Ingabe ubulokhu uthatha imithi yesifo sengqondo esifana nokucindezeleka isikhathi eside? Manje njengoba uzizwa ungcono kakhulu, ucabange ngokunciphisa imithi, kodwa bekungelula njengoba ubucabanga. Ingabe udidekile ngobunzima obungavamile obuhambisana nokuyeka imithi? Khona-ke lesi sihloko sizoba sibaluleke kakhulu kuwe. Ake sixoxe ngalokhu ngokuningiliziwe.
Cabanga ngendaba yowesifazane ogama lakhe linguMorgan Stewart. Wayesethathe imithi yokucindezeleka iminyaka eminingi. Wayethatha imithi ebizwa ngokuthi iSertraline (igama lomkhiqizo elithi Zoloft). Ngemva kwesikhashana, wanquma ukuthi kudingeka ayeke ukuthatha imithi ngoba isimo sakhe sengqondo sasithuthuka. Udokotela wakhe wamtshela ukuthi ayeke konke ngesikhathi esisodwa noma, ukuze aphephe, anciphise imithi. UMorgan wakhetha le yokugcina.
Kodwa ngemva kwamasonto ambalwa enciphisa iphilisi lika-50 mg libe yisigamu, waqala ukuzwa izimpawu ezingavamile. Ukushaya kwenhliziyo okusheshayo okungachazeki, isiyezi, ukukhala ezindlebeni zakhe, ikhanda elibuhlungu elinzima, kanye nokungalali . Ngemva kwenyanga noma ezimbili eyeke ngokuphelele umuthi, isimo sakhe saba sibi kakhulu. Wayengakwazi ukuhlala phansi athule, wayengakwazi ukulala kahle, futhi waqala ukuba nemicabango ephazamisayo yokulimaza umuntu amthandayo noma yena ngokwakhe.
Izinto zaba zimbi kakhulu kangangokuthi uMorgan waze wachitha izinsuku ezimbalwa esibhedlela sezengqondo. Kulapho-ke aqaphela khona ukuthi lokhu kwakungeyona inkinga yokucindezeleka kwakhe ebuyayo, kodwa kwakuyizimpawu zokuhoxa ezihambisana nokuyeka imithi. Odokotela babiza lezi zimpawu ngokuthi "izimpawu zokuhoxa". Kodwa akekho owayazi kahle ukuthi enzeni ngazo. Ekugcineni, wanikezwa eminye imithi emibili (''Clonazepam'' kanye ''Buspirone'') ukulawula lezi zimpawu ezintsha. Ekugcineni, wakwazi ukuyeka umuthi owodwa futhi wanamathela eminye imithi emibili okwakunzima ukuyiyeka. Kodwa-ke, kwakungesikhathi efuna ulwazi ku-inthanethi lapho uMorgan afunda khona ngale ndlela entsha enesisekelo sesayensi esibizwa ngokuthi ''Hyperbolic Tapering''.
Kungani ngezinye izikhathi kungalungile ukunciphisa imithi ngendlela evamile?
Ngokwezifundo ezithile, phakathi kuka-30% no-40% wabantu abayeka ukuthatha imithi yokucindezeleka bangase babe nezimpawu ezithile zokuhoxa. Ingozi yemiphumela emibi kakhulu iphezulu kakhulu uma abantu asebethathe le mithi isikhathi esingaphezu konyaka beyeka.
Inkinga isendleleni esetshenziswa odokotela abaningi ukunciphisa imithi. Ibizwa ngokuthi "i-linear tapering." Kalula nje, lokhu kuhilela ukunciphisa umthamo wemithi ngenani elifanayo njalo ngesonto noma ngenyanga . Isibonelo, ukunciphisa cishe ngama-milligram ayi-10 njalo ngesonto.
"Kodwa le ndlela ishesha kakhulu kumuntu obelokhu ethatha umuthi isikhathi eside," kusho uDkt. Mark Horowitz, udokotela nomcwaningi oseLondon. "Le ngozi iphezulu kakhulu uma umuthi usuzomiswa ngokuphelele."
Uchaza ngale ndlela: Cabanga ngomuntu othatha ama-milligram angu-20 esidakamizwa `(Lexapro)`. Ukusinciphisa kusuka ku-5 kuya ku-0 kuzwakala kunamandla aphindwe kabili ebuchosheni kunokusinciphisa kusuka ku-20 kuya ku-15. Kufana nokugxuma eweni. Nakuba i-5mg ingase ibonakale njengomthamo omncane kodokotela, akusibo ubukhulu bephilisi obubalulekile, kodwa umphumela onawo ebuchosheni.
Ngakho-ke, uma uqala ukunciphisa umuthi, akuzizwa sengathi kuyinkinga enkulu. Kodwa uma unciphisa ama-milligram ambalwa okugcina, kungazwakala sengathi "kuyinto esabekayo." Uma odokotela bengakuqapheli lokhu, bangase bacabange ukuthi, "Lesi siguli sesiphinde sabuyela esimweni saso."
Okuhlangenwe nakho komuntu siqu kukadokotela
UDkt. Horowitz ukwazi kahle lokhu, ngoba naye ngokwakhe usedlule kukho. Lapho kancane kancane eyeka ukuphuza umuthi iLexapro, ayewusebenzisa iminyaka eyi-12, naye waba nemiphumela emibi kakhulu, okuhlanganisa nemicabango yokuzibulala. "Kwakuyisipiliyoni esesabekayo kakhulu engake ngasithola empilweni yami," usho kanje.
Kwakungemva kwalokhu okuhlangenwe nakho lapho aqala ukucabanga ngokujulile ngale ndaba. Wafunda ngokucophelela izimpawu ezazizovela uma eyeka ukuthatha lo muthi.
| Izimpawu Zokuyeka | |
|---|---|
| Izimpawu ezivamile | Izimpawu ezingavamile kakhulu |
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Iyini isayensi ngemuva kwale ndlela ebizwa ngokuthi i-Hyperbolic Tapering?
Kalula nje, "i-Hyperbolic Tapering" iyindlela yokunciphisa kancane kancane umthamo womuthi, ukuwunciphisa kancane kancane, bese uwunciphisa nakakhulu. Lena inqubo ehamba kancane kakhulu eyenzeka ezinyangeni eziningi, ngezinye izikhathi iminyaka.
Isibonelo, umthamo wemithi yomuntu ungancishiswa ngo-10% njalo ngenyanga . Kodwa-ke, lo 10% ubalwa kusukela kumthamo wakamuva, oncishisiwe. Ngakho-ke njengoba umthamo wemithi uncishiswa, inani lokunciphisa liba lincane. Ucwaningo lukhombisile ukuthi le ndlela ingasetshenziswa ngempumelelo ekumiseni imithi yokucindezeleka, ukuqwasha, ukukhathazeka, nezinye izifo zengqondo, kanye nasekumiseni imithi yezinye izimo.
Kodwa lokhu akulula ukukwenza. Kunezinselele ezimbili ezinkulu kulokhu:
1. Ukuthola udokotela onolwazi: Kunzima ukuthola udokotela onolwazi ngale ndlela futhi ongakha uhlelo olufanela wena.
2. Ukuthola imithamo emincane kakhulu: Izinkampani zemithi azikhiqizi amaphilisi ngemithamo emincane kangaka. Ngakho-ke kufanele usebenzise umuthi owuketshezi noma wenze le mithamo emincane ngekhemisi elixuba imithi. Zombili lezi zingabiza kakhulu.
Le ndlela ibaluleke kangakanani ngempela? Kungani odokotela bethu bengazi okwengeziwe ngayo?
Abanye ochwepheshe bathi le ndlela ethi "Hyperbolic Tapering" iyadingeka kuphela kubantu abambalwa kakhulu abanezimpawu ezinzima, nokuthi kubantu abaningi, izimpawu ezenzeka lapho umuthi uyekwa ngendlela evamile zincane futhi ziyanyamalala zodwa.
Kodwa uDkt. Horowitz akavumelani. Uthi, "Lokhu akuyona inkinga yabantu abambalwa." Ucwaningo lwakhe lukhombisile ukuthi umuntu oyedwa kwabayisikhombisa (1/7) ophuza umuthi iminyaka engaphezu kwemibili uba nemiphumela emibi kakhulu.
Inkinga enkulu ukuthi odokotela abaningi abaqeqeshwe kahle kulokhu. Bafundiswa ukuthi imiphumela emibi incane futhi izophela ezinsukwini ezimbalwa. Ngakho-ke, lapho isiguli sifika futhi sikhala ngezimpawu ezinzima, sicabanga ukuthi, "Lokhu akukhona ukuhoxa, ukugula kwakho kwengqondo sekubuyile." Bese bebuyisela isiguli emithini.
Iqiniso lokuthi izinkulungwane zabantu abanjengalaba ziya ku-inthanethi ukuze zitholele izixazululo zazo lisho ukuthi kube nokwehluleka okukhulu endaweni ethile ohlelweni lwethu lwezokwelapha.
Yingakho iziguli eziningi zisungule amaqembu aku-inthanethi ukuze zixoxe ngezinkinga zazo futhi zithole izixazululo, ngoba odokotela bazo abazithathi ngokungathi sína.
'Njengokuvuka ephusheni'
Namuhla, uMorgan uthi uzizwa sengathi "uvuka ephusheni elibi." Udokotela wakhe wayengayisekeli le ndlela entsha, ngakho wafuna usizo komunye udokotela owayeqeqeshwe kulokhu.
Walungisa umuthi wakhe ekhaya. Wancibilikisa iphilisi emanzini, wasebenzisa isirinji, walinganisa ukuthi mangaki amamililitha okwakudingeka awathathe nsuku zonke. Kodwa lena indlela eyingozi kakhulu futhi eyinselele. Wakwenza lokhu izinyanga ezingu-15 futhi wakwazi ukuyeka ukuthatha i-Clonazepam ngaphandle kwemiphumela emibi emisha.
Okubalulekile: Kuyingozi kakhulu ukuzama lezi zinto wedwa. Kufanele nakanjani ucabangele ukwenza lezi zinto ngaphansi kokuqondisa kukadokotela owaziyo ngalokhu. Ukuphutha umthamo kungaba nemiphumela emibi kakhulu.
UMorgan uthi impilo yakhe igcwele injabulo futhi. "Sengikhululekile manje," usho kanje. "Kuyisimangaliso, uma ubheka ukuthi bengikuphi."
Umlayezo Wokuya Nawe Ekhaya
- Lapho beyeka imithi yesikhathi eside yezifo zengqondo ezifana nokucindezeleka, abanye abantu bangase babe nemiphumela emibi kakhulu (izimpawu zokuyeka).
- Indlela ejwayelekile (i-linear tapering) elandelwa odokotela abaningi ayisebenzi kuwo wonke umuntu, ikakhulukazi labo asebethathe imithi isikhathi eside.
- I-Hyperbolic Tapering iyindlela ephephile yokunciphisa umthamo wemithi kancane kancane, ngamanani amancane kakhulu, ezinyangeni noma eminyakeni.
- Ungalokothi uyeke ukuthatha imithi noma ushintshe umthamo ngokwakho ngaphandle kokukhuluma nodokotela wakho.
- Uma unenkinga yokuyeka imithi yakho, khuluma nodokotela wakho ngale ndlela ye-Hyperbolic Tapering. Angase angazi ngayo, kodwa ukukhuluma ngalolu cwaningo olusha kungakusiza ukuthola ikhambi.
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