Okuqukethwe
Nakuba abanye bekholelwa ukuthi kungenzeka ukuphendukela kumaphilisi okucindezeleka ngokucindezeleka okuncane, abanye badonsa amaphilisi futhi benqabe ukuwaphuza ngisho nalapho bexilongwa kakhulu. Likuphi iqiniso? Ake sibhekane nodokotela bengqondo.
Ama-antidepressants angenye yezidakamizwa ezisetshenziswa kakhulu emhlabeni. Kunombono wokuthi zisetshenziselwa kuphela ukulwa nokucindezeleka, kodwa leli qembu lezidakamizwa lisiza ngezinkinga ezihlukahlukene: ukuphazamiseka kokukhathazeka-ukwesaba, ukuhlaselwa kwesibindi, isifo sofuba esicasulayo, ubuhlungu obungapheli kanye ne-migraines.
Yini enye ebalulekile ukwazi ngabo? Ongoti bathi.
U-Alina Evdokimova, udokotela wezifo zengqondo:
1. Avela kanjani futhi nini ama-antidepressants?
Ngo-1951, ukuhlolwa kwemitholampilo kwezidakamizwa ezilwa nesifo sofuba kwenziwa eNew York. Ngokushesha abacwaningi baqaphela ukuthi iziguli ezithatha le mishanguzo zaqala ukuzwa inkanuko encane namandla amakhulu, futhi ezinye zazo zaqala ngisho nokuphazamisa ukuthula.
Ngo-1952, udokotela wezifo zengqondo waseFrance uJean Delay wabika ukusebenza kwalezi zidakamizwa ekwelapheni ukucindezeleka. Lolu cwaningo lwaphindwa odokotela bengqondo baseMelika - kwaba ngo-1953 lapho uMax Lurie noHarry Salzer babiza le mithi ngokuthi "ama-antidepressants."
2. Ingabe ama-antidepressants esikhathi esisha ahlukile kozakwabo bangaphambili?
Zibonakala ngemiphumela emibi embalwa enezilinganiso eziphezulu zokusebenza kahle. Ama-antidepressants amasha asebenza kuma-receptors obuchopho "okuhloswe kakhulu", isenzo sawo siyakhetha. Ngaphezu kwalokho, ama-antidepressants amaningi amasha angasebenzi kuphela kuma-serotonin receptors, kodwa futhi kuma-norepinephrine nama-dopamine receptors.
3. Kungani ama-antidepressants anemiphumela eminingi kangaka engemihle?
Eqinisweni, kuyinganekwane ukuthi baningi kakhulu. Ama-antidepressants anesilinganiso semiphumela emibi eminingi njenge-analgin eyaziwayo.
Imiphumela engemihle yemithi elwa nokucindezeleka ibangelwa umphumela wawo enanini le-serotonin, i-norepinephrine, i-dopamine, kanye nama-histamine receptors, ama-adrenoreceptors nama-cholinergic receptors ebuchosheni. Ake ngikunikeze isibonelo sami engisithandayo mayelana ne-serotonin. Wonke umuntu ucabanga ukuthi le hormone equkethwe ebuchosheni. Kodwa eqinisweni, amaphesenti angu-5 kuphela engqikithi ye-serotonin yomzimba esebuchosheni! Itholakala ngokuyinhloko kwamanye amangqamuzana ezinzwa zepheshana lesisu, kuma-platelet, kwamanye amaseli omzimba.
Ngokwemvelo, lapho uthatha ama-antidepressants, okuqukethwe kwe-serotonin ayanda nje ebuchosheni, kodwa nasemzimbeni wonke. Ngakho-ke, ezinsukwini zokuqala zokungeniswa, isicanucanu nobuhlungu besisu kungenzeka. Futhi, i-serotonin ayibophezeleki nje kuphela ngesimo sengqondo nokumelana nesimiso sezinzwa ekushukumiseni kwangaphandle, kodwa futhi iyi-neurotransmitter evimbelayo, ngakho-ke, isibonelo, imiphumela emibi ngendlela yokuncipha okungenzeka kwe-libido.
Ngokuvamile kuthatha cishe isonto elilodwa ukuze umzimba uvumelane noshintsho lokuqukethwe kwe-serotonin.
4. Kungenzeka yini ukuba umlutha wezidakamizwa ezidambisa ukucindezeleka?
Izinto ezibangela ukulutheka zinenombolo yezimpawu zesici:
izifiso ezingalawuleki zokusebenzisa izidakamizwa
ukuthuthukiswa kokubekezelela into (ukwanda okuqhubekayo komthamo kuyadingeka ukuze uthole umphumela),
ukuba khona kwezimpawu zokuhoxiswa (ukuhoxiswa, i-hangover).
Konke lokhu akulona uphawu lwama-antidepressants. Ababangeli ukwanda kwemizwa, abashintshi ukwazi, ukucabanga. Kodwa-ke, ngokuvamile inkambo yokwelashwa ngama-antidepressants yinde impela, ngakho-ke, uma ukwelashwa kuphazamiseka kusenesikhathi, izimpawu ezibuhlungu kungenzeka zibuye futhi. Ngokuvamile kungenxa yalokhu okwenza abantu abavamile bakholelwe ukuthi ama-antidepressants ayalutha.
U-Anastasia Ermilova, udokotela wezifo zengqondo:
5. Asebenza kanjani ama-antidepressants?
Kunamaqembu amaningana ama-antidepressants. Izimiso zomsebenzi wabo zisekelwe ekulawulweni kwama-neurotransmitters obuchopho - isibonelo, i-serotonin, i-dopamine, i-norepinephrine.
Ngakho-ke, iqembu «elidumile» kakhulu lama-antidepressants - ama-SSRIs (i-serotonin reuptake inhibitors ekhethiwe) - ukwandisa inani le-serotonin emgodini we-synaptic. Ngasikhathi sinye, ama-antidepressants afaka isandla ekwenzeni isimo sangemuva sibe ngcono, kodwa asibangeli injabulo.
Indlela yesibili ebalulekile yokwenza kusebenze izici zokukhula kwe-neuronal. Ama-antidepressants asiza ukwakha ukuxhumana okusha ebuchosheni, kodwa le nqubo ihamba kancane - yingakho isikhathi sokuthatha le mithi.
6. Ingabe ama-antidepressants ayelapha ngempela noma ayasebenza kuphela ngesikhathi sokusetshenziswa?
Umphumela we-antidepressant uvela kuphela emavikini angu-2-4 wokungeniswa futhi uzinzisa kahle isimo sengqondo. Ukwelashwa kwesiqephu sokuqala sokugula kwenziwa kuze kube yilapho izimpawu ziphela, khona-ke ukuphinda kuvinjwe okungenani izinyanga eziyisithupha - okungukuthi, ukwakheka kwalezo zixhumanisi ze-neural "ezikwaziyo ukuphila ngaphandle kokucindezeleka nokukhathazeka."
Ngeziqephu eziphindaphindiwe zokudangala, isikhathi sokwelashwa singakhula, kodwa hhayi ngenxa yokwakhiwa kokuncika ku-antidepressant, kodwa ngenxa yezimpawu zenkambo yesifo, izingozi zokubuyela emuva kanye nesidingo sokusebenzisa isikhathi eside " udondolo” ukuze alulame.
Ekupheleni kwenkambo yokwelashwa, udokotela uzonciphisa kancane kancane umthamo we-antidepressant ukugwema ukuhoxiswa kwe-syndrome futhi avumele izinqubo ze-biochemical ebuchosheni ukuthi zivumelane nokuntuleka "kwe-crutch". Ngakho-ke, uma ungayeki ukwelashwa kusenesikhathi, ngeke kudingeke uphinde usebenzise ama-antidepressants.
7. Kwenzekani uma uphuza utshwala ngenkathi uthatha ama-antidepressants?
Okokuqala, kufanele kukhunjulwe ukuthi utshwala bunomphumela ophambene, okungukuthi "ukucindezeleka". Emiyalweni yawo wonke ama-antidepressants, kunconywa ukuyeka utshwala ngenxa yokuntuleka kwedatha ethembekile mayelana nokusebenzisana kwalezi zinto.
Ngamagama alula: akekho ozokunikeza impendulo kanye nanoma yiziphi iziqinisekiso zombuzo othi "kungenzeka yini ukuba nengilazi yewayini ngeholide?" Kungaba kubi kakhulu kumuntu onenhlanganisela yengilazi yewayini kanye nemithamo emincane yamaphilisi okucindezeleka, futhi othile uzitika ngotshwala ngesikhathi sokwelashwa ngemicabango “mhlawumbe uzoyithwala kulokhu” — futhi uyayithwala (kodwa lokhu akunembile).
Kungaba yini imiphumela? Ukwenyuka kwengcindezi, ukwanda kwemiphumela emibi, ukubona izinto ezingekho. Ngakho-ke kungcono ukuyidlala iphephile!
U-Oleg Olshansky, udokotela wezifo zengqondo:
8. Ingabe imithi yokucindezeleka ingabangela umonakalo wangempela?
Ngizoshintsha igama elithi «letha» ukuze «shayela». Yebo, bangakwazi - emva kwakho konke, kunemiphumela emibi kanye ne-contraindications. Ama-antidepressants anqunyelwe izizathu ezinhle nezizwakalayo. Futhi lokhu kwenziwa udokotela onomthwalo wemfanelo wempilo yesiguli: kokubili okungokomthetho nokuziphatha.
Ngeke ngibhale ukuthi yini engadalwa ukuphuza ama-antidepressants - vele uvule imiyalelo futhi uyifunde ngokucophelela. Kuyoze kubhalwe lapho ukuthi yimaphi amaphesenti abantu abanalokhu noma lokho kusabela okungalungile futhi ngaphansi kwaziphi izimo okungenakwenzeka ngokuphelele ukuwathatha.
Into ebaluleke kakhulu lapho uchaza ukwelashwa kwe-AD ukuhlola kahle isimo somuntu. Noma yimuphi umuthi ungaba yingozi. Ukubekezelelana komuntu ngamunye, ikhwalithi yomuthi ngokwawo kanye nokuxilongwa kahle kudlala indima lapha.
9. Kungani ama-antidepressants anqunyelwe ukucindezeleka kuphela, kodwa nakwezinye izifo zengqondo?
Kunemibono eminingana mayelana nezimbangela zokucindezeleka. Okuthandwa kakhulu kubo kusekelwe eqinisweni lokuthi umuntu unokuntuleka kwe-monoamines (ama-neurotransmitters) - i-serotonin, i-dopamine ne-norepinephrine. Kodwa uhlelo olufanayo lwe-monoamines ludlala indima ehamba phambili ekuthuthukiseni ezinye izifo.
10. Ungakwazi yini ukuphuza ama-antidepressants uma ungenayo i-depression, kodwa isikhathi esinzima empilweni yakho?
Kuya ngokuthi lesi “nkathi enzima” ilethe kusiphi isimo umuntu. Konke kumayelana nendlela azizwa ngayo. Bese kuba udokotela esiza, ongabheka futhi ahlole isimo sesiguli. Isikhathi esinzima singadonsa futhi sehle siye “phansi” kakhulu. Futhi ama-antidepressants angakusiza ukubhukuda. Nokho, leli akulona iphilisi eliwumlingo. Ukushintsha impilo yakho akulula ngaso sonke isikhathi. Noma iyiphi indlela, awudingi ukuzihlola wena.