Ingabe uzithola ushukumisa umzimba wakho ngokungazikhetheli? Ake sixoxe nge-Tardive Dyskinesia!

Ingabe ngezinye izikhathi uzizwa sengathi izingxenye zomzimba wakho, njengengalo noma umlenze, noma isimo sobuso, zinyakaza nje ngokungalawuleki? Noma ingabe othile omaziyo uke waba nalezi zimpawu ezingavamile ngemva kokuthatha imithi ethile? Uma uke wezwa ngento enjalo, khona-ke isimo esizokhuluma ngaso namuhla, esibizwa ngokuthi i-Tardive Dyskinesia, sizoba yinto ebalulekile kuwe. Nakuba kuyigama elide, ake siqonde ukuthi liyini.

Kuyini i-Tardive Dyskinesia?

Kalula nje, i-Tardive Dyskinesia (TD) iyisifo sezinzwa, noma iqoqo lezimpawu, lapho imisipha yomzimba wakho inyakaza khona ngokungazi, ngaphandle kokulawula kwakho. Njengokunyakazisa isandla noma isimo sobuso sishintsha ngokuzumayo.

Imbangela eyinhloko yalesi simo ukusetshenziswa kwesikhathi eside kwemithi ethile yokugula kwengqondo, ikakhulukazi imithi yesizukulwane sokuqala yokulwa nesifo sengqondo (ama-neuroleptics). Kodwa-ke, le mithi akuyona yodwa engabangela lokhu. Eminye imithi nayo ingabangela lokhu.

Igama elithi "Tardive" lisho "ukubambezeleka" noma "ukuphuza." Igama elithi "Dyskinesia" lisho ukungathandi, okungukuthi, ukunyakaza kwemisipha okungalawulwa. Ngakho-ke kulesi simo, lokhu kunyakaza okungathandi kuvela ngemva kokuqala ukuthatha umuthi isikhathi esithile, ngezinye izikhathi iminyaka. Kodwa-ke, ngezinye izikhathi lesi simo singavela ngisho nangemva kokuthatha umuthi isikhathi esifushane. Lesi simo kungenzeka kakhulu kubantu abangaphezu kweminyaka engu-65, ngisho nangokusebenzisa umuthi isikhathi esifushane.

Sivame kangakanani lesi simo?

Abacwaningi bathi okungenani ama-20% abantu abasebenzisa imithi yokwelapha ingqondo yesizukulwane sokuqala bahlakulela i-tardive dyskinesia. Ukusabalala kwalesi simo kwezinye izinhlobo zemithi akukafundwa, ngakho-ke kunzima ukunikeza inani eliqondile.

Ziyini izimpawu ze-Tardive Dyskinesia?

I-Tardive dyskinesia ingabangela ukunyakaza ezindaweni ezinjengalezi ongeke ukwazi ukuzilawula:

• Imisipha ebusweni bakho
• Ulimi
• Intamo
• Imisipha yesiqu
• Izandla nezinyawo

Ukunyakaza kobuso okungahleliwe:

• Ukunyakaza kokushaya izindebe noma ukumunca.
• Ukuhlikihla noma ukufinya ubuso ngaphandle kwesizathu.
• Ukukhipha ulimi noma ukucindezela ulimi esihlathini.
• Ukunyakaza kokuhlafuna.
• Izihlathi ezikhukhumezayo.
• Ukucwayiza kwamehlo okusheshayo / i-blepharospasm. Cabanga ukuthi bekungaba yinto ecasulayo kanjani ukube ubuqhubeka nokucwayiza amehlo akho.

Okunye ukunyakaza okungahleliwe:

• Ukunyakaza kweminwe okuphindaphindiwe, njengokudlala upiyano.
• Ukusunduza noma ukushukumisa i-pelvis yakho.
• Ukuhamba ngezinyawo okufana nedada.
• Ukungakwazi ukuhlala uthule, umuzwa ongapheli wokungaphumuli (akathisia). Lokhu kungaba yinto engakhululekile neze.

Lezi zimpawu zingase zibe mnene kakhulu futhi zingabonakali kalula kwabanye abantu, kodwa kwabanye zingaba zimbi kakhulu kangangokuthi zingathinta imisebenzi yansuku zonke kuze kube sezingeni lokuba zingenzeki .

Odokotela bangase basebenzise amagama anjengalawa ukuchaza lezi zimpawu:

• I-Dystonia: Ukufinyela kwemisipha okungalawulwa.
• I-Myoclonus: Ukugxumagxuma kwemisipha okungazelelwe, okufushane.
• I-Buccolingual stereotypy: Ukunyakaza okuphindaphindiwe okubandakanya umlomo nolimi.
• Ama-Tics: Ukufinyela kwemisipha okuvamile, ikakhulukazi ebusweni.

Yiziphi izimbangela ze-Tardive Dyskinesia?

Abacwaningi abazi kahle ukuthi yini ebangela lokhu. Kodwa-ke, umqondo oyinhloko ukuthi kungase kubangelwe ukusetshenziswa kwemithi ebizwa ngokuthi ``i-dopamine antagonists`` evimba ama-receptor e-neurotransmitter ``dopamine`` ebuchosheni. Lokhu kungenzeka noma ngabe uthatha le mithi isikhathi esifushane noma isikhathi eside. Kodwa-ke, ingozi iphakeme uma uyithatha isikhathi eside. Ngezinye izikhathi, i-TD ingenzeka ngemva kokuyeka le mithi, ukushintsha umthamo, noma ngisho nokunciphisa.

Cabanga nje, uma uthatha izidakamizwa zokuvimba ama-dopamine receptor isikhathi eside, ama-dopamine receptors ebuchosheni (ikakhulukazi lawo ase-basal ganglia, ingxenye yobuchopho esiza ukulawula ukunyakaza) aba nomuzwa ojulile. Kucatshangwa ukuthi lokhu kunyakaza okungalawulwa kubangelwa i-dopamine eningi kakhulu noma ama-receptors abe nomuzwa ojulile.

Ngaphezu kwe-dopamine, kucatshangwa ukuthi amanye ama-neurotransmitter receptors, njenge -serotonin, i-acetylcholine, ne-GABA, nawo ayabandakanyeka. Lokhu kungaba yingakho i-TD ngezinye izikhathi ibangelwa yimithi engeyona imithi yokwelapha ingqondo.

Yimiphi imithi ebangela i-Tardive Dyskinesia?

I-Tardive dyskinesia ingabangelwa ukusetshenziswa kwemithi elandelayo:

• Imithi yokulwa nesifo sengqondo / ama-neuroleptics: Lezi yizona ezibangela kakhulu.
• I-Metoclopramide noma eminye imithi yokulwa nesicanucanu.
• Eminye imithi yokucindezeleka .

Akuvamile kakhulu, le mithi ingabangela i-TD:

• I-Lithium.
• Imithi yokuvimbela ukuquleka.
• Ama-antihistamine, ikakhulukazi i-hydroxyzine.
• Imithi yokulwa nomalaleveva iyimithi enikezwa umalaleveva.

Imithi yokulwa nesifo sengqondo kanye ne-TD

Imithi yokulwa nesifo sengqondo (ama-neuroleptics) isetshenziswa kakhulu ukwelapha izifo zengqondo ezifana ne-schizophrenia. Le mithi iyimbangela evame kakhulu ye-TD.

Ama-antipsychotic esizukulwane sokuqala ("ajwayelekile") kucatshangwa ukuthi anengozi ephezulu yokubangela i-TD kune-antipsychotics yesizukulwane sesibili ("angavamile").

Ezinye izibonelo zemithi yokulwa nokuphazamiseka kwengqondo yesizukulwane sokuqala:

• I-Chlorpromazine (i-Chlorpromazine)`
• I-Fluphenazine `(Fluphenazine)`
• I-Haloperidol `(Haloperidol)`
• I-Perphenazine `(Perphenazine)`
• I-Prochlorperazine `(Prochlorperazine)`
• I-Thioridazine `(Thioridazine)`
• I-Trifluoperazine `(Trifluoperazine)`

I-Metoclopramide kanye ne-tardive dyskinesia

I-Metoclopramide umuthi osetshenziselwa ukwelapha i-chronic acid reflux (GERD), uhlobo olubi kakhulu lwe-gastritis. Iphinde isetshenziswe ekwelapheni i-gastroparesis ehlobene nesifo sikashukela.

Kukhona ubudlelwano obuqinile phakathi kwe-metoclopramide ne-TD. Izici eziyingozi zokuthuthukisa i-TD ngenxa yalo muthi zifaka:

• Ukuba neminyaka engu-65 noma ngaphezulu.
• Ukuba ngowesifazane.
• Ukuba nesifo sikashukela.
• Ukuthatha i-metoclopramide amasonto ayi-12 noma ngaphezulu.

Ama-antidepressants kanye ne-TD

Ama-antidepressant asetshenziselwa ukwelapha izimo ezinjengokucindezeleka, ukukhathazeka, kanye nesifo esibangela ukucindezeleka ngokweqile. Le mithi cishe ingabangela i-TD kubantu abangaphezu kweminyaka engu-65. Lokhu kungenxa yokuthi ubuchopho buyashintsha njengoba iminyaka ikhula. Lokhu kuvame ukungabi yinto evamile kakhulu kune-TD ebangelwa imithi yokwelapha ukucindezeleka kwengqondo.

Imithi yokucindezeleka elandelayo ihlobene ne-`(TD)`:

• I-Trazodone (lena i-modulator ye-serotonin).
• I-Amitriptyline, i-clomipramine, kanye ne-doxepin (lezi ziyimithi yokucindezeleka ye-tricyclic).
• I-Fluoxetine ne-sertraline (lezi yi-SSRIs).
• I-Phenelzine kanye ne-rasagiline (lezi yi-MAOIs).
• I-Selegiline (futhi eyi-MAOI) ihlotshaniswa ne-TD uma ithathwa ne-levodopa.

I-Lithium ne-TD

I-Lithium umuthi osetshenziselwa ukwelapha isifo sokuphazamiseka kwengqondo. Iphinde ihlotshaniswe ne-TD. Kodwa-ke, uma uthatha i-lithium kanye nomuthi wokulwa nesifo sengqondo, ingozi yakho yokuthola i-TD iphezulu kakhulu.

Imithi yokulwa nokuquleka kanye ne-TD

Imithi yokulwa nokuquleka isetshenziselwa ukuvimbela nokulawula ukuquleka. I-Carbamazepine ne-lamotrigine zihlotshaniswa ne-TD, kodwa azivamile ukubangela i-TD. I-Phenytoin nayo ihlotshaniswa ne-TD.

Ama-antihistamine kanye ne-TD

Ama-antihistamine asiza ngezimpawu zokungezwani komzimba. I-Hydroxyzine, ikakhulukazi, ihlotshaniswa ne-TD uma isetshenziswa isikhathi eside.

Abantu abangaphezu kweminyaka engu-65 abake basebenzisa ama-phenothiazines (ama-antipsychotics ajwayelekile) banamathuba amaningi okuthuthukisa i-TD lapho bethatha i-hydroxyzine.

Imithi yokulwa nomalaleveva kanye ne-TD

Imithi yokulwa nomalaleveva efana ne-chloroquine kanye ne-amodiaquine ihlobene ne-TD.

Yiziphi izici ezibangela i-Tardive Dyskinesia?

Ezinye izici zingase zandise ingozi yakho yokuthola i-tardive dyskinesia. Ezinye zazo zifaka:

• Ubudala: Abantu abangaphezu kweminyaka engama-40 banamathuba amaningi okuthola isifo sofuba. Abantu abangaphezu kweminyaka engama-65 basengozini enkulu ngenxa yezinguquko ohlelweni lwezinzwa ezenzeka ngokuguga.
• Ubulili: Abesifazane banamathuba amaningi okuthola i-TD. Abesifazane asebekhulile abaphuza imithi yokwelapha izifo zengqondo cishe unyaka wonke basengozini ephezulu ngo-30% yokuthola i-TD.
• Uhlanga: Ezinye izifundo zikhombisile ukuthi abantu abamnyama baseMelika banamathuba amaningi okuthola isifo sofuba kunabamhlophe. Futhi, abantu basePhilippines nabase-Asia banamathuba amancane okuthola isifo sofuba kunalabo abadabuka eCaucasus. (Kudingeka ezinye izifundo zendawo ukuze kutholakale ukuthi lokhu kusebenza kanjani eSri Lanka.)
• Isifo se-Bipolar: Abantu abanesifo se-bipolar bangase babe nomuzwa omkhulu we-TD kunabanye lapho bethatha imithi yokwelapha izifo zengqondo.

Abacwaningi okwamanje bafunda izici zofuzo ezandisa noma ezinciphisa ingozi yokuthola i-TD.

Yiziphi izinkinga ezingaba khona ze-Tardive Dyskinesia?

Ukunyakaza okungalawulwa okubangelwa yi-tardive dyskinesia kungaba yinto engakhululekile neze. Kungathinta nenhlalakahle yakho yezenhlalo neyomzwelo. Lokhu kungaba nomthelela omkhulu empilweni yakho yengqondo. Kungenza kube nzima nokwenza imisebenzi yansuku zonke.

I-TD ngokuvamile ayisona isimo esibulalayo. Kodwa-ke,Akuvamile kakhulu, uma i-TD iba nkulu futhi ithinta i-larynx (lapho kutholakala khona izintambo zezwi - i-laryngospasm) kanye ne-diaphragm (imisipha ekusiza ukuphefumula), ingabangela ubunzima bokuphefumula futhi ibe yingozi empilweni.

I-Tardive Dyskinesia itholakala kanjani?

Udokotela wakho uzobuza ngezimpawu zakho, umlando wezokwelapha, kanye nokusebenzisa imithi. Udokotela wakho angase asole i-tardive dyskinesia (TD) uma uthatha umuthi owaziwayo ukuthi ubangela i-tardive dyskinesia. Bazokwenza ukuhlolwa ngokomzimba kanye nokuhlolwa kwezinzwa. Ungathunyelwa futhi kuchwepheshe, njengodokotela wezinzwa, uchwepheshe wezinkinga zokunyakaza, noma wezifo zengqondo.

Odokotela basebenzisa i-Diagnostic and Statistical Manual of Mental Disorders (DSM-5) ukuthola i-tardive dyskinesia. Ngokusho kwe-DSM-5 , ukuze kutholakale ukuthi une-tardive dyskinesia, izimpawu kumele ziqhubeke okungenani inyanga eyodwa ngemva kokuyeka imithi. Uma uneminyaka engu-40 noma ngaphansi, kumele ukuthi ubusebenzisa imithi okungenani izinyanga ezintathu, noma uma ungaphezu kweminyaka engu-40, kumele ukuthi ubusebenzisa imithi inyanga eyodwa.

Udokotela wakho angase acele ezinye izivivinyo ukuqinisekisa i-TD noma ukuqeda ezinye izimo ezinezimpawu ezifanayo, njengesifo sikaHuntington. Lokhu kungafaka phakathi izivivinyo zelebhu kanye nezivivinyo zezithombe, njenge-CT scan noma i-MRI yobuchopho. Kodwa-ke, i-TD ivame ukuba ukuxilongwa kwezokwelapha. Lokhu kusho ukuthi odokotela benza ukuxilongwa ngokusekelwe emlandweni wezokwelapha ophelele kanye nokuhlolwa ngokomzimba okuphelele, ngaphandle kwezivivinyo ezengeziwe.

Yiziphi izindlela zokwelapha i-Tardive Dyskinesia?

Izifundo zokuphathwa kwe-tardive dyskinesia zibonise imiphumela exubile. Ezinye izifundo zibonisa ukuthi izimpawu ziyathuthuka lapho umthamo wemithi yokulwa nesifo sengqondo wehliswa noma uyekwa. Ezinye zibonisa ukuthi akukho mehluko.

Udokotela wakho angase akuncome ukuyeka umuthi obangela isifo sakho sofuba, uma kungenzeka. Ngeshwa, lokhu akwenzeki ngaso sonke isikhathi. Lokhu kungenxa yokuthi ukuyeka umuthi kungenza isimo esiyisisekelo esilawulwa umuthi sibe sibi kakhulu.

Uma uba ne-TD ngenkathi uthatha umuthi wokulwa nesifo sengqondo wesizukulwane sokuqala, udokotela wakho angase akushintshele kumuthi wokulwa nesifo sengqondo wesizukulwane sesibili.

Ngaphandle kokuyeka noma ukushintsha ama-antipsychotics, ubufakazi obuqine kakhulu bokwelashwa kwe-TD okwamanje buyatholakala ekilasini lemithi ebizwa ngokuthi i-VMAT inhibitors. I-Deutetrabenazine kanye ne-valbenazine manje sekuboniswe ukuthi kuphephile futhi kusebenza kahle. Uma une-TD ephakathi kuya kwenzima ethinta ikhwalithi yempilo yakho, udokotela wakho angase ancome le mithi.

Ingabe i-Tardive Dyskinesia ingelapheka? (Ingabe ingaguqulwa?)

Ngeshwa, izimo eziningi ze-tardive dyskinesia azivamile, okusho ukuthi zihlala isikhathi eside. Nakuba imithi ingasiza ekulawuleni izimpawu, ayikwazi ukwelapha noma ukuguqula ngokuphelele lesi simo.

Yini okufanele ngiyilindele uma ngine-Tardive Dyskinesia?

I-Tardive dyskinesia ayithinti wonke umuntu ngendlela efanayo. Izimpawu zingahluka kusukela kwezincane kuya kwezinzima. Futhi, yize ukwelashwa kusiza abanye abantu ukuphatha izimpawu zabo, kungase kungabi njalo kwabanye. Udokotela wakho uzosebenza nawe ukuthola uhlelo lokwelapha olungcono kakhulu. Bangakunikeza umbono omuhle wokuthi yini ongayilindela.

Ingabe i-Tardive Dyskinesia ingavinjelwa?

I-Tardive dyskinesia yisimo esinzima ukusibikezela. Akuwona wonke umuntu othatha imithi ethile ozoba naso.

Uma unezici eziyingozi ezenza kube lula ukuthi ube nalesi simo, khuluma nodokotela wakho. Ungase ukwazi ukuvimbela i-tardive dyskinesia ngokusebenzisa umuthi ohlukile. Ukuze unciphise ingozi yakho yokuthola i-TD, udokotela wakho uzokunikeza umthamo ophansi kakhulu womuthi wokulwa nesifo sengqondo isikhathi esifushane kakhulu.

Uma uthatha umuthi owaziwayo ukuthi ubangela i-TD, khuluma nodokotela wakho mayelana nokuhlolwa okuvamile kwezinkinga zokunyakaza. Ukutholwa kusenesikhathi kwezimpawu ze-TD kungasiza ekunciphiseni ubukhali bazo. Kungcono ukwenza lokhu kuhlolwa zingakapheli izinyanga ezintathu kuya kweziyisithupha uqale umuthi ongabangela i-TD.

Ngingazinakekela kanjani uma ngine-Tardive Dyskinesia?

Udokotela wakho uzosebenza nawe ukuze ahlele uhlelo lwakho lokwelashwa njengoba kudingeka. Nazi ezinye izinyathelo ongazithatha ukuze uphathe i-TD:

• Hlola izimpawu njalo nodokotela wakho njalo ezinyangeni ezintathu kuya kweziyisithupha.
• Gcina irekhodi lezimpawu zakho. Uma uthola izimpawu ezintsha, yazisa udokotela wakho.
• Zijwayeze ukuzinakekela, okuhlanganisa nokuzivocavoca umzimba. Ukuzivocavoca kungasiza ekunciphiseni ezinye izimpawu zokunyakaza.
• Khuluma nodokotela wakho ngemisebenzi yakho yansuku zonke kanye nekhwalithi yempilo yakho.
• Uma impilo yakho yengqondo neyenhlalo ithintwa yi-TD, funa usizo kumeluleki wezempilo yengqondo .

Kufanele ngiye nini egumbini lezimo eziphuthumayo?

Uma unenkinga yokuphefumula ngenxa ye-tardive dyskinesia, shayela u-911 (1990 eSri Lanka) ngokushesha noma uye ekamelweni lezimo eziphuthumayo eliseduze.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Tardive dyskinesia (TD) ithinta abantu ngendlela ehlukile. Kwabanye, ingaba nomthelela omkhulu ezingeni labo lokuphila. Kodwa khumbula, udokotela wakho uzosebenza nawe ukuqapha nokuphatha i-TD yakho. Bangancoma futhi bashintshe uhlelo lokwelashwa ukuze luvumelane nezidingo zakho, futhi baphakamise amasu okuzinakekela angasiza. Ungalokothi uyeke ukuthatha imithi yakho noma ushintshe umthamo ngaphandle kweseluleko sikadokotela wakho. Khuluma nodokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho.

I- Tardive dyskinesia, ukunyakaza okungahleliwe, imiphumela emibi yemithi, ama-antipsychotics, ama-neuropathies, i-dopamine, ama-VMAT inhibitors