Ukucindezeleka akuyona nje umuzwa wokudabuka, kuyisimo sezokwelapha esidinga ukwelashwa. Ngezinye izikhathi, ngisho nangemva kokusebenzisa imithi ehlukahlukene yokucindezeleka, ukucindezeleka kwabanye abantu akuthuthuki. Sibiza lolu hlobo lokucindezeleka okumelana nokwelashwa. Namuhla, sikhuluma ngendlela yesimanje yokwelapha engasiza abantu abanjalo nalabo abahlushwa ukucindezeleka okukhulu ngemicabango yokuzibulala.

Iyini i-Spravato? Isebenza kanjani?

I-Spravato iyisifutho samakhala esiqukethe umuthi i-esketamine . Kuyindlela yokwelapha eyavunywa yi-US FDA ngo-2019.

Cishe uke wezwa igama elithi ketamine ngaphambilini. I-Ketamine umuthi onikezwa ngemithambo yegazi (IV) njengomuthi wokuqeda ubuhlungu kanye nokubulala izinzwa ezibhedlela. Iphinde isetshenziswe emitholampilo yezilwane. Kungenzeka ukuthi uke wezwa leli gama ngoba abanye abantu balisebenzisa kabi ukuze bathole ukudakwa kakhulu futhi bazizwe bengaboni kahle.

I-Spravato uhlobo olukhethekile lwe-ketamine. Kalula nje, lo muthi usebenza kuma-receptor asebuchosheni bethu abizwa ngokuthi ama-N-methyl D-aspartate (NMDA) receptors . Ngalokhu, unganciphisa izimpawu zokucindezeleka ngokushintsha amakhemikhali ahilelekile esimweni sethu sengqondo.

Uthole kanjani ukuthi lo muthi usebenza kahle kangakanani?

Kuye kwenziwa izifundo ezine zezokwelapha ukuze kuhlolwe ukuphepha nokusebenza kahle kweSpravato. Lezi zifundo zazihlanganisa abantu abadala abaneminyaka ephakathi kuka-18 no-64.

Basebenzise uhlelo olukhethekile lokuthola amaphuzu ukuze balinganise ubukhulu bokucindezeleka kanye nokuthuthukiswa kwezimpawu. Lubizwa ngokuthi i-Montgomery-Asberg Depression Rating Scale (MADRS) . Luyimibuzo enemibuzo eyi-10. Lubuza ngezinto ezifana nemizwa, imizwa yecala, izindlela zokulala, kanye nemicabango yokuzibulala. Amaphuzu asukela ku-0 kuya ku-60, kanti amaphuzu aphezulu abonisa ukucindezeleka okukhulu . Ngemva kokwelashwa, lapho amaphuzu e-MADRS eba mabi kakhulu, amaphuzu aphansi, okubonisa ukuthuthuka okwengeziwe kwezimpawu.

Iyini imiphumela yalezi zifundo?

Le miphumela ikhombisa ukuthi abantu abasebenzisa iSpravato babe nokwehla okukhulu kwezimpawu zokucindezeleka. Izifundo ziphinde zathola ukuthi labo abaqhubeka nokusebenzisa iSpravato babe nokubuyela kwezimpawu emuva kwesikhathi eside.

Okukhethekile ngalokhu ukuthi iSpravato ikhombisa ukwehla okukhulu kwezimpawu zingakapheli amahora angama-24 iyisebenzisa . Ama-antidepressant ajwayelekile athatha amasonto ambalwa ukukhombisa imiphumela. Ngakho-ke, lokhu kungabaluleka kakhulu esimweni esiphuthumayo.

Ingabe i-Spravato ingasebenzisana neminye imithi?

Yebo, udinga ukuqaphela ngeminye imithi uma uthatha iSpravato.

• Imithi yokucindezeleka kwegazi: I-Spravato ingakhuphula ukucindezeleka kwegazi okwesikhashana. Le ngozi iyanda uma uthatha olunye uhlobo lokucindezeleka, njenge -monoamine oxidase inhibitor (MAOI) , noma izikhuthazi zezinkinga zokunaka. Ngakho-ke, uma uthatha le mithi, kufanele uhlolwe ukucindezeleka kwegazi njalo.
• Imithi ebangela ukozela kanye nesiyezi: I-Spravato ingabangela ukozela kanye nesiyezi. Le miphumela emibi ingenziwa ibe mibi kakhulu uma usebenzisa izidakamizwa ezicindezela uhlelo lwezinzwa oluphakathi, njenge- benzodiazepines (isb., i-alprazolam, i-clonazepam), ama-opioid (ama-painkiller), kanye notshwala .

Ngithola kanjani ukwelashwa kwe-Spravato?

Lona akusiwo umuthi ongawuthenga ekhemisi bese uwuthatha uye nawo ekhaya ukuze uwusebenzise.

Ngenxa yemiphumela emibi kanye nengozi yokusebenzisa kabi iSpravato, lokhu kwelashwa kungenziwa kuphela ezikhungweni zokwelapha eziqinisekisiwe . Lezi zikhungo kumele zibhaliswe ngaphansi kohlelo olukhethekile olubizwa ngeSpravato REMS (Risk Evaluation and Mitigation Strategy).

1. Khuluma nodokotela wakho: Uma unesifiso salokhu kwelashwa, khuluma nodokotela womndeni wakho noma udokotela wezifo zengqondo.

2. Ukudluliselwa: Uma udokotela wakho ecabanga ukuthi iSpravato ikufanele, uzokudlulisela esikhungweni sokwelashwa esiqinisekisiwe.

3. Ukubonisana: Uzobe usunikezwa ukubonisana esikhungweni sokwelapha. Lapho, odokotela bazohlola nesimo sakho bese beqhubeka nokunquma ukuthi lokhu kulungile yini kuwe.

4. Ukuqala ukwelashwa: Uma konke kulungile, ukwelashwa kungaqala ekuvakasheni kwakho kwesibili.

Uyisebenzisa kanjani i-Spravato?

Lokhu kuthathwa kanye noma kabili ngesonto, esikhungweni esiqinisekisiwe, ngaphansi kokuqondisa kwabasebenzi bezokwelapha .

• Isilinganiso kanye nokusetshenziswa: Udokotela wakho uzonquma isilinganiso osidingayo. Bazokufundisa nendlela yokusebenzisa i-nasal spray.
• Ukudla namanzi: Njengoba umuthi ungabangela isicanucanu nokuhlanza, kuyalulekwa ukugwema ukudla amahora ama-2 ngaphambi kokwelashwa nokuphuza amanzi imizuzu engama-30 ngaphambi kokwelashwa .
• Isikhathi sokubuka:Ngemva kokuthatha i-Spravato, uzoqashwa udokotela wakho okungenani amahora ama-2 ukuze ahlole izinguquko ekucindezelweni kwegazi lakho kanye neminye imiphumela emibi.
• Ukushayela: Lo muthi ungathinta ukugxilisa ingqondo kwakho kanye nekhono lakho lokwenza izinqumo ngosuku lokwelashwa. Ngakho-ke, kufanele uhlele ukuthi othile akushayele ngemoto akuyise ekhaya esuka esikhungweni sokwelashwa . Kungcono ukushayela noma ukwenza eminye imisebenzi edinga ukugxilisa ingqondo ngosuku olulandelayo ngemuva kokulala kahle ebusuku.

Yiziphi imiphumela emibi futhi zingagwenywa kanjani?

I-Spravato ingaba nemiphumela emibi kakhulu, yingakho inikezwa kuphela ngaphansi kokuqondisa kukadokotela.

• Ukozela nokudideka: Ukulala ngokweqile, isiyezi, ukuquleka, kanye nokuhlukana kungenzeka.
• Ubunzima bokuphefumula: Ukuphefumula kungase kube kancane noma kube mfushane. Lokhu kuyiqiniso ikakhulukazi uma unezinye izimo zokuphefumula noma uthatha eminye imithi enciphisa ukuphefumula kwakho.
• Ukwanda komfutho wegazi: Umfutho wegazi ungakhuphuka okwesikhashana cishe amahora ama-4 ngemuva kokuthatha umuthi. Uma uzwa ubuhlungu besifuba, ubunzima bokuphefumula, ikhanda elibuhlungu, ukushintsha kombono, noma ukuxhuzula , tshela udokotela wakho ngokushesha .
• Imicabango yokuzibulala eyandisiwe: Njengakweminye imithi yokucindezeleka, kunengozi encane yokuthi abanye abantu bangase babe nemicabango noma izenzo zokuzibulala ezandisiwe ngesikhathi sokuqala kokuthatha iSpravato. Tshela udokotela wakho ngokushesha uma unezinguquko ezintsha noma ezinkulu ekuziphatheni noma emicabangweni yakho.

Uma kunesimo esiphuthumayo, shayela i-Suwa Saria Ambulance Service ku-1990 , noma shayela ucingo lwe-hotline yezempilo yengqondo ku-1926. Noma hamba uye esibhedlela esiseduze i-Emergency Treatment Unit (ETU) .