Eyona >> Ulwazi Lweziyobisi >> I-SSRIs: Ukusetyenziswa, iimveliso eziqhelekileyo kunye nolwazi lokhuseleko

I-SSRIs: Ukusetyenziswa, iimveliso eziqhelekileyo kunye nolwazi lokhuseleko

Ulwazi lweziyobisi

NgoDisemba ka-1987, iProzac (i-fluoxetine) yamkelwa yi-US Food and Drug Administration (FDA) kunyango loxinzelelo. Kwisithuba seminyaka emithathu kwavela umfanekiso wephepha leProzac Iindaba zeendaba kwiphephancwadi ,eyayiyincoma njengesiyobisi esiphumelelayo kuxinzelelo. Iprozac yayiyeyokuqala kwiklasi entsha yamachiza ukunyanga uxinzelelo olubizwa ngokuba yi-serotonin reuptake inhibitors, okanye ii-SSRI.

Ezi zidambisi-mayeza zintsha zakhawuleza zayifumana imithambo edala — njenge-Pamelor (nortriptyline) kunye ne-Elavil (amitriptyline), eyaziwa njengee-tricyclics, kunye ne-Nardil (phenelzine) kunye ne-Parnate (i-tranylcypromine), eyaziwa ngokuba yi-monoamine oxidase inhibitors (MAOIs) -ezona ziyobisi ziqhelekileyo yoxinzelelo. Ababoneleli ngezeMpilo bakholelwa ukuba ii-SSRI zikhuselekile kwaye zithintele ubunzima bokufumana ubunzima obuqhelekileyo kwii-tricyclic kunye nemicimbi yoxinzelelo lwegazi kunye nee-MAOIs.

Namhlanje, i-SSRI ye-anti-depressants ihlala iyeyona ichiza liqhelekileyo lokudakumba kunye noxinzelelo oluthile lokuphazamiseka, ukuphazamiseka okungafunekiyo, kunye noxinzelelo lwasemva koxinzelelo. Qhubeka nokufunda ukuze ufunde okungakumbi malunga nee-SSRI kubandakanya amagama egama eliqhelekileyo, ukusetyenziswa, ulwazi ngokhuseleko, kunye neendleko.Itheyibhile engezantsi idwelisa ii-SSRIs eziqhelekileyo ezikhoyo ngoku.

Uluhlu lwee-SSRI
Igama lebrand (igama eliqhelekileyo)	Ixabiso eliphakathi lemali	Ugcino olulodwa	Funda nzulu
UCelexa (citalopram)	Iidola ezingama-302 nge-30, iipilisi ezingama-20 mg	Fumana ikhuphoni zikaCelexa	Iinkcukacha zikaCelexa
IFluvoxamine	Iidola ezingama-64 nge-60, iipilisi ezili-100 mg	Fumana iFluvoxamine coupons	Iinkcukacha zeFluvoxamine
ILexapro (esitalitalopram)	Iidola ezingama-402 nge-30, iipilisi ezili-10 mg	Fumana amatikiti eLexapro	Iinkcukacha zeLexapro
I-Paxil (iparoxetine)	Iidola ezingama-236 nge-30, iipilisi ezingama-20 mg	Fumana amatikiti ePaxil	Iinkcukacha zePaxil
I-Pexeva (paroxetine)	$ 436 nge-30, iipilisi ezingama-20 mg	Fumana amatikiti ePexeva	Iinkcukacha zikaPxevava
Iprozac (fluoxetine)	Iidola ezingama-531 nge-30, ii-capsules ezingama-20 mg	Fumana amatikiti eProzac	Iinkcukacha zeProzac
I-Trintellix (vortioxetine)	Iidola ezingama-399 nge-30, iipilisi ezingama-20 mg	Fumana amatikiti eTrintellix	Iinkcukacha zeTrintellix
IVibryd (vilazodone)	$ 320 nge-30, iipilisi ezingama-40mg	Fumana iikhuphoni zeViibryd	Iinkcukacha zeViibryd
Zoloft (sertraline)	$ 378 nge 30, 100 iipilisi mg	Fumana amatikiti eZoloft	Iinkcukacha zeZoloft

Ezinye ii-SSRI

Isimboli (olanzapine / fluoxetine) : ukuyaindibaniselwano ye-antipsychotic drug kunye ne-SSRI esetyenziselwa ukunyanga iziqendu zokudakumba kwi ukuxhuzula (isifo sika-manic-depress) kunye noxinzelelo olukhulu olungaphenduliyo kwamanye amayeza.

Yintoni ii-SSRIs?

Ukuphuhliswa kwee-SSRI kwii-1970s bekusekwe kwithiyori yokuba amanqanaba asezantsi e-serotonin adlala indima kwizigulana ezazidandathekileyo ngokwezonyango. Iprozac, kunye nezinye ii-SSRI ezilandelelweyo, zenzelwe ngokukodwa ukonyusa amanqanaba e-serotonin kwingqondo. Lo msebenzi wokukhetha yayiyindlela eyahlukileyo yokwenza isenzo kwizinto ezindala zokuthomalalisa uxinzelelo ezazikho ngelo xesha.

Isebenza njani i-SSRIs?

I-Serotonin yi-neurotransmitter, okanye umthunywa weekhemikhali, ophethe imiqondiso phakathi kweeseli zemithambo-luvo, okanye ii-neurons, kwingqondo. Xa ubuchopho buthumela umyalezo, i-serotonin ikhutshwa kwi-neuron enye ize iphinde ithathwe kwaye iphinde ibuyiselwe kwakhona ngumamkeli kwi-neuron efumanayo. Umsebenzi we-SSRIs ngokuthintela ukubuyiselwa kwakhona, okanye ukuphinda kuthathwe, i-serotonin kwi-receptor ye-neuron efumanayo. Oku kuvumela i-serotonin engakumbi, ekucingelwa ukuba inefuthe elihle kwimood, imvakalelo, kunye nokulala, ukubakho ukuphucula ukuhanjiswa kwemiyalezo phakathi kwee-neurons. Ii-SSRI zibizwa ngokuba ziyakhetha kuba ezona mpembelelo zazo ziphambili zikwiserotonin hayi kwezinye ii-neurotransmitters.

Zisetyenziselwa ntoni ii-SSRI?

Ingxaki enkulu yokudandatheka (MDD)
Ingxaki yokujonga okunyanzelekileyo (i-OCD)
Ingxaki yoxinzelelo lwentlalo (SAD)
Ukuphazamiseka kwengqondo (PD)
Uxinzelelo lwasemva koxinzelelo lwasemva (PTSD)
Ukuphazamiseka kwangaphambi kokuya exesheni (PMDD)
Bulimia amanosa

Ngubani onokuthatha ii-SSRI?

Abantwana kunye nolutsha

I-anti-depressants, kubandakanya onke amayeza e-SSRI, anesilumkiso esinebhokisi egunyazisiweyo ye-FDA, ekwabizwa ngokuba isilumkiso sebhokisi emnyama , ngenxa yomngcipheko okhulayo wokuzibulala ebantwaneni, kulutsha nakwabantu abadala abancinci (ukuya kuthi ga kwi-24 yeminyaka ubudala). I-FDA ivumile ezi zinto zilandelayo ukuze zisetyenziswe ebantwaneni nakwishumi elivisayo ngeendlela ezahlukeneyo zokufumanisa isifo:

Iprozac yoxinzelelo kunye ne-OCD
I-Zoloft ye-OCD
I-Fluvoxamine ye-OCD
ILexapro yoxinzelelo

Abantu abadala

Ii-SSRI ngokubanzi zithathwa njengekhuselekileyo kwaye zinokusetyenziswa kubantu abadala ngaphandle kokuba zine-hypersensitivity eyaziwayo kuso nasiphi na isithako.

Abadala

Ii-SSRI ngokubanzi zithathwa njengezikhuselekileyo nezisebenzayo ukuba zisetyenziswe kubantu abadala ngaphandle kokuba zine-hypersensitivity eyaziwayo kuso nasiphi na isithako. Izigulana ezigugileyo zinokuba semngciphekweni omkhulu we-hyponatremia, okanye amanqanaba asezantsi e-sodium, xa uthatha ii-SSRI-oku kunokuqwalaselwa ngokutshintshela kwidosi esezantsi okanye idosi engaphantsi rhoqo.

Kungenxa yokuba babonakalise ubuncinci obunokubakho kunxibelelwano lweziyobisi, iziyobisi ze-SSRI zithathwa njengezinazo eyona iprofayili yezokhuseleko kubantu abadala NguCelexa, Lexapro, kunye noZoloft.

Ngaba ii-SSRI zikhuselekile?

Ii-SSRI zithwala isilumkiso esinebhokisi malunga nomngcipheko wokucinga ngokuzibulala nokuziphatha kwezinye izigulana ezisencinci. Izigulana zabo bonke ubudala eziqaliswe kwii-SSRI kufuneka zijongwe njengeempawu zokuzibulala kunye nokuziphatha.

Ngenxa yokuba ii-SSRIKucingelwa ukuba basebenze ngendlela efanayo babelana ngezilumkiso ezifanayo:

Isifo seSerotonin yimeko enobuzaza nenokubangela ubomi obunobungozi apho kukho i-serotonin eninzi emzimbeni. Umsebenzi we-SSRI ngokunyusa amanqanaba e-serotonin anokukhokelela kumanqanaba agqithisileyo, ngakumbi xa ethathwa namanye amachiza anyusa i-serotonin efana ne-triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, dextromethorphan, amphetamines, iSt John's Wort, kunye ne-monoamine oxidase inhibitors (MAOIs). Iimpawu zeserotonin syndrome zinokubandakanya umkhuhlane omkhulu, ukuxhuzula, ukubetha kwentliziyo okungalinganiyo, okanye ukudlula. Unonophelo lonyango olungxamisekileyo lunokufuneka ukuba kukho naziphi na kwezi mpawu.
Xa uyeka i-SSRI, iimpawu zokurhoxa, ezinje ngokudinwa, zinokwenzeka ukuba ziyekwe ngesiquphe. Izigulana kufuneka zilandele iingcebiso zomboneleli wazo wezempilo kweyona ndlela yokuthomalalisa ichiza.
Ii-SSRIs zinokubangela isiqendu esidibeneyo / somntu kwizigulana ezine ukuxhuzula .
Ii-SSRI kufuneka zisetyenziswe ngononophelo kwizigulana ezinembali yokuhlaselwa.
Ii-SSRI zinokunyusa umngcipheko wokopha ngakumbi ukuba zisetyenzisiwe kunye iziyobisi ezingasebenziyo ezichasayo (ii-NSAID) njenge-aspirin, ibuprofen, okanye naproxen, okanye iziyobisi ze-anticoagulant ezifana ne-warfarin.
Ukuvalwa kwe-Angle iglaucoma Kwenzekile kwizigulana ezithatha ii-SSRI ngee-angles ezinganyangekiyo ze-anatomiki ezincinci.
I-Hyponatremia, imeko apho inqanaba le-sodium egazini liphantsi kakhulu, ixeliwe ngokusetyenziswa kwe-SSRI. Iimpawu zingabandakanya isicaphucaphu, intloko ebuhlungu, ukudideka nokudinwa.
Izigulana ezikwi-SSRI zinokuba namava obunzima obulahlekileyo, ngakumbi abo sele betyebe kakhulu.
Ezinye ii-SSRI zinokubangela ukuphazamiseka kwesingqisho sentliziyo kwaye kufuneka zisetyenziswe ngononophelo kwizigulana ezinemingcipheko yokunyusa i-QT.
Ii-SSRI zinokuphazamisa ukugweba kunye nezakhono zeemoto kwaye abaguli kufuneka basebenzise isilumkiso xa besebenzisa oomatshini.

Izithintelo ze-SSRI

Ii-SSRI zinokunyusa amathuba okubangela iziphumo ebezingalindelekanga ezimandla kwaye kufuneka zisetyenziswe ngononophelo, okanye kungenjalo, kwabo banezi meko zilandelayo:

Ngexesha lesigaba somntu sokuphazamiseka kwengqondo okuguquguqukayo
UKUYA ukuphazamiseka kwegazi
Uhlobo lwe-1 okanye lwe-2 yeswekile
Isathuthwane (ngaphandle kokuba isifo sokuwa silawulwe kakuhle)
I-glaucoma emxinwa
Izintso ezinobunzima, isibindi, okanye iingxaki zentliziyo

Unxibelelwano lwe-SSRI

Xa zidityaniswe namanye amachiza, ii-SSRI zinokuphazamisa ukusebenza kwazo kwaye zinokuba neempendulo eziyingozi. Ukudibana kweziyobisi nomntu ngamnye kwi-SSRI nganye kunokufumaneka kwiinkcukacha zeemveliso zonxibelelwano Uluhlu lwee-SSRI ngentla. Unxibelelwano olubalulekileyo oluqhelekileyo kuzo zonke ii-SSRI zezi zilandelayo:

Ii-SSRI azifanele zithathwe kunye nee-MAOIs okanye kwiiveki ezimbini zokuthatha ii-MAOIs ukunqanda umngcipheko we-serotonin syndrome.
Ii-SSRIs akufuneki zithathwe nezinye i-serotonergic, okanye i-serotonin eyandayo, iziyobisi ezinje nge-serotonin-norepinephrine reuptake inhibitors (SNRIs), triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, okanye iSt.John's Wort.
Ii-SSRI zinokunyusa umngcipheko wokopha xa zithathwa namanye amayeza anyusa umngcipheko wokopha, njengee-NSAID (umz., Aspirin okanye ibuprofen) okanye abacoci begazi (umzekelo, warfarin).

Ngaba ungathatha ii-SSRI xa ukhulelwe okanye uncelisa?

Isigqibo sokusebenzisa ii-SSRI ngexesha ukukhulelwa okanye ngelixa ukuncancisa isekwe kwibhalansi phakathi komngcipheko kunye nesibonelelo. Umngcipheko wokukhubazeka kokuzalwa kwabantwana boomama abathatha ii-SSRI ngexesha lokukhulelwa usezantsi, nangona i-paroxetine (Paxil, Pexeva)inxulunyaniswa ne umngcipheko omncinci weziphene zokuzalwa kunye nokusetyenziswa kwayo kuyadimazeka. Umboneleli wezempilo wabasetyhini ngowona mthombo wolwazi xa ulawula unyango lwe-anti-depressant xa ukhulelwe okanye uncancisa.

Ukumisa ii-SSRI

Nangona ii-SSRI azikho likhoboka, ukusilela kwiidosi ezininzi zalo naluphi na uxinzelelo ngokulandelelana okanye ukuyeka unyango ngesiquphe kunokubangela iimpawu zokurhoxa. Ngamanye amaxesha kubizwa njalo ukuyeka isifo kwaye zinokubandakanya ezi mpawu zilandelayo:

Imvakalelo ngokubanzi yokungoneliseki
Isicaphucaphu
Ukuba nesiyezi
Ukuhamba
Iimpawu ezinjengomkhuhlane

Izigulana kufuneka zijongwe kwezi mpawu xa ziyeka unyango nge-SSRI. Ukuncitshiswa kancinci kwethamo kunokumisa ngesiquphe kuyacetyiswa xa kunokwenzeka. Ukuba iimpawu ezinganyamezelekiyo zenzeka emva kokuhla kwethamo okanye ekuphelisweni kwonyango, emva koko ukuphinda uqalise idosi ebimiselwe ngaphambili kunokuqwalaselwa. Umboneleli wezempilo unokuqhubeka nokunciphisa idosi kodwa kwinqanaba elincinci lokuhamba kancinci.

Ngaba izinto ezilawulwa yi-SSRI?

Hayi, ii-SSRI azizizo izinto ezilawulwayo.

Iziphumo eziqhelekileyo ze-SSRI

Oku kulandelayo ziziphumo ebezingalindelekanga eziqhelekileyo xa uthatha ii-SSRI. Olu ayilo luhlu olupheleleyo kwaye kuya kufuneka usoloko uqhagamshelana nengcali yezempilo ngaphambi kokuba uthathe ii-SSRI.

Ukuphuthelwa
Isicaphucaphu
Intloko ebuhlungu
I-Asthenia (ubuthathaka obungaqhelekanga okanye ukunqongophala kwamandla)
Urhudo
Ukuphelelwa ngumdla wokutya
Ukozela
Ixhala
Uvalo
Umlomo owomileyo
Ukunciphisa i-libido (ukulahleka kwesondo)
Ukuzamla
Ukungcangcazela
Ukutya
Umkhuhlane wesi sifo
Ukuba nesiyezi
Ukubila okugqithisileyo
Ukungasebenzi kakuhle
Ukungabi namandla
Amaphupha angaqhelekanga
Ukuqunjelwa
Irhashalala
Ukuhlanza
Ukuphazamiseka okubonakalayo
Ukuhla ukusinda

Ixabisa malini i-SSRIs?

Ii-SSRI zinexabiso elibanzi kuxhomekeke kwichiza elithile, ubungakanani, kunye nedosi. Kuba ii-SSRI ezininzi ziyafumaneka kwifom yohlobo oluqhelekileyo, zincinci kakhulu kunegama lomlingani. Umzekelo, ifluoxetine yohlobo oluqhelekileyo I-20 mg ngosuku ixabisa malunga ne- $ 16 ngenyanga. Uhlobo lwegama lophawu, iProzac, luya kubiza malunga ne- $ 534 ngenyanga. Ngokwesiqhelo yeyokine I-20 mg ngosuku ixabisa malunga ne- $ 14 ngenyanga. Inguqulelo yohlobo lophawu, uCelexa, yayixabisa malunga ne-305 yeedola ngenyanga. UKUYA Ikhadi elilodwa lokuKhathalela inokunciphisa iindleko ezithile zokuyalela ukuya kuthi ga kwiipesenti ezingama-80 kwiikhemesti ezithatha inxaxheba.