I doctor chuan depression damdawi a pe che em? A nih loh leh i hriatte chuan he damdawi hi an hmang em? Khawtlangah he damdawi chungchang hi thawnthu tam tak awm mah se, thluak a nghawng dan leh a rah chhuah eng nge thleng tih hre tak tak mi engzat nge awm? Mi tam takin he damdawi hi an hlau hle a, mahse chu hlauhna chhan chu hriat lohna a ni. Chuvangin, vawiin hian he thu hi awlsam tak leh chiang takin i hrethiam ang u, kan thianpa nen kan inbia ang maiin.
Heng antidepressant te hi engte nge ni?
Heng damdawite hi ‘antidepressant’ tia koh ni mah se, rilru lam natna, lungkhamna nasa tak leh beiseina nei lo rilru natna thlentu depression enkawlna atan chauh hman a ni lo. Heng damdawi te hi kum 1950 chho vela hman tan a ni. Tunah chuan lungngaihna bakah hian heng damdawi te hi OCD (Obsessive-Compulsive Disorder), Social Phobia, Panic Disorder, GAD (Generalized Anxiety Disorder), leh PTSD (Posttraumatic Stress Disorder) ang chi natna atan pawh pawm a ni tawh bawk.
Chu bâkah, doctor-te chuan natna khirh tak, mut theih lohna, leh luak chhuak ang chi natnate tân he damdawi hi an pe ṭhîn thei bawk. Hei hi ‘off-label’ hmanna an ti a. Chumi awmzia chu chutiang dinhmun atan chuan damdawi chu official-in pawm a la ni lo tihna a ni a, mahse doctor chuan damloin a hlawkpui ngei a ring.
He damdawi hian engtin nge kan thluak a nghawng?
A awlsam zawngin, heng damdawi te hian kan thluaka chemical thenkhat level a thlak danglamin hna a thawk a ni. Heng chemical te hi neurotransmitter kan ti a . Hengte hi thil tam tak thununtu an ni a, kan rilru put hmang, kan rilru put hmang, mut leh ei duhna te hi a ni.
Hetiang hian han ngaihtuah teh. Kan thluaka nerve cell te hian heng ‘messenger’ neurotransmitter an tih te hi an inbiakpawhna atan an hmang thin. Nerve cell pakhat chuan he thuchah hi a chhuah a, chu thuchah chu a dang cell-ah a thawn chhuak ta a ni. Message a thlen hnuah chuan messenger chu rang takin original cell-ah an hruai kir leh a (hei hi reuptake an ti a ni ).
Antidepressant hian a tih ber chu chu reuptake process chu tlem a tikhawtlai a ni. Tichuan chu messenger (entir nan, serotonin) chu nerve cell pahnih (the synapse) inkar gap-ah chuan rei zawk a awm ta a ni. Tichuan rei zawk a thawk thei a, kan mood a titha thei bawk.
Thudik tak chu, mithiamte pawhin heng damdawi te hian engtin nge an hnathawh tih hi 100% in an chiang lo a, a chhan chu mihring thluak hi thil buaithlak tak a nih vang a ni. Mahse zirchianna chuan symptoms control nan an pui thei tih a tarlang.
Reuptake inhibitor chi hrang hrang hman tlanglawn tak tak
Tunah hian antidepressant damdawi pek tam berte chu he pawlah hian an tel a ni. Chungte chu chi hrang hrangah then a ni.
1. SSRIs (Selective Serotonin Reuptake Inhibitors) te hi a tha ber pawl a ni.
Hengte hi doctor-te’n damdawi an pek hmasak berte an ni. A hming ang bawkin, hengte hian neurotransmitter serotonin chu a bik takin an target a ni. Serotonin hi kan rilru put hmang, kan nungchang leh kan hriatrengna ang chi thil atan a pawimawh hle.
He damdawi hi i ei tan tirh chuan a result kimchang hmuh theih nan kar engemaw zat, a chang chuan thla 2-3 thleng pawh a ngai thei. Chuvangin dawhtheih a pawimawh. Tin, he damdawi hi doctor thurawn tel lo chuan i ei nghal mai ngai lo. Chutianga tih chuan symptoms duhawm lo (antidepressant discontinuation syndrome) a thlen thei a ni.
Serotonin Syndrome - Thil ngaihtuah tur awm tak!
A chang chuan serotonin level tisangtu damdawi dang, SSRI ang chi i ei hian thluaka serotonin awm zat hi a tul lovah a pung thei a ni. Hei hi a hlauhawm thei hle.
| Serotonin Syndrome natna lan chhuah dan tlangpui | |
|---|---|
| - Lungkhamna, rilru hahdam lohna | - Mitmeng (dilated pupils) a awm |
| - Nausea, luak chhuak, pum na | - Muscle twitching, a nghet lo |
| - Thaw tam lutuk, khur chhuak | - Mit chu a sir lehlamah a inher chak |
| Damdawi ina luh nghal ngai symptom na tak tak: | |
| - Buaina nasa tak emaw delirium emaw | - Khawsik sang tak a nei |
| - Heart rate a chak hle | - Seizures awm thei |
| - Thisen sang a sang | - Thil hriatna hloh |
Heng natna khirh tak tak te hi i neih chuan damdawi in hnai ber Emergency Treatment Unit (ETU) ah kal nghal rawh .
2. SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) te hi a tha ber pawl a ni.
Hengte hi SSRI hnua damdawi class hmasawn deuh deuh an ni. Neurotransmitter serotonin leh norepinephrine te hi an nghawng vek a ni . Norepinephrine hi kan ngaihven leh fimkhur nan a pawimawh hle. Chuvangin heng damdawi te hi natna rei tak (e.g., diabetic neuropathy, fibromyalgia) enkawlna atan an hmang fo thin.
- Entirna hman tlanglawn tak: Duloxetine (Cymbalta), Venlafaxine (Effexor) .
- Side effects awm tlangpui: luak chhuak, hmui vawt, hah, mutthilh, luak chhuak, thawk hah.
3. NDRIs (Norepinephrine leh Dopamine Reuptake Inhibitors) te hi a tha hle.
He damdawi hian neurotransmitters norepinephrine leh dopamine level a tisang a ni . Dopamine hi kan hlimna, kan chêttîrna leh kan ngaihsakna atân a pawimawh hle.
- Entirnan: Bupropion (Wellbutrin) tih hi a ni. Hei hi damdawi a ni a, meizuk bânsan turin a pui thei bawk.
- Special note: Antidepressant dang aiin sexual side effect a nei tlem zawk. Mahse, seizure vei hlauhawm tak tan chuan a tha lo.
A chi dang, hlui mahse a la pawimawh hle
Tunah hian heng damdawi te hi hman lar ni lo mah se, damdawi thar zawka chhân lêt lo mi ṭhenkhat tân chuan a ṭangkai hle thei a ni. Mahse, side effect tam tak an nei a ni.
Tricyclic leh tetracyclic antidepressant (TCA) te hi a tha hle.
Hengte hi damdawi hlui zawk, kum 1950 chho atanga hman tan tawh an ni. Damdawi thar ang maia thawk tha mahse, side effect a nei tam zawk. Entîr nân, mutthilh, kâ a vawt, taksa rihna a tipung a, heart rate a tidanglam thei bawk.
- Entirna tlangpui: Amitriptyline, Nortriptyline, Clomipramine te hi a ni.
Monoamine oxidase inhibitor (MAOI) te hi a tha hle.
Hengte hi damdawi hlui tak tak leh hman tlem tak a ni bawk. When using these , i ei tur chungchangah fimkhur hle a ngai. A chhan chu amino acid ‘Tyramine’ awmna chaw (e.g., aged cheese, soy sauce, sa thenkhat, thei thenkhat) i ei chuan i thisen sang hi hlauhawm takin a sang thei a ni. Tin, hengte hi antidepressant dang nena ei hi a hlauhawm hle bawk.
Damdawi, vitamin emaw, herbal product emaw i ei tur eng pawh doctor hnenah hriattir a pawimawh hle a, heng damdawi te hian an inzawm thei a ni.
Damdawi atana pui turin nutraceuticals ei theih a ni
Hengte hi damdawi ni lovin, damdawi lam harsatna thenkhata pui thei dietary supplement emaw nutritional supplement emaw an ni. Depression tan chauh hman a tha lo. Mahse, doctor-in a thurawn angin mainstream treatment nen hman dun theih a ni.
- SAMe (S-adenosyl-methionine): Taksa siam chhuah, neurotransmitter siamna atana puitu chemical a ni.
- Omega-3 Fatty Acids: Hengte hi a bik takin fish oil-a awmte hian thluaka inflammation engemaw zat a tihziaawm thei a ni.
- Vitamin D: Zirchianna atanga a lan dan chuan he vitamin, ni ênga hmuh chhuah hi tlakchhamna leh lungngaihna hi a inzawm tlat a ni.
Mahse, hengte hi mahni duh dan anga lak hi a tha lo tih hre reng ang che . I doctor nen inbia la, a remtihna chauhvin hmang rawh. A chhan chu a chang chuan hengte hi i ei tur damdawi dang nen an inzawm thei a ni.
Take-Home Thuchah a ni
- Antidepressant hi thluaka chemical (neurotransmitters) hnathawh tidanglam thei damdawi chi khat a ni.
- Heng damdawi te hian a thawh chhuah theih nan kar engemaw zat emaw thla engemaw zat emaw a la ngai thei a, chuvangin dawhtheih a pawimawh .
- Doctor thurawn tel lovin damdawi eng pawh ei tan ngai suh, a dose thlak ngai suh, a nih loh leh rang takin chawlhsan ngai suh. Chutianga tih chu thil hlauhawm tak a ni thei.
- Damdawi dang, vitamin emaw, herbal product emaw i ei lai chu i doctor hnenah hrilh rawh.
- Thil langsar tak tak, buaina nasa tak, khawsik sang, leh seizure te a awm chuan damdawi in Emergency Department (ETU)-ah kal nghal tur a ni a, serotonin syndrome a nih theih avangin.
- He damdawi chungchangah hian ngaihtuahna emaw hlauhna emaw i neih chuan i doctor nen inhawng takin sawi rawh.
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