Amayeza oxinzelelo kunye neziphumo ebezingalindelekanga

Umxholo

• I-serotonin reuptake inhibitors ekhethiweyo
• Iziphumo ebezingalindelekanga ze-SSRI
• I-Serotonin-norepinephrine reuptake inhibitors
• Iziphumo ebezingalindelekanga ze-SNRI
• I-Tricyclic yoxinzelelo
• Iziphumo ebezingalindelekanga ze-TCA
• I-Norepinephrine kunye ne-dopamine reuptake inhibitors
• Iziphumo ebezingalindelekanga ze-NDRI
• I-Monoamine oxidase inhibitors
• Iziphumo ebezingalindelekanga ze-MAOI
• Yongeza okanye ukongeza amayeza
• Ezinye iziyobisi

Ushwankathelo

Unyango lwengxaki yokudakumba (eyaziwa ngokuba kukudakumba okukhulu, uxinzelelo lweklinikhi, uxinzelelo lwe-unipolar, okanye i-MDD) kuxhomekeke kumntu kunye nobukrakra besigulo. Nangona kunjalo, oogqirha bahlala befumana ezona ziphumo zibalaseleyo xa omabini amayeza amiselweyo, anje ngoxinzelelo, kunye nonyango lwengqondo zisetyenziswa ngokudibeneyo.

Okwangoku, ngaphezulu kwamashumi amabini anesibini amayeza okulwa uxinzelelo ayafumaneka.

I-anti-depressants iyaphumelela kunyango loxinzelelo, kodwa alikho ichiza elinye elibonisiweyo njengelona liphumelelayo- lixhomekeke ngokupheleleyo kwisigulana nakwimeko ezizezabo. Kuya kufuneka ukuba uthathe amayeza rhoqo iiveki ezininzi ukuze ubone iziphumo kwaye ujonge naziphi na iziphumo ebezingalindelekanga.

Nanga amayeza athomalalisa uxinzelelo kunye neziphumo ebezingalindelekanga eziqhelekileyo.

I-serotonin reuptake inhibitors ekhethiweyo

Inkqubo eqhelekileyo yonyango yoxinzelelo kuqala iqala ngonyango lwe-serotonin reuptake inhibitor (SSRI) ekhethiweyo.

Xa ingqondo ingenzi ngokwaneleyo i-serotonin, okanye ingenako ukusebenzisa i-serotonin esele ikhona ngokuchanekileyo, ulungelelwaniso lweekhemikhali kwingqondo lunokungalingani. Umsebenzi we-SSRI ukutshintsha inqanaba le-serotonin kwingqondo.

Ngokukodwa, ii-SSRI zithintela ukubuyiselwa kwakhona kwe-serotonin. Ngokuthintela ukubuyiselwa kwakhona, ii-neurotransmitters zinokuthumela kwaye zifumane imiyalezo yemichiza ngokufanelekileyo. Oku kucingelwa ukuba kukonyusa imeko yokunyusa imeko ye-serotonin kunye nokuphucula iimpawu zokudakumba.

Ezona SSRIs zixhaphakileyo zibandakanya:

• fluoxetine (Prozac)
• Ikitalopram (Celexa)
• iparoxetine (Paxil)
• i-sertraline (iZoloft)
• I-escitalopram (iLexapro)
• ifluvoxamine (iLuvox)

Iziphumo ebezingalindelekanga ze-SSRI

Iziphumo eziqhelekileyo ezibangelwa ngabantu abasebenzisa ii-SSRI zibandakanya:

• iingxaki zokugaya ukutya, kubandakanya urhudo
• isicaphucaphu
• umlomo owomileyo
• ukungazinzi
• intloko ebuhlungu
• ukuphuthelwa okanye ukozela
• ukunciphisa umnqweno wesondo kunye nobunzima bokufikelela kwi-orgasm
• Ukungasebenzi kakuhle kwe-erectile
• Ukuphazamiseka (jitteriness)

I-Serotonin-norepinephrine reuptake inhibitors

I-Serotonin-norepinephrine reuptake inhibitors (i-SNRIs) ngamanye amaxesha ibizwa ngokuba yi-reuptake inhibitors. Basebenza ngokuthintela ukuphinda kuthathwe, okanye ukuphinda kwenziwe kwakhona, i-serotonin kunye ne-norepinephrine.

Nge-serotonin eyongezelelweyo kunye ne-norepinephrin ejikelezayo kwingqondo, ibhalansi yeekhemikhali yengqondo ingasetwa kwakhona, kwaye ii-neurotransmitters kucingelwa ukuba zinxibelelana ngokufanelekileyo. Oku kunokuphucula imeko kunye nokunceda ukukhulula iimpawu zoxinzelelo.

Ii-SNRI ezichazwe ngokubanzi zibandakanya:

• venlafaxine (i-Effexor XR)
• I-desvenlafaxine (iPristiq)
• duloxetine (ICymbalta)

Iziphumo ebezingalindelekanga ze-SNRI

Iziphumo eziqhelekileyo ezibangelwa ngabantu abasebenzisa i-SNRI zibandakanya:

• ukwanda kokubila
• ukwanda koxinzelelo lwegazi
• ukubetha kwentliziyo
• umlomo owomileyo
• ukukhawuleza kwentliziyo
• iingxaki zokugaya ukutya, ukuqunjelwa
• utshintsho kumdla wokutya
• isicaphucaphu
• isiyezi
• ukungazinzi
• intloko ebuhlungu
• ukuphuthelwa okanye ukozela
• ukunciphisa i-libido kunye nobunzima bokufikelela kwi-orgasm
• Ukuphazamiseka (jitteriness)

I-Tricyclic yoxinzelelo

I-Tricyclic antidepressants (TCAs) zayilwa nge-1950s, kwaye zaziphakathi kwezona zinto zakudala ezazisetyenziselwa ukunyanga uxinzelelo.

Ii-TCA zisebenza ngokuthintela ukubuyiselwa kwakhona kwe-noradrenaline kunye ne-serotonin. Oku kunokunceda umzimba ukuba wandise izibonelelo zokonyusa imood ze-noradrenaline kunye ne-serotonin ekhupha ngokwendalo, enokuthi iphucule imeko kunye nokunciphisa iziphumo zoxinzelelo.

Oogqirha abaninzi banika ii-TCAs kuba kucingelwa ukuba zikhuselekile njengamayeza amatsha.

Ii-TCAs eziqhelekileyo zichaphazela:

• umgca we-amitriptyline (Elavil)
• imipramine (Tofranil)
• i-doxepin (iSinequan)
• itrimipramine (iSurmontil)
• clomipramine (Anafranil)

Iziphumo ebezingalindelekanga ze-TCA

Iziphumo ezivela kule klasi ye-anti-depressants zihlala ziba nzima. Amadoda athanda ukufumana iziphumo ebezingalindelekanga ezimbalwa kunabafazi.

Iziphumo eziqhelekileyo ezibangelwa ngabantu abasebenzisa ii-TCA ziquka:

• ukutyeba kwakho
• umlomo owomileyo
• ukungaboni kakuhle
• ukozela
• ukubetha kwentliziyo okukhawulezayo okanye ukubetha kwentliziyo okungaqhelekanga
• ukudideka
• iingxaki zesinyi, kubandakanya ubunzima bokuchama
• ukuqhina
• Ukuphulukana nomnqweno wesini

I-Norepinephrine kunye ne-dopamine reuptake inhibitors

Okwangoku inye kuphela i-NDRI evunyiweyo yi-FDA yoxinzelelo.

• ibuproprion (Wellbutrin)

Iziphumo ebezingalindelekanga ze-NDRI

Iziphumo ebezingalindelekanga eziqhelekileyo ezifunyanwa ngabantu abasebenzisa i-NDRI zibandakanya:

• ukuxhuzula, xa kuthathwa ngeedosi eziphezulu
• ixhala
• Uxinzelelo
• uvalo
• Ukuphazamiseka (jitteriness)
• ukucaphuka
• ndingcangcazela
• ingxaki yokulala
• ukungazinzi

I-Monoamine oxidase inhibitors

I-Monoamine oxidase inhibitors (i-MAOIs) ngamayeza aqhele ukwenziwa kuphela xa amanye amayeza kunye nonyango zisilele.

Ii-MAOIs zithintela ingqondo ukuba ingaphuli iikhemikhali norepinephrine, serotonin, kunye nedopamine. Oku kuvumela ingqondo ukuba igcine amanqanaba aphezulu ezi khemikhali, ezinokuthi zikonyuse imo kunye nokuphucula unxibelelwano lwe-neurotransmitter.

Ezona MAO ziqhelekileyo zibandakanya:

• phenelzine (uNardil)
• selegiline (Emsam, Eldepryl, kunye noDeprenyl)
• I-tranylcypromine (iParnate)
• Isocarboxazid (iMarplan)

Iziphumo ebezingalindelekanga ze-MAOI

Ii-MAOIs zihlala zineziphumo ebezingalindelekanga ezininzi, uninzi lwazo lubi kwaye luyingozi. Ii-MAOIs zinokubakho ekusebenzisaneni okuyingozi kunye nokutya kunye namayeza angaphezulu kwekhawunta.

Iziphumo eziqhelekileyo ezibangelwa ngabantu abasebenzisa i-MAOIs zibandakanya:

• ukulala emini
• ukuphuthelwa
• isiyezi
• uxinzelelo lwegazi oluphantsi
• umlomo owomileyo
• uvalo
• ukutyeba kwakho
• ukunciphisa umnqweno wesondo okanye ubunzima bokufikelela kwi-orgasm
• Ukungasebenzi kakuhle kwe-erectile
• iingxaki zesinyi, kubandakanya ubunzima bokuchama

Yongeza okanye ukongeza amayeza

Ukudakumba okunganyangekiyo kunyango okanye kwizigulana eziqhubeka nokuba neempawu ezingasonjululwanga, kunokumiselwa iyeza lesibini.

Ezi zonyango zongezelelekileyo zihlala zisetyenziselwa ukunyanga ezinye iingxaki zempilo yengqondo kwaye zinokubandakanya amayeza alwa noxinzelelo, izinto zokuqinisa imeko, kunye ne-antipsychotic.

Imizekelo ye-antipsychotic evunyiweyo yi-Food and Drug Administration (i-FDA) ukuze isetyenziswe njengezongezo kunyango lokudakumba zibandakanya:

• aripiprazole (Yenza)
• iquetiapine (iSeroquel)
• i-olanzapine (iZyprexa)

Iziphumo ebezingalindelekanga zamayeza ongezelelweyo anokufana nezinye iziyobisi.

Ezinye iziyobisi

Amayeza e-Atypical, okanye lawo angahambelaniyo nakwezinye iindidi zamachiza, zibandakanya i-mirtazapine (Remeron) kunye ne-trazodone (i-Oleptro).

Iziphumo ebezingalindelekanga ezingundoqo zala mayeza kukozela. Ngenxa yokuba omabini la mayeza angabangela ukulala, zihlala zithathwa ebusuku ukuthintela ingqalelo kunye neengxaki zokugxila.