Yintoni eyahlukileyo phakathi kwama-SSNRIs kunye nee-SNRI kunye nee-NRIs?
Kukho ukudideka malunga nemigaqo ye-SSNRI ne-SNRI. Nguwuphi umehluko phakathi kwe-serotonin-norepinephrine reuptake inhibitors (SSNRIs) kunye ne-norepinephrine inhibitors (SNRIs) ekhethiweyo, kwaye ingabe le migaqo ingasetyenziswa ngokungafaniyo?
SSNRIs vs SNRIs - Ukudideka kweMigomo
I-SNRI imele i-serotonin-norepinephrine i-reuptake inhibitor kunye ne-serotonin-norepinephrin reuptake inhibitor.
I-SSNRI ibhekisele kuphela kwi-serotonin-norepinephrine e-inhibitor ekhethiweyo kodwa isetyenziswano ngokufanayo kunye ne-SNRI ngoku kwaye yayingasetyenziswanga yodwa. Kwaye kukho kwakhona i-norepinephrine reuptake inhibitors, ebizwa ngokuba yi-NRIs.
Kukho ii-SSRI
Kanti olunye udidi lweemithi, i- SSRIs okanye i-serotonin ekhethiweyo i-inhibitors ekhethiweyo , lenza oku kudideke ngakumbi. I-SSRI iquka imishanguzo efana neProzac, Paxil, Zoloft, neCelexa. Njengoko i-SSNRIs okanye i-SNRIs, inokuthi ibenze i-mania kubantu abanentsholongwane ye-bipolar kwaye abaqhelekanga basebenzise bodwa.
Umsebenzi we-SSNRIs kunye ne-SNRIs
Umsebenzi we-SSNRIs okanye we-SNRIs ngokumvimbela ukubuyiswa kwakhona kwezi- neurotransmitters , iikhemikhali ezithumela imiyalezo ebuchosheni. I-reuptake inhibitors isebenza ngokuvimbela ukubuyiswa kwakhona kwezi khemikhali ngamaseli avela kuwo, ukunyusa ngokuphumelelayo inani lemichiza ekhoyo kwi-synapse (kwaye iyakwazi ukubopha ngesisele esilandelayo yokuthumela umyalezo.) Ngamanye amazwi, i-reuptake inhibitor iza kusebenza ngendlela efana nokukhansela inkonzo yerhasi eyithunyelwa ekuthatyeni inkunkuma.
Kule meko, nangona kunjalo, "inkunkuma" yikhemikhali eyenza indima ebalulekileyo ekuqaliseni nasekulawuleni imizwelo.
I-SSNRIs (okanye i-SNRIs) inqanda zombini i- serotonin ye- neurotransmit (ngezinye izihlandlo ebizwa ngokuba "yinto efanelekileyo" yamachiza) kunye ne-norepinephrin, okubangele ukuphucula kwimiqondo.
Iziyobisi kule candelo ziquka:
- I-Cymbalta (duloxetine) isetyenziselwa ukunyanga uxinzelelo, ukukhathazeka ngokubanzi kwezixhala (GAD) kunye nezinye iintlobo zentlungu.
- I-Exexor (venlafaxine) isetyenziselwa ukunyanga uxinzelelo, i-GAD, i- panic disorder kunye ne- disorder disorder disorder .
- I-Savella (i-milnacipran) yi-serotonin-norepinephrine i-reuptake inhibitor evunyelwe ukuphatha i-fibromyalgia.
- I-Pristiq (desvenlafaxine) ivunyiwe ukuphatha uxinzelelo .
- I-Fetzima (levomilnacipran) ivunyiwe ukuphatha uxinzelelo.
Imiphumo emibi ye-SNRIs
Iziphumo eziqhelekileyo zempembelelo ziyahluka phakathi kwabantu abahlukeneyo kodwa zingabandakanya:
- Utywala
- Ukuxela
- Umlomo omile
- Isisu esimoshakele
- Ukukhathala
- Intloko
- Ukutyunjwa
- Imiba yesondo
- Ukuxhalabisa
- Unzima ukulala
- Ukulahleka kokutya
I-Norepinephrine Reuptake Inhibitors (NRIs)
I-NRIs yimishanguzo ekhubaza ukubuyiswa kwakhona kwe-norepinephrine kodwa angenakwandisa ukubuyiswa kwakhona kwe-serotonin kwingqondo. Ziyasetyenziselwa izifo ezinjengeengxaki zokunqongophala / ukugula kwengxaki (ADHD), ukudandatheka kunye nokuxhalabisa. Amachiza aqhelekileyo afaka:
- I-Strattera (i-atomoxetine) isetyenziselwa ukuphatha i-ADHD.
- I-Ludiomil (i-maprotiline) isetyenziselwa ukudandatheka kunye nokuxhalaba.
Imiphumo emibi ye-NRIs
Iziphumo eziphambili ze-NRI ziquka:
- Ubomvu besikhumba
- Iimbuzi
- Ukutshiza
- Rash
- Ukunyaniseka kwenhliziyo
- Imiba yesondo
- Ukukhathala okanye ubuthathaka
- Umbono ongezantsi
- Ukutyunjwa
- Ikhumba elikhanyayo
- Isisu esimoshakele
I-SNRIs kwi-Bipolar Disorder
I-SNRI ingasetyenziselwa abantu abaneengxaki zokugulisa i-bipolar, kodwa zivakalelwa kukuba ukusetyenziswa kwazo kufuneka kupheleliswe ekusebenziseni kwexesha elifutshane ngenxa yokudandatheka kwengqondo. Ezinye iziphumo zifumene izidandlululo ezinjenge-SNRI ezincedo kulo mqathango, kodwa ngokubanzi, ukusebenzisa izidalwa ezidandathelwanayo zokudandatheka kwe-bipolar kubonakala kungabonakali kakhulu kwimbali yendalo yesifo. Oku kuyinyaniso nokuba xa basebenziselwa ukuhlaziywa kwemizwelo okanye imithi ye-antipsychotic. Ngokwahlukileyo, ukusetyenziswa kwexesha elide le-SNRIs (okanye i-SSRIs) kwandisa kakhulu ingozi ye- mania okanye i- hypomania .
I-Anti-depressant-Induced Mania ne-Bipolar Disorder
Njengoko kuphawuliwe, i-anti-depressants efana ne-SNRI inokubangela isiqhelo somntu kubantu abane-disiphagence disorder. Ukuba unentsholongwane ye-bipolar I-disorder , mhlawumbi kufuneka ube nesimo se-stabilizer okanye i-antipsychotic kunye nokuba ugqirha wakho uncoma iyeza ezixinzelelekayo.
Amanye amayeza asetyenziswa kwi-Bipolar Disorder
Kukho ezinye iindidi ezininzi zamachiza aqhelekileyo asetyenziswa ukuphatha ingxaki ye-bipolar. Ezi ziquka:
Iimpawu zokuzinza
Njengoko igama lichaza, i- stability help help keep your mood stability kwaye ikuncede ukuba ungabikho kwiimpawu ze-manic okanye ze-hypomanic episodes. Ambalwa amachiza asetyenziswa njengama-stabilizers ngokwenene anticonvulsants asetyenziselwa abantu abanesithuthwane. Ezinye izinto eziqhelekileyo ezizinzileyo zilandelayo:
- Lithium
- Depakote (divalproex sodium)
- Tegretol (carbamazepine)
- Lamictal (lamotrigine)
Imiphumo emihle eyenzekayo yoxinzelelo lweemvakalelo zixhalabile, zixubha, zixhaphazele isisu, ukuxhamla, ukutshatyalaliswa kwentetho, ukuvuvukala, ukuthuthumela, ukuguqulwa kombono, ukunyaniseka kwentliziyo, ukuhamba ngokuvuthayo, ukucoca kunye nokutya.
Anti-Psychotics
Iyeza-antipsychotic (mhlawumbi i -antipsychotic okanye i- antipyytictic antiyytic ) ingongezwa okanye yatshintshwe kwi-regimen yakho yonyango ukuba usenokuba neengxaki ngeemeko zakho ziphantsi okanye ziphezulu kakhulu. Imizekelo ye-antipsychotics iquka:
- Risperdal (risperidone)
- Geodon (ziprasidone)
- Zyprexa (olanzapine)
- Abilify (aripiprazole)
- Latuda (lurasidone)
Imiphumo emibi ye-antipsychotics ingabandakanya uxinzelelo lwegazi oluphantsi, umbono onqamlekileyo, utywala, ukufumana isisindo, ukuthatha, ukulala, umlomo owomileyo, ukuhlanza, i-tics okanye ukuthuthumela. Inani elisezantsi lamhlophe yegazi kunye nesisu esisisulu.
I-Anti-Anxiety Medication
Ukuba unenkathazo kunye nokukhathazeka kunye / okanye ubuthongo bakho, ingcali yakho yezempilo yengqondo inokukunikezela unyango oluxhatshazwayo oluthiwa yi- benzodiazepine ukunceda. Eziqhelekileyo ziquka:
- Xanax (alprazolam)
- Klonopin (clonazepam)
- Valium (diazepam)
- Ativan (lorazepam)
Imiphumo emibi yemithi yokuxhalabisa ingabandakanya ukudideka, ukulala, ubuthakathaka, ubunzima bokuphefumla, intetho edibeneyo kunye neengxaki zokusebenzisana. Bavame ukuthathwa ngaphambi kokulala ukuze bancede ulale, nangona kunjalo, ukuze ungayi kuqaphela le miphumo.
ILizwi
Nangona i-SNRI ingaba luncedo kubantu abanexinzelelo, indima yabo ekuphatheni ukuxinezeleka okuhamba neengxaki ze-bipolar akucaci kakuhle. Ngenxa yokuphazamiseka kwe-bipolar, la mayeza kufuneka asetyenziswe kuphela ngokudibanisa nesimo se-stabilizer okanye i-antipsychotic mithi, kwaye emva nje kwexesha elifutshane elidityanisiweyo lokudandatheka kwengqondo xa kucinga ukuba iinzuzo ziza kukhulula ingozi.
Izifundo zibonisa ukuba ukusetyenziswa kwexesha elide, ngaphezu kwezinto ezinokubangela ukucima imania okanye i-hypomania, kunokubangela iziphumo ezimbi kubantu abanentsholongwane ye-bipolar. Ngokuqinisekileyo, bonke abantu abaneengxaki ze-bipolar bahluke, kwaye isifo sakho sengqondo sinokuvakalelwa kukuba ukusebenzisa ixesha elide le miyeza kuya kunceda wena ngabanye.
Imithombo:
Frye, M., McElroy, S., Prieto, M. et al. I-Factical Risk Factor i-Serotonin Transporter Gene Variants edibene ne-Antidepressant-Induced Mania. Umbhalo we-Clinical Psychiatry . 2015. 76 (2): 174-80.
McGirr, A., Vohringer, P., Ghaemi, S., uLam, R., noL. Yatham. Ukhuseleko kunye noPhulo lwe-Second-generation Generation Anti-depressant Therapy kunye ne-Mood Stabilizer okanye i-Atypical Antipsychotic kwi-Depression Bipolar Depress: Uhlolo lokuHlola kunye ne-Meta-Analysis ye-Randomised Trials-Controled Trials. I-Lancet Psychiatry . 2016. 3 (12): 1138-1146.
Vardi, K., Warner, J., noN. Philip. Iimiphumo zokusetyenziswa kwe-Anti-depressionant kunye nokuxhalabisa kwi-Psychiatric Rehospitalization kwi-Bipolar Depression. Ama-Annals we-Clinical Psychiatry . 2014. 26 (3): 207-16.
Vieta, E., noMarriga. Ukuxhatshazwa okuxhasayo kwi-Bipolar Depress. I-Lancet Psychiatry . 2016. 3 (12): 1095-1096.