Ingabe nawe unesifo sokucindezeleka okukhulu, noma njengoba sibiza ngokwezokwelapha, i-Major Depression Disorder (MDD)? Ngisho nangemva kokusebenzisa umuthi owodwa noma emibili oyinikezwe udokotela, awuzizwa ungcono noma ushintsha? "Ngenzenjani manje?" Ungase ucabange ngokukhungatheka okukhulu. Kuvamile kakhulu ukuzizwa unesizungu futhi ungenalusizo ngesikhathi esinjengalesi. Kodwa ungesabi. Awuwedwa. Njengoba isayensi ithuthuka, kuvela amathemba amasha. Namuhla sikhuluma ngethemba elisha elinjalo.
Okokuqala, ake sikukhumbuze kancane ngemithi yokucindezeleka evamile enikezwa udokotela.
Uma usuqalile ukwelashwa kokucindezeleka, udokotela wakho kungenzeka ukuthi uqale wakubhalela uhlobo lomuthi olubizwa ngokuthi 'i-antidepressant yendabuko.' Kunezinhlobo eziningana eziyinhloko zalezi. Le mithi isebenza ngokulinganisela umsebenzi wezithunywa zamakhemikhali ebuchosheni, ezibizwa ngokuthi ama-neurotransmitters , athinta isimo sethu sengqondo nemizwa. Lokhu kufaka phakathi i-serotonin , i-norepinephrine , kanye ne-dopamine .
Kodwa kunezinselele ezimbalwa ngale mithi. Enye ukuthi ithatha isikhathi ukuqala ukusebenza. Ngokuvamile kufanele ulinde cishe amasonto amane kuya kwayisishiyagalombili ukuze ubone imiphumela. Enye ukuthi le mithi ayisebenzi ngendlela efanayo kuwo wonke umuntu. Izifundo zibonisa ukuthi cishe abantu ababili kwabathathu abayisebenzisayo abalulami ngokugcwele .
Ukuze kube lula ngawe ukuqonda, ake sibheke eminye yemithi esetshenziswa kakhulu etafuleni elifana naleli.
| Isigaba Sezidakamizwa | Izibonelo Ezivamile |
|---|---|
| Ama-SSRI (Ama-Selective Serotonin Reuptake Inhibitors) | I-Citalopram, i-Escitalopram, i-Fluoxetine, i-Paroxetine, i-Sertraline |
| Ama-SNRI (ama-Serotonin-Norepinephrine Reuptake Inhibitors) | I-Duloxetine, i-Venlafaxine |
| Ama-Antidepressants Angavamile | I-Bupropion, i-Mirtazapine, ne-Trazodone |
Uma uke wazama umuthi owodwa noma ngaphezulu kodwa ungazizwa ungcono, ungakhathazeki. Akulona iphutha lakho. Yizikhathi ezinjengalezi lapho odokotela becabanga khona ngemithi emisha nethuthukisiwe.
Ngakho-ke yiziphi lezi zindlela ezintsha zokwelapha ze-NMDA?
Kalula nje, lena indlela ehluke ngokuphelele yokwelapha ukucindezeleka. Ngokungafani nemithi yangaphambilini, lokhu kwelashwa kuhlose ama-receptor asebuchosheni abizwa ngokuthi i-N-methyl-D-aspartate (NMDA) .
Cabanga ngalokhu. Kumuntu onesifo sokucindezeleka okukhulu, ezinye izingxenye ezibalulekile zobuchopho zingase zingabi matasa kangako, njengokuthi 'zilele' (azisebenzi kahle). Lokho okwenziwa ukwelashwa kwe-NMDA ukulawula isenzo senye i-neurotransmitter enamandla ebizwa ngokuthi i-glutamate , nokuqinisa ukuxhumana phakathi kwalawo maseli obuchopho 'alele' (ama-neurons). Lokho kusho ukuthi ngokuzumayo kusheshisa ukushintshana kwemiyalezo phakathi kwamangqamuzana obuchopho.
Ochwepheshe bakholelwa ukuthi lokhu kuvuselelwa okunamandla nokungazelelwe kokuxhumana phakathi kwamangqamuzana obuchopho yikona okubangela ukwehla okusheshayo okumangalisayo kwezimpawu zokucindezeleka.
Inzuzo enkulu yalokhu ijubane. Nakuba imithi evamile ingathatha amasonto ukusebenza, eminye imithi ye-NMDA ingaqala ukunikeza impumuzo ebalulekile kanye noshintsho esigulini emahoreni ambalwa .
Yiziphi izindlela zokwelapha eziqondiswe ku-NMDA? Ingabe zikhona izingozi?
I-Ketamine iyisidakamizwa esiyinhloko esisetshenziselwa ukwelapha ukucindezeleka okumelana nokwelashwa ngokugxila kuma-receptor e-NMDA.
Lokhu kuvame ukunikezwa isiguli ngomthambo (ofakwa emthanjeni noma nge-IV) nge-saline . Kodwa kukhona into okudingeka uyikhumbule lapha.
Lokhu akuyona neze indlela yokuqala yokwelapha udokotela angancoma ngayo ukucindezeleka.
Lokhu kusetshenziswa kuphela ezigulini ezinokucindezeleka okukhulu ezizame zonke ezinye izindlela futhi ezingaphumelelanga. Futhi, lokhu kwelashwa kwenziwa esibhedlela, ngaphansi kokubhekwa okuseduze kodokotela abangochwepheshe kanye nabasebenzi abaqeqeshiwe. Lona akuwona umuthi ongathengwa ekhemisi bese uyiswa ekhaya.
Kungani wenza lokho? Ngoba njengayo yonke imithi, kunemiphumela emibi engaba khona. Ngesikhathi sokwelashwa, ungase ubhekane nezinguquko ekucindezelweni kwegazi, isiyezi, isicanucanu, futhi ngezinye izikhathi ukuhlukana okuncane neqiniso. Ukubhekwa kwezokwelapha kubalulekile ukuze kulawulwe konke lokhu.
Ngingazi kanjani ukuthi ngifanelekela lolu hlobo lokwelashwa?
Lona ngumbuzo obaluleke kakhulu. Impendulo yalokhu inganqunywa kuphela udokotela wakho okwelaphayo. Ukuthi ungumuntu ofanele yini ukwelashwa okuthuthukisiwe njengokwelashwa kwe-NMDA kuzoncika ezintweni eziningana:
- Yiziphi izinhlobo zemithi yokucindezeleka oke wayisebenzisa ngaphambili?
- Zasetshenziswa isikhathi esingakanani, futhi ngesilinganiso esifanele?
- Umzimba wakho wasabela kanjani kuzo?
- Ubunzima bamanje bezimpawu zakho zokucindezeleka.
- Isimo sakho sempilo iyonke (ezinye izifo, eminye imithi oyiphuzayo, njll.).
Ngakho-ke, into engcono kakhulu ongayenza ukukhuluma ngokukhululekile nodokotela wakho ngakho konke okusengqondweni yakho. Ungesabi ukubuza imibuzo efana nokuthi, "Dokotela, bengilokhu ngithatha lo muthi izinyanga manje, kodwa angikaze ngibone umehluko," noma "Ingabe ayikho enye indlela engingayinqoba ngayo lokhu?" Lapho ukhuluma kakhulu ngemizwa yakho kanye nokuhlangenwe nakho kwakho, kulapho kuzoba lula khona ngodokotela wakho ukukhetha ukwelashwa okungcono kakhulu kuwe.
Umlayezo Wokuya Nawe Ekhaya
- Isifo sokucindezeleka okukhulu (MDD) yisimo esibucayi esidinga ukwelashwa. Ama-antidepressant avamile (SSRIs, SNRIs) awasebenzi kahle ngokulinganayo kuwo wonke umuntu.
- Kulabo abangasabeli emithini evamile, manje sekukhona izindlela zokwelapha zesimanje ezifana neKetamine, ehlose ama-receptor e-NMDA.
- Lokhu kungathinta i-glutamate ebuchosheni, kuqinise ngokushesha ukuxhumana phakathi kwamangqamuzana obuchopho, futhi kunikeze ukuphulukiswa okusheshayo.
- Lezi izindlela zokwelapha ezikhethekile, futhi zinikezwa kuphela iziguli ezihlulekile kwezinye izindlela zokwelapha, ngaphansi kokuqashwa okuqinile kwezokwelapha esibhedlela.
- Uma ungatholi impumuzo ekwelashweni kwakho kwamanje, ungalilahli ithemba futhi ukhulume ngokukhululekile nodokotela wakho ngazo zonke izinketho.
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