Ukuya kwi-anti-depressants: Isikhokelo sokuqala kwimiphumo emibi

Ulwazi lweziyobisi

Ukuba wena, njengam, unesifo esiphakathi ukuya koxinzelelo olukhulu, unxunguphalo olungapheliyo, okanye isifo esiyi-bipolar, kusenokwenzeka umboneleli wakho ukuba akunike iyeza lokuthintela uxinzelelo. Ndiyakwazi ukukuxelela ngamava ukuba la machiza anokutshintsha ubomi. Kunye nonyango lokuthetha, i-anti-depressants inokunyanga iimpawu ezikugcina ekubeni uphile ubomi obupheleleyo. Banokukukhulula kusizi olunzulu, uloyiko, ukucaphuka, kunye nezinye izinto ezininzi eziphazamisa umsebenzi, isikolo kunye nolwalamano lomntu.

Kukho iindidi ezininzi zamachiza okulwa uxinzelelo, kwaye zonke zisebenza ngeendlela ezahlukeneyo. Kodwa inye into abafana ngayo kukuba bayabutshintsha ubukho beekhemikhali ezithile kwingqondo yakho. Le yinto elungileyo, ngeendlela ezininzi, kuba iyanceda ukunyanga uxinzelelo okanye uxinzelelo. Kodwa njengawo onke amayeza, inokubangela iziphumo ebezingalindelekanga ngokunjalo.

Iqela lamagqirha kunye noosokhemesti banceda ekwenzeni esi sikhokelo sibanzi kunyango lwe-anti-depressant kunye neziphumo ebezingalindelekanga.

Zeziphi iintlobo zoxinzelelo?

I-anti-depressants ngamayeza onyango anyanga iimpawu zoxinzelelo lweklinikhi, ukuphazamiseka koxinzelelo, ukungahambi kakuhle kwexesha, kunye ne-dysthymia (okanye uxinzelelo olungapheliyo). Zonke zisebenza ngokulungisa ukungalingani kwemichiza kwee-neurotransmitters kwingqondo ezinxulumene notshintsho lwemood kunye nokuziphatha.

I-anti-depressants eyahlukeneyo ijolise kwi-neurotransmitters ezahlukeneyo kwingqondo nakwinkqubo yemithambo-luvo, utshilo uJustin Hall, MD, ugqirha wezifo zengqondo Impilo yokuZiphatha eAnnapolis, eMaryland. I-Serotonin yeyona neurotransmitter ekujolise kuyo kakhulu enxulunyaniswa noxinzelelo kunye noxinzelelo.

I-Serotonin ijolise ikakhulu kuba yi-neurotransmitter exhaphake kakhulu kuxinzelelo. Le khemikhali ine imisebenzi eyahlukeneyo emzimbeni womntu . Oogqirha abaninzi kunye nabantu nje bayibiza ngokuba yikhemikhali eyonwabileyo, kuba iyaziwa ngokwandisa ulonwabo kunye nemvakalelo yokuphila. Kodwa inokuchaphazela ukwetyisa kwakho, ukuhamba kwamathumbu, inkumbulo, ukulala, kunye nezinye izinto ezininzi.

Iiklasi zeziyobisi ezichasayo zibandakanya:

• Ukukhetha i-serotonin reuptake inhibitor (SSRI)
• Iserotonin-norepinephrine reuptake inhibitor (SNRI)
• I-Tricyclic antidepressant (TCA)
• I-Monoamine oxidase inhibitor (MAOI)
• Umchasi weSerotonin kunye nokuphinda uthathe i-inhibitor (SARI)
• Uxinzelelo lwe-Atypical

Ngolunye lwezi klasi, kwanamachiza angaphakathi kuzo, achaphazela amanqanaba ee-neurotransmitters ezahlukeneyo, utshilo u-Alam Hallan, uFarm.D., Umlawuli wekhemesti kwisibhedlele iGuelph General e-Ontario, Canada.

Ngesi sizathu, zonke izigulana zifuna isicwangciso sonyango esenzelwe umntu ngamnye. Eyona arhente ilungileyo yesigulana esithile yeyona nto isebenza kakuhle kubo, utshilo uGqirha Hallan. Uninzi lwezigulana zihlala ziqala nge-SSRI okanye i-SNRI. Ukuba abaziphenduli ezo ziyobisi, banokuzama ii-TCAs okanye ii-atypicals. Ii-MAOIs zigcinelwe iimeko ezingavumiyo ngenxa yokunxibelelana okunzima.

Ukukhetha i-serotonin reuptake inhibitors (i-SSRIs) kunye ne-Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Zombini SSRIs kwaye I-SNRIs ezimiselweyo ukunyanga uxinzelelo kunye noxinzelelo. Basebenza ngokujolisa kwiikhemikhali kwingqondo yakho ebizwa ngokuba zii-neurotransmitters. Xa ingqondo yakho ithumela imiyalezo isuka kwenye iseli iye kwenye, njengokuziva wonwabile ngezi ndaba, okanye le movie iyahlekisa, loo miyalezo ihamba ngoncedo lwee-neurotransmitters.

I-SSRIs ijolise kwi-neurotransmitter ebizwa ngokuba yi-serotonin, kunye ne-SNRI ejolise kuzo zombini i-serotonin kunye ne-norepinephrine. Ngokwesiqhelo, xa ingqondo yakho ithumela imiyalezo isuka kwi-neuron iye kwenye, umthumeli ukhupha isuntswana le-neurotransmitter ukuhambisa lo myalezo, emva koko iphinda ibuyise i-neurotransmitter emva kokuba umyalezo uhanjisiwe.

I-SSRI anti-depressants isebenza ngokuthintela ukubuyiselwa kwakhona (okanye ukuphinda kuthathwe) i-serotonin kwingqondo yakho, emva kokuba ihambise imiyalezo yayo eyonwabisayo. Ke ngoko, ingqondo yakho iya kuba ne-serotonin engakumbi yokuhambisa imiyalezo eyonwabisayo. Ezona zixhaphakileyo zichazwe kwi-anti-depressants, ii-SSRI zithathwa njengeyona ndlela isebenzayo kunye neziphumo ebezingalindelekanga ezimbalwa. Eminye imizekelo ibandakanya uCelexa (citalopram), Lexapro (escitalopram), Paxil (paroxetine), Prozac (fluoxetine) kunye noZoloft (sertraline).

Ngokufanayo, ii-SNRI zonyusa amanqanaba kuzo zombini i-serotonin kunye ne-norepinephrine kwingqondo yakho.

INorepinephrin yenye ye-neurotransmitter edlala indima ekuzinziseni imeko. Eminye imizekelo yee-SNRI zibandakanya iCymbalta (duloxetine), iEffexor (venlafaxine), kunye nePristiq (desvenlafaxine).

I-Tricyclic antidepressants (TCAs)

I-Tricyclic (okanye i-tetracyclic) ye-antidepressants zezinye zezinto zokuqala zokuthomalalisa uxinzelelo. Zisebenza kakuhle, kodwa ziza neziphumo ebezingalindelekanga, ngenxa yoko zithathelwa indawo ngamayeza amatsha ngaphandle kokuba ii-SSRI okanye ii-SNRI azisebenzi.

I-cyclic antidepressants ikwathintela ukuphinda kuthathwe i-serotonin ye-neurotransmitters kunye ne-norepinephrine, inyusa amanqanaba ala makhemikhali mabini kwingqondo. Nangona kunjalo, ii-TCAs zinokuchaphazela ezinye ii-neurotransmitters ngokunjalo, yiyo loo nto baneziphumo ebezingalindelekanga ezininzi. Imizekelo yee-TCAs zibandakanya i-amitriptyline kunye ne-amoxapine.

I-Monoamine oxidase inhibitors (MAOIs)

Njengabanye, i-monoamine oxidase inhibitors (MAOIs) sebenza ngokuchaphazela ii-neurotransmitters. Ngokukodwa, ii-MAOIs zichaphazela i-dopamine, i-serotonin, kunye ne-norepinephrine, eyaziwa ngokudibeneyo njenge-monoamines. Kukho ikhemikhali kwingqondo ebizwa ngokuba yi-monoamine oxidase, esusa ezo zi-neurotransmitters. Umsebenzi we-MAOIs ngokuthintela i-monoamine oxidase, ke ngoko ivumela uninzi lwee-neurotransmitters ukuba zihlale kwingqondo.

Ezi zezona zinto zakudala ezazidambisa uxinzelelo, zaphuhliswa kwii-1950s. Baye basebenza ekunyangeni ukuphazamiseka okukhulu koxinzelelo. Nangona kunjalo, njengee-TCAs, ziza neziphumo ebezingalindelekanga ezininzi. Kukho inani lokudibana kweziyobisi okuyingozi phakathi kwe-MAOIs kunye nezinye iziyobisi, okwenza kube nzima ukunyanga abantu abaneengxaki zempilo yengqondo kunye nezinye iimeko zonyango. Eminye imizekelo ibandakanya iNardil (phenelzine) kunye neMarplan (isocarboxazid).

Umchasi weSerotonin kunye ne-reuptake inhibitors (ii-SARIs)

Umchasi weSerotonin kunye ne-reuptake inhibitors (ii-SARIs) Ngaba i-FDA-ivunyiwe njengemithi yokuxinezeleka, kodwa isetyenziswa ngokuqhelekileyo ngaphandle kwelebula njengezixhobo zokulala. Njenge-SSRI, zisebenza ngokuthintela ukuphinda kuthathwe kwakhona kwi-serotonin. Kodwa zikwasebenza njengabachasi, zithintela i-receptor ethile ye-serotonin ebizwa ngokuba yi-5HT2a, ethintela ukusebenza kweprotein yokuhambisa ye-serotonin.

Eminye imizekelo yee-SARIs zibandakanya i-Desyrel (trazodone) kunye ne-Serzone (nefazodone).

Uxinzelelo lwe-Atypical

I-anti-depressant ye-Atypical ifana nje nokuba ivakala-ayiqhelekanga. Oku kuthetha ukuba abahambelani nakwezinye iindidi ze-anti-depressants, kwaye basebenza ngeendlela ezizodwa. Nangona kungekho ndlela yakushwankathela indlela la machiza asebenza ngayo, kwanele ukuba bathi bonke bayatshintsha ukwakheka kwee-neurotransmitters ezithile kwingqondo yakho, kubandakanya i-dopamine, i-serotonin, kunye / okanye i-norepinephrine. Eminye imizekelo ye-atypical antidepressants yiWellbutrin (bupropion) kunye neRemeron (mirtazapine).

Ukuqonda iziphumo ebezingalindelekanga ze-anti-depressants

Ngelixa kukho uluhlu olubanzi lweziphumo ebezingalindelekanga ezithatha amayeza okulwa noxinzelelo kunokubangela, ezi zezona ziqhelekileyo:

• Ukwehla kobunzima okanye ukuzuza
• Iingxaki zesondo, kubandakanya ukuphulukana nomnqweno wesini, ukungasebenzi kakuhle kwe-erectile, kunye nabanye
• Ukuphuthelwa
• Ukozela
• Ukudinwa
• Intloko ebuhlungu
• Isicaphucaphu
• Umlomo owomileyo
• Umbono omfiliba
• Ukuqunjelwa
• Ukuba nesiyezi
• Ukuphazamiseka
• Ukucaphuka
• Ixhala
• Ukubetha kwentliziyo ngokungaqhelekanga

Ukongeza kwezi, kukho ixesha elide kunye nexesha elifutshane iziphumo ebezingalindelekanga zonyango.

Iziphumo zexesha elide ze-anti-depressants

Ngelixa uninzi lweziphumo ebezingalindelekanga zihlala ixesha elifutshane, zimbalwa ezihlala ixesha elide-ezi ziphumo zinqabileyo kwaye zinokulawulwa ngeendlela ezininzi, ezichazwe ngezantsi. Iziphumo ebezingalindelekanga zexesha elide zibandakanya utshintsho lomzimba, iingxaki zesondo, ukulala, ukozela nokudinwa.

Ukutyeba kwakho

Isizathu sokufumana ubunzima ngelixa uthatha uxinzelelo lwexesha elide asikacaci. Kungenzeka ukuba abaguli abakhe batya kancinci ngelixa babedandathekile benomdla wokubuya kunyango, uGqirha Hallan ucebisa, okanye amayeza anokubangela utshintsho kwimetabolism. Kwiimeko ezininzi, iphakathi ukuya kuthi ga kwiiponti ezintlanu okanye njalo ngonyaka.

Olunye uphononongo lonyango lubonakalisile ukuba ukusetyenziswa kwexesha elide kwezidambisi zonyusa umngcipheko wezifo ezinxulumene nokufumana ubunzima, uhlobo lwe-2 yeswekile .

Ukuba ukulawula oku kulandelayo kukutya kunye nokuzilolonga akusebenzi, uGqirha Hallan ucebisa ukuzama iyeza elitsha. Onke la machiza asebenza ngokwahlukileyo kubantu abohlukeneyo, ke iyeza elinye alinakubangela iziphumo ebezingalindelekanga ezifanayo kuwo wonke umntu, nokuba kuyaziwa ukuba kunokubangela iziphumo ebezingalindelekanga.

Ukudakumba ngokwesondo

Iziphumo ebezingalindelekanga ngokwesondo zihlala zizinto eziqhelekileyo ezinokukhokelela ekubeni abantu bayeke amayeza abo nangona besenza kakuhle amayeza, utshilo uGqirha Hall.

Ngapha koko, uninzi lwesiqingatha sazo zonke izigulana ezithatha ii-SSRI zinokuba neziphumo ebezingalunganga zesini, kubandakanya ukunciphisa ukuqhuba kwesondo, ukunciphisa amandla okuba ne-orgasm, ukoma kwilungu lobufazi, okanye ukungasebenzi kakuhle kwe-erectile.

Ngelixa ezinye iziphumo ebezingalindelekanga zihlala ixesha elifutshane, ezi ziphumo bezesondo zinokuqhubeka ngalo lonke ixesha isigulana sithatha i-antidepressants. Nangona kunjalo, akufuneki batyhafise okanye babe yingozi. Ukuba ziyabakhathaza ukuya kwinqanaba apho ukhetha ukungawasebenzisi khona amayeza, uGqirha Hall ucebisa ukuba uthethe nogqirha wakho malunga nokunciphisa idosi, ukuthatha amayeza ngexesha elahlukileyo losuku, okanye ukutshintshela kwelinye iyeza.

Iingxaki zokulala

Umahluko ukusuka kwichiza ukuya kwiziyobisi kunye nesigulana ukuya kwisigulana, uninzi lwee-anti-depressants zibangela ubunzima ngokulala-nokuba kukulala okanye ukozela. Ukuba uhlangabezana nale mpembelelo yecala, uGqirha Hall ucebisa ukuba ulibeke ixesha kumayeza akho ngokwendlela abuchaphazela ngayo ubuthongo bakho: Ukuba i-antidepressant yakho ikwenza wozele, yithathe ngaphambi kokuba ulale. Ukuba ikugcina uvukile, yithathe kusasa. Ngokwesiqhelo, ukuphaphama okanye ukulala okuchaphazela iziyobisi kuya kuphela emva kweeyure ezininzi.

Iziphumo zexesha elifutshane ezichasene noxinzelelo

Ngelixa uninzi lwabantu lunophawu olukhululekileyo kwii-anti-depressants, akuqhelekanga ukuba ube neziphumo ebezingalindelekanga zexesha elifutshane ezihlala iintsuku ezimbalwa okanye iiveki ezimbalwa. Oku kunokubandakanya isicaphucaphu, intloko ebuhlungu, umlomo owomileyo, umbono ophuthileyo, ukuqhina, kunye nomsindo okanye ukucaphuka.

Isicaphucaphu

Isicaphucaphu senzeka malunga neepesenti ezingama-25 zezigulana ezixinzelelekileyo. Ihlala iqala kwangoko emva kokuqalisa unyango kwaye yehle emva kweeveki ezimbini okanye ezintathu. Nangona kunjalo, iyaqhubeka kulo lonke unyango malunga nesinye kwisithathu sabo bantu. I-nausea ixhaphake kakhulu nge-venlafaxine kunye nee-SSRIs kunee-atypicals ezinje nge-bupropion, mirtazapine, okanye i-reboxetine. Ngokuqhelekileyo inokulawulwa ngokuthatha amayeza akho kwisisu esigcweleyo.

Intloko ebuhlungu

Uphando lupapashwe kwiphephancwadi Unyango lwezonyango ifumanise ukuba iintloko zezona zinto zixhaphakileyo kubantu abangama-40,000 abasandula ukuqalisa ukuthatha ii-antidepressants. Abo bathathe ii-TCAs kunye nee-SSRI zazinokwenzeka ngakumbi kunabo bathatha ii-SNRIs okanye i-bupropion yokufumana iintloko. Nangona kunjalo, uninzi lwabantu luyakha ukunyamezelana nezi ziphumo bezingalindelekanga, kwaye ziyahamba emva kwexesha elifutshane.

Umlomo owomileyo

Amava umlomo owomileyo ? Oku kunokuba ngenxa yokuba amachiza ngokufutshane athintela ukuveliswa kwamathe komzimba wakho. Ii-TCAs zisenokwenzeka ukuba zibangele umlomo owomileyo kunee-SSRI.

UGqirha Hallan ucebisa ngokuncancisa iitshiphusi, ukuthatha amanzi rhoqo, ukuhlafuna itshungama, ukusebenzisa iminti, okanye ukuxukuxa.

Iingxaki zombono

Abantu abanombono opholileyo bayichaza njengokungabikho kobukhali okanye ukucaca kumbono wabo. Umbono opholileyo uxhaphake kakhulu kwii-TCA. Abantu banokuba namava okutsha, ukurhawuzelela, kunye nokubomvu kweliso, okanye ulwazelelelo lweliso. Ukongeza, abanye abantu bathi amehlo abo abuthathaka ekukhanyeni.

Ukuba uthatha i-anti-depressants kwaye ufumana umbono ophukileyo, qala ufumane uvavanyo lwamehlo ukulawula ezinye iingxaki zombono. Unokuzama ukusebenzisa amaconsi wamehlo kunye ne-humidifier ukuze uhlaziye amehlo akho. Thetha nomboneleli wakho malunga nokutshintsha idosi yakho ukuba le mpembelelo yecala iyaqhubeka ngaphezulu kweeveki ezimbalwa.

Ukuqunjelwa

I-neurotransmitter serotonin inemisebenzi eliqela ngaphandle kokwenza uzive wonwabile-inokuchaphazela ukuhamba kwamathumbu akho, kananjalo, kuba i-serotonin ikhona emathunjini akho. Ngamanye amaxesha, ii-SSRIs ezithile kunye nee-TCAs zinokubangela ukuqunjelwa kwixesha elifutshane. Izigulana ziyakwazi ukuyilawula ngokusebenzisa laxatives, ukusela amanzi amaninzi, kunye nokutya ifibre ngakumbi.

Ukuba nesiyezi

Utywala buqheleke kakhulu kwii-TCAs kunye nee-MAOIs kunezinye iiklasi zoxinzelelo. Isizathu sokuba la ma meds ngamanye amaxesha abangele ukuba nesiyezi kukuba banokuhlisa uxinzelelo lwegazi. UGqirha Hall ucebisa ukuba uthathe amayeza akho ngexesha lokulala ukunceda ukulawula oku kulandelayo.

Ukucaphuka okanye uxinzelelo

Zombini ukuba nochuku kunye noxinzelelo ziziphumo ebezingalindelekanga ezichaseneyo nezidambisi, kodwa zenzeka kwinani elincinci lezigulana. Isizathu mhlawumbi sihambelana ne-serotonin. Njengoko sele kuphawuliwe, amanqanaba asezantsi e-serotonin kwingqondo anokukhokelela kuxinzelelo kunye noxinzelelo, yiyo loo nto la mayeza onke esebenza ukwandisa amanqanaba e-serotonin ngandlela thile. Kwiintsuku zokuqala zonyango, umzimba wakho usebenza ngokulungelelanisa amanqanaba akho e-serotonin, ebangela ukuba batshintshe. Oku kunokubangela ukuphuma kancinci koxinzelelo okanye ukucaphuka. Njengoko amanqanaba akho e-serotonin esiya esiba nokomelela, ezi mpawu kufuneka zinciphe.

Imiphumela	I-SSRI	ISNRI	TCA	I-MAOI	ISARI	Wellbutrin	Isikhumbuzo
Ukutyeba kwakho	X		X	X	X		X
Ukungasebenzi kakuhle ngokwesondo	X	X	X	X	X
Iingxaki zokulala	X	X	X	X	X	X	X
Isicaphucaphu	X	X	X	X	X	X	X
Intloko ebuhlungu	X	X	X	X	X	X	X
Umlomo owomileyo	X	X	X	X	X	X	X
Iingxaki zombono	X	X	X	X	X	X	X
Ukuqunjelwa		X	X	X	X	X	X
Ukuba nesiyezi	X	X	X	X	X	X	X
Ukucaphuka	X	X	X	X	X		X
Ixhala	X	X	X	X		X	X
Ukubila okugqithisileyo		X	X	X		X
Ukugcinwa komchamo		X	X	X
Uxinzelelo lwegazi oluphantsi		X	X	X	X

Iziphumo ebezingalindelekanga ezimandundu zokuxinezeleka

Ukuza kuthi ga ngoku, zonke iziphumo ebezingalindelekanga esixubushe ngazo azinabungozi, nokuba ziyaphazamisa. Kukho, nangona kunjalo, kunqabile kunqabile, kodwa kukwabaluleke kakhulu, iziphumo ebezingalindelekanga ezinokwenzeka xa uthatha i-anti-depressants. Babandakanya ukuzibulala, i-serotonin syndrome, kunye ne-hyponatremia.

Ngethamsanqa, ezi ziphumo bezingalindelekanga ziyingozi kakhulu, kwaye umngcipheko mkhulu kwinyanga yokuqala yonyango.

Iingcinga zokuzibulala

Okona kuninzi, ii-anti-depressants zinceda ukunciphisa zonke iimpawu zoxinzelelo, kubandakanya ukuzibulala. Nangona kunjalo, inani elincinci lezigulana ezisengozini-zihlala zikhulile-zinamava emngciphekweni omkhulu wokunyuka kokucinga ngokuzibulala.

NgokukaGqirha Hallan, oku kwenzeka kuphela kwiimeko ezithile. Umzekelo, umntu odandatheke ngokungaginyisi mathe unokuba neengcinga zokuzibulala. Kodwa iimpawu zokudakumba ziphantse ukumkhusela ekusebenzeni kwezo ngcinga kuba zikwabangela ukuba azive edinwe kakhulu kunye nokuphelelwa ngamandla. Nje ukuba aqale unyango, amandla kunye nokudinwa kunokuphucula ngokwaneleyo ukumnika amandla okulandela iinjongo zakhe zokuzibulala.

Ukuthintela lempembelelo yecala, kuya kufuneka wabelane naziphi na iingcinga zokuzibulala onazo nomboneleli wakho wezempilo ngaphambi kokuba uqale unyango.

Isifo seSerotonin

Iserotonin syndrome yinto esongela ubomi engxamisekileyo eyenzeka kwinani elincinci kakhulu lezigulana, utshilo uGqirha Hallan. Ngumngcipheko othile kwabo bakumayeza angaphezu kwesinye. Iqela leempawu zibandakanya ukuphazamiseka, ukungcangcazela, ukubila kunye nehiperthermia. Ukuthatha izongezo ezithile, njengeSt. John's Wort, kunokunyusa umngcipheko wale meko.

Ukuba ufumana ezi mpawu ngelixa uthatha i-anti-depressant, funa uncedo lonyango ngokukhawuleza. Bazakuyeka ii-meds zakho, banike iiarhente eziguqukayo, kwaye bancede ukulawula iimpawu zakho.

Hyponatremia

IHyponatremia yenye yeziphumo ebezingalindelekanga eziyingozi kwaye ibonwa malunga nezigulana ezi-1 kwezi-2 000 ezithatha ii-SSRI, uGqirha Hallan uyacacisa. Ngokubhekisa kukunqongophala kwesodiyam egazini, i-hyponatremia kucingelwa ukuba ibangelwe kukunyuka kwemveliso yehomoni yokuchama, eyenza ukuba umzimba ugcine amanzi amaninzi, ngaloo ndlela kunciphisa inani lesodium emzimbeni, utshilo. Izigulana, ngakumbi abaguli abadala, abasemngciphekweni kufuneka babekwe esweni kusetyenziswa uvavanyo lwelebhu.

Iimpawu zokurhoxa koxinzelelo

Ngaphandle kokuba ufumane isiphumo esiyingozi se-anti-depressants kwaye uye wadibana nogqirha wakho, ayisiyongcamango ilungileyo ukuyeka ukuyisebenzisa turkey ebandayo. Ukuyekiswa kwe-anti-depressants kunokubangela iimpawu zokurhoxa, ezinje:

• Ixhala
• Ukuphuthelwa okanye amaphupha acacileyo
• Intloko iyaduma
• Intloko ebuhlungu
• Ukuba nesiyezi
• Ukudinwa
• Iimpawu ezinjengomkhuhlane
• Isicaphucaphu
• Ukucaphuka

Ukuba kufuneka uyeke ukusebenzisa i-anti-depressants, okanye utshintshe idosi yakho, kubalulekile ukuba uthethe nomboneleli wakho kuqala. Unokukunika ishedyuli yokuzikhupha kumayeza ukuze unciphise iimpawu zokurhoxa.