Imibuzo emi-6 yokubuza ugqirha wakho ukuba iimpawu zakho ze-MDD aziphuculi

Umxholo

• 1. Ngaba ndiwathatha amayeza am ngendlela eyiyo?
• 2. Ngaba ndikwisiyobisi esifanelekileyo?
• 3. Ngaba ndithatha idosi efanelekileyo?
• 4. Zeziphi ezinye iindlela zonyango endinokukhetha kuzo?
• 5. Ngaba eminye imiba ingangunobangela weempawu zam?
• 6. Uqinisekile ukuba ndidandathekile?

Ukuxinezeleka kusebenza kakuhle ekulawuleni iimpawu kunye nokudakumba okukhulu (MDD). Nangona kunjalo sisinye kwisithathu sabantu esiya kufumana isiqabu esaneleyo kwiimpawu zabo ngesiyobisi sokuqala abazizamayo. Ngokumalunga nabantu abane-MDD abayi kufumana isiqabu esipheleleyo kwi-antidepressant, nokuba yeyiphi na abayithathayo ekuqaleni. Abanye baya kuba ngcono okwethutyana, kodwa ekugqibeleni, iimpawu zabo zinokubuya.

Ukuba ufumana izinto ezinje ngokudabuka, ukungalali kakuhle, kunye nokuzithemba okuphantsi kwaye amayeza awancedi, lixesha lokuba uthethe nogqirha wakho ngezinye iindlela. Nayi imibuzo emithandathu yokukhokelela kwingxoxo kwaye ikufumane kwindlela efanelekileyo yonyango.

1. Ngaba ndiwathatha amayeza am ngendlela eyiyo?

Ukuya kuthi ga kwisiqingatha sabantu abaphila nokudakumba abayithathi i-anti-depressant yabo ngendlela eyalelwe ngugqirha-okanye konke konke. Ukwehla kweedosi kunokuchaphazela indlela elisebenza ngayo iyeza.

Ukuba awukenzi njalo, yiya kwimiyalelo yedosi nogqirha wakho ukuze uqiniseke ukuba uthatha ichiza ngokuchanekileyo. Ungaze uyeke ukuthatha amayeza akho ngesiquphe okanye ngaphandle kokubonisana nogqirha wakho. Ukuba iziphumo ebezingalindelekanga ziyakukhathaza, buza ugqirha wakho ukuba ungatshintshela kwidosi esezantsi, okanye kwelinye ichiza elinemiphumo emibi embalwa.

2. Ngaba ndikwisiyobisi esifanelekileyo?

Iindidi ngeendidi ze-anti-depressants ziyavunywa ukunyanga i-MDD. Ugqirha wakho usenokuba uqalile kwi-serotonin reuptake inhibitor (SSRI) ekhethiweyo njenge-fluoxetine (Prozac) okanye i-paroxetine (Paxil).

Olunye ukhetho lubandakanya:

• I-serotonin-norepinephrine
  I-reuptake inhibitors (i-SNRIs) efana ne-duloxetine (iCymbalta) kunye ne-venlafaxine (i-Effexor
  XR)
• iziyobisi ezichasayo
  Njenge-bupropion (Wellbutrin) kunye ne-mirtazapine (Remeron)
• mzantsiweb
  i-antidepressants efana ne-nortriptyline (Pamelor) kunye ne-desipramine (Norpramin)

Ukufumana iyeza elisebenzelayo ungathatha uvavanyo kunye nephutha. Ukuba ichiza lokuqala olizamayo alincedi emva kweeveki ezimbalwa, ugqirha wakho angakutshintshela kwelinye uxinzelelo. Yiba nomonde, kuba kungathatha iiveki ezintathu okanye ezine ukuba iyeza lakho liqale ukusebenza. Ngamanye amaxesha, kunokuthatha ukuya kuthi ga kwiiveki ezisi-8 ngaphambi kokubona utshintsho kwimood yakho.

Enye indlela ugqirha wakho anokukulinganisa ngayo ichiza elifanelekileyo kukuvavanya i-cytochrome P450 (CYP450). Olu vavanyo lujonga ukwahluka kwemfuza echaphazela indlela umzimba wakho owenza ngayo izinto ezichasayo. Oku kunokunceda ugqirha wakho ukuba aqonde ukuba zeziphi iziyobisi ezinokulungiswa ngcono ngumzimba wakho, zikhokelela kwiziphumo ebezingalindelekanga ezimbalwa kunye nokusebenza okuphuculweyo.

3. Ngaba ndithatha idosi efanelekileyo?

Ugqirha wakho unokukuqala kwidosi ephantsi ye-antidepressant ukubona ukuba iyasebenza. Ukuba ayenzi njalo, baya kuyandisa kancinci idosi. Injongo kukukunika amayeza aneleyo ukunciphisa iimpawu zakho, ngaphandle kokubangela iziphumo ebezingalindelekanga ezingathandekiyo.

4. Zeziphi ezinye iindlela zonyango endinokukhetha kuzo?

Amachiza okulwa noxinzelelo ayisiyiyo kuphela unyango kunyango lwe-MDD. Unokuzama nokunyanga kwengqondo njengokunyanga ngokuziphatha kwengqondo (CBT). Nge-CBT, usebenza nonyango olukunceda ekuchongeni iipateni eziyingozi zokucinga kwaye ufumane iindlela ezifanelekileyo zokujongana nemiceli mngeni ebomini bakho. ifumanisa ukuba indibaniselwano yamayeza kunye ne-CBT isebenza ngcono kwiimpawu zoxinzelelo kunokonyango kuphela.

I-Vagus nerve stimulation (VNS) lolunye unyango olusetyenziswa ngoogqirha kuxinzelelo xa i-anti-depressants ingasebenzi. Kwi-VNS, ucingo luxutywe ecaleni kwethambo le-vagus elibaleka ukusuka emva kwentamo yakho liye kwingqondo yakho. Iqhotyoshelwe kwisixhobo esinjenge-pacemaker esidlulisa iimpembelelo zombane kwingqondo yakho ukunciphisa iimpawu zokudakumba.

Ngenxa yoxinzelelo olukhulu, unyango lwe-electroconvulsive (ECT) lukhetho. Le ayisiyiyo "unyango lokothuka" olwalukhe lwanikwa abaguli abakwiindawo zokukhusela ingqondo. I-ECT lunyango olukhuselekileyo nolusebenzayo lokudakumba olusebenzisa imisinga yombane ethambileyo ukuzama ukuguqula ubuchwephesha bobuchwephesha.

5. Ngaba eminye imiba ingangunobangela weempawu zam?

Zininzi izinto ezinokuthi zibe mandundu ngakumbi iimpawu zoxinzelelo. Kungenzeka ukuba enye into eyenzekayo ebomini bakho ikwenza buhlungu, kwaye unyango lodwa alwanele ukusombulula ingxaki.

Cinga ngezi zinto zinokubangela imeko yokudana:

• Utshintsho lobomi kutshanje,
  njengokulahlekelwa ngumntu omthandayo, umhlala-phantsi, inyathelo eliphambili, okanye uqhawulo-mtshato
• isizungu ekuhlaleni
  ndedwa okanye ukungabikho konxibelelwano olwaneleyo ekuhlaleni
• iswekile ephezulu, yenziwe
  ukutya
• umthambo omncinci kakhulu
• uxinzelelo oluphezulu oluvela kwi
  umsebenzi onzima okanye ubudlelwane obungenampilo
• ukusetyenziswa kweziyobisi okanye utywala

6. Uqinisekile ukuba ndidandathekile?

Ukuba uzame i-anti-depressants ezininzi kwaye azisebenzi, kunokwenzeka ukuba enye imeko yonyango okanye ichiza olithathayo sisizathu sokuba ube neempawu ze-MDD.

Iimeko ezinokubangela ukudakumba-njengeempawu zibandakanya:

• igqithisile okanye
  i-thyroid engasebenzi (i-hypothyroidism okanye i-hyperthyroidism)
• ukumelwa yintliziyo
• ilupus
• Isifo seLyme
• isifo seswekile
• Isifo sengqondo esiyingozi
• isifo sokuqinelwa yimithambo (multiple sclerosis) (MS)
• ukubetha
• Isifo sikaParkinson
• iintlungu ezingapheliyo
• ianemia
• ukuthintela ukuphefumla xa ulala
  (OSA)
• ukuhlukunyezwa kwesiyobisi
• ixhala

Iziyobisi ezinokubangela iimpawu zokudakumba zibandakanya:

• Iintlungu ze-opioid ziyadambisa
• uxinzelelo lwegazi oluphezulu
• icorticosteroids
• iipilisi zokulawula inzala
• umthomalalisi

Ukuba iyeza libangela iimpawu zakho, ukutshintshela kwelinye ichiza kunokunceda.

Kwakhona kunokwenzeka ukuba unesinye isimo sempilo yengqondo, njengengxaki yokuguquguquka kwengqondo.Ukuba kunjalo, kuya kufuneka uxoxe nezinye iindlela zokhetho nonyango. Ukuphazamiseka kwengqondo kunye nezinye iimeko zempilo yengqondo zifuna unyango olwahlukileyo kwi-MDD.