Wake wazizwa ungenakho ukuthula okungajwayelekile okwenza wangakwazi ukuhlala endaweni eyodwa noma endaweni eyodwa ngisho nesikhathi esifushane? Ingabe uzizwa sengathi uhambahamba futhi unyakazise imilenze yakho ngaso sonke isikhathi unomuzwa wokungahlaliseki ovela ngaphakathi? Lokhu kungaba umphumela wemithi oyiphuzayo. Namuhla sizokhuluma ngalesi simo (Akathisia). Ungesabi, kubaluleke kakhulu ukuqaphela lokhu.
Kuyini lokhu (Akathisia)? Ake sikuqonde kalula.
I-Akathisia empeleni iyiqoqo lezimpawu ezihlobene nohlelo lwezinzwa kanye nengqondo (`(Neuropsychiatric syndrome)`). Futhi, iyisifo sokunyakaza. Kulesi simo, kunzima kakhulu ukuhlala noma ukuhlala unganyakazi ngenxa yokungaphumuli okukhulu okuvela ngaphakathi. Igama elithi "akathisia" livela olimini lwesiGreki, elisho "ukungakwazi ukuhlala". Lesi simo sivame ukwenzeka lapho kusetshenziswa imithi ethile, ikakhulukazi imithi ethi `(Antipsychotic)` noma `(Neuroleptic)` esetshenziselwa izifo zengqondo. Akukhona lokho kuphela, lokhu (akathisia) kungahlotshaniswa nezimo ezithile zezokwelapha ezifana `(Parkinson's disease)`. Umuntu one-(akathisia) uzizwa engaphumuli kakhulu futhi engaphumuli ngaphakathi. Yingakho enesifiso esikhulu sokunyakaza njalo, ikakhulukazi ukuhambisa imilenze yakhe. Ngokuvamile lokhu kunyakaza kwenziwa ngendlela efanayo ngokuphindaphindiwe (`okuphindaphindayo`). Lesi sifiso esingalawuleki sokunyakaza singaba sicindezela kakhulu. Odokotela bahlukanisa lesi simo (akathisia) ngezinhlobo eziningana, kuye ngokuthi izimpawu ziqala nini nokuthi zihlala isikhathi esingakanani.
- I-akathisia ebukhali: Lokhu kuvame ukwenzeka ezinsukwini ezimbalwa zokuqala ngemuva kokuqala umuthi, ikakhulukazi umuthi wokulwa nesifo sengqondo, noma lapho umthamo ukhushuliwe. Kuhlala isikhathi esingaphansi kwezinyanga eziyisithupha.
- I-akathisia engapheli: Lolu hlobo lwe-akathisia lwenzeka lapho izimpawu zihlala isikhathi esingaphezu kwezinyanga eziyisithupha. Lungahlala izinyanga noma ngisho neminyaka.
- I-Tardive akathisia: Lokhu kwenzeka ngemva kokuqala imithi ethile, ukwandisa umthamo, noma ngisho nangemva kwezinyanga ezintathu. Ngokuvamile kuhlotshaniswa nesinye isifo sokunyakaza esibizwa ngokuthi i-tardive dyskinesia.
- I-akathisia yokuhoxiswa: Lesi simo singase senzeke uma umthamo wemithi ethile uncishisiwe noma uyekwa ngokuphelele.
Ingabe i-Akathisia iyafana nokukhathazeka?
Cha, ungadidanisi lokhu okubili. I-Akathisia kanye nokukhathazeka kuyizimo ezimbili ezihlukene. I-Akathisia iyisifo sokunyakaza, kanti ukukhathazeka kuyisimo sempilo yengqondo. Kodwa-ke, zingaba nezici ezifanayo. Isibonelo, ukungahlaliseki, kanye nokungakwazi ukulawula imicabango nokuziphatha komuntu. Kodwa-ke, isici esiyinhloko se-akathisia isifiso esingalawuleki sokunyakaza njalo. Izimpawu ezisekelwe ekwesabeni noma ekukhathazekeni azivamile. Kodwa-ke, kuvamile ukuthi abantu abane-akathisia bazizwe bekhathazekile futhi becindezelekile ngenxa yalesi sifiso esingalawuleki sokunyakaza.
Ngeshwa, lesi simo (i-Akathisia) sivame ukuhlonzwa kabi njengokukhathazeka okuqhubekayo kanye/noma ukuphazamiseka.
Ivame kangakanani i-Akathisia?
I-Akathisia yisifo sokunyakaza esivame kakhulu esihlotshaniswa nemithi ye-psychotropic, ikakhulukazi imithi ye-antipsychotic. Kulinganiselwa ukuthi abantu abangafika ku-24% abane
-schizophrenia abathatha imithi yalesi sifo bane-akathisia. Kokunye ukuhlola, abantu abangu-39% abathatha i-clozapine kanye nabantu abangu-45% abathatha imithi ye-antipsychotics yesizukulwane sokuqala (i-FGA) babene-akathisia.
Ziyini izimpawu ze-(Akathisia)?
Izimpawu ze-akathisia zivame ukuvela ngemuva kokuthi uqale ukuthatha umuthi we-antipsychotic, noma ngemuva kokuthi udokotela wakho enyuse umthamo. Uphawu oluyinhloko
umuzwa wokungaphumuli, noma ukujima . Abantu abane-akathisia bazizwa benesifiso esikhulu sokunyakazisa imizimba yabo, ikakhulukazi imilenze yabo, kusukela ezinqeni zabo kuya emaqakaleni abo. Uma une-akathisia, ungenza lezi zinto:
- Ngihlala ngiphambanisa imilenze yami bese ngiyiqondisa futhi.
- Imilenze yami iyaqhubeka nokuhamba ngenkathi ngihleli.
- Uma umile, udlulisela isisindo kusuka komunye umlenze uye komunye.
- Nginyakaza ngiphinde ngibuye ngibuye ngihleli.
- Bahlala behamba beya phambili naphambili, noma bema endaweni eyodwa bese bezenza sengathi bayahamba.
Komunye umuntu, lezi zimpawu nokunyakaza kungase kubonakale njengomuntu ohlala ezulazula futhi engakwazi ukuhlala phansi.
Uma unalezi zimpawu, kubalulekile ukukhuluma nodokotela wakho ngokushesha okukhulu. Kuzwakala kanjani ukuba ne-(Akathisia)?
Abantu abane-Akathisia bavame ukuchaza ukuzizwa benokuphazamiseka okukhulu kwangaphakathi kanye nesifiso esingalawuleki sokunyakaza. Bavame ukuchaza ukuzizwa bengenakuphumula futhi bengakwazi ukuphumula. Bangase futhi bazizwe becindezelekile lapho kudingeka bahlale bethule, njengasemugqeni. Lokhu kuphazamiseka kwangaphakathi kuvame ukubangela abantu abane-Akathisia ukuba bazizwe bekhathazekile futhi becindezelekile. I-Akathisia ende ithi,
Kuye kwahlotshaniswa nengozi eyengeziwe yokuzilimaza noma ukuziphatha kokuzibulala. Uma unemicabango yokuzibulala noma uzizwa sengathi uzozilimaza, kubalulekile ukufuna usizo lwezokwelapha ngokushesha.
Yiziphi izimbangela ze-Akathisia?
Ososayensi abakayazi imbangela eqondile ye-akathisia. Kodwa bacabanga ukuthi kungenxa yokuthi eminye imithi ivimba ama-receptor ebuchosheni athola ikhemikhali ebizwa ngokuthi i-dopamine. I-Dopamine iyi-neurotransmitter, ikhemikhali esiza ngemisebenzi eminingi ebalulekile yomzimba, okuhlanganisa nokunyakaza kwethu. Lokhu kuvinjelwa kubangela ukunyakaza okungalawulwa. Kunemithi eminingana ehlotshaniswa ne-akathisia: I-Akathisia ihlotshaniswa nezimo ezithile zempilo:- Isifo sikaParkinson .
- Ukutheleleka kobuchopho/ ukuvuvukala (`i-Encephalitis`).
- Ukulimala ekhanda (Ukulimala kobuchopho okubuhlungu - i-TBI).
Imithi yokulwa nesifo sengqondo ehlobene ne-Akathisia
I-Akathisia yisifo sokunyakaza esivame kakhulu esihlotshaniswa nemithi yokulwa nesifo sengqondo. Odokotela ngezinye izikhathi bayibiza ngokuthi i-akathisia ebangelwa yi-antipsychotic. Imithi yokulwa nesifo sengqondo, noma i-neuroleptics, iwela ezinhlotsheni ezimbili eziyinhloko:- Isizukulwane sokuqala noma ama-antipsychotics "ajwayelekile" (i-FGA).
- Isizukulwane sesibili noma "esihlukile" `(Ama-Antipsychotics - SGA)`.
I-Akathisia ivame ukuhlotshaniswa nemithi esesigabeni se-`(FGA)`, ikakhulukazi leyo enamandla kakhulu futhi esetshenziswa ngemithamo ephezulu. Ingozi iphansi kancane ngemithi ye-`(SGA)`. Odokotela banikeza le mithi ye-`(FGA)` kanye ne-`(SGA)` yezifo ezahlukahlukene ze-neuropsychiatric. Isibonelo:- Ukuphazamiseka kokuziphatha ku-dementia.
- Isifo se-bipolar.
- Ukucindezeleka.
- Izinkinga zokudla.
- Isifo sokukhathazeka esijwayelekile.
- Ukungalali .
- Isifo sokuzikhukhumeza ngokweqile (`Isifo sokuzikhukhumeza ngokweqile -I-OCD ).
- Ukuphazamiseka kobuntu.
- Isifo sokucindezeleka ngemva kokucindezeleka (PTSD).
Isifo sokungezwani komzimba (Schizoaffective disorder). I-Schizophrenia kanye nezinkinga ezihlobene nayo.
Izibonelo zeminye imithi ye-FGA (enamagama omkhiqizo) engase ihlotshaniswe ne-Akathisia:- "I-Chlorpromazine (Thorazine®)"
- `I-Fluphenazine (Prolixin®)`
- `I-Haloperidol (Haldol®)`
- `I-Loxapine (Loxitane®)`
- "I-Prochlorperazine (Compro®, Compazine®)"
Eminye yemithi ye-SGA esengozini enkulu ye-Akathisia ihlanganisa:- `I-Paliperidone (Invega®)`
- `I-Ziprasidone (Geodon®)`
Ama-antidepressants ahlobene ne-Akathisia
Nakuba kungavamile njengemithi yokulwa nesifo sengqondo, eminye imithi yokucindezeleka nayo ihlotshaniswa ne-akathisia. Lokhu kufaka phakathi:- Ama-Selective serotonin reuptake inhibitors (SSRIs): Lawa ama-antidepressants avame ukunqunywa. Izibonelo: i-fluoxetine (Prozac®), i-paroxetine (Paxil®).
- I-Monoamine oxidase inhibitors (MAOIs): Lezi kwakuyimithi yokuqala yokucindezeleka eyasungulwa. Nakuba yayisebenza kahle, imithi emisha nephephile enemiphumela emibi embalwa manje isisetshenziswa kaningi.
- Ama-antidepressant e-Tricyclic (TCA): Odokotela banikeza lawa uma amanye ama-antidepressant engasebenzi. Izibonelo: i-clomipramine (i-Anafranil®), i-amitriptyline (i-Elavil®).
Odokotela banikeza imithi yokucindezeleka ezimweni ezifana nalezi:- Ukucindezeleka.
- Isifo se-bipolar.
- Izinkinga zokukhathazeka.
- Ubuhlungu obungapheli.
- Isifo sokuzikhukhumeza ngokweqile (OCD).
- Ukuhlaselwa uvalo.
- Isifo sokucindezeleka ngemva kokucindezeleka (PTSD).
Kulinganiselwa ukuthi phakathi kuka-10% no-18% wabantu abanesifo se-bipolar I abathatha imithi yokucindezeleka bahlakulela i-akathisia. Eminye imithi ehlobene ne-Akathisia
Eminye imithi engase ihlotshaniswe ne-Akathisia:- Imithi yokucanuzela noma ukuhlanza (imithi yokulwa nokugabha), isib. i-metoclopramide.
- Imithi yomfutho wegazi ophakeme, isibonelo i-`reserpine`, i-`methyldopa`.
- Ama-calcium channel blockers, isibonelo i-cinnarizine, i-diltiazem.
- Imithi yokudambisa ubuhlungu.
- Umuthi wokudambisa isiyezi.
- `I-Azithromycin` (i-antibiotic esetshenziswa kabanzi).
- `I-Buspirone` (umuthi wokukhathazeka).
I-Akathisia ingabangelwa nezidakamizwa ezingekho emthethweni ezifana ne-amphetamine, i-methamphetamine, ne-cocaine. Ungayibona kanjani (i-Akathisia)?
Odokotela bavame ukuxilonga i-Akathisia ngokubheka ukuziphatha kwesiguli kanye nezimpawu zaso (`ukubonwa kwezokwelapha`). Lokhu akudingi ukuhlolwa kwegazi noma ukuhlolwa kwezithombe. Indlela evame kakhulu esetshenziswa ukuhlola izinga le-Akathisia yi-`Barnes Akathisia-Rating Scale (BARS)``. Uma ucabanga ukuthi une-Akathisia, udokotela wakho uzokubuza imibuzo mayelana nezimpawu zakho, umlando wezokwelapha, kanye nemithi yamanje. Bazophinde bahlole ukuziphatha kwakho kanye nokunyakaza kwakho. Ngeshwa, i-Akathisia ivame ukuba nzima ukuyixilonga. Ngoba izimpawu zayo zifana nezinye izimo zempilo yengqondo, isibonelo:- Isifo sengqondo.
- Ukuhlanya.
- Isifo sokungakwazi ukunaka/sokungasebenzi kahle (ADHD).
- Ukucindezeleka okubangelwa ukucindezeleka.
Iphathwa kanjani i-Akathisia?
Okwamanje akukho ukwelashwa okuqondile kwe-Akathisia. Uma i-Akathisia yakho ibangelwa umuthi, udokotela wakho cishe uzozama ukukushintshela komunye umuthi noma anciphise umthamo womuthi owuthathayo njengamanje (uma kungenzeka). Ezinye izifundo zibonise ukuthi imithi elandelayo ingasiza nge-Akathisia:- Ama-Beta-blocker, isibonelo i-propranolol.
- Ama-Benzodiazepine (uhlobo lwemithi esetshenziselwa ukwelapha izimo ezifana nokukhathazeka, ukuqwasha, kanye nokuquleka).
- I-mirtazapine ephansi (isidakamizwa sokucindezeleka).
- Imithi yokulwa ne-cholinergic (uhlobo lomuthi osetshenziselwa ukwelapha izimo ezifana ne-asthma).
- I-Vitamin B6.
Ingabe i-Akathisia ingavinjelwa?
Ososayensi basazama ukuqonda ngokugcwele i-Akathisia, izimbangela zayo, kanye nokwelashwa kwayo. Kodwa bayazi ukuthi i-Akathisia inamathuba amaningi okukhula ezimweni ezilandelayo:- Uma uthatha umuthi wesizukulwane sokuqala wokulwa nesifo sengqondo.
- Uma uphuza umuthi omningi kakhulu.
- Uma udokotela wakho ekhulisa umthamo wemithi yakho ngokuzumayo, noma kakhulu.
- Uma uneminyaka ephakathi noma umdala.
Uma ubheka la maqiniso, indlela engcono kakhulu yokuvimbela i-Akathisia ukuthi odokotela baqale le mithi ngesilinganiso esiphansi kakhulu futhi bandise kancane kancane umthamo uma kudingeka. Ngaphambi kokuqala noma yimuphi umuthi, kubalulekile ukukhuluma nodokotela wakho ngezingozi, izinzuzo, kanye nemiphumela emibi engaba khona. Iyini i-prognosis ye-(Akathisia)?
Uma i-Akathisia iqashelwa kusenesikhathi futhi imithi eyibangela iyekwa (uma kungenzeka), lesi simo sivame ukuba ngcono. Kodwa-ke, uma i-Akathisia ingelashwa, ingaba buthakathaka kakhulu. Abantu abaningi abane-Akathisia babhekana nokukhathazeka okukhulu nokucindezeleka (`dysphoria`). Bangase babe nemicabango yokuzibulala. Uma unemicabango yokuzibulala, kubalulekile ukufuna usizo lwezokwelapha ngokushesha.
Kufanele ubonane nini nodokotela mayelana (ne-Akathisia)?
Uma unezimpawu ze-Akathisia, kubalulekile ukukhuluma nodokotela wakho. Uma besheshe bathole imbangela, kulapho besheshe bashintshe imithi yakho futhi balawule lesi simo. I-Akathisia ingumphumela ocasulayo kakhulu ongabangelwa eminye imithi. Uma ukhathazekile ukuthi ungase ube ne-Akathisia ngemuva kokuqala imithi yesimo sempilo yengqondo noma ukuphazamiseka kwezinzwa, ungesabi ukubuza udokotela wakho ngakho. Uma unezimpawu ze-Akathisia, tshela udokotela wakho ngokushesha okukhulu. Izinto ezibaluleke kakhulu okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)
- I-Akathisia yisimo lapho ukungaphumuli kwangaphakathi kubangela ukungakwazi ukuhlala endaweni eyodwa kanye nesifiso esiqhubekayo sokunyakaza.
- Lokhu kungabangelwa kakhulu eminye imithi yokulwa nokuphazamiseka kwengqondo. Kungabangelwa futhi imithi yokucindezeleka kanye neminye imithi.
- Izimpawu zifaka phakathi ukuqhaqhazela kwemilenze, ukuhambahamba, kanye nokungakwazi ukuhlala endaweni eyodwa.
- Lokhu akusikho ukukhathazeka, kodwa kungabangela ukukhathazeka.
- Uma unalezi zimpawu, qiniseka ukuthi utshela udokotela wakho. Lesi simo singalawulwa ngokushintsha umthamo womuthi wakho noma ukushintshela komunye umuthi.
- Ungalokothi uyeke ukuthatha imithi yakho noma ushintshe umthamo ngaphandle kweseluleko sikadokotela wakho.
- I-Akathisia ingabuyiselwa emuva uma itholakale futhi yelashwa kusenesikhathi.
Uma uneminye imibuzo mayelana nalokhu, ungangabazi ukukhuluma nodokotela wakho. Hlala uphilile!
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