Kodi mulinso ndi vuto la kuvutika maganizo kwambiri, kapena monga momwe madokotala amalitchulira, Matenda Ovutika Maganizo Akuluakulu (MDD)? Ngakhale mutagwiritsa ntchito mankhwala amodzi kapena awiri omwe dokotala wakupatsani, simukumvabe kusintha kulikonse? "Ndichite chiyani tsopano?" Mwina mukuganiza mokhumudwa kwambiri. Ndizachibadwa kumva kuti ndinu nokha komanso mulibe thandizo panthawi ngati iyi. Koma musachite mantha. Simuli nokha. Pamene sayansi ikupita patsogolo, ziyembekezo zatsopano zimabukanso. Lero tikulankhula za chiyembekezo chatsopano chotere.
Choyamba, tiyeni tikukumbutseni pang'ono za mankhwala ofala oletsa kuvutika maganizo omwe amaperekedwa.
Ngati mwayamba kale kulandira chithandizo cha kuvutika maganizo, dokotala wanu mwina poyamba anakupatsani mtundu wa mankhwala otchedwa 'mankhwala oletsa kuvutika maganizo achikhalidwe.' Pali mitundu ingapo ikuluikulu ya mankhwalawa. Mankhwalawa amagwira ntchito polinganiza ntchito ya mankhwala muubongo, otchedwa ma neurotransmitters , omwe amakhudza malingaliro athu ndi momwe timamvera. Izi zikuphatikizapo serotonin , norepinephrine , ndi dopamine .
Koma pali zovuta zingapo ndi mankhwala awa. Choyamba ndi chakuti amatenga nthawi kuti ayambe kugwira ntchito. Nthawi zambiri mumayenera kudikira pafupifupi milungu inayi mpaka isanu ndi itatu kuti muwone zotsatira zake. Chinanso ndi chakuti mankhwala awa sagwira ntchito mofanana kwa aliyense. Kafukufuku akusonyeza kuti pafupifupi anthu awiri mwa atatu aliwonse omwe amagwiritsa ntchito mankhwalawa samachira mokwanira .
Kuti mumvetsetse mosavuta, tiyeni tiwone mankhwala ena omwe amagwiritsidwa ntchito kwambiri patebulo ngati ili.
| Gulu la Mankhwala Osokoneza Bongo | Zitsanzo Zodziwika |
|---|---|
| SSRIs (Zoletsa Kubwerezabwereza kwa Serotonin) | Citalopram, Escitalopram, Fluoxetine, Paroxetine, Sertraline |
| Ma SNRI (Zoletsa Kubwerezabwereza kwa Serotonin-Norepinephrine) | Duloxetine, Venlafaxine |
| Mankhwala Oletsa Kuvutika Maganizo Osazolowereka | Bupropion, Mirtazapine, ndi Trazodone |
Ngati mwayesapo mankhwala amodzi kapena angapo awa koma simukumva bwino, musadandaule. Si vuto lanu. Nthawi ngati izi ndi zomwe madokotala amaganizira za mankhwala atsopano komanso apamwamba kwambiri.
Ndiye kodi mankhwala atsopano a NMDA awa ndi ati?
Mwachidule, iyi ndi njira yosiyana kwambiri yochiritsira kuvutika maganizo. Mosiyana ndi mankhwala akale, chithandizochi chimayang'ana ma receptors muubongo otchedwa N-methyl-D-aspartate (NMDA) .
Taganizirani izi motere. Mwa munthu amene ali ndi vuto lalikulu la kuvutika maganizo, ziwalo zina zofunika muubongo zingakhale zochepa, monga ngati 'akugona' (osagwira ntchito mokwanira). Zimene mankhwala a NMDA amachita ndikuwongolera momwe neurotransmitter ina yamphamvu yotchedwa glutamate imagwirira ntchito, ndikulimbitsa kulumikizana pakati pa maselo a ubongo 'ogona' (ma neuron). Izi zikutanthauza kuti mwadzidzidzi zimafulumizitsa kusinthana mauthenga pakati pa maselo a ubongo.
Akatswiri amakhulupirira kuti kuyambiranso kwadzidzidzi komanso kwamphamvu kwa kulumikizana pakati pa maselo a ubongo ndiko komwe kumayambitsa kuchepa mofulumira kwambiri kwa zizindikiro za kuvutika maganizo.
Ubwino waukulu wa izi ndi liwiro. Ngakhale kuti mankhwala ochiritsira amatha kutenga milungu ingapo kuti agwire ntchito, mankhwala ena a NMDA amatha kuyamba kupereka mpumulo waukulu komanso kusintha kwa wodwalayo mkati mwa maola ochepa .
Kodi ndi mankhwala ati omwe amagwiritsidwa ntchito pochiza NMDA? Kodi pali zoopsa zilizonse?
Ketamine ndi mankhwala ofunikira omwe amagwiritsidwa ntchito pochiza kuvutika maganizo kosachiritsika ndi mankhwala poyang'ana ma receptors a NMDA.
Kawirikawiri mankhwalawa amaperekedwa kwa wodwalayo kudzera mu mtsempha (wolowetsedwa m'mitsempha kapena m'mitsempha) ndi saline . Koma pali chinthu china chomwe muyenera kukumbukira apa.
Iyi si njira yoyamba yomwe dokotala angakulimbikitseni pa matenda a kuvutika maganizo.
Izi zimagwiritsidwa ntchito kokha kwa odwala omwe ali ndi vuto lalikulu la kuvutika maganizo omwe ayesa njira zina zonse koma osapambana. Komanso, chithandizochi chimachitikira kuchipatala, moyang'aniridwa bwino ndi madokotala apadera ndi ogwira ntchito ophunzitsidwa bwino. Ichi si mankhwala omwe angagulidwe ku pharmacy ndikutengedwa kunyumba.
Chifukwa chiyani mumachita zimenezo? Chifukwa monga mankhwala ena onse, pali zotsatirapo zina zomwe zingachitike. Pa nthawi ya chithandizo, mungakumane ndi kusintha kwa kuthamanga kwa magazi, chizungulire, nseru, komanso nthawi zina kusiya kuona zenizeni. Kuyang'aniridwa ndi dokotala ndikofunikira kuti muthane ndi zonsezi.
Ndingadziwe bwanji ngati ndili woyenera kulandira chithandizochi?
Funso lofunika kwambiri ndi ili. Yankho la funsoli likhoza kudziwika ndi dokotala wanu yekha. Ngati ndinu woyenera kulandira chithandizo chapamwamba monga chithandizo cha NMDA, zimadalira zinthu zingapo:
- Kodi ndi mitundu iti ya mankhwala oletsa kuvutika maganizo yomwe mudagwiritsapo ntchito kale?
- Anagwiritsidwa ntchito kwa nthawi yayitali bwanji, komanso pa mlingo woyenera?
- Kodi thupi lanu linayankha bwanji?
- Kuopsa kwa zizindikiro zanu za kuvutika maganizo panopa.
- Mkhalidwe wanu wonse wa thanzi (matenda ena, mankhwala ena omwe mukumwa, ndi zina zotero).
Choncho, chinthu chabwino kwambiri chomwe mungachite ndikulankhula momasuka ndi dokotala wanu za chilichonse chomwe chili m'maganizo mwanu. Musaope kufunsa mafunso monga, "Dokotala, ndakhala ndikumwa mankhwalawa kwa miyezi ingapo tsopano, koma sindinazindikire kusiyana kulikonse," kapena "Kodi palibe njira ina yothanirana ndi vutoli?" Mukamalankhula zambiri za momwe mukumvera komanso zomwe mwakumana nazo, zimakhala zosavuta kuti dokotala wanu asankhe chithandizo chabwino kwambiri kwa inu.
Uthenga Wopita Nawo Kunyumba
- Matenda aakulu ovutika maganizo (MDD) ndi vuto lalikulu lomwe limafuna chithandizo. Mankhwala oletsa kuvutika maganizo (SSRIs, SNRIs) sagwira ntchito mofanana kwa aliyense.
- Kwa iwo omwe salabadira mankhwala ochiritsira, tsopano pali mankhwala amakono monga Ketamine, omwe amalimbana ndi ma receptors a NMDA.
- Izi zimatha kukhudza glutamate muubongo, kulimbitsa mwachangu kulumikizana pakati pa maselo a ubongo, ndikuchiritsa mwachangu.
- Izi ndi mankhwala apadera, ndipo amaperekedwa kwa odwala omwe alephera kulandira chithandizo china, motsogozedwa ndi dokotala kuchipatala.
- Ngati simukupeza mpumulo kuchokera ku mankhwala omwe mukuwagwiritsa ntchito panopa, musataye mtima ndipo kambiranani momasuka ndi dokotala wanu za njira zonse zomwe mungasankhe.
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