Indibaniselwano yonyango loxinzelelo

Umxholo

• Indima yamayeza
• Ukudakumba koxinzelelo
• Iintsholongwane
• I-L-Triiodothyronine
• Izikhuthazi
• Unyango lwendibaniselwano njengoNyango lokuqala

Ukuba unengxaki yokudakumba (MDD), kusenokwenzeka ukuba sele uthatha i-anti-depressant. Ukudityaniswa kwonyango lweziyobisi luhlobo lonyango oogqirha abaninzi kunye noogqirha bengqondo abebelusebenzisa kakhulu kule minyaka ilishumi idlulileyo.

Indima yamayeza

Kude kube kutshanje, oogqirha baye bamisela iyeza lokuthomalalisa uxinzelelo kwiklasi enye kuphela yamachiza, elinye ngexesha. Oku kubizwa ngokuba yi-monotherapy. Ukuba elo chiza aliphumelelanga, banokuzama elinye iyeza ngaphakathi kwelo klasi, okanye batshintshele kwelinye iklasi lezidambisi.

Uphando ngoku lubonisa ukuba ukuthatha i-anti-depressants kwiiklasi ezininzi kunokuba yeyona ndlela yokunyanga i-MDD. Olunye uphononongo lufumanise ukuba ukusebenzisa indlela yokudibanisa kumqondiso wokuqala we-MDD kunokuphinda kabini amathuba okuxolelwa.

Ukudakumba koxinzelelo

Ngokwayo, i-bupropion iyasebenza ngokunyanga i-MDD, kodwa inokusetyenziswa ngokudibeneyo namanye amayeza kuxinzelelo olunzima lokunyanga. Ngapha koko, i-bupropion yenye yezona ziqhelekileyo zisetyenziselwa indibaniselwano yonyango. Ihlala isetyenziswa ngokukhetha i-serotonin reuptake inhibitors (i-SSRIs) kunye ne-serotonin- norepinephrine reuptake inhibitors (SNRIs). Ngokuqhelekileyo kunyamezeleka kakuhle kubantu abaye bafumana iziphumo ebezingalindelekanga ezibi ezivela kwamanye amayeza okulwa uxinzelelo. Inokuphinda ikhulule ezinye zeempembelelo zesondo (ukunciphisa i-libido, i-anorgasmia) enxulunyaniswa nee-SSRIs ezidumileyo kunye nee-SNRI.

Kubantu abafumana ukuphulukana nokutya kunye nokulala, i-mirtazapine inokukhetha. Iziphumo zalo eziqhelekileyo ezichaphazelekayo kukufumana ubunzima kunye nokuthambisa. Nangona kunjalo, i-mirtazapine khange ifundwe kubunzulu njengeyeza lokudibanisa.

Iintsholongwane

Uphando lubonisa ukuba kunokubakho isibonelelo sokunyanga iimpawu ezishiyekileyo kubantu abathatha ii-SSRI nge-antipsychotic atypical, ezinje nge-aripiprazole. Iziphumo ebezingalindelekanga ezinokubakho ezinxulunyaniswa nala mayeza, njengokufumana ubunzima, ukungcangcazela kwemisipha, kunye nokuphazamiseka emzimbeni, kufuneka ziqwalaselwe ngononophelo njengoko zinokuqhubeka okanye zenze mandundu ngakumbi iimpawu zoxinzelelo.

I-L-Triiodothyronine

Abanye oogqirha basebenzisa i-L-Triiodothyronine (T3) ngokudibanisa unyango kunye ne-tricyclic antidepressants (TCAs) kunye ne-monoamine oxidase inhibitors (MAOIs). Iingcebiso zophando i-T3 ibhetele ekukhawuleziseni impendulo yomzimba kunyango kunokuba kwandise amathuba okuba umntu angene kuxolelo.

Izikhuthazi

D-amphetamine (Dexedrine) kunye ne-methylphenidate (Ritalin) zizikhuthazi ezisetyenziselwa ukunyanga uxinzelelo. Zingasetyenziswa njenge-monotherapy, kodwa zisenokusetyenziswa kunyango oludibeneyo kunye namayeza oxinzelelo. Ziluncedo kakhulu xa isiphumo esinqwenelekayo kukusabela ngokukhawuleza. Izigulana ezibuthathaka, okanye abo baneemeko zekomorbid (ezinje nge-stroke) okanye izifo ezinganyangekiyo, banokuba ngabagqatswa abafanelekileyo kolu manyano.

Unyango lwendibaniselwano njengoNyango lokuqala

Amanqanaba okuphumelela konyango lwe-monotherapy asezantsi, kwaye ke abaphandi abaninzi kunye noogqirha bakholelwa kwelokuqala kunye nelona ndlela lifanelekileyo lokunyanga i-MDD lunyango lonyango oludibeneyo. Okwangoku, oogqirha abaninzi baya kuqala ngokunyanga iyeza elinye lokudakumba.

Ngaphambi kokwenza isigqibo malunga namayeza, yinike ixesha lokusebenza. Emva kwexesha lokulingwa (ngesiqhelo malunga neeveki ezi-2 ukuya kwezi-4), ukuba awubonisi mpendulo yaneleyo, ugqirha wakho anganqwenela ukutshintsha amayeza okanye ongeze iyeza elongezelelweyo ukubona ukuba indibaniselwano iyanceda na ukuba icebo lakho lonyango liphumelele.