Eyona >> Ulwazi Lweziyobisi >> Mncinci kangakanani umncinci kakhulu kwizidambisi zengqondo? Mdala kangakanani ubudala?

Mncinci kangakanani umncinci kakhulu kwizidambisi zengqondo? Mdala kangakanani ubudala?

Ulwazi lweziyobisi

Ukunyanga uxinzelelo ngamayeza asetyenziselwa ukunyanga ukudakumba , imeko ehlala ineempawu ezahlukileyo kumaqela ahlukeneyo. Ngokubanzi, ibangela iimvakalelo ezihlala ixesha elide zosizi kunye nokuphulukana nomdla kwinto eyonwabisa kanye. Abantu abaninzi abanedepression bayarhoxa, baphelelwe lithemba, banomsindo, badimazeke, kwaye babe namava emzimbeni njengokuncipha / ukuzuza okanye iingxaki zokulala.

I-anti-depressants eminye yemigqaliselo exhaphakileyo e-US Amaziko oLawulo lweNtsholongwane kunye noThintelo (CDC) axela ukuba I-15.4% yabantu baseMelika abaneminyaka engama-40-59 uthathe i-anti-depressant kwiintsuku ezingama-30 ezidlulileyo.

Kodwa abantu abadala abaphakathi asiyiyo yodwa enexinzelelo. Kwenzeka kumncinci kwaye mdala kakhulu, nako. Inkqubo ye- i-CDC Qaphela ukuba baphantse babe zizigidi ezi-2 abantwana abaphakathi kweminyaka emi-3 neli-17 abanodandatheko, bahlala bedityaniswa nezinye iingxaki zempilo yengqondo ezinje ngoxinzelelo kunye neengxaki zokuziphatha. Amaxabiso oxinzelelo kubantu abadala aqikelelwa kwi 1% ukuya ku-5% kuluhlu , kodwa ingangamaxesha alishumi aphezulu kwabo bafuna ukhathalelo lwempilo ekhaya okanye ukulaliswa esibhedlele, ngokweCDC.

Ngokukhawuleza ukubamba uxinzelelo, kungcono, utsho IBeth Salcedo, MD , owayengumongameli we Ixhala kunye noxinzelelo loMbutho waseMelika kunye nomphathi wezonyango kwiZiko iRoss. Kufuneka ifunyanwe kwaye inyangwe kwangoko. Ngokwesiqhelo, sizama ukuyinyanga nge-psychotherapy, unyango lokuziphatha, kunye nongenelelo losapho kuba ezi ndlela zixhobisa abantu kwaye zibanika izixhobo zokuphila ubomi babo bonke. Kodwa, ngokuqinisekileyo, amayeza lukhetho olufanelekileyo. Kwaye akukho minyaka apho ndingathi lo mntu mncinci kakhulu okanye mdala kakhulu ukuba angafumana uxinzelelo. Zininzi izinto ezidlalayo nokuba unike umntu i-antidepressant.

Ngaba uxinzelelo lukhangeleka njani ebantwaneni?

Ngelixa banokwabelana ngeempawu ezifanayo, abantwana bafumana ukudakumba ngokwahlukileyo kunabantu abadala. Abantwana ngabona banokwenzeka [kunabantu abadala] ukuba babonakalise utshintsho lweemvakalelo ngesiquphe, uburhalarhume, nokuba nomsindo endaweni yokudakumba, utsho UNatasha Nambiar, MD , Umcebisi kwezonyango kwi-eMediHealth. Ubunzima bokulala, ukwehla kobunzima, kunye noxinzelelo kubonakala kuqhelekile kubantwana abancinci, ngelixa ukonyuka kokutya, ukutyeba, kunye nokucotha kwimoto kubonakala ngathi kuyanda kulutsha.

Ngaba abantwana banokumiselwa i-anti-depressants?

I-FDA ivume i-anti-depressants yabantwana, kunye nokusetyenziswa okunyuka ngokobudala. Nye ukufunda ukusuka ngo-2018ifumanise ukuba abantwana kwelona qela lincinci lesifundo (iminyaka emi-3-5 ubudala) bafumana nje i-0.8% yemigqaliselo yeziyobisi zengqondo (kubandakanya neyeza lokudandatheka), ngelixa ulutsha lufikelela kwi-7.7%. Umbutho weAmerican Psychological Association (APA) uxela ukuba 3.4% yabantwana i-13-19 bathathe i-anti-depressants kwinyanga ephelileyo.

Zeziphi ezona zithomalaliso zibalaseleyo kubantwana?

Inkqubo ye-Ukutya kunye noLawulo lweziyobisi (FDA)uvume kuphela amayeza amabini okunyanga uxinzelelo kubantwana . Iprozac (fluoxetine), i-serotonin reuptake inhibitor ekhethiweyo (SSRI) -isiyobisi esinceda ukunyusa amanqanaba e-serotonin, enye yezo zivakalelwa ziikhemikhali ezilungileyo, kwingqondo-yamkelwe abantwana abancinci njenge-8. ILexapro (ifumanopram), enye i-SSRI, yamkelwe yabantwana abali-12 nangaphezulu.

Oko akutsho ukuba ugqirha akayi kumisela enye i-anti-depressant yomntwana. Ukuba ichiza livunyiwe yi-FDA, oogqirha bakhululekile ukukunika nasiphi na isizathu nakubani na abacinga ukuba siza kusebenza. Oku kubizwa Ukusetyenziswa kwelebheli . Abanye oogqirha banikezela ezinye ii-SSRI zokuthintela uxinzelelo-ezinje nge UCelexa kwaye Zoloft —Ukusetyenziswa ebantwaneni.

Uninzi lwee-SSRI zithathwa njengezikhuselekileyo kuwo onke amaqela eminyaka, kwaye uninzi lwamachiza akweli klasi anokusetyenziswa ngokubanzi, utshilo uGqirha Salcedo. Udidi oludala lwamachiza, ekuthiwa zii-tricyclic anti-depressants, azisoloko zimiselwe-kulutsha okanye kumdala-ikakhulu kuba zininzi imiphumela kwaye ziyingozi xa zigqithile.

Nokuba uthini na uxinzelelo olumiselweyo, iingcali zithi la machiza asebenza ngcono kuxinzelelo olumodareyithayo (izidanga zoxinzelelo zisekwe kwizinto ezifana nenani leempawu, ubude bexesha, nokuba ziphazamisa kangakanani ebomini). Banokusebenza ngcono xa besetyenziswa ngokubambisana nonyango, ngakumbi unyango oluthetha okanye unyango lokuziphatha, olunceda abantu ukuba batshintshe indlela abacinga ngayo malunga neemeko ezithile kunye namava.

Lunjani uxinzelelo kubantu abadala?

Uxinzelelo kubantu abadala luhlala luzenza njengenkqubo yokuguga eqhelekileyo, kwaye ngenxa yoko, ihlala ihamba ingafunyanwa kwaye inganyangwa. Ngamanye amaxesha uxinzelelo kubantu abadala lunokulinganisa isifo sengqondo esixhalabisayo, utshilo uGqirha Salcedo. Ke unokubona ukulahleka kwememori yexesha elifutshane, ukufumana amagama-ubunzima, ingxaki ngamagama. Kubaluleke kakhulu ukukhupha uxinzelelo xa ubona ukuphazamiseka kwengqondo kubantu abadala. Ukongeza, iimeko ezithile zonyango (umzekelo, ezinye iimeko zemithambo ebangela ukuba imithambo yegazi iqine) kwaye amayeza asetyenziselwa ukubaphatha anokuba negalelo kuxinzelelo.

Ngokwe- IZiko leLizwe lokuGuga , ezinye iimpawu zoxinzelelo kubantu abadala zibandakanya:

Ukudinwa
Iingxaki zokulala
Ukuhamba okanye ukuthetha kancinci
Utshintsho kubunzima / ukutya
Kunzima ukugxila
Ukungazithembi
Iingcinga zokuzibulala

Ngaba kufuneka kusetyenziswe i-anti-depressants kubantu abadala?

Nangona i-anti-depressants yezigulana ezigugileyo kufuneka zikhethwe ngononophelo ngenxa yegalelo lezempilo kunye nokunxibelelana kweziyobisi okunokwenzeka, abantu abadala banako kwaye kufuneka banyangwe kulo naluphi na uxinzelelo oluchongiweyo. Uphando lupapashwe kwiphephancwadi Ukuphononongwa kweengcali zeNeurotherapeutics uphawula amanqanaba aphezulu okuwohloka ngokwasemzimbeni nangokwasemzimbeni, ukufa kunye nokuzibulala kwabantu abadala abanexinzelelo olunganyangekiyo. Ngaphezu koko, abaphandi bayaqaphela ukuba xa isetyenziswe ngokubambisana ne-psychotherapy, i-anti-depressants kubantu abadala iphucula kakhulu umgangatho wobomi kunye namazinga okufa aphantsi.

Zeziphi ezona zithomalaliso zibalaseleyo kwizigulana esele zikhulile?

Xa kuziwa kwi-anti-depressants kubantu abadala, uninzi lweengcali zincoma ii-SSRI okanyei-norepinephrine reuptake inhibitors (SNRIs) ekhethiweyo, encedisa ukonyusa imichiza yobuchopho i-serotonin kunye ne-norepinephrine. La machiza athanda ukuba neziphumo ebezingalindelekanga ezimbalwa kunye nokunxibelelana kweziyobisi kunezo zidala zoxinzelelo kwiimarike. Zikwabonakala ngathi ziyasebenza kubantu abadala njengoko zinjalo kwabancinci, nangona abanye oogqirha bacebisa ukuqala kwisiqingatha sedosi eqhelekileyo kwaye ngokuthe ngcembe ukuyinyusa ngelixa ujonge iziphumo ebezingalindelekanga kunye nokuphuculwa kwemood. Ukuba akukho phuculo lubonakalayo emva kweeveki ezine kwidosi epheleleyo, unokufuna iyeza elahlukileyo.

Ngokuqhelekileyo kusetyenziswa i-anti-depressants kunye ne-dosages, ngokweminyaka

Iidosi eziqhelekileyo zokulwa noxinzelelo ngokweqela lobudala
Uxinzelelo	Umntwana / Umntwana ofikisayo	Umntu omdala	Abantu abadala
ILexapro	10-20 mg yonke imihla	10-20 mg yonke imihla	10 mg yonke imihla
Iprozac	10-20 mg yonke imihla	10-80 mg yonke imihla	Ugqirha wakho unokuqala ngedosi esezantsi kwaye ngokuthe ngcembe andise ukuba kukho imfuneko. Ukuhla kakhulu kuxhomekeke kubudala kunye nezinye izinto zempilo.
UCelexa	Ayivunyelwanga abo bangaphantsi kwe-18, kodwa isenokumiselwa kusetyenziso lweelebheli ezingekhoyo. Idosi yahluka ngesigulana.	20-40 mg yonke imihla	Akukho ngaphezulu kwe-20 mg yonke imihla kubantu abadala abadala kunama-60; Amanani aphezulu anokubangela ukungahambi kakuhle kwentliziyo kwisingqi