Iimviwo ezifutshane kunye nexesha elide zisetyenziselwa ukuxhalabisa
Ukuba unesifo sokukhathazeka ngokubanzi (GAD) uya kufumana udibaniso lwenyango yokuthetha kunye neyeza. I-GAD ibonakaliswe yimpawu zengxaki ezingapheliyo , ukuxhalabisa kunye nokuxhatshazwa okungenasisiseko okanye ubunzima kakhulu kunokuba abantu banolwazi oluqhelekileyo . Izifundo ziye zafumanisa ukuba amaninzi angama-60 ukuya kuma-65 ekhulwini kulabo abane-GAD banesifo sengqondo esithile kunye naso-ngokuqhelekileyo ukudibanisa ukuphazamiseka kwengxaki kunye nokudakumba okukhulu .
Ionyango ze-GAD zibandakanya i-benzodiazepines, i-anti-depressants, kunye ne-azapirones.
Benzodiazepines
I-Benzodiazepines isebenza ngokuphumelelayo ekunciphiseni ukuhlaselwa kweentlanzi kunye nokuziphatha kwe-phobic , kunye nesigaba esilindelekileyo sokuhlasela . Zisetyenziselwa ukunyanga iimpawu ze-GAD ngexesha elifutshane ngelixa i-anti-depressants iqala ukusebenza. Izidakamizwa kule klasi ziquka iKlonopin (clonazepam), i-Ativan (lorazepam), ne-Xanax (alprazolam).
Nangona i-benzodiazepines isenza ngokukhawuleza, malunga nesigamu sezigulane zifumana iimpawu zokuxothwa xa zisuswe kwiyeza kwaye ezininzi iiklinikhi zikholelwa ukuba izigulane ezitholayo zingahlakulela ukunyamezela kwisiza. Emva kokuba i-antidepressant egqityiweyo iqala ukusebenza, idosi ye-benzodiazepine iyancipha ngokukhawuleza ize ikwazi ukuma ngokukhuselekileyo.
I-Benzodiazepines ibangele i-sedation kwaye inokunyuka ukuwa, kwaye ibangela ukudideka kunye neengxaki zememori ekukhuleni. Umntu osebenza kunye noomatshini obukhulu unokuba ngumviwa ohluphekileyo.
Imbali yokusetyenziswa kakubi kotywala okanye iziyobisi zingabakho ukungqinelana nokusetyenziswa kwe-benzodiazepine.
Ukuxhatshazwa
Kukho iindidi ezahlukeneyo zokuxhatshazwa kwengqondo ezingasetyenziswa ekuphatheni i-GAD. Ezi zonyango zingathabatha iiveki ukuba zenzeke. Ngenxa yokuba i-anti-depressants ihamba ngokukhawuleza kunokusebenza kwe-benzodiazepines, idlalwa ngokubambisana kunye ne-benzodiazepine ngexesha lokuqala unyango.
- I-Serotonin Reuptake Inhibitors (SSRIs) ekhethiweyo: Le klasi ifaka iLexapro (escitalopram), i-Paxil (i-paroxetine), i-Prozac (i-fluoxetine) kunye ne-Zoloft (i-sertraline). Imiphumo emibi ye- SSRI inzima kakhulu kunezo zi-tricyclic antidepressants (TCAs). I-SSRI ivelisa iziphumo ezincinane zomzimba kunye nobunzima obuncinci kunye nobuncwane kunezo TCA.
- I-Serotonin-Norepinephrine Reuptake Inhibitors (i-SNRIs) : Le klasi iquka i-Cymbalta (duloxetine) kunye ne-Effexor (venlafaxine), engasetyenziselwa i-GAD. Ziyabonwa njengeziyimpumelelo njenge-SSRI kwaye zonyango lokuqala lwe-GAD.
- I-Tricyclic Antidepressants (TCAs) : I-Tofranil (imipramine) isoloko isetyenziselwa ukuphatha uxhalaba. Ezinye iziyobisi ze-tricyclic ezitholakale zisebenzisekile ekuphatheni i-panic disorder ziquka iPamelor (nortriptyline), i-Norpramin (desipramine) kunye ne-Anafranil (i-clomipramine). I-Tricyclics, ngokungafani ne-benzodiazepines, idinga kuphela umthamo omnye wosuku lwamachiza. Bafundisisa kakuhle kwaye banceda ukukhusela ukuxinezeleka, okusoloko kuphazamiseka ukuphazamiseka kwengxaki. Nangona kunjalo, i-TCA ingavelisa iimvakalelo ezifana nokuhlaselwa kwe-panic . Izigulane zengxaki yokuphazamiseka zihlala zixhala kakhulu kwii-tricyclic; abanye banokufumana ukusebenza (ukuguqulwa komzimba, ukunyaniseka nokungazinzi) ekuqaleni kokunyango. Ngokuqhelekileyo, unyango kunye ne-TCA luqala ngomlinganiselo osezantsi owandiswa ngaphezu kwexesha. Abanye oogqirha bacetyisa ukuba isigulane sihlukanise umthamo, sininzi lwamachiza athathwe ngaphambi kokulala, ngaloo ndlela kubangela ezininzi iziphumo zecala ukuba zenzeke xa isigulane silele. Enye into ebangelwa yi-tricyclics kukuba ngamanye amaxesha ivelisa imiphumo yesifo sengqondo (njengesixinzelelo kunye neentliziyo ezithintekayo) kunye nokufumana ubunzima kunye nokwehla.
- I-Monoamine Oxidase Inhibitors (ii-MAOIs) : Ezi ziyobisi zifunyenwe ziphumelele kakhulu kunyango lweengxaki zokuxhalabisa, kuquka ukuphazamiseka kwesifo kunye ne- social phobia . Kukho, nangona kunjalo, iziphumo ezithile ezibi kakhulu kunye nala mayeza. Abantu abathatha i-MAOIs kufuneka babe nokutya okuthintela ngenxa yezinto ezibizwa ngokuba yi-tyramine efumaneka kwiindawo ezithile zokutya. Ukusebenzisana phakathi kwe- tyramine kunye nee-MAOI kunokunciphisa ubunzima bexinzelelo olubhekiselele ekunyuseni okukhulu kwegazi.
Azapirones
I-Buspirone ingasetyenziselwa ukuphatha i-GAD. Igama lophawu lweBupar alusekho kwiimarike, kodwa i-generics inokufumaneka.
I-Buspirone iyakwenza ngokukhawuleza kwaye idinga iiveki ezimbalwa ukuba isebenze. I-Buspirone ayibangeli i-sedation njenge-benzodiazepines kwaye ayikhokelela ekuxhomekeke kweziyobisi.
> Imithombo:
> Ukukhathazeka ngokuxhalabisa: Iintlobo, ukuxilongwa kunye noTyango. NIH MedlinePlus. https://medlineplus.gov/magazine/issues/summer15/article/summer15pg6-8.html.
> Ukukhathazeka ngokuqhelekileyo Ukukhathazeka: Xa ukhathazeka kukufumana ukuLawula. ISiko leSizwe seMpilo yengqondo. https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad/index.shtml.
> Greist JH. Uxinzelelo oluqhelekileyo lwexhala (GAD). http://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/generalized-anxiety-disorder-gad#v1025319.
> Imithi. Ukuxhalabisa kunye Nokunyanzelwa kweMelika. https://www.adaa.org/finding-help/treatment/media.