Fumana ezona Antipsychotic zaBantwana

Umxholo

• Wamkelekile
• Isebenza njani iAtypical Antipsychotic Work kwaye ngubani oyifunayo?
• Iimeko eziPhathwe ngeAtypical Antipsychotic
• Ischizophrenia
• Ukuxhuzula
• Aripiprazole (Yenza)
• IQuetiapine (iSeroquel)
• I-Olanzapine kunye neRisperidone
• Ukuphazamiseka kwindawo yonke
• Ukuphazamiseka kwindlela yokuziphatha
• Ukhuseleko lweAtypical Antipsychotic
• Inkxalabo yezokhuseleko nge-antipychychotic ebantwaneni nakwishumi elivisayo
• Ukutyeba kwakho
• Iingxaki zentliziyo kunye neswekile
• Indlela yokuziphatha yokuzibulala
• Ezinye iziphumo ebezingalindelekanga
• Ukukhetha iAtypical Antipsychotic yaBantwana
• Ukuthetha nogqirha wakho
• Siwavavanye njani ama-Antipsychotic
• Ukwabelana ngale Ngxelo
• Ngathi
• Izalathiso

• Isishwankathelo
• Ingxelo epheleleyo

Amayeza amiselweyo abizwa ngokuba yi-antipychychotic atypical, ebandakanya i-aripiprazole (Abilify), asenapine (Saphris), clozapine (Clozaril), iloperidone (Fanapt), olanzapine (Zyprexa), paliperidone (Invega), quetiapine (Seroquel), risperidone (Risperdone) (UGeodon), banikwa abantwana kunye nolutsha ukuba banyange ischizophrenia kunye ne-bipolar disorder. Zikwasetyenziselwa ukuzama ukunciphisa ubukrakra, ukuba nochuku, kunye nokuziphatha okuzenzakalisayo okunxulunyaniswa nokuphazamiseka okuthe gabalala, kubandakanya i-autism kunye ne-Asperger syndrome, kunye nokuphazamiseka kwendlela yokuziphatha. Kodwa ukumisela la machiza kubantu abancinci kuyaphikisana kuba khange kufundwe kakuhle, kwaye ukhuseleko lwexesha elide kunye nokusebenza kwabantwana nolutsha alwaziwa.

Izifundo kubantu abadala ziye zafumanisa ukuba ii-antipsychotic atypical zinokubangela iziphumo ebezingalindelekanga ezibi, ukhuseleko lwexesha elide yinkxalabo ethile malunga nokusetyenziswa kwabo ebantwaneni. Ezinye zezona zinto zixhalabisayo zibandakanya ukungalawuleki okungalawulekiyo kunye neenyikima ezifana nesifo sika-Parkinson (esaziwa njengeempawu ze-extrapyramidal), umngcipheko owandayo wesifo seswekile, ukuzuza okukhulu kwesisindo, kunye namanqanaba aphezulu e-cholesterol kunye ne-triglyceride. Amachiza e-antypychotic anticychotic nawo angonyusa umngcipheko wokufa ngaphambi kwexesha, ikakhulu ngenxa yemivumbo, kubantu abadala abanesifo sengqondo esixhalabisayo. Le mngcipheko ifundwe ikakhulu kubantu abadala; Iziphumo ebantwaneni azaziwa ncam ngeli xesha.

Ngenxa yokunqongophala kobungqina, asinakukwazi ukukhetha eyona nto ilungileyo yokuthenga isifo se-antipsychotic yabantwana abane-schizophrenia, ukuphazamiseka kwengqondo okuguquguqukayo, ukuphazamiseka okuthe gabalala, okanye ukuphazamiseka kwendlela yokuziphatha. Endaweni yoko, abacebisi bethu bezonyango bacebisa ukuba abazali baqwalasele ngononophelo ubungozi kunye nezibonelelo ezinokubakho. Abantwana abanezi ngxaki kufuneka bafumane unyango olubanzi, olubandakanya unyango lokuziphatha, ukuqeqeshwa kwabazali, kunye neenkqubo ezizodwa zemfundo, kunye naluphi na unyango lweziyobisi.

Ukuthatha isigqibo sokuba usebenzise elinye lala mayeza kufuneka lenziwe ngokudibeneyo nogqirha womntwana wakho. Ukuqwalaselwa okubalulekileyo kubandakanya indleko, ezinokubaluleka, iziphumo ebezingalindelekanga ezinokubakho, nokuba ngaba iyeza libonakalisiwe ukuba liyasebenza kwimeko okanye iimpawu zomntwana wakho ezibalaseleyo. Ukuba umntwana wakho unemeko esele ikho-umzekelo, i-ADHD okanye uxinzelelo-kuya kufuneka uqiniseke ukuba baphathwa ngokufanelekileyo, kuba oku kunokuziphucula iimpawu zomntwana wakho.

Le ngxelo yapapashwa ngo-Matshi 2012.

Isiqulatho

• Icandelo 1: Wamkelekile
• Icandelo 2: Isebenza njani iAtypical Antipsychotic Work kwaye ngubani oyifunayo?
• Icandelo 3: Ukhuseleko lweAtypical Antipsychotic
• Icandelo 4: Ukukhetha iAtypical Antipsychotic yaBantwana
• Icandelo 5: Ukuthetha nogqirha wakho
• Icandelo 6: Sayivavanya njani iAntipsychotic
• Icandelo 7: Ukwabelana ngale Ngxelo
• Icandelo 8: Ngathi
• Icandelo 9: Izalathiso

Funda ngokugqithisileyo

Wamkelekile

Le ngxelo igxile ekusebenziseni amayeza amiselweyo abizwa ngokuba yi-atypical antipsychotic ngabantwana nakwishumi elivisayo, abaneminyaka eli-18 nangaphantsi. I-antypychychotic ye-Atypical isetyenziselwa ukunyanga isifo sengqondo kunye nokuphazamiseka kwengqondo. Zikwasetyenziselwa ukuzama ukunciphisa ubundlongondlongo, ukuba nochuku, ukurhoxa ekuhlaleni / ukonqena, kunye nezinye iimpawu ebantwaneni nakwishumi elivisayo ezinengxaki yophuhliso, kubandakanya i-autism kunye ne-Asperger syndrome, kunye nokuphazamiseka kwendlela yokuziphatha (kodwa kufanele kuqatshelwe ukuba ii-antipsychotic atypical azenzi ukunceda iingxaki zonxibelelwano eziphambili ze-autism kunye nokuphazamiseka okufanayo.)

Ukuyalela abantwana kunye nolutsha amayeza okulwa ne-psychotic kuyaphikisana kuba akukho bungqina buninzi malunga nokhuseleko okanye ukusebenza kakuhle kula maqela abudala.Uninzi lwezinto esizaziyo zivela kwizifundo zabantu abadala. Njengoko iTheyibhile 1 ibonisa, uninzi lwe-antipsychotic atypical aluvunywanga luLawulo lwezoKutya kunye noLawulo lweziyobisi ukuze lusetyenziswe ngabantwana. Kodwa banokusetyenziswa ngokusemthethweni "ngaphandle kwelebheli," oko kuthetha ukuba ichiza linokumiselwa ukunyanga imeko elingenayo imvume ye-FDA. (Oku ngakumbi malunga nesiqendu 2.)

Ngaphandle kokungabikho kobungqina, la mayeza ahlala emiselwe abantwana kunye nolutsha. Oku kuncede ukwenza i-antipsychotic ye-atypical iklasi yesihlanu ethengisa kakhulu iziyobisi e-US ngo-2010, nge- $ 16.1 yezigidigidi kwintengiso, ngokwe-IMS Health.

I-Clozapine (Clozaril), eyafumaneka e-US ngo-1989, yayiyi-antipsychotic yokuqala evunyiweyo yi-FDA. Namhlanje, ihlala inikwa kuphela xa amanye amayeza engaphumeleli kuba inokubangela ukuphazamiseka kwegazi kwabanye abantu. Yalandelwa zezinye ii-antipsychotic ze-atypical, kubandakanya i-aripiprazole (Abilify), asenapine (Saphris), iloperidone (Fanapt), olanzapine (Zyprexa), paliperidone (Invega), quetiapine (Seroquel), risperidone (Risperdal), kunye ziprasidone (Geodon) . (Jonga iTheyibhile 1.)

I-antypychychotic ye-atypical inokubangela iziphumo ebezingalunganga, kubandakanya ukuqina kwemisipha, ukuhamba kancinci kunye nokungcangcazela okungafunekiyo (okwaziwa njengeempawu ze-extrapyramidal), ukuzuza ubunzima obukhulu, umngcipheko okhulayo wohlobo lweswekile yesi-2, kunye namanqanaba aphezulu e-cholesterol. (Iziphumo ebezingalindelekanga zidweliswe kwiTheyibhile 2.) Abantu abaninzi abaqala ukuthatha enye abayithathi ixesha elide, nokuba iyazinciphisa iimpawu zabo, kuba abanako okanye abafuni kunyamezela iziphumo ebezingalindelekanga.

Ukulawula abantwana abanengxaki yokukhula okanye yokuziphatha kunokuba ngumceli mngeni kubazali nakoogqirha. Ngenxa yokuba kuncinci kakhulu okwaziwayo malunga nokusetyenziswa kwe-antipsychotic atypical ebantwaneni, kwaye ngenxa yobunzima obunxulunyaniswa nezi ngxaki, iiNgxelo zabaThengi eziThengiweyo eziThengiweyo azikukhuthazi ukhetho lonyango oluthile okanye ukhethe eyona nto ithengwayo kule ngxelo ikhethekileyo. Endaweni yoko, sivavanya uphando lwezonyango ukukunceda uqonde izibonelelo kunye nemingcipheko ye-antipsychotic ye-atypical ukuze uthathe isigqibo, kunye nogqirha womntwana wakho, nokuba zilungele na umntwana wakho.

Le ngxelo yinxalenye yeprojekthi yeeNgxelo zabaThengi yokukunceda ufumane amayeza akhuselekileyo, asebenzayo akunika elona xabiso liphezulu kwidola yakho yokhathalelo lwempilo. Ukuze ufunde okungakumbi malunga neprojekthi kunye nezinye iziyobisi esivavanye ezinye izifo kunye neemeko, yiya kwi-CRBestBuyDrugs.org.

Itheyibhile 1. Amachiza e-Antipsychotic Drugs avavanyiwe kule Ngxelo
Igama lesiqhelo	Igama lebrand	Ngokwesiqhelo iyafumaneka	Ukuvunywa kwe-FDA yabantwana
Aripiprazole	Hlaziya	Hayi	Ukuvunywa kokusetyenziswa kwabakwishumi elivisayo abane-schizophrenia, abakwishumi elivisayo abanesifo sokuphazamiseka kwengqondo esixubeneyo okanye iziqendu zomntu, kunye nochuku olunxulunyaniswa ne-autism.
I-Asenapine	USafris	Hayi	Hayi
IClozapine	UClozaril Fazaclo	Ewe	Hayi
Iloperidone	Uxhaso	Hayi	Hayi
Olanzapine	Zyprexa Zyprexa Zydis	Hayi*	Ukuvunywa kokusetyenziswa kwabakwishumi elivisayo abane-schizophrenia, kunye nolutsha olunengxaki yokuphazamiseka kwengqondo okuxubeneyo okanye iziqendu zomntu.
IPaliperidone	Invega	Hayi	Hayi
IQuetiapine	ISeroquel ISeroquel XR	Hayi*	Ukuvunywa kokusetyenziswa kunyango lwabantwana abaneziqendu ze-manic kwisifo se-bipolar, nakwishumi elivisayo abane-schizophrenia.
IRisperidone	Umngcipheko	Ewe	Ukuvunywa kokusetyenziswa kwabakwishumi elivisayo abane-schizophrenia, abakwishumi elivisayo abanesifo esiyi-bipolar mix okanye i-manic episodes, kunye nokungakhathali okunxulunyaniswa ne-autism.
I-Ziprasidone	UGeodon	Hayi	Hayi

Ulawulo lwezoKutya kunye neDrug linike imvume yokwenziwa kwemveliso yohlobo oluthile kodwa akukho nanye ekhoyo ngeli xesha.

Buyela phezulu Funda ngokugqithisileyo Buyela kuLuhlu lweZiqulatho

Isebenza njani iAtypical Antipsychotic Work kwaye ngubani oyifunayo?

Ayaziwa ngokuthe ngqo ukuba isebenza njani i-antipsychotic ukunceda ukukhulula iimpawu. Kodwa into esiyaziyo kukuba ichaphazela amanqanaba eekhemikhali kwingqondo ebizwa ngokuba zii-neurotransmitters, ezidlala indima ebalulekileyo ekuziphatheni nasekuqondeni, kunye nokulala, imo yoxinzelelo, ingqalelo, inkumbulo kunye nokufunda. Oku kunokuba yindlela abazinciphisa ngayo iimpawu zengqondo, ezinje ngombono, ukukhohlisa, ukucinga okungalungelelananga, kunye nokuphazamiseka kwi-schizophrenia kunye ne-bipolar disorder. Isenokucacisa ukuba bangabunciphisa njani ubundlongondlongo, ukuba nochuku, kunye nokuziphatha okuzenzakalisayo okunxulunyaniswa nokuphazamiseka okuthe gabalala kuphuhliso kunye nokuphazamiseka kokuziphatha. Kodwa kubungqina obunqongopheleyo obukhoyo, akukacaci ukuba bakwenza kakuhle kangakanani oku, nokuba bahlala besebenza ngaphezulu kwexesha elide.

Iimeko eziPhathwe ngeAtypical Antipsychotic

Uninzi lwezifundo kwi-antipsychotic atypical zijolise kunyango lwe-schizophrenia kunye ne-bipolar disorder. Amanye amachiza anemvume ye-FDA yokunyanga ezo meko kubantwana nakwishumi elivisayo nakubantu abadala. Kodwa zikwasetyenziswa “ngaphandle kwelebheli,” oko kuthetha ukuba bamiselwe ngoogqirha ukunyanga iimeko ezingakhange zivunywe yi-FDA.

Ngaphandle kwelebheli ukumisela oogqirha kuyinto eqhelekileyo kwaye isemthethweni, nangona kungekho semthethweni kwiinkampani ezixuba amayeza ukukhuthaza amayeza abo ekusetyenzisweni kwelebheli. Ukusetyenziswa kwelebula ngaphandle kwe-antipsychotic ebantwaneni kubandakanya unyango lweengxaki zokukhula, ezinje nge-autism kunye ne-Asperger syndrome, kunye nokuphazamiseka kwendlela yokuziphatha. (I-Aripiprazole kunye ne-risperidone zivunyiwe kwabo bane-autism-spectrum disorder, kodwa ezinye ii-antipsychotic atypical azikho.)

Kuzo zonke iimeko ezine-i-bipolar disorder, i-schizophrenia, ukuphazamiseka kokukhula, kunye nokuphazamiseka kwendlela yokuziphatha-ubungqina obuxhasa ukusetyenziswa kwe-antipsychotic yabantu abancinci kunqunyelwe kwizifundo ezimbalwa, zexeshana elincinci, ngaphandle kobungqina obulungileyo ixesha elide ukusebenza kwexesha kunye nokhuseleko.

Ngokubanzi, uphononongo ngokusetyenziswa kwe-antipychychotic yintsholongwane ngabantwana babandakanyeke kuphela malunga ne-2,640 yabo. Phantse i-1 000 labantwana babenengxaki yokuphazamiseka engqondweni, abangama-600 babeneengxaki zokukhula, abangama-640 babeneziphene, yaye abangaphantsi kwama-400 babene-schizophrenia.

Ibhokisi ekwicandelo 2 ibonisa ukuba zeziphi iziyobisi ezifundwe ebantwaneni, kwaye zithini iimeko. Kuphela yi-aripiprazole (Abilify), i-olanzapine (iZyprexa), i-quetiapine (i-Seroquel), kunye ne-risperidone (i-Risperdal) eziye zafundwa kubantwana abane-bipolar disorder. Kwishumi elivisayo elinesiqalo esitsha se-schizophrenia, kuphela yi-olanzapine (Zyprexa), quetiapine (Seroquel), kunye ne-risperidone (Risperdal) eziye zafundwa. I-Aripiprazole (i-Abilify), i-olanzapine (iZyprexa), kunye ne-risperidone (i-Risperdal) ziye zafundwa kubantwana abaneengxaki zokukhula, ngelixa i-risperidone (i-Risperdal) ifundwe kubantwana abaneziphazamiso zokuziphatha eziphazamisayo.

Kwimeko nganye yezi meko ebantwaneni, ubungqina ngokuthelekisa ngokuthe ngqo enye ye-antipsychotic ye-atypical ukuya kwenye buncinci kakhulu okanye abukho kwaphela. Ubungqina benzuzo kunye nokwenzakala bukhankanywe ngezantsi ngemeko yesiyobisi ngasinye.

Ischizophrenia

Akucaci ukuba bangaphi abantwana abaphethwe yi-schizophrenia ngenxa yokuba esi sifo singahlali sifunyanwa de kube badala, ngokwe-National Institute of Mental Health. I-Schizophrenia ifunyenwe kubantwana abancinci njenge-5 kodwa oku kunqabile. Amadoda ahlala efumana iimpawu zokuqala xa bekwishumi elivisayo nasekuqaleni ukuya phakathi kwe-20; Abasetyhini bahlala bechongwa okokuqala kwi-20 ukuya kwi-30s.

Abantu abane-schizophrenia banengxaki yokucinga ngokudibeneyo kunye nokungenangqondo, kodwa ngokuchasene nenkolelo edumileyo, abanabuntu obahlukeneyo. Banokurhoxa, boyike, kwaye baphazamiseke, kwaye babe namava kunye nokukhohlisa. Kwaye banokuba nobunzima obukhulu ekunxibelelaneni nabanye ngokweemvakalelo.

Abantu abaninzi abane-schizophrenia baphila ubomi obunentsingiselo kwaye basebenza kakuhle ngonyango olululo. Uninzi lwezifundo ze-atypical antipsychotic drug zijolise kubantu abadala abane-schizophrenia. Bafunyenwe benceda ukunciphisa iimpawu, ukuphucula umgangatho wobomi, kunye nokunciphisa ithuba lomntu owenza okubi kuye okanye kwabanye. Kodwa izifundo kusetyenziso lwee-antipsychotic ngabakwishumi elivisayo abafunyenwe isifo seschizophrenia kutsha nje.

I-Antypychychotic ye-Atypical efundwe kuBantwana nakwishumi elivisayo, ngesiGulo
Igama lesiqhelo	Igama lebrand	Ukuphazamiseka
		Abantwana abanengxaki yokuphazamiseka engqondweni	Abakwishumi elivisayo abanesifo sengqondo esitsha	Abantwana abaneengxaki zokuziphatha eziphazamisayo	Abantwana abaneengxaki zokukhula ezigcweleyo
Aripiprazole	Hlaziya	& khangela;			& khangela;
Olanzapine	Zyprexa	& khangela;	& khangela;		& khangela;
IQuetiapine	KwiSeroquel	& khangela;	& khangela;
IRisperidone	Umngcipheko	& khangela;	& khangela;	& khangela;	& khangela;

& khangela; ibonisa ukuba ichiza lifundwe njengonyango lwesifo kubantwana kunye / okanye kulutsha. I-Asenapine (Saphris), Clozpine (Clozaril), iloperidone (Fanapt), paliperidone, kunye ne-ziprasidone (Geodon) azidweliswanga kuba khange zifundwe ebantwaneni.

Izifundo zabantu abadala zibonisa ukuba malunga nesiqingatha sabo bane-schizophrenia bafumana ukuncipha okubonakalayo kwiimpawu zabo emva kokuthatha i-antipsychotic. Ezinye iimpawu, njengokuphazamiseka, zinokuba ngcono kwiintsuku nje ezimbalwa. Ezinye, ezinjengokukhohlisa kunye nemibono, zinokuthatha iiveki ezine ukuya kwezintandathu ukuzola. Ngenxa yoko, phantse wonke umntu ofunyenwe ene-schizophrenia uya kufumana iyeza lokuthintela ukugula.

Kodwa ii-antipsychotic atypical azisebenzi kuwo wonke umntu. Phantse iipesenti ezingama-20 zabantu abane-schizophrenia abafumani sibonelelo kubo, kwaye amanye ama-25 ukuya kuma-30 eepesenti anamava nje okwehla kweempawu.

Izifundo ezibini ezincinci ngokuthelekisa ngokuthe ngqo isiphumo se-antipsychotic atypical ezisetyenziswa ngabakwishumi elivisayo abane-schizophrenia khange bafumane mahluko mkhulu phakathi kwamayeza avavanyiweyo. I-Olanzapine (iZyprexa) kunye nequetiapine (Seroquel) zinefuthe elifanayo kwiimpawu emva kweenyanga ezintandathu kwisifundo esincinci kakhulu kulutsha olufumene isifo sesifo sengqondo. I-Risperidone (Risperdal) kunye ne-olanzapine (iZyprexa) zikhokelele kuphuculo olufanayo kwiimpawu kwiiveki ezisibhozo.

Ukuxhuzula

Uninzi lwabantu abane-bipolar disorder bahlala banikwa isifo kwi-20 okanye kwi-20s yabo yokuqala. IZiko leSizwe lezeMpilo yeNgqondo liqikelela ukuba imeko ichaphazela abangaphantsi kwesithathu ekhulwini kulutsha, kodwa eyona nto ixhaphakileyo ayaziwa kuba kunzima ukufumanisa isifo ebantwaneni. Oku kungenxa yokuba iimpawu azicacanga ebantwaneni kunakubantu abadala, kwaye zinokudibana nezinye iimeko zobuntwana, ezinje nge-ADHD okanye ukungaziphathi kakuhle.

Iimpawu ezibalaseleyo zokuphazamiseka kwengqondo okuguqukayo kukutshintsha okubukhali phakathi kweemoods eziphezulu kakhulu-okanye imania-kunye neemowudi eziphantsi kakhulu-okanye uxinzelelo. Kwiimeko ezininzi, ezo zinto zibaxekileyo zihlala iiveki ezininzi. Kukho ixesha eliphakathi phakathi kwemo "yesiqhelo". Kodwa abanye abantu abane-bipolar disorder banokuba namaxesha apho iimpawu ze-mania kunye noxinzelelo zikhona ngaxeshanye. Ezi zibizwa ngokuba “zizixube” iziqendu.

I-antypychychotic ye-Atypical zihlala zingasetyenziselwa ukunyanga ukuphazamiseka kwengqondo de abantu baqale bazame amanye amayeza, kubandakanya i-lithium, i-divalproex kunye ne-carbamazepine.

Izifundo zabantu abadala ziye zafumanisa ukuba zonke ii-antipsychotic zinokunceda ukunciphisa iimpawu ze-mania zesifo esiyi-bipolar, ngama-40 ukuya kuma-75 eepesenti yabantu abafumana ukwehla kweempawu. Kodwa kuye kwakho izifundo ezimbalwa kwiziphumo zamachiza kubantu abadala abane-bipolar disorder kune-schizophrenia, kwaye bambalwa phakathi kwabantwana abanesifo se-bipolar.

Nantsi into eyaziwayo ukuza kuthi ga ngoku:

Aripiprazole (Yenza)

Kwisifundo esinye, impendulo yexesha elifutshane-ethetha ukuba iipesenti ezingama-50 okanye ukuncitshiswa okukhulu kweempawu-kwabonwa kwiipesenti ezingama-45 ukuya kuma-64 zabantwana nakwishumi elivisayo abathatha i-aripiprazole emva kweeveki ezine zonyango xa kuthelekiswa neepesenti ezingama-26 ezazithatha i-placebo. Ukuxolelwa-isisombululo esigqibeleleyo seempawu- kufezekisiwe kwiipesenti ezingama-25 ukuya kuma-72 zabantwana abathatha i-aripiprazole ngokuthelekiswa neepesenti ezi-5 ukuya kwezingama-32 kwi-placebo. Kodwa ekupheleni kwesifundo, abantwana abathatha i-aripiprazole bakala umgangatho wabo wobomi usezantsi kunabo baphathwa nge-placebo.

IQuetiapine (iSeroquel)

Kwisifundo esinye, i-58 ukuya kwi-64 yeepesenti yabantwana kunye nolutsha olunempawu ze-mania lubonise impendulo emva kweeveki ezintathu zonyango lwe-quetiapine xa kuthelekiswa neepesenti ezingama-37 ezithathe indawo ye-placebo. Uxolelo lubonwe ngaphezulu kwesiqingatha esithathe i-quetiapine ngokuthelekiswa neepesenti ezingama-30 kwindawo ye-placebo.

Xa i-quetiapine yayisetyenziswa nelinye ichiza, i-di-valproex, ngabakwishumi elivisayo abaneziqendu ezibukhali ze-mania, iipesenti ezingama-87 zabonisa impendulo emva kweeveki ezintandathu xa kuthelekiswa neepesenti ezingama-53 ezazithatha i-divalproex kuphela. Kwesinye isifundo esithelekisa i-quetiapine ne-divalproex kulutsha olunengxaki yokuphazamiseka engqondweni, omabini la machiza akhokelela kumgangatho wobomi ophucukileyo ekupheleni kweeveki ezine. Uphuculo lubonwe kumandla abo okuhlangana nabanye kunye nokulawula indlela abaziphethe ngayo, okukhokelela kukuphazamiseka okumbalwa kubomi bosapho. Kwaye abazali babo bakwi-quetiapine bathi abantwana babo basebenze ngcono esikolweni, kokubini ekuhlaleni nasezifundweni, kwaye baziva bhetele ngeziqu zabo.

IQuetiapine ayingcono kune-placebo xa kufikwa kumaxesha oxinzelelo lwengxaki yokuphazamiseka kwengqondo. Kuphononongo lwabaselula abangama-32 abanesiganeko sokudakumba esinxulunyaniswa nesifo esiyi-bipolar, i-quetiapine ayikhokelelanga kuphuculo lweempawu okanye inqanaba lokuphuculwa kokuxolelwa emva kweeveki ezisibhozo zonyango xa kuthelekiswa ne-placebo.

I-Olanzapine kunye neRisperidone

Olunye uphononongo oluncinci luthelekisa i-risperidone (Risperdal) kunye ne-olanzapine (iZyprexa) kwi-31 yabantwana abasesikolweni abanesifo se-bipolar ababonisa iimpawu ze-mania. Amachiza abonise ukusebenza ngokufanayo ekupheliseni iimpawu emva kweeveki ezisibhozo zonyango. Isifundo esikhulu siyafuneka ukuqinisekisa ezo ziphumo.

Uphononongo lolutsha olunempawu zeemania lufumanise ukuba ama-59 ukuya kuma-63 epesenti abathathe i-risperidone (Risperdal) iiveki ezintathu bafumana impendulo ngokuthelekiswa neepesenti ezingama-26 ezithathe indawo ye-placebo. Kwisifundo esifanayo ne-olanzapine (Zyprexa), iipesenti ezingama-49 zolutsha oluthatha amayeza lubonise impendulo xa kuthelekiswa neepesenti ezingama-22 ezithathe indawo ye-placebo. Zombini ezi zifundo zafumanisa ukuba i-risperidone kunye ne-olanzapine zikhokelela kwizigulana ezininzi ezifumana ukuxolelwa xa kuthelekiswa ne-placebo.

Ukuphazamiseka kwindawo yonke

Ukuphazamiseka okuthe gabalala kuphuhliso kubandakanya i-Autism spectrum disorders (i-autism kunye ne-Asperger syndrome) kunye ne-Rett syndrome, ukungahambelani kokukhula komntwana, kunye nokuphazamiseka okuthe gabalala okuphuhlisayo (okuhlala kubizwa ngokuba "kukuphazamiseka okwandayo, kungachazwanga ngenye indlela").

Ngokomndilili, omnye kubantwana abali-110 e-U.S banendlela ethile yokuphazamiseka kwengqondo, ngokutsho kwamaZiko okuLawula nokuThintela izifo. I-Autism, exhaphake kakhulu kubafana kunamantombazana, iye icace gca ngaphambi kweminyaka yobudala emi-3. Unobangela awaziwa. Abantu abane-autism banengxaki yokunxibelelana nabanye kunye nezakhono zonxibelelwano, kunye nokuziphendulela ngokweemvakalelo, kwaye babonisa ngokubanzi ukuthintelwa nokuziphatha okuphindaphindayo, imisebenzi kunye nomdla.

Akukho lunyango, kodwa lukhona unyango olunokunceda. Inkqubo emiselweyo yemfundo okanye yemihla ngemihla ejolise kuphuculo lwezakhono kunye neendlela zonxibelelwano zihlala zisetyenziswa, kunye neendlela zokulawula indlela yokuziphatha kunye nonyango lokuziphatha. I-Antipsychotic imiselwe, ukuba kukho imfuneko, ngenjongo yokunciphisa isimilo esiphazamisayo, kubandakanya ukungasebenzi kakuhle, ukungxamiseka, ukuba ndlongondlongo kunye nokuziphatha okuzenzakalisayo. Olunye unyango lunokusetyenziselwa ukunyanga ezinye iingxaki, ezinje ngoxinzelelo okanye uxinzelelo.

Zimbalwa izifundo eziye zajonga ukusetyenziswa kwe-antipsychotic ngabantwana abanezi ngxaki. Olona phando lukhulu, olubandakanya abantwana abali-101 abanesifo esigqugqisayo sokukhula, lufumanise ukuba iipesenti ezingama-69 zabo bathathe i-risperidone (i-Risperdal) bakalwe “bephucuke kakhulu” emva kweeveki ezisibhozo zonyango xa kuthelekiswa neepesenti ezili-12 ezithathe indawo ye-placebo. I-Risperidone (i-Risperdal) kuphela kwe-antipsychotic ye-atypical eye yafundwa kubantwana abakwiminyaka yobudala bokukhula abanesifo esigcweleyo sokukhula, kodwa ayifumanekanga ingcono kune-placebo.

Akucaci ukuba izibonelelo ze-risperidone zihlala ixesha elide. Ubungqina obulinganiselweyo bubonisa ukuba emva kweenyanga ezine zonyango, iipesenti ezili-10 zabantwana ezibonisa ukuphucuka bayayeka ukuthatha iyeza nokuba kungasasebenzi okanye befumana iziphumo ebezingalindelekanga. Oku kukhokelele ekubuyeleni kwakhona-ukubuya kweempawu kwinqanaba labo lokuqala-ngepesenti ye-63, ngelixa kuphela iipesenti ze-13 zabo baqhubeka nokuthatha iyeza iinyanga ezimbini ezongeziweyo baphinde baphinda

Kwizifundo ezibini ezibandakanya abantwana abangama-316, abo bathathe i-aripiprazole (Abilify) babengenakufane bazenzakalise okanye babonakalise ubundlongondlongo kwabanye xa kuthelekiswa nabo bafumana indawo ye-placebo. Babengenacaphukiso kangako, babenomsindo omncinci wokugqajukelwa ngumsindo, babenengxaki yokutshintsha kwemozulu okanye imeko yokudakumba, kwaye babethanda ukungxola okanye ukungxola ngendlela engafanelekanga.

Ubungqina obunqongopheleyo bufumaneka ekusetyenzisweni kwe-olanzapine (Zyprexa) ngabantwana abaneengxaki zokukhula ezigcweleyo. Zimbini kuphela izifundo ezibandakanya abantwana abangaphantsi kwama-25 ezikhoyo. Iziphumo zibonisa ukuba i-olanzapine iphezulu kune-placebo kwaye iyafana ne-haloperidol (Haldol) endala. Kodwa ngenxa yenani elincinci kakhulu labantwana abafundileyo, izifundo ezinkulu ziyafuneka ukumisela ukuba ezo zinto zifunyanisiweyo zinokusetyenziswa ngokubanzi kubantwana abaneengxaki zokukhula ezigcweleyo.

Ukuphazamiseka kwindlela yokuziphatha

Ukuphazamiseka kokuziphatha kubandakanya ukuphikiswa kokuchasana nokuphikisana, ukungaziphathi kakuhle, kunye nokuphazamiseka kwendlela yokuziphatha (ethi yona kuncwadi lwezonyango lubizwe ngokuba "kukuphazamiseka kwendlela yokuziphatha, ngaphandle kokuchazwa ngenye indlela"). Ukuphazamiseka kokuchasana nokuchasana kwenzeka malunga ne-1 ukuya kwi-6 yeepesenti yolutsha, kwaye ukungaziphathi kakuhle kwenzeka kwiipesenti ezi-1 ukuya kwezi-4.

Iimpawu ezibonwe kubantwana abafunyaniswe benengxaki yokuchasana nokuchasana kubandakanya ubutshaba, ukungakhathali, kunye nokudelela igunya. Ivela ngaphambi kweminyaka eyi-8, kwaye ixhaphake kakhulu kubafana. Ngamanye amaxesha, ubukrakra beempawu bunokunyuka kunye nobudala kwaye buye bube luphawu lokuziphatha okungalunganga. Abantwana abaye bafunyaniswa benengxaki yokuphazamiseka ekuziphatheni bahlala bekwabonisa ukusilela / ukuphazamiseka kwengqondo (ADHD).

Abantwana abanengxaki yokuziphatha babonisa ipatheni yobundlongondlongo ebantwini nasezilwanyaneni, ukonakaliswa kwempahla kunye / okanye ukubiwa kwepropathi, kunye neminye imithetho emikhulu eyophula umthetho, ihlala ingenamvandedwa. Ukuziphatha kokuphazamiseka kuhlala kufunyaniswa ngaphambi kweminyaka eyi-16, kwaye kuxhaphake kakhulu kubafana. Zombini iingxaki ezichasayo ezichasayo kunye nokuziphatha kunxulunyaniswa neengxaki ezibalulekileyo ezisebenza ekhaya, esikolweni, kwaye, kamva emsebenzini. Abantwana abanengxaki yokuchasana ngokuchaseneyo bahlala befumana iingxaki kuqeqesho esikolweni, kwaye bahlala beneengxaki zomthetho njengabantu abadala.

Abantwana abaneendlela ezifanayo, kodwa ezingabalulekanga kangako, zokuziphatha, xa kuthelekiswa nezo zichasayo ezichasayo okanye ukungaziphathi kakuhle, banokufunyanwa benokuziphatha okuphazamisayo okanye ukuphazamiseka kokuziphatha okungachazwanga ngenye indlela. Abantwana abanale meko babonakalisa ngokubonakalayo ukungahambelani phakathi kwabantu kunye nobudlelwane bosapho, kunye / okanye ukuphazamiseka kokusebenza kwesikolo.

Unyango oluphambili lokuphazamiseka ekuziphatheni okuphazamisayo lusekwe kusapho kwaye lubandakanya uqeqesho lolawulo lwabazali. Unyango ngamayeza lubonwa njengolongezayo kwaye lujolise kwiimpawu ezithile. Kwisigqibo sokuqala amayeza, kubalulekile ukuba uthathele ingqalelo ezinye iimeko umntwana anokuba nazo. Umzekelo, amayeza e-ADHD anokuba luncedo ukuba umntwana uneengxaki zokuziphatha kunye ne-ADHD. Kubantwana abanokuziphatha okungalunganga, izinto ezinokuqinisa imeko, ezinje nge-lithium kunye ne-valproate, zinokuba luncedo. I-Antipsychotic imiselwe abantwana abaneziphazamiso ekuziphatheni okuphazamisayo ukunciphisa ubundlongondlongo obunxulumene nale miqathango, kodwa zimbini kuphela i-antipsychotic-risperidone kunye nequetiapine eziye zafundelwa oku kusetyenziswa. Akukho machiza antipsychotic avunyiweyo yi-FDA kunyango lokuphazamiseka kwendlela yokuziphatha.

Kuphononongo lwabantwana abaneempawu zokuphazamiseka kwendlela yokuziphatha ephazamisayo, abo bafumana risperidone babonisa phantse kabini inqanaba lokuphucula indlela yokuziphatha ekuziphatheni kwengxaki ngaphezulu kweeveki ezintandathu ukuya kwezilishumi zonyango xa kuthelekiswa nabo bathatha indawo ye-placebo. Malunga neepesenti ezingama-27 zabantwana abaqhubeke nokuthatha i-risperidone kwiinyanga ezintandathu babenokubuyela umva xa kuthelekiswa neepesenti ezingama-42 zabantwana abangazange bafumane lonyango, kodwa inqanaba lokuphucuka lancipha kuwo omabini la maqela.

Kuphononongo lwabakwishumi elivisayo abaneempawu zokuziphatha eziphazamisayo ezifuna ukulaliswa esibhedlele, i-risperidone iphucule kuvavanyo lwabo luphela, ngeepesenti ezingama-21 kuvavanywa "njengokuphazamiseka okuphawuleka okanye okuphazamisekileyo" xa kuthelekiswa neepesenti ezingama-84 ezithatha indawo ye-placebo.

I-Quetiapine (Seroquel) ayifumanekanga ukuba iyasebenza ekuphuculeni indlela yokuziphatha ehambelana nokunxaxha kokuziphatha. Kuphela kwesifundo esikhoyo, i-quetiapine yayingekho bhetele kunendawo ye-placebo yokunciphisa ubundlongondlongo kunye ne-hyperactivity kulutsha olunengxaki yokuziphatha kunye nokuziphatha okuphakathi. Omnye wabantwana abasithoba (iipesenti ezili-11) wayeka ukuthatha amayeza ngenxa ye-akathisia, isiphumo esibi esenza ukuba abantu bazive ngathi abanakuhlala phantsi. IQuetiapine yayingaphezulu kune-placebo kumanyathelo ehlabathi okuphucula iimpawu kunye nomgangatho wobomi.

Buyela phezulu Funda ngokugqithisileyo Buyela kuLuhlu lweZiqulatho

Ukhuseleko lweAtypical Antipsychotic

I-antypychychotic ye-Atypical inokubangela iziphumo ebezingalindelekanga ezibalulekileyo, ezithintela ukusebenziseka kwazo ngokubanzi. (Jonga iTheyibhile 2, ngezantsi.) Abantu abaninzi abaqala ukuthatha enye abayithathi ixesha elide, nokuba iyazinciphisa iimpawu zabo, kuba abanako okanye abafuni kunyamezela iziphumo ebezingalindelekanga. Ukongeza, abantu abane-schizophrenia kunye ne-bipolar bathambekele ekuyekiseni amayeza abo ngenxa yohlobo lwesifo sabo. Basenokungayiqondi into yokuba banesifo sengqondo, basilele ukwamkela ukuba bayaxhamla kunyango, bayalibala ukuselwa, okanye bayeke ukulithatha xa ezona mpawu zibuhlungu zithomalala.

Esinye seziphumo ebezingalindelekanga ze-antipsychotic ezinxulumene nentshukumo ezinxulumene nentshukumo (i-extrapyramidal) -i-tics ezingalawulekiyo kunye neenyikima ezifana nesifo sika-Parkinson. Iziphumo ebezingalindelekanga ze-extrapyramidal ziyahamba xa iyeza liphelisiwe okanye idosi yehlisiwe. Kodwa ingxaki ethile yokuhamba ebizwa ngokuba yi-tardive dyskinesia inokukhula ngokusetyenziswa kwexesha elide kwaye inokuqhubeka nasemva kokuba isiguli siyekile ukuthatha i-antipsychotic.

Amachiza e-antypychotic e-atypical nawo abangela ezinye iziphumo ebezingalindelekanga, kubandakanya ukonyuka komngcipheko wohlobo lwe-2 yeswekile, ukuzuza ubunzima, kunye ne-cholesterol kunye ne-triglyceride. Ukongeza, kuye kwafunyanwa ukuba kwandise umngcipheko wokufa ngaphambi kwexesha, ikakhulu ngenxa yemivumbo, kubantu abadala abanesifo sengqondo esixhalabisayo. Le mngcipheko ifundwe ikakhulu kubantu abadala; Iziphumo ebantwaneni azaziwa ncam ngeli xesha.

Itheyibhile 2. Iziphumo ebezingalindelekanga ezinxulunyaniswa neAtypical Antipsychotic
Ezincinci ukuya kuthi ga ngokuPhakathi Ezi zinokunciphisa okanye zinyamalale ngokuhamba kwexesha, okanye zincitshiswe ukuba idosi yehlisiwe. Bayemka xa kunqunyanyisiwe iyeza. Uluhlu olungezantsi lu-alfabhethi kwaye alulandelelananga nokubaluleka, ubungqongqo, okanye ukuphindaphinda. Uninzi lwabantu luneziphumo ezingaphezulu kwesinye. Kodwa amava kunye nobukrakra beziphumo ebezingalindelekanga ziyahluka kakhulu kumntu.
Ilungu kunye nokuhamba komzimba okungaqhelekanga, ukujija kwemisipha, ukungcangcazela kunye ne-spasms	Ukuphuthelwa
Ukuya exesheni ngokungaqhelekanga	Ukubetha imilebe kunye nokuhamba ngolwimi ngokungaqhelekanga
Umbono omfiliba	Ukuqina kwemisipha okanye ubuthathaka
Ukuqunjelwa	Ukubetha kwentliziyo okukhawulezayo
Isiyezi ekumeni okanye ekuhambeni ngokukhawuleza	Ukungazinzi
Umlomo owomileyo	Ukuhlala, ukozela
Ukugcwala okugqithisileyo	Ukungasebenzi kakuhle ngokwesondo
Ukuziva ulambile ngakumbi kunesiqhelo	Irhashalala
Iziphumo ezibi kakhulu ezinokubakho - Oku kunokufuna ukuyeka ichiza okanye ukutshintshela kwelinye elahlukileyo. Zihlala zibuyela umva, kodwa kwezinye iimeko, zinokuhlala ngokusisigxina, kwaye, kwimeko ye-agranulocytosis, kwanokusongela ubomi.
Igranulocytosis † - Ukusilela komongo wethambo ukuvelisa iiseli ezimhlophe ezilwa nezifo, ezinokukhokelela kusulelo olubi okanye olubulalayo. Lo mngcipheko unxulunyaniswa ikakhulu ne-clozapine, kwaye kufuneka kwenziwe uvavanyo lwegazi rhoqo xa uthathwa.
Utshintsho kwimetabolism ezibangela ukungaqheleki kweswekile yegazi kunye nezinye iingxaki, ezinokuthi zikhokelele kuhlobo lweswekile yesi-2 kunye nomngcipheko ophezulu wesifo sentliziyo kunye nemivumbo kubantu abadala.
Isifo esinganyanzelekanga † - Ukudumba kwentliziyo yemisipha enokubulala. Lo mngcipheko unxulunyaniswa ikakhulu ne-clozapine.
Ukuxhuzula † - Lo mngcipheko unxulunyaniswa ikakhulu ne-clozapine.
Ukutyeba okubalulekileyo - Iipesenti ezisi-7 okanye ukwanda okukhulu kubunzima bomzimba ngaphambi kwexesha (isixa esipheleleyo sixhomekeke kubunzima bokuqala bomntwana). IClozapine kunye ne-olanzapine zombini zibangela ukutyeba okukhulu kunezinye i-antipsychotic.
I-Tardive dyskinesia- Ukuhamba okungalawulekiyo komzimba okunokubandakanya ukungcangcazela kunye ne-spasms.

Inxulunyaniswa ikakhulu ne-clozapine; kufuneka kuvavanywe igazi rhoqo xa uyithatha.

Ngokubanzi, iipesenti ezingama-80 ukuya kuma-90 zabantu abadala abathatha i-antipsychotic yalo naluphi na uhlobo baya kuba nefuthe elinye; uninzi luya kuba nangaphezulu kwesinye. Kulabo bafumana iziphumo ebezingalindelekanga:

• Iipesenti ezingama-20 ukuya kuma-30 ziya kuba nefuthe elibi okanye elinganyamezelekiyo kwaye ziyeke ukuthatha iyeza kwiintsuku, iiveki, okanye iinyanga ezimbalwa.
• I-35 ukuya kwi-45 yepesenti iyayeka ukuthatha iyeza kwiinyanga ezintandathu.
• Ama-65 ukuya kuma-80 eepesenti aya kuyeka ukuthatha amayeza kwiinyanga ezili-12 ukuya kwezi-18.

Inkxalabo yezokhuseleko nge-antipychychotic ebantwaneni nakwishumi elivisayo

Ngenxa yezifundo ezinqunyelweyo zabantwana nakwishumi elivisayo, iziphumo ezibi ze-antipsychotic atypical aziwa ngokupheleleyo. Iprofayile yesiphumo secala iyahluka ngokwamachiza, ke xa uqwalasela enye yomntwana wakho, umngcipheko wechiza ngalinye kufuneka uthathelwe ingqalelo ngokuchasene nesibonelelo esinokubakho. La macandelo alandelayo asisishwankathelo seziphumo ebezingalindelekanga ezifumaneka kwizifundo ezibandakanya abantwana nolutsha.

Ukutyeba kwakho

Ukutyeba kobunzima yeyona nto ixhaphakileyo ehambelana ne-atypical antipsychotic ethathwe ngabantwana nakwishumi elivisayo. I-Risperidone (i-Risperdal) enikezwe ngeedosi ezisezantsi, umzekelo, ikhokelela ekuzuzeni ubunzima obumalunga neepawundi ezi-4 kubantwana abaneengxaki zokukhula okanye ukuphazamiseka kwendlela yokuziphatha xa kuthelekiswa nezo zinikwe i-placebo. Akukacaci nokuba obu bunzima buzinzile okanye buqhubeka ukonyuka ngaphezulu kwexesha elide. Ubungqina obukhoyo ngoku bucebisa ngokuqhubeka kokufumana ubunzima, ngoqikelelo lweephawundi ezi-4 ukuya kwezi-12 ngonyaka omnye ukuya kuthi ga kwiipawundi ezili-18 emva kweminyaka emibini.

Ukutyeba kwakhona yeyona ngxaki inengxaki ne-aripiprazole (Abilify). Kwisifundo esinye, iipesenti ezili-15 zabantwana abazithathileyo bafumana ubunzima bokutyeba (ubuncinci iipesenti ezisi-7 ngaphezulu kwesisindo sokuqala) ngaphezulu kweeveki ezisibhozo. Kwesinye isifundo, iipesenti ezingama-32 zabantwana bafumana ubunzima obubonakalayo xa bekwi-aripiprazole. Kuzo zombini ezi zifundo, abantwana abathatha indawo ye-placebo banamava okufumana ubunzima. Nokuba ukutyeba kobunzima okunxulunyaniswa ne-aripiprazole kuyaqhubeka ngaphezulu kwexesha elide akucaci kuba akukho zifundo zexesha elide zokufumana ubunzima kunye nonyango oluqhubekayo olukhoyo.

I-Olanzapine (iZyprexa) ikwanxulunyaniswa nokuzuza ubunzima, abantwana bafumana i-7.5 ukuya kwi-9 yeepawundi ngaphezulu kweeveki ezintandathu ukuya kwezilishumi zonyango. Olunye uphononongo lufumanise ukuba isibini kwisithathu sabantwana sifumene ubuncinci iipesenti ezisi-7 ngaphezulu kobunzima bokuqala. Njengakwimeko ye-aripiprazole (Abilify), izifundo zokufumana ubunzima kubantwana abaqhubeka nokuthatha i-olanzapine ixesha elide azifumaneki.

Itheyibhile 3. Ukufumana ubunzima bomzimba ngeAtypical Antipsychotic kuBantwana nakwishumi elivisayo
Iziyobisi	Ukufumana ubunzima kwiiponti ngaphezulu kweeveki ezi-6 ukuya kwezi-8
	Ukuphazamiseka okuGcweleyo koPhuculo okanye ukuphazamiseka kokuziphatha	Ukuxhuzula	Ischizophrenia
Aripiprazole (Yenza)	3-4	<1	–
I-Olanzapine (iZyprexa)	7.5 ukuya ku-9	7.4	–
IQuetiapine (iSeroquel)	–	3	4-5
IRisperidone (iRisperdal)	4	2	2

IQuetiapine ikwabangela ukutyeba. Umzekelo, kuphononongo lwabantwana abanesiganeko sokudakumba esiba nengxaki yokuguquguquka kwengqondo, abo bafumana i-quetiapine bafumana malunga neeponti ezi-3 ngaphezulu kunalezo zifumene i-placebo.

Iingxaki zentliziyo kunye neswekile

Amanye amachiza e-antipsychotic atypical angonyusa i-cholesterol iyonke (LDL kunye ne-triglycerides). Ukongeza, ezo ziyobisi-ngaphandle kwe-aripiprazole (Abilify) -inokunyusa iswekile yegazi, okanye ezinye iimpawu zesifo seswekile, kwabanye abantwana, okanye yenze ukuba iswekile esegazini ibe nkulu kakhulu kwabo banesifo seswekile.

Akunakwenzeka ukuba uxele umngcipheko owandisiweyo weziyobisi, okanye ukuba elinye ichiza libi ngaphezu kwelinye kubantwana. Ngokusekwe kwizifundo ezipapashiweyo, i-olanzapine (iZyprexa) inokubangela ukonyuka okukhulu kwamanqanaba e-cholesterol ebantwaneni kunabantu abadala.

Ngelixa iipateni zesingqisho sentliziyo (i-EKGs) zaziqhelekile, isifundo esinye sabonisa ukonyuka okwethutyana kwinqanaba lentliziyo kunye ne-risperidone kwiiveki ezimbini zokuqala zonyango. Inqanaba labathathi-nxaxheba labuyela esiqhelweni emva kweeveki ezimbini zonyango.

Indlela yokuziphatha yokuzibulala

Kwizifundo zabantwana abathatha i-antipsychotic atypical, babekho abambalwa ababonisa indlela yokuzibulala, kodwa akunakwenzeka ukuxelela ukuba oku kubonisa ukwanda okanye ukwehla komngcipheko wokuzibulala, okanye akukho mpembelelo kwaphela.

Amayeza onyango, anje ngoxinzelelo oluthile, afunyenwe enyusa umngcipheko kulutsha. Kuba i-aripiprazole (Abilify) kunye nequetiapine (Seroquel) zabelana ngomsebenzi ofanayo we-neurotransmitter kwingqondo njengalezi zidambisi zintsholongwane, la machiza anesilumkiso esinzulu sokuba angonyusa umngcipheko wokuzibulala nokuziphatha, nangona ubungqina bungacacanga.

Kubantu abadala abane-schizophrenia, i-clozapine (iClozaril, i-Fazaclo ODT) kuphela kwesiyobisi se-antipsychotic esifunyenwe ukunciphisa umngcipheko wokuzibulala okanye wokuzibulala. Oku akuzange kufundwe kubantwana.

Ezinye iziphumo ebezingalindelekanga

Izifundo ze-risperidone (Risperdal) zifumene amaqondo asezantsi ezinye iziphumo ebezingalindelekanga, kodwa oku kunokuba ngenxa yamadosi asezantsi asetyenzisiweyo, kunye nokulandela okufutshane. Amalungu angaqhelekanga kunye nokuhamba komzimba (iimpawu ze-extrapyramidal), zazingafane kwenzeke kwizilingo zexesha elifutshane, kodwa zaxelwa rhoqo kunakwizigulana ezithatha indawo ye-placebo.

I-Risperidone yaziwa ngokubangela amanqanaba anyukayo e-hormone prolactin, enceda kwimveliso yobisi lwebele emva kokukhulelwa. Kwabafazi abangakhulelwanga kunye namadoda, ukwanda kweprolactin kunokubangela ukwandisa amabele kunye neengxaki zomsebenzi wesondo. Izifundo zabantwana zifumanise ukuba i-risperidone inyuse amanqanaba eprolactin, kodwa akukho namnye wabonisa iimpawu okanye iimpawu ezinje ngokwandiswa kwebele. Akucaci ukuba, ngokuhamba kwexesha, amanqanaba eprolactin ahlala ephakanyisiwe okanye abuyela esiqhelweni.

Ezinye iziphumo ebezingalindelekanga zibonwa rhoqo nge-aripiprazole (Abilify) kune-placebo kubandakanya ukulala, ukuvuza amathe, ukungcangcazela, isicaphucaphu, okanye ukugabha. Ukuhamba okungaqhelekanga kweengalo, imilenze, okanye umzimba kwabonwa rhoqo kubantwana abathatha i-aripiprazole. Ukuqhubeka kokufunda kuyafuneka ukumisela ukuba ngaba iziphumo ebezingalindelekanga ziyasombulula, zihlala zihlala zihleli, okanye zisiba mandundu ngokuqhubeka nonyango.

Kuphononongo lokusetyenziswa kwequetiapine (Seroquel) kunyango lwabakwishumi elivisayo abanesifo sokuziphatha, iipesenti ezili-11 zabo bathatha amayeza bayeka ngenxa ye-akathisia, imeko apho umntu eziva engonwabanga, ngokungathi abakwazi kuhlala phantsi. Ngaphandle koko, ichiza lalinyamezeleka kakuhle.

Ezinye iziphumo ebezingalindelekanga ezichazwe ngabantwana abathatha i-olanzapine zibandakanya i-sedation kunye nokwanda kokutya.

Ngokubanzi, iziphumo ebezingalindelekanga zixelwa rhoqo nge-olanzapine (Zyprexa) kunokuba kunjalo nge-quetiapine (Seroquel) okanye i-risperidone (Risperdal). Ubungqingqwa babukhona rhoqo kwizigulana ezanyangwa nge-olanzapine xa kuthelekiswa ne-quetiapine, kwaye ukudinwa kwakuhlala rhoqo nge-olanzapine xa kuthelekiswa ne-risperidone. Kodwa izigulana ezininzi ezithatha i-risperidone zichaze intshukumo enxulumene nokuhamba ngokuthelekiswa nezo zithatha i-olanzapine.

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Ukukhetha iAtypical Antipsychotic yaBantwana

Ngenxa yomzimba omncinci wobungqina malunga nokusetyenziswa kwe-antipychotic ye-atypical ngabantwana nakwishumi elivisayo, kunzima ukumisela ukusebenza kwabo kwexesha elifutshane kunye nokhuseleko. Kwaye akukho nto iyaziwayo malunga nokukhuseleka kwexesha elide kunye nokusebenza kuba izifundo ezibandakanya abantu abancinci bezincinci kwaye zincinci ngexesha.

Ke asinakukwazi ukukhetha eyona nto ilungileyo yokuthenga i-antipsychotic ukuze isetyenziswe ngabantwana nakwishumi elivisayo abane-schizophrenia, i-bipolar disorder, ukuphazamiseka okuthe gabalala, okanye ukuphazamiseka kwendlela yokuziphatha. Endaweni yoko, abacebisi bethu bezonyango bacebisa ukuba abazali bahlolisise ngenyameko umngcipheko kunye nezibonelelo. Isicwangciso sonyango esibanzi sabantwana abanezi ngxaki kufuneka sibandakanye unyango lokuziphatha kwengqondo, uqeqesho lolawulo lwabazali kunye neenkqubo zemfundo ezizodwa, kunye naluphi na unyango lweziyobisi.

Ukuthatha isigqibo sokuba usebenzise elinye lala mayeza kwaphela, kwaye ukuba kunjalo, yeyiphi, ekufuneka yenziwe ngokudibeneyo nogqirha womntwana wakho kwaye kufuneka isekwe kwizinto ezininzi ezibalulekileyo. Umzekelo, zeziphi iimpawu zomntwana wakho ezibaluleke kakhulu, ezibandezelayo, okanye eziphazamisayo? Ngaba ezi mpawu zifunyenwe ukuba ziyasinciphisa iziyobisi? Ngaba izibonelelo zanele okanye zibalulekile kuwe nakumntwana wakho?

Kuya kufuneka uthathele ingqalelo indleko zonyango, ezinokubakho kakhulu. Kwaye uphonononge iziphumo ebezingalindelekanga zeziyobisi ekukhanyeni kwimbali yezempilo yomntwana wakho ukuze uqiniseke ukuba kufanelekile. La machiza akafundiswanga ngokwaneleyo kubantwana ngokubhekisele kwiziphumo ebezingalindelekanga, ke kuya kufuneka ukuba uqwalasele ubungqina obuvela kwizifundo zabantu abadala.

Ukuba umntwana wakho unemeko esele ikhona - umzekelo, i-ADHD okanye uxinzelelo- kuya kufuneka uqiniseke ukuba ziyanyangwa. Oku kunokuphucula iimpawu zomntwana wakho. Ngengxaki yokuguquguquka kwengqondo, kukho ezinye, iziyobisi eziphandwe kakuhle ezikhoyo, ezinje nge-lithium, i-divalproex, kunye ne-carbamazepine, ekufuneka izanywe kuqala ngaphambi kokujonga i-antipsychotic atypical.

Ukuba uthatha isigqibo sokunika umntwana wakho i-antipsychotic, sicebisa ukuba usebenzise idosi esebenzayo esezantsi ukunciphisa ukubakho kweziphumo ebezingalindelekanga. Kwaye qiniseka ukuba umntwana wakho uphinde avavanywe ngugqirha ukufumanisa ukuba ngaba amayeza lawo ayanceda na kwaye ayimfuneko.

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Ukuthetha nogqirha wakho

Olu lwazi silubonisa apha alwenzelwanga ukuba luthathe indawo yesigwebo sikagqirha. Kodwa siyathemba ukuba iya kukunceda wena nogqirha womntwana wakho ukuba nigqibe ukuba ngaba i-antipsychotic ilungile na.

Yikhumbule into yokuba abantu abaninzi bayathandabuza ukuxoxa ngeendleko zonyango kunye nogqirha wabo, kwaye olo phononongo lufumanise ukuba oogqirha abahlali belithathela ingqalelo ixabiso xa bemisela amayeza. Ngaphandle kokuba uyinyuse, ugqirha wakho unokucinga ukuba indleko ayisiyiyo into kuwe.

Abantu abaninzi (kubandakanya noogqirha) bacinga ukuba amachiza amatsha angcono. Ngelixa olo luqikelelo lwendalo ukwenza, akuyonyani oko. Izifundo ziye zafumanisa ukuba amayeza amaninzi amadala alungile kwaye kwezinye iimeko angcono kunamayeza amatsha. Cinga ngabo "bazamile kwaye bayinyani," ngakumbi xa kufikwa kwingxelo yabo yokhuseleko. Amachiza amatsha awakahlangani novavanyo lwexesha, kwaye iingxaki ezingalindelekanga zinokwenza kwaye zikhule xa sele zifikile kwintengiso.

Ewe, amanye amayeza amatsha amatsha asebenza ngakumbi kwaye akhuselekile. Thetha nogqirha wakho malunga ne-pluses kunye ne-minuses yamayeza amatsha xa kuthelekiswa namayeza amadala, kubandakanya neziyobisi eziqhelekileyo.

Amayeza amiselweyo aya “generic” xa amalungelo abenzi enkampani ephela kuwo, ngesiqhelo emva kweminyaka eli-12 ukuya kweli-15. Ngelo xesha, ezinye iinkampani zinokwenza kwaye zithengise iyeza.

Iijenerikhi zibiza kakhulu kunamayeza amatsha egama, kodwa azikho ngaphantsi iziyobisi ezisemgangathweni. Ewe, uninzi lweegeneric zihlala ziluncedo kwiminyaka emininzi emva kokuba kuthengisiwe okokuqala. Kungenxa yoko le nto ngaphezulu kwama-60 epesenti kuyo yonke imimiselo e-US namhlanje ibhalelwe i-generic.

Omnye umba obalulekileyo onokuthetha ngawo nogqirha wakho kukugcina irekhodi lamachiza owathathayo. Zininzi izizathu zoku:

• Okokuqala, ukuba ubona oogqirha abaliqela, umntu ngamnye usenokungazi ngamayeza abanye abawisele wona.
• Okwesibini, kuba abantu bahlukile ekuphenduleni kwabo kunyango, kuqhelekile ukuba oogqirha namhlanje banike uninzi ngaphambi kokufumana olusebenza kakuhle okanye olusebenzayo.
• Okwesithathu, abantu abaninzi bathabatha amayeza aliqela amiselweyo, amayeza angabhaliswanga, kunye nezongezo zokutya ngexesha elinye. Banokunxibelelana ngeendlela ezinokuthi zinciphise izibonelelo ozifumana kwichiza okanye zibe yingozi.
• Okokugqibela, amagama amayeza amiselweyo-zombini generic kunye ne-brand-zihlala kunzima ukubiza nokukhumbula.

Kuzo zonke ezo zizathu, kubalulekile ukugcina uluhlu olubhaliweyo lwawo onke amayeza kunye nezibonelelo ozithathayo, kwaye uziphonononge rhoqo noogqirha bakho.

Njalo soloko uqinisekile ukuba uyaliqonda idosi yeyeza elimiselwe wena kunye nokuba zingaphi iipilisi ekulindeleke ukuba uzithathe yonke imihla. Ugqirha wakho kufuneka akuxelele olu lwazi. Xa ugcwalisa amayeza ekhemesti okanye ukuba uwufumana ngeposi, jonga ukuba idosi kunye nenani leepilisi ngosuku kwisitya seepilisi ziyahambelana nemali athe uyixelele yona ugqirha.

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Siwavavanye njani ama-Antipsychotic

Uvavanyo lwethu ikakhulu lusekwe kuvavanyo oluzimeleyo lwenzululwazi lobungqina bokusebenza, ukhuseleko, kunye neziphumo ezibi ze-antipsychotic.Iqela loogqirha kunye nabaphandi kwiZiko lezeMpilo lase-Oregon lezeNzululwazi kwiZiko lokuSebenza eliQinisekise ubungqina lenze uhlalutyo njengenxalenye yeProjekthi yokuHlola ukuSebenza kweziyobisi, okanye i-DERP. I-DERP yinkqubo yokuqala yohlobo lwayo eyahlukeneyo yokuvavanya ukusebenza ngokuthelekisa kunye nokhuseleko lwamakhulu amayeza amiselweyo.

Isishwankathelo sohlalutyo lwe-DERP lwe-antipsychotic sisiseko sale ngxelo. Umcebisi kwiiNgxelo zabaThengi eziThengiweyo eziLungileyo ukwalilungu leqela lophando olusekwe e-Oregon, elingenamdla kwezemali kuyo nayiphi na inkampani okanye imveliso.

Uphengululo olupheleleyo lwe-DERP ye-antipsychotic iyafumaneka kwi //derp.ohsu.edu/about/final-documentdisplay.cfm. (Olu luxwebhu olude kunye nobuchwephesha olubhalelwe oogqirha.)

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Ukwabelana ngale Ngxelo

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Ngathi

Umbutho wabathengi, umpapashi weeNgxelo zabaThengi & ujikelezeR; , ngumbutho ozimeleyo nongenzi nzuzo onjongo zawo ukusukela ngo-1936 ibikukubonelela abathengi ngolwazi olungakhethi cala kwimpahla neenkonzo kunye nokwenza indawo yentengiso efanelekileyo. Iwebhusayithi yi www.CRBestBuyDrugs.org. Iwebsite yemagazini yiConsumerReports.org.

Ezi zixhobo zenziwe zabakho sisibonelelo esivela kwiNkqubo yeGqwetha likaMmeli wabathengi kunye noMmeli weMfundo, exhaswa ngemali kukuhlaliswa kwabantu abaninzi kumabango obuqhetseba babathengi malunga nokuthengiswa kweyeza leNeurontin.

I-Engelberg Foundation ibonelele ngesibonelelo esikhulu ukuxhasa ngezimali ukuyilwa kweprojekthi ukusukela ngo-2004 ukuya ku-2007. Inkxaso-mali yokuqala eyongezelelekileyo yavela kwiThala leeNcwadi leSizwe lezoNyango, inxalenye yamaZiko ezeMpilo kaZwelonke. Inkcazo eneenkcukacha zeprojekthi iyafumaneka kwiCRBestBuyDrugs.org.

Silandele inkqubo yokuhlela engqongqo yokuqinisekisa ukuba ulwazi olukule ngxelo nakwiNgxelo zabaThengi Eyona Webhusayithi yokuthenga iziyobisi ichanekile kwaye ichaza iindlela ezamkelweyo zeklinikhi. Ukuba sifumana impazamo okanye saziswa kwenye siya kuyilungisa ngokukhawuleza okukhulu. Kodwa iiNgxelo zabaThengi kunye nababhali bayo, abahleli, abapapashi, amaphepha-mvume, kunye nababoneleli abanakuba noxanduva lweziphene zonyango okanye ukushiywa, okanye nasiphi na isiphumo sokusetyenziswa kolwazi kule ndawo. Nceda ujonge kwisivumelwano somsebenzisi kwi-CRBestBuyDrugs.org ngolwazi oluthe kratya.

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Izalathiso

1. Iiapps J, Winkler J, Jandrisevits MD, iiapps J, uWinkler J, uJandrisevits MD. Ukuphazamiseka kweBipolar: iimpawu kunye nonyango kubantwana nakwishumi elivisayo. Umongikazi wePediatr. Ngo-2008; 34 (1): 84-8.
2. UArango C, uRobles O, uParellada M, uFraguas D, uRuiz-Sancho A, uMedina O, uZabala A, uBombin I, uMoreno D. Olanzapine xa kuthelekiswa ne-quetiapine kulutsha olunesiqendu sokuqala sengqondo. I-Eur yabantwana abakwishumi elivisayo kwi-Psychiatry. 2009; 18 (7): 418-28.
3. IBarzman DH, iLungu lePalamente leDelBello, iAdler CM, iStanford KE, iStrakowski SM. Ukusebenza kunye nokunyamezeleka kwe-quetiapine xa kuthelekiswa ne-divalproex kunyango lokunyanzeliswa kunye nokusebenza ngamandla kulutsha olunengxaki yokuphazamiseka kwengqondo kunye nokuphazamiseka kokuziphatha. Ijenali yePychopharmacology yomntwana kunye neyolutsha. Ngo-2006; 16 (6): 665-70.
4. Amaziko oLawulo lweZifo. Ukudalwa kokuPhazamiseka kweAtism Spectrum-Autism kunye neNethiwekhi yokujonga abaKhubazekileyo kuPhuhliso, eUnited States, 2006. MMWR. Ngo-2009; 58 (SS10): 1-20.
5. ICorrell CU, uManu P, uOlshanskiy V, uNapolitano B, uKane JM, uMalhotra AK. Umngcipheko weCardiometabolic wesizukulwana sesibini ngamayeza e-antipsychotic ngexesha lokuqala lokusetyenziswa kwabantwana nakwishumi elivisayo. Ijenali yoMbutho Wezonyango waseMelika. 28 Oktobha 2009. 302 (16): 1765-1773.
6. I-Cummings CM, iFristad MA, iCummings CM, kunye neFristad MA. Ukuphazamiseka kwengqondo kubantwana: Ukwamkelwa kukhathalelo lokuqala. I-Curr Opin Pediatr. Ngo-2008; 20 (5): 560-5.
7. Ukufumana i-RI, uMcNamara NK, i-Branicky LA, i-Schluchter MD, i-Lemon E, i-Blumer JL. Isifundo somqhubi wenqwelo moya esingaboniyo kabini se-risperidone kunyango lokuziphatha gwenxa. Ijenali yeAmerican Academy yabantwana noLutsha iPsychology. 2000; 39 (4): 509-16.
8. Ukufumana i-RL, i-Nyilas M, i-Forbes RA, i-McQuade RD, i-Jin N, i-Iwamoto T, i-Ivanova S, i-Carson WH, i-Chang K. Unyango olunamandla lwe-bipolar yabantwana I-disorder, i-manic okanye i-episode ephihliweyo, ene-aripiprazole: isifundo esilawulwa yi-placebo. Ijenali yoNyango lwezeMpilo. Ngo-2009; 70 (10): 1441-51.
9. IGoldstein BI. Ukuphazamiseka kwengqondo kubantwana: Ngaphezu kwengxaki yomsindo. IPediatrics. Ngo-2010; 125 (6): 1283-5.
10. I-Haas M, iLungu lePalamente likaDelbello, uPandina G, uKushner S, uVan Hove I, uAugustyns I, uQuiroz J, uKusumakar V. Risperidone kunyango lwe-mania ebukhali ebantwaneni nakwishumi elivisayo abanesifo sokuphazamiseka kwengqondo. ukufunda. Ukuphazamiseka kwiBipolar. 2009; 11 (7): 687-700.
11. UHazell P, uWilliam R, uHazell P, uWilliam R. Uhlalutyo lokuhlela: Ukutshintsha kweembono kulutsha olunengxaki yokuphazamiseka kwengqondo kunye nokuphazamiseka okuthe gabalala. I-Curr Opin yengqondo. Ngo-2008; 21 (4): 328-31.
12. U-Luby J, Mrakotsky C, Stalets MM, Belden A, Heffelfinger A, Williams M, Spitznagel E. Risperidone kubantwana abasaqala isikolo abanengxaki yokuphazamiseka kwimbonakalo ye-autistic: Uphando lokhuseleko kunye nokusebenza kakuhle. Ijenali yePychopharmacology yomntwana kunye neyolutsha. Ngo-2006; 16 (5): 575-87.
13. UMaglione M, et al. Ukusetyenziswa kweelebheli ezingekho kwilebheli yeeAntipical Antipsychotic: Uhlaziyo Uvandlakanyo lokuSebenza ngokukuthelekisekayo Nomb. 43. (Ilungiswe eSouthern California / RAND Ubungqina obusekwe kubungqina phantsi kweSivumelwano No. HHSA290-2007-10062-1.) Upapasho lwe-AHRQ Nombolo 11- EHC087-EF. I-Rockville, MD: I-Arhente yoPhando ngezeMpilo kunye noMgangatho. NgoSeptemba 2011.
14. UMarcus RN, uOwen R, uKamen l, uManos G, uMcQuade RD, uCarson WH, uAman MG. Isifundo esilawulwa yi-placebo, sedosi esisigxina se-aripiprazole ebantwaneni nakwishumi elivisayo abanochuku olunxulunyaniswa nengxaki ye-autistic. Ijenali yeAmerican Academy yabantwana noLutsha iPsychology. 2009; 48 (11): 1110-9.
15. UMcCracken JT, et al. I-Risperidone kubantwana abane-autism kunye neengxaki ezinzulu zokuziphatha. Ijenali eNtsha yaseNgilani yoNyango. Ngo-2002; 347 (5): 314-21.
16. IZiko leSizwe lezeMpilo yeNgqondo. Ukuphazamiseka kwengqondo phakathi kwabantwana. Iyafumaneka kwi nimh.nih.gov/ Statistics / 1bipolar_child.shtml. Kufumaneka ngo-Matshi 10, 20011.
17. IZiko leSizwe lezeMpilo yeNgqondo. Ischizophrenia. Iyafumaneka ku- nimh.nih.gov/statistics/ 1SCHIZ.shtml. Kufumaneka ngo-Matshi 10, 20011.
18. Iiyunithi zoPhando kwiNethiwekhi yezeMpilo yaBantwana yezeNgqondo yePsychopharmacology Autism. Unyango lweRisperidone yokuphazamiseka kwengqondo kwi-autistic: Izibonelelo zexesha elide kunye nokupheliswa okungaboniyo emva kweenyanga ezi-6. Ijenali yaseMelika yoNyango. 2005; 162 (7): 1361-9.
19. Seeman P.Athypical antipsychotic: Indlela yokusebenza. Ngaba uJ Psychiatry. NgoFebruwari 2002; 47 (1): 27-38.
20. Snyder R, Turgay A, Aman M, Binder C, Fisman S, Carroll A.Iziphumo ze-risperidone ekuziphatheni nasekuphazamiseni indlela yokuziphatha kwabantwana abane-IQ eyoyikisayo. Ijenali yeAmerican Academy yabantwana noLutsha iPsychology. Ngo-2002; 41 (9): 1026-36.

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Qaphela: Ukuba ibhokisi yexabiso iqulethe , Oko kubonisa ukuba idosi yeso siyobisi kunokwenzeka ukuba ifumaneke ngexabiso eliphantsi lenyanga ngeenkqubo zesaphulelo ezibonelelwa ziivenkile ezinkulu zetyathanga. Umzekelo, iKroger, iklabhu kaSam, ithagethi kunye neWalmart inikezela ngamachiza akhethiweyo enziwe ngenyanga i $ 4 okanye iinyanga ezintathu zonikezelo lweedola ezili-10. Ezinye iivenkile zeevenkile, ezinje ngeCostco, iCVS, iKmart, kunye neWalgreens, zibonelela ngeenkqubo ezifanayo. Ezinye iinkqubo zinezithintelo okanye umrhumo wobulungu, ke jonga iinkcukacha ngononophelo kwizithintelo kwaye uqiniseke ukuba ichiza lakho liyagutyungelwa.

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