Ukufumanisa kunye neMbali yeLithium yeengxaki zoMoya
Kwakuphi i-lithium yokuqala efunyenwe njengesilwanyana sempilo yengqondo, kwaye yintoni imbali yalo myeza? Isebenza njani ngokwenene? Yaye yintoni ingcinga kunye nokuphikisana okukhoyo ngokuqwalasela indima ye-lithium ekwenzeni unyango lwe-bipolar?
Ukufunyanwa kweLithium
I-lithium yinto eyenzeka ngokwemvelo (inombolo yesithathu kwitheyibhile yenkcazelo) eyafumaneka kuqala ngo-1817 kwaye yafunyanwa kwimigodi e-Australia naseChile.
Kodwa iziphumo ezizinzileyo, kodwa, zazingabonakali kwaze kwaba sekupheleni kwekhulu leminyaka.
Ngomdla, iLithium yayisetyenziselwa ukuphatha imeko yokuvuvukala kwe-arthritic, gout. (Ubuncinane ugqirha omnye, ekugqibeleni, wagqiba ukusukela kuloo gout yayiyimbangela yeziphazamiso zengqondo.) Kwakuqala ukusetyenziswa kwe-mania ngo-1871, kunye neDenmark iholele indlela, kodwa incinci yashicilelwa malunga neyeza kunama-half-century . Kamva, ngawo-1940, i-lithium yayisetyenziswe njengemishanguzo yegazi kodwa ngokukhawuleza yabonisa ukuba nemiphumo emibi kakhulu ukuba isebenzise kule ndlela.
Wayengu-psychiatrist u-John Cade, owathi ngo-1949, wapapasha iphepha lokuqala ekusebenziseni i-lithium kunyango lwe -mania . Ukususela ngelo xesha, i-lithium yayimiselwe ngokubanzi, kwaye imithombo yamaminerali equkethe i-lithium yayisetyenziselwa ukuphulukisa impahla.
I-US Yokutya Nezolawulo Zezidakamizwa ayizange ivume i-lithium ukusetyenziswa kwaye-1970, kwaye ukusetyenziswa kwe-lithium e-US yaqala kamva, kwaye yatshintshelwa kwezinye iziyobisi ngaphambili, kunezinye iindawo ezininzi emhlabeni jikelele.
I-Lithium isebenza njani?
Ukwazi ukuba i-lithium yinto eyenzeka ngokwemvelo, umntu unokucinga ukuba ukumisela isicatshulwa kunokuxhasa ukusilela emzimbeni. Nangona uphando aluzange lubonise ukuba le ntsholongwane ye-bipolar ingabangelwa yi-lithium deficiency. Kunoko, kwenzeka ukuba le nto yendalo isenomvuzo wokuba usebenze njengesigxina.
Kwaphela iminyaka engama-50, abantu abadandathelweyo bendoda babephathwa nge-lithium nangona isayensi yezobugcisa ayinayo nayiphi na ingcamango yokokuba yintoni okanye yasebenza ngayo. (Igama le-disability manic-depression latshintshwe ngokusemthethweni kwi-disorder bipolar ngo-1980.) Emva koko ngo-1998, abaphandi baseYunivesithi yaseWisconsin bavule imfihlelo. Imfihlelo ye-lithium ihambelene neeseli zesigulane kwingqondo, kunye ne-receptors ye- glutamate ye-neurotransmitter . Ukuze siqonde oku, masibuye siphinde sithethe ngomsebenzi weeurotransmitter kwingqondo kunye nolwalamano lwabo kunye neengxaki zempilo yengqondo.
Neurotransmitters kunye neMpilo yengqondo
Imilayezo inxalenye enye yengqondo ihamba njani, kwaye ngokwenza njalo, kubangela izenzo? Kuphela kwimihla embalwa edlulayo-xa izazinzulu ziye zahlukanisa i-neurotransmitters, izithunywa zeekhemikhali zengqondo ezisebenzisayo ukuhambisa ulwazi ukusuka kommandla omnye ukuya kwelinye-ukuba siqala ukuqonda le nkqubo.
I-neurotransmitters iqulethwe ekupheleni kwe-neuron enye (okanye i-nervous.) Umtsalane wombane ohamba kunye neentsholongwane ziphumo kwiziphumo ze-neurotransmitters ezikhishwa kwi-space (i-synapse) phakathi kwe-nerve eyodwa kunye elandelayo. Ezinye ze-neurotransmitters zibophelela kwi-cell receptors kwisalathisi esilandelayo, impendulo ngokuguqula loo myalezo kwenye iinjongo zombane.
Ama-neurotransmitters asele kwi-synapse (abo abangazibopheli kumamkeli kwi-neuron elandelayo) bayabuyiselwa phezulu kwi-neuron yokuqala ukuba isetyenziswe kwakhona.
Kukho iintlobo ezininzi ze-neurotransmitters kwingqondo. Ezinye zezi ziquka:
- Serotonin
- Norepinephrin
- Dopamine
- Acetylcholine
- IGABA (gamma aminobutyric acid)
- Glutamate
I-Glutamate ibonakala iyisifo se-neurotransmitter esithinteka kakhulu kwisigaba somntu sesifo sengqondo sokuphazamiseka kwengqondo (nangona le nto ilula kakhulu kwaye inkxalabo yezempilo yengqondo iquka ukudibanisa i-neurotransmitter kunye nezinye iinkqubo.) I-Glutamate yinkxalabo ye-neurotransmitter ephezulu yengqondo kwaye kucinga ukuba yintliziyo engummangaliso ochaphazelekayo ekufundeni nasekukhunjweni.
I-GABA, ngokuchaseneyo, i-neurotransmitter engavimbeliyo.
I-lithium ne-Glutamate Stabilization
Abaphandi baseYunivesithi yaseWisconsin bafumene ukuba i-lithium inomphumo omninzi kwiziphumo zokufumana i-glutamate ye-neurotransmitter-acting for keeping the amount of glutamate esebenzayo phakathi kweeseli kwisigxina, inqanaba lempilo, akukho ncinane okanye encinci.
Uprofesa weeYunivesithi waseWisconsin weZikolo zezoMpilo uDkt. Lowell Hokin, owawulathisa uphando, wathi ekuphandleni kwabo kungacetyiswa ukuba i-glutamate eninzi phakathi kwe-neurons idala i-mania, kwaye ingancinci, ixinzelelo. Kufuneka kubekho ngaphezulu kunokuba, ekubeni imithi yokuxhatshazwayo, umzekelo, sebenze kuma-receipt of other neurotransmitters ezifana ne- serotonin kunye ne- dopamine . Nangona kunjalo, ngokuqinisekileyo le nto yayiyinqanaba eliphambili ekuqondeni isiseko sezinto eziphilayo ze-bipolar disorder.
Qaphela: inani elikhulu le glutamate elongezelelweyo lingakhokelela ekuthinjeni isisu okanye ukubulala iseli lesibini ukusuka ekugqithiseni (oku kucatshulwa ukuba idlale indima inxaxheba kwisifo se-Alzheimer kunye nemivimbo.)
Ngelixa i-lithium ibonakala ithatha indima ekumodareyithini amanqanaba e-glutamate engqondweni, kwaye ngoko ke, ukulinganisela nokudakumba, kukho imibuzo efunekayo ukuphendula. Nangoku, imiphumo ye-lithium ebuchosheni ayikude iqondwe.
Ezinye iindlela zokusebenzisa iLithium
Ukongeza kwimiba ye-bipolar, ngamanye amaxesha i-lithium isetyenziselwa ukudandatheka okungaxhamliyo (ukudakumba okukhulu) kunye neengxaki zesifo se-schizoaffective. Ngenxa yefuthe le-lithium yokuzinzisa kwi-glutamate receptors, izazinzulu zifunda nokuba le nyilisi ingazikhusela ekufeni kweeseli ezenzeka kwiimeko ezifana ne-Parkinson's, i-Huntington kunye ne-Alzheimer's disease.
I-Lithium Toxicity kunye neempembelelo zecala
Njengamachiza amaninzi kwiimarike, i-lithium iza kunye nohlu lweempembelelo kunye nezilumkiso. Inyosi ye-lithium inokuba yingozi kakhulu, kunye nemiphumo emibi kwaye ingapheliyo. Iimiphumo ezichaphazelekayo ze-lithium ziqhelekileyo kunye, kwaye kunye nemithi emininzi yempilo yengqondo, ezi ziphumo zivame ukuphazamisa ukusebenzisa kwazo.
Ukongezelela, i-lithium iyaziwa ukusebenzisana neentlobo ezahlukeneyo zemithi, njengezinye iziyobisi zempilo yengqondo, imishanguzo yegazi, iziyobisi ze-Parkinson, kunye nabanye ababulali beentlungu.
Zonke ezo zithi, kukho ambalwa amachiza afumanekayo kunyango lwe-bipolar disorder ezingenayo imiphumo ebalulekileyo.
Yiyiphi indima yeLithium kwiNyango ye-Bipolar Disorder Today?
Impendulo yombuzo othi, "Yiyiphi indima ekufuneka i-lithium iyenze ekwenzeni unyango lwe-bipolar namhlanje?" ziyahlukahluka kuxhomekeke ekubeni ngubani oyicelayo nokuba uhlala phi.
Ukongezelela kwimbali yokuqhaqhafaza, kukho imibono ehlukeneyo malunga nokusetyenziswa kwe-lithium namhlanje. Abanye oogqirha baye baye ekuthiwa yi-lithium "ingozi engeyingozi" kanti abanye babheka i-lithium njengeyona ndlela yonyango eyona yonyango eyona nto ifumaneka kwi-bipolar disorder. Abanye oogqirha bathi baninzi i-lithium yonyango olubaluleke kakhulu lwempilo yengqondo efunyenweyo.
Njengeminye eminye imiba enxulumene nempilo yengqondo, impendulo yangempela mhlawumbi ilele phakathi kwezinto ezigqithiseleyo kwaye ibonakaliswe kwiindlela ezahlukeneyo emhlabeni jikelele. I-United States inegama lokuba "lokugqibela kunye nokuqala" ngokubhekiselele ekusebenziseni kwesi sigqirha, ngokukhawuleza phakathi kwamanye amazwe ukuba isebenzise ukusetyenziswa kwayo, kwaye kwangaphambili ukucebisa ezinye iindlela (ezinye izimo ezinjenge- Depakote (valproic acid) kunye nemithi yokulwa ne- antipsychotic .)
E-US, i-lithium ayisoloko isetyenziselwa umgca wokuqala wabantu abanesifo sengqondo sokuguquguquka kwengqondo, nangona isasetyenziselwa ukuxhatshazwa kakhulu kwe-bipolar kunye nezinye iyeza. Ucwaningo olwenziwa ngo-2017, nangona kunjalo, luchaza ukuba kukho inxaxheba eqinile kwinqanaba lokuqala le-lithium kunyango lwe-mania kumaxhegu.
Ngaphantsi kweMbali yeLithium
Imbali ye-lithium ibalulekile ukuqonda xa ukhangela ukufunyanwa kweendlela zokuzinzisa imimoya, kwaye ngoku kutshatyalaliswa kwenzululwazi ukuphanda iimeko zamachiza ezinokukhathazeka kwemizwelo engqondweni.
Ukuqonda oku kutsha kwezithunywa zeekhemikhali kwingqondo ejongene neengxaki zempilo yengqondo kubalulekile ekunciphiseni ukunyaniseka kweengxaki zempilo yengqondo. Nangona kusekho indlela ende yokuhamba, kunye nempilo yengqondo isenokuba yinkinga enkulu kunokuba isithi isifo senhliziyo, uphando oluqhubekayo namhlanje-njengendlela esebenzayo ngayo i-lithium-isinyathelo esona siphumo esihle.
> Imithombo
- > De Frazio, P., Gaetano, R., Caroleo, M. et al. I-lithium kwiLate-Life Mania: Uhlolo lokuHlola. Izifo Neuropsychiatric kunye neNyango . 2017. 13: 755-766.
- > Gershon, S. Lithium: Ufunyenwe, Ukhohliwe kwaye Ubuye wabuya. Inethiwekhi Yomhlaba Yomlando We-Neuropsychopharmacology . Agasti 15, 2013.
- > Mfutshane, E. Imbali yeThethium Therapy. 2009. 11 (0 2): 4-9.
- > Sani, G., Perugi, G., noL. Tondo. Ukunyangwa kwe-Bipolar Disorder kwi-Lifetime Perspective: Ngaba iLithium isoloko iyona khetho ekhethekileyo? . Uphando lwezonyango . Ngo-2017 ngoMeyi 5. (Epub ngaphambi kokuprinta).