Wave uchitora mishonga yechirwere chepfungwa chakadai sekuora mwoyo kwenguva yakareba here? Zvino zvawava kunzwa zviri nani, wafunga nezvekuderedza mushonga, asi hazvina kunge zviri nyore sezvawaifunga. Wakambovhiringidzika nematambudziko anoshamisa anouya nekumira mushonga here? Saka chinyorwa chino chichava chakakosha kwauri. Ngatitaurei nezvazvo zvakadzama.
Funga nezvenyaya yemukadzi anonzi Morgan Stewart. Akanga achitora mushonga wekuderedza kushushikana kwemakore. Akanga achitora mushonga unonzi Sertraline (zita rekuti Zoloft). Mushure mechinguva, akasarudza kuti aifanira kurega kutora mushonga uyu nekuti mafungiro ake akanga ava nani. Chiremba wake akamuudza kuti arege zvese panguva imwe chete kana kuti, kuti ave akachengeteka, arege kushandisa mushonga wacho. Morgan akasarudza wechipiri.
Asi mushure memavhiki mashoma ekuderedza piritsi re50 mg kusvika pahafu, akatanga kuona zviratidzo zvisinganzwisisike. Kurova kwemoyo nekukurumidza kusingatsananguriki, dzungu, kurira munzeve dzake, musoro wakakomba, uye kushaya hope . Mwedzi mumwe kana miviri mushure mekurega mushonga zvachose, mamiriro ake ezvinhu akawedzera kuipa. Aisagona kugara pasi, aisagona kurara zvakanaka, uye akatanga kuva nepfungwa dzakaipa dzekukuvadza mumwe munhu waanoda kana iye pachake.
Zvinhu zvakatoipa zvekuti Morgan akatopedza mazuva mashoma ari muchipatara chepfungwa. Ndipo paakaona kuti uku kwaisava kudzoserwa kwake nekuora mwoyo, asi zviratidzo zvekurega kushandisa mushonga zvaiuya nekumira kushandisa mushonga. Vanachiremba vanoti izvi "zviratidzo zvekurega kushandisa mushonga". Asi hapana aiziva zvekuita nezvazvo. Pakupedzisira, akanyorerwa mimwe mishonga miviri (''Clonazepam'' na''Buspirone'') kuti adzore zviratidzo izvi zvitsva. Pakupedzisira, akakwanisa kumisa mumwe mushonga uye akabatirira pamishonga miviri yainge yakaoma kumisa. Zvisinei, Morgan akadzidza nezvenzira iyi itsva ine hwaro hwesainzi hunonzi `'Hyperbolic Tapering''.
Sei dzimwe nguva zvisiri izvo kuderedza mishonga nenzira yakajairika?
Zvichienderana nedzimwe ongororo, pakati pe30% ne40% yevanhu vanorega kutora mishonga yekuora mwoyo vanogona kusangana nezviratidzo zvekurega kushandisa mishonga iyi. Njodzi yemigumisiro yakaipa yakanyanya kunyanya kana vanhu vanga vachitora mishonga iyi kwenguva inopfuura gore vakarega.
Dambudziko riri munzira inoshandiswa navanachiremba vazhinji kuderedza mishonga. Inonzi "linear tapering." Zvichitaurwa zviri nyore, izvi zvinosanganisira kuderedza mushonga nechiyero chakafanana vhiki rega rega kana mwedzi wega wega . Semuenzaniso, kuderedza neanenge mamirigiramu gumi vhiki rega rega.
"Asi nzira iyi inokurumidza zvikuru kumunhu anga achitora mushonga kwenguva yakareba," anodaro Dr. Mark Horowitz, chiremba uye muongorori wekuLondon. "Njodzi iyi inonyanya kukwira kana mushonga wacho wava kuda kumira zvachose."
Anotsanangura izvi seizvi: Fungidzira mumwe munhu achitora mamirigiramu makumi maviri emushonga `(Lexapro)`. Kuuderedza kubva pa5 kusvika pa0 kunoita sekunge kwakasimba kuuropi kane makumi maviri pane kuuderedza kubva pa20 kusvika pa15. Zvakafanana nekusvetuka kubva padombo. Kunyange hazvo 5mg ingaita semushonga mudiki kuna vanachiremba, haisi saizi yepiritsi inonyanya kukosha, asi mhedzisiro yaro pauropi.
Saka, paunotanga kuderedza mushonga, hazvinzwi sedambudziko guru. Asi paunoderedza mamirigiramu mashoma ekupedzisira, zvinogona kunzwa sekuti "hasha." Kana vanachiremba vasingazive izvi, vanogona kufunga kuti, "Murwere uyu adzokera kuchirwere."
Zvakaitika kuna chiremba pachake
Dr. Horowitz anoziva izvi zvakanaka, nekuti iye pachake akambosangana nazvo. Paakarega zvishoma nezvishoma kutora mushonga weLexapro, waakanga achitora kwemakore gumi nemaviri, akasanganawo nemigumisiro yakaipa, kusanganisira kufunga nezvekuzviuraya. "Chaiva chiitiko chinotyisa kupfuura zvese chandati ndambosangana nacho muhupenyu hwangu," anodaro.
Mushure mechiitiko ichi ndipo paakatanga kufunga zvakadzama nezvenyaya iyi. Akanyatsoongorora zviratidzo zvaizoitika kana akarega kutora mushonga uyu.
| Zviratidzo zveKurega Kunwa | |
|---|---|
| Zviratidzo zvakajairika | Zviratidzo zvisingawanzoitiki |
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Chii chiri sainzi iri shure kwenzira iyi inonzi Hyperbolic Tapering?
Zvichitaurwa zviri nyore, "Hyperbolic Tapering" inzira yekuderedza zvishoma nezvishoma mushonga, kuuderedza zvishoma nezvishoma, uye kuuderedza zvakanyanya. Iyi inzira inononoka zvikuru inoitika kwemwedzi yakawanda, dzimwe nguva makore.
Semuenzaniso, muyero wemushonga wemunhu unogona kuderedzwa ne10% mwedzi wega wega . Zvisinei, iyi 10% inoverengerwa kubva pamuyero wazvino uno, wakaderedzwa. Saka sezvo muyero wemushonga uchideredzwa, huwandu hwemuyero hunova hushoma. Tsvagiridzo yakaratidza kuti nzira iyi inogona kushandiswa zvinobudirira pakumisa mishonga yekuora mwoyo, kushaya hope, kuzvidya mwoyo, nezvimwe zvirwere zvepfungwa, pamwe nekumisa mishonga yezvimwe zvirwere.
Asi izvi hazvisi nyore kuzviita. Pane matambudziko maviri makuru panyaya iyi:
1. Kuwana chiremba ane ruzivo: Zvakaoma kuwana chiremba ane ruzivo nezvenzira iyi uye anogona kugadzira hurongwa hunokunakira.
2. Kuwana mishonga midiki: Makambani emishonga haagadzire mapiritsi mumishonga midiki kudaro. Saka unofanira kushandisa mushonga wemvura kana kuti mishonga midiki iyi inogadzirwa kuburikidza ne pharmacy inosanganisa mishonga. Zvese izvi zvinogona kudhura.
Nzira iyi inokosha zvakadini chaizvo? Sei vanachiremba vedu vasingazive zvakawanda nezvayo?
Dzimwe nyanzvi dzinoti nzira iyi ye "Hyperbolic Tapering" inongodiwa chete kuvanhu vashoma vane zviratidzo zvakakomba, uye kuti kuvanhu vazhinji, zviratidzo zvinoitika kana mushonga ukamiswa nenzira yakajairika zvishoma uye zvinopera zvega.
Asi Dr. Horowitz haabvumirani nazvo. Anoti, "Iri harisi dambudziko revanhu vashoma." Ongororo yake yakaratidza kuti munhu mumwe chete pavanhu vanomwe (1/7) vanotora mushonga uyu kwemakore anopfuura maviri vanowana migumisiro yakaipa.
Dambudziko guru nderekuti vanachiremba vazhinji havana kudzidziswa zvakanaka panyaya iyi. Vanodzidziswa kuti migumisiro yacho haina kunyanya kuipa uye ichapera mumazuva mashoma. Saka, kana murwere akasvika onyunyuta nezvezviratidzo zvakakomba, vanofunga kuti, "Uku hakusi kurega, chirwere chako chepfungwa chadzoka." Ipapo vanodzosera murwere pamushonga.
Kuwanda kwevanhu vakaita seizvi vari kuenda paindaneti kuti vawane mhinduro dzavo zvinoreva kuti pane dambudziko guru ravepo mukati mehurongwa hwedu hwekurapa.
Ndosaka varwere vazhinji vakagadzira mapoka epamhepo ekutaura nezvematambudziko avo uye kutsvaga mhinduro, nekuti vanachiremba vavo havazvitore sezvine musoro.
'Sekumuka kubva kuhope'
Nhasi, Morgan anoti anonzwa sekunge "ari kumuka kubva kuhope dzakaipa." Chiremba wake akanga asingatsigire nzira itsva iyi, saka akatsvaga rubatsiro kubva kune mumwe chiremba akadzidziswa izvi.
Akagadzirira mushonga wake kumba. Akanyungudutsa piritsi mumvura, akashandisa sirinji, ndokuyera kuti aifanira kunwa ma milliliters mangani zuva rega rega. Asi iyi inzira ine njodzi uye inonetsa. Akaita izvi kwemwedzi gumi nemishanu uye akakwanisa kurega kutora Clonazepam pasina mimwe migumisiro mitsva.
Zvakakosha: Zvine njodzi zvikuru kuedza zvinhu izvi uri wega. Unofanira kungofunga nezvekuita zvinhu izvi uchitarisirwa nachiremba anoziva nezvazvo. Kukanganisa mwero wemushonga kunogona kuva nemigumisiro yakaipa.
Morgan anoti hupenyu hwake hwazara nemufaro zvakare. "Ndasununguka izvozvi," anodaro. "Chishamiso, tichifunga nezvekwandaiva."
Mharidzo Yekuenda Nayo Kumba
- Pakurega kushandisa mishonga kwenguva refu yezvirwere zvepfungwa zvakaita sekuora mwoyo, vamwe vanhu vanogona kusangana nemigumisiro yakaipa (zviratidzo zvekurega kushandisa mishonga).
- Nzira yakajairika (linear tapering) inoteverwa navanachiremba vazhinji haishande kune wese munhu, kunyanya avo vanga vachitora mushonga kwenguva yakareba.
- Kutora mishonga yeHyperbolic Tapering inzira yakachengeteka yekuderedza mushonga zvishoma nezvishoma, muhuwandu hushoma, kwemwedzi kana makore.
- Usamborega kutora mishonga kana kuchinja mwero wemushonga wega usina kutaura nachiremba wako.
- Kana uchinetseka nekurega kushandisa mushonga wako, taura nachiremba wako nezve nzira iyi yeHyperbolic Tapering. Anogona kunge asingazvizive, asi kutaura nezvetsvagurudzo itsva iyi kunogona kukubatsira kuwana mhinduro.
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