai kākou e kamaʻilio me ka ʻoiaʻiʻo. Ua hala nā makahiki he ʻumi o ka noiʻi ʻana i nā lāʻau hoʻoulu no ADHD, a ma waena o 70% a me 90% o ka poʻe e hoʻohana ana iā lākou e hōʻike ana i ka hoʻomaikaʻi nui ʻana i kā lākou mau hōʻailona.

Eia nō naʻe, he kakaikahi loa ka noiʻi ʻana e pili ana i ka pono o nā SNRI no ADHD. Ma kekahi mau noiʻi liʻiliʻi o ka lāʻau venlafaxine, ma waena o hoʻokahi hapakolu a me ʻelua hapakolu o nā keiki i komo i hōʻike i kahi hoʻomaikaʻi ʻana i nā hōʻailona (ʻoi aku ka hyperactivity a me ka nānā ʻole). Eia naʻe, ua haʻalele ka nui i nā noiʻi ma muli o nā hopena ʻaoʻao. Ua hōʻike pū kekahi noiʻi o ka duloxetine i kahi hoʻomaikaʻi. No laila, ʻaʻole hiki iā mākou ke ʻōlelo i kēia manawa he like ka maikaʻi o kēia mau mea me nā mea hoʻoulu.

He aha ka pilikia koʻikoʻi loa o nā SNRI?

ʻO kēia ka mea āu e pono ai e makaʻala nui ai ma ke ʻano he makua.

Loaʻa i kēia mau lāʻau lapaʻau kahi ʻōlelo aʻo kūikawā a koʻikoʻi loa i kapa ʻia he ʻōlelo aʻo 'pahu ʻeleʻele'. ʻO ke ʻano kēia, e like me nā antidepressants āpau, hiki i kēia mau lāʻau lapaʻau ke hoʻonui i ka pilikia o nā manaʻo pepehi kanaka a i ʻole nā ​​​​hana i nā keiki a me nā ʻōpio, ʻoiai ke hoʻomaka mua lākou e lawe i ka lāʻau .

Kāu keiki:

• Inā ʻoe e hōʻike ana i nā hōʻailona o ke kaumaha,
• Inā ʻoe e kamaʻilio nei e pili ana i ka hōʻeha ʻana iā ʻoe iho,
• Inā kākou e kamaʻilio e pili ana i ka make,
• Inā ʻoe e hōʻike ana i nā loli ʻano ʻē a koke,

E kāhea koke aku i kāu kauka, me ka hoʻokaʻulua ʻole. A i ʻole e lawe iā ia i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa. Mai hoʻohaʻahaʻa i kēia pilikia.