Ngaba wakha waziva ungazinzi ngendlela engaqhelekanga eyakwenza ungakwazi ukuhlala kwindawo enye okanye kwindawo enye nokuba lixesha elifutshane? Ngaba uziva ufuna ukuhambahamba ungcangcazelise imilenze yakho ngalo lonke ixesha uziva ungazolanga ngaphakathi? Oku kungaba yimpembelelo yeyeza olisebenzisayo. Namhlanje siza kuthetha ngale meko (Akathisia). Musa ukoyika, kubaluleke kakhulu ukuqaphela oku.
Yintoni le (Akathisia)? Masiyiqonde ngokulula.
I-Akathisia yingqokelela yeempawu ezinxulumene nenkqubo yemithambo-luvo kunye nengqondo (`(Neuropsychiatric syndrome)`). Kwakhona, sisifo sokuhamba. Kule meko, kunzima kakhulu ukuhlala okanye ukuhlala ungashukumi ngenxa yokungaphumli okukhulu okuvela ngaphakathi. Igama elithi "akathisia" livela kulwimi lwesiGrike, elithetha "ukungakwazi ukuhlala". Le meko idla ngokuvela xa kusetyenziswa amayeza athile, ngakumbi amayeza athi `(Antipsychotic)` okanye `(Neuroleptic)` asetyenziselwa izifo zengqondo. Ayipheleli apho, le (akathisia) inokunxulunyaniswa neemeko ezithile zonyango ezifana `(Parkinson's disease)`. Umntu one (akathisia) uziva engaphumli kwaye engaphumli ngaphakathi. Yingakho enomnqweno omkhulu wokuhambahamba rhoqo, ngakumbi ukuhambisa imilenze yakhe. Rhoqo ezi ntshukumo zenziwa ngendlela efanayo ngokuphindaphindiweyo (`repetitive`). Lo mnqweno ongalawulekiyo wokushukuma unokuba buhlungu kakhulu. Oogqirha bahlula le meko (akathisia) kwiindidi ezahlukeneyo, kuxhomekeke ekubeni iimpawu ziqala nini kwaye zihlala ixesha elingakanani.
- I-acute akathisia: Oku kwenzeka rhoqo kwiintsuku zokuqala emva kokuqala amayeza, ingakumbi i-antipsychotic, okanye xa umthamo unyusiwe. Ihlala ixesha elingaphantsi kweenyanga ezintandathu.
- I-akathisia engapheliyo: Olu hlobo lwe-akathisia lwenzeka xa iimpawu ziqhubeka ixesha elingaphezu kweenyanga ezintandathu. Zinokuhlala iinyanga okanye iminyaka.
- I-Tardive akathisia: Oku kwenzeka emva kokuqala amayeza athile, ukwandisa umthamo, okanye emva kweenyanga ezintathu. Idla ngokunxulunyaniswa nesinye isifo sokuhamba esibizwa ngokuba yi-tardive dyskinesia.
- I-akathisia yokurhoxiswa: Le meko inokwenzeka xa umthamo wamanye amayeza uncitshisiwe okanye uyekwa ngokupheleleyo.
Ingaba i-Akathisia iyafana ne-Anxiety?
Hayi, musa ukubhidanisa ezi zinto zimbini. I-Akathisia kunye nexhala ziimeko ezimbini ezahlukeneyo. I-Akathisia sisifo sokuhamba, ngelixa ixhala limeko yempilo yengqondo. Nangona kunjalo, zinokwabelana ngeempawu ezifanayo. Umzekelo, ukungazinzi, kunye nokungakwazi ukulawula iingcinga kunye nokuziphatha komntu. Nangona kunjalo, uphawu oluphambili lwe-akathisia kukufuna ukuhamba rhoqo. Iimpawu ezisekelwe kuloyiko okanye ixhala azinqabile. Nangona kunjalo, kuqhelekile ukuba abantu abane-akathisia bazive bexhalabile kwaye bexinezelekile ngenxa yale nkanuko yokuhamba engalawulekiyo.
Ngelishwa, le meko (Akathisia) idla ngokuchongwa gwenxa njengexhala eliqhubekayo kunye/okanye ukuphazamiseka.
Ixhaphake kangakanani i-Akathisia?
I-Akathisia yeyona ngxaki yokushukuma eqhelekileyo enxulunyaniswa namayeza e-psychotropic, ingakumbi amayeza e-antipsychotic. Kuqikelelwa ukuba ukuya kuthi ga kwi-24% yabantu abane
-schizophrenia abathatha amayeza esi sifo bane-akathisia. Kolunye uphando, ama-39% abantu abathatha i-clozapine kunye nama-45% abantu abathatha i-antipsychotics yesizukulwana sokuqala (FGA) babene-akathisia.
Zithini iimpawu ze-(Akathisia)?
Iimpawu ze-akathisia zihlala zibonakala emva kokuba uqale ukuthatha amayeza okulwa nesifo sengqondo, okanye emva kokuba ugqirha wakho enyuse umthamo. Uphawu oluphambili
kukuziva ungazinzi, okanye ukuxhalaba . Abantu abane-akathisia baziva benqwenela kakhulu ukushukumisa imizimba yabo, ingakumbi imilenze yabo, ukusuka ezinqeni ukuya emaqatheni abo. Ukuba une-akathisia, ungenza ezi zinto:
- Ndihlala ndinqumla imilenze yam ndize ndiyilungise kwakhona.
- Imilenze yam iyaqhubeka nokuhamba ngelixa ndihleli.
- Xa umile, udlulisela ubunzima ukusuka komnye umlenze ukuya komnye.
- Ndishukuma ndisiya phambili ndihleli.
- Bahlala behamba besiya phambili nangasemva, okanye bema endaweni enye besenza ngathi bayahamba.
Komnye umntu, ezi mpawu kunye neentshukumo zinokubonakala ngathi ngumntu ohlala eshukuma kwaye engakwazi ukuhlala phantsi.
Ukuba unezi mpawu, kubalulekile ukuthetha nogqirha wakho ngokukhawuleza. Kuvakala njani ukuba ne (Akathisia)?
Abantu abane-Akathisia badla ngokuchaza ukuziva bengenazolo ngaphakathi kunye nomnqweno ongalawulekiyo wokuhamba. Badla ngokuchaza ukuziva bengenazolo kwaye bengakwazi ukuphumla. Basenokuziva bexinezelekile xa kufuneka bahlale bezolile, njengakwimigca emide. Oku kungazolo ngaphakathi kudla ngokubangela ukuba abantu abane-Akathisia babe nexhala kunye nokudakumba. I-Akathisia ende ithi,
Kuye kwanxulunyaniswa nomngcipheko okhulayo wokuzilimaza okanye ukuziphatha okubi. Ukuba ucinga ngokuzibulala okanye uziva ngathi uza kuzilimaza, kubalulekile ukuba ufune uncedo lwezonyango ngoko nangoko.
Zithini izizathu ze-Akathisia?
Izazinzulu azikayazi eyona nto ibangela i-akathisia. Kodwa zicinga ukuba kungenxa yokuba amanye amayeza avala ii-receptors ezikwingqondo ezifumana ikhemikhali ebizwa ngokuba yi-dopamine. I-Dopamine yi-neurotransmitter, ikhemikhali enceda kwimisebenzi emininzi ebalulekileyo yomzimba, kuquka nokuhamba kwethu. Oku kuthinteleka kubangela iintshukumo ezingalawulekiyo. Kukho amayeza aliqela anxulumene ne-akathisia: I-Akathisia ikwanxulunyaniswa neemeko ezithile zempilo:- Isifo sikaParkinson .
- Usulelo lobuchopho/ ukudumba (`I-Encephalitis`).
- Ukulimala entloko (Ukulimala kwengqondo okubuhlungu - iTBI).
Amayeza e-antipsychotic anxulumene ne-Akathisia
I-Akathisia yeyona ngxaki yokushukuma eqhelekileyo enxulunyaniswa namayeza okulwa nesifo sengqondo. Oogqirha ngamanye amaxesha bayibiza ngokuba yi-antipsychotic-induced akathisia. Amayeza okulwa nesifo sengqondo, okanye i-neuroleptics, awela kwiindidi ezimbini eziphambili:- Isizukulwana sokuqala okanye "ii-antipsychotics" eziqhelekileyo (i-FGA).
- Isizukulwana sesibini okanye "esahlukileyo" `(Antipsychotics - SGA)`.
I-Akathisia idla ngokunxulunyaniswa namayeza akudidi lwe-`(FGA)`, ingakumbi lawo anamandla ngakumbi kwaye asetyenziswa kwiidosi eziphezulu. Umngcipheko uphantsi kancinci ngamayeza e-`(SGA)`. Oogqirha banika la mayeza e-`(FGA)` kunye ne-`(SGA)` kwiingxaki ezahlukeneyo ze-neuropsychiatric. Umzekelo:- Ukuphazamiseka kokuziphatha kwi-dementia.
- Ukuxhuzula.
- Uxinzelelo.
- Iingxaki zokutya.
- Ingxaki yokuxhalaba ngokubanzi.
- Ukungalali .
- Isifo sokungakhathali (`Isifo sokungakhathali -I-OCD ).
- Iingxaki zobuntu.
- Ingxaki yoxinzelelo emva kwesiganeko esibuhlungu (PTSD).
Isifo sokunganyamezelani kakuhle kwengqondo (Schizoaffective disorder). I-Schizophrenia kunye neengxaki ezinxulumene nayo.
Imizekelo yamayeza athile e-FGA (anegama leebhrendi) anokunxulunyaniswa ne-Akathisia:- ``I-Chlorpromazine (Thorazine®)''
- `I-Fluphenazine (iProlixin®)`
- `Haloperidol (Haldol®)`
- `ILoxapine (Loxitane®)`
- ``I-Prochlorperazine (Compro®, Compazine®)''
Amanye amayeza e-SGA asengozini enkulu ye-Akathisia aquka:- `I-Paliperidone (Invega®)`
- `I-Ziprasidone (Geodon®)`
Ii-antidepressants ezinxulumene ne-Akathisia
Nangona ingaqhelekanga njengamayeza okulwa nesifo sengqondo, ezinye izidambisi-ntlungu nazo zidibene ne-akathisia. Ezi ziquka:- Ii-Selective serotonin reuptake inhibitors (SSRIs): Ezi zezona zi-antidepressants ezinikwa kakhulu. Imizekelo: i-fluoxetine (Prozac®), i-paroxetine (Paxil®).
- I-Monoamine oxidase inhibitors (ii-MAOI): Ezi yayizizo zokuqala izidambisi-ntlungu ukwenziwa. Nangona zazisebenza kakuhle, amayeza amatsha, akhuselekileyo aneziphumo ebezingalindelekanga ezimbalwa ngoku asetyenziswa rhoqo.
- Ii-Tricyclic (TCA) antidepressants: Oogqirha banika ezi xa ezinye ii-antidepressants zingasebenzi. Imizekelo: i-clomipramine (Anafranil®), i-amitriptyline (Elavil®).
Oogqirha banika amayeza okudakumba kwiimeko ezifana nezi:- Uxinzelelo.
- Ukuxhuzula.
- Iingxaki zokuxhalaba.
- Intlungu engapheliyo.
- Isifo sokungakhathali (OCD).
- Uhlaselo loloyiko.
- Ingxaki yoxinzelelo emva kwesiganeko esibuhlungu (PTSD).
Kuqikelelwa ukuba phakathi kwe-10% kunye ne-18% yabantu abanesifo se-bipolar I abasebenzisa amayeza okudakumba baba ne-akathisia. Amanye amayeza anxulumene ne-Akathisia
Amanye amayeza anokunxulunyaniswa ne-Akathisia:- Amayeza okunyanga isicaphucaphu okanye ukuhlanza (amayeza okulwa nokugabha), umz. i-metoclopramide.
- Amayeza oxinzelelo lwegazi oluphezulu, umz. `reserpine`, `methyldopa`.
- Izithinteli zeCalcium channel, umz. iCinnarizine, iDiltiazem.
- Izinto zokuthomalalisa umzimba.
- Amayeza okunyanga isiyezi.
- `Azithromycin` (isibulali-ntsholongwane esisetyenziswa kakhulu).
- `I-Buspirone` (iyeza lokuxhalaba).
I-Akathisia inokubangelwa ziziyobisi ezingekho mthethweni ezifana ne-amphetamine, i-methamphetamine, kunye ne-cocaine. Indlela yokuqaphela (Akathisia)?
Oogqirha badla ngokuxilonga i-Akathisia ngokujonga indlela isigulane esiziphatha ngayo kunye neempawu zaso (`ukujonga kweklinikhi`). Oku akudingi vavanyo lwegazi okanye uvavanyo lwemifanekiso. Eyona ndlela ixhaphakileyo esetyenziswayo ukuvavanya inqanaba le-Akathisia yi-`Barnes Akathisia-Rating Scale (BARS)``. Ukuba ucinga ukuba une-Akathisia, ugqirha wakho uza kukubuza imibuzo malunga neempawu zakho, imbali yezonyango, kunye namayeza angoku. Baza kujonga nokuziphatha kwakho kunye neentshukumo zakho. Ngelishwa, i-Akathisia idla ngokuba nzima ukuyixilonga. Kuba iimpawu zayo ziyafana nezinye iimeko zempilo yengqondo, umzekelo:- Ingqondo.
- Ubuhlanya.
- Ingxaki yokunqongophala kwengqalelo/yokungasebenzi kakuhle (ADHD).
- Ukudandatheka okubangelwa kukuphazamiseka kwengqondo.
Iphathwa njani i-Akathisia?
Okwangoku akukho nyango luthile lwe-Akathisia. Ukuba i-Akathisia yakho ibangelwa liyeza, ugqirha wakho uya kuzama ukukutshintshela kwelinye iyeza okanye anciphise umthamo wamayeza owasebenzisayo ngoku (ukuba kunokwenzeka). Ezinye izifundo zibonise ukuba la mayeza alandelayo anokunceda kwi-Akathisia:- Ii-Beta-blockers, umzekelo i-propranolol.
- IiBenzodiazepines (udidi lwamayeza asetyenziselwa ukunyanga iimeko ezifana nokuxhalaba, ukungalali, kunye nokuxhuzula).
- I-mirtazapine enedosi ephantsi (iyeza lokudakumba).
- Ii-Anticholinergics (uhlobo lweyeza elisetyenziselwa ukunyanga izifo ezifana ne-asthma).
- IVithamin B6.
Ngaba i-Akathisia ingathintelwa?
Izazinzulu zisazama ukuqonda ngokupheleleyo i-Akathisia, izizathu zayo, kunye nonyango. Kodwa bayazi ukuba i-Akathisia inokwenzeka ngakumbi kwiimeko ezilandelayo:- Ukuba uthatha amayeza e-antipsychotic esizukulwana sokuqala.
- Ukuba uthatha amayeza amaninzi kakhulu.
- Ukuba ugqirha wakho ngequbuliso wonyusa umthamo wamayeza akho, okanye kakhulu.
- Ukuba uneminyaka ephakathi okanye umdala.
Ngenxa yezi nyaniso, eyona ndlela ilungileyo yokuthintela i-Akathisia kukuba oogqirha baqale la mayeza ngedosi ephantsi kangangoko kwaye bandise idosi kancinci kancinci ukuba kuyimfuneko. Ngaphambi kokuba uqale naliphi na iyeza, kubalulekile ukuthetha nogqirha wakho malunga neengozi, iingenelo kunye nemiphumo emibi enokubakho. Ithini i-prognosis ye-(Akathisia)?
Ukuba i-Akathisia ibonwa kwangethuba kwaye amayeza ayibangelayo ayekiswa (ukuba kunokwenzeka), imeko idla ngokuba ngcono. Nangona kunjalo, ukuba i-Akathisia ayinyangwa, inokuba buthathaka kakhulu. Abantu abaninzi abane-Akathisia bafumana uxinzelelo olukhulu kunye nokudakumba ('dysphoria'). Basenokuba neengcamango zokuzibulala. Ukuba ucinga ngokuzibulala, kubalulekile ukufuna uncedo lwezonyango ngokukhawuleza.
Ufanele uye nini kugqirha malunga (no-Akathisia)?
Ukuba uneempawu ze-Akathisia, kubalulekile ukuthetha nogqirha wakho. Okukhona befumana unobangela ngokukhawuleza, kokukhona benokutshintsha amayeza akho ngokukhawuleza baze balawule imeko. I-Akathisia sisiphumo esingathandekiyo kakhulu esinokubangelwa ngamanye amayeza. Ukuba ukhathazekile ukuba unokufumana i-Akathisia emva kokuqala amayeza esifo sengqondo okanye ukuphazamiseka kwengqondo, ungoyiki ukubuza ugqirha wakho ngayo. Ukuba uneempawu ze-Akathisia, xelela ugqirha wakho ngokukhawuleza. Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)
- I-Akathisia yimeko apho ukungazinzi kwangaphakathi kubangela ukungakwazi ukuhlala kwindawo enye kunye nesidingo esiqhubekayo sokuhamba.
- Oku kunokubangelwa ikakhulu ngamayeza athile okulwa nesifo sengqondo. Kunokubangelwa namayeza okudakumba kunye namanye amayeza.
- Iimpawu ziquka ukungcangcazela kwemilenze, ukuhambahamba, kunye nokungakwazi ukuhlala kwindawo enye.
- Oku akukokukhathazeka, kodwa kunokubangela ixhala.
- Ukuba unale mpawu, qiniseka ukuba uxelele ugqirha wakho. Le meko inokulawulwa ngokutshintsha umthamo wamayeza akho okanye ukutshintshela kwelinye iyeza.
- Ungaze uyeke ukuthatha amayeza akho okanye utshintshe umthamo ngaphandle kwengcebiso kagqirha wakho.
- I-Akathisia inokuguqulwa ukuba ifunyaniswe kwaye inyangwa kwangethuba.
Ukuba unemibuzo engaphezulu malunga noku, ungathandabuzi ukuthetha nogqirha wakho. Hlala usempilweni!
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