Amachiza asetshenziselwa ukuphatha i-stpile kunye ne-migraines iye yaboniswa ukuba isebenze ekunciphiseni ukusetyenziswa kotywala kunye nokunyangwa kwe-cocaine. Kodwa i-topiramate ayinakufumana imvume yokuba unyango lwe-addiction ngenxa yezoqoqosho.
Ubuncinane ubuncinane iminyaka eyi-10, uphando olwenziwe uphando lubonise ukuba i-topiramate, ithengiswa njenge-Topamax, isebenza ngokuphumelelayo ekuphatheni utywala .
Ngo-2003, isifundo seZiko lezeNzululwazi lwezeMpilo eSouth Texas soTywala neTeknoloji (i-START) Isiko safumana ukuba izifundo ezazisengxakini izidakwa ziphindwe ngokuphindaphindiweyo ukuba zihlale zingenangqondo inyanga, xa kuthelekiswa neqela le-placebo.
Ukusebenza ngokuCoca
Kwisifundo esilandelayo emva konyaka, abaphandi be-START Centre, abaholwa nguDkt. Bankole A. Johnson, baqhuba "uvavanyo lwe-clinical trial" oluye lwagqiba ekubeni i-topiramate inefuthe elikhulu ekuphuzeni kunokuba naltrexone kunye ne- acamprosate , Amachiza amabini avunyelwe unyango lotywala. Uphando olutshanje luye lwabonisa ukuba i-topiramate iyaphumelela ngakumbi ekunciphiseni inani abaphuza kakhulu abaphuzayo kunokuba bakhiphe ukuzila ukuzithemba ngokuziselayo abaxhasi.
Ukunciphisa Ukusetyenziswa konke
Ngokwesiko, injongo yokunyanga kweengxaki zokusetyenziswa kotywala kotywala kuye kwaba ukufikelela ekuzikhumbuleni, kodwa kwiminyaka yakutshanje kunokugxila ngakumbi ekunciphiseni umonakalo okanye ukunciphisa inani lotywala abaphuzayo okanye ukunciphisa inani labo lokusela.
Ngokutsho kophando, i-topiramate ifumaneke ukuba iphumelele ekunciphiseni utywala jikelele kunokuba iimithi ezivunyiweyo zangoku ziyi-disulfiram, naltrexone, kunye ne-acamprosate.
Gxininisa ekunciphiseni ukulimaza
Uphando olusandul 'ulwaphulo lokunxiliswa kotywala kulo lonke i-Veterans Health Administration lifumene ukuba ii-VA
oogqirha babecala i-topiramate ngenxa yezigulane zabo ezixhomekeke kutywala ephezulu kune-naltrexone kunye ne-acamprosate.
Ukusetyenziswa kweziyobisi okwangoku kungakhangela i-VA ngenxa yokuba ayivunyelwanga ukusetyenziswa njengoluhlobo lokusetyenziswa kwezidakamizwa zokusetyenziswa kotywala, kodwa oko akuzange kumise oogqirha ukuba bayigcine xa injongo yonyango iyanciphisa umonakalo wokusetyenziswa ngokweqile kotywala.
Ababhali be-VA bacwaninga ukuba ukusetyenziswa kwe-topiramate ngaphezu kwamanye amayeza kubonisa ukutshintsha kwonyango lotywala ngokubhekiselele ekunciphiseni ukusetyenziswa komsebenzi, kunokuba kuphephe ukuyeka.
I-Topiramate esebenzayo kwi-Cocaine
Ngoku kutshanje, uphando lufumene ukuba i-topiramate iyasebenza kwakhona ekuphatheni umlutha we-cocaine . Ucwaningo oluphindwe kabini kwiYunivesithi yaseMarike School School of Medicine abadala abayi-142 abafuna unyango ngokuxhomekeka kwe-cocaine bafumene ukuba i-topiramate yandisa inani le-cocaine elingenanto.
Ngaphambili, uphando lubone ukuba i-topiramate inokunceda ukunciphisa ukusetyenziswa kweziyobisi ngabasebenzisi abangafunanga unyango lwe-cocaine. Isebenza ngokuchaphazela indlela ubuchopho buchaphazela ngayo i-cocaine, ngoko ukunciphisa ukukhanga kwesilwanyana.
I-Topiramate yipilisi yokuqala efunyenwe ngempumelelo ekuphatheni umlutha we-cocaine, ngokubhaliweyo kwabalobi.
Olunye uphando luye lwabonisa ukuba lusebenza ngokuphelisa ukutshaya .
I-Topiramate Ayikho Uphawu lokuthengisa olude
Nangona uphando lubonisa ukuba i-topiramate iphumelele kakhulu, ngokubhekiselele, ekunciphiseni ukusela okuyingozi kunye nokunyanga umlingo we-cocaine, amayeza angasetyenziselwa ukufikelela ngokupheleleyo. Ngenxa yokuba ayivunywanga yi-US Food and Drug Administration ngokukhethekileyo unyango lweziyobisi, iinkampani ze-inshorensi zingenakho ukuhlawula imiqathango yazo.
Ukongezelela, kuba i-topiramate ayisakhuselekiswa yilephawu lokuthengisa, kwaye ngoko ke, ivuleleke kwimveliso yendalo, ayinakwenzekayo kwiinkampani zonyango ukuba iqhube inkqubo ebiza kakhulu ukufumana imvume ye-FDA yokusetyenziswa kweziyobisi zonyango.
Nayiphi na unyango lwezobisi lokunxila okanye utywala luya kuba yinto ebizayo yokungena kwinkqubo yokhathalela indawo yokuhlala, kodwa ngaphandle kokuthatha inxaxheba kwe-inshurensi, i-topiramate iya kuba yindleko kuneeminye imithi evunyiweyo ye-FDA.
Nangona i-topiramate ayiyiyo i-FDA evunyelwe ukunyangwa kotywala kunye noxilongo, akukho nto inqatshelwe kubanikezeli benonophelo lwempilo echaza loo nkunkuma kulezo njongo.
Imithombo:
Del Re, AC, kunye ne "Imithi ye-topiramate yokunyangwa kweengxaki zokusetyenziswa kotywala kwiiVeterans Health Administration." I-Addiction Science and Practice Practice 8 Julayi 2013
UFran, J, et al "I-Pharmacotherapy yoTywala: Uhlobo lwamayeza okwangoku." I-Opinion yangoku kwi-Neurobiology . 23 uAgasti 2013.
Johnson, BA, et al, "I-Topiramate yonyango lwe-Cocaine." JAMA Psychiatry . 16 Oktobha 2013.
Kampman KM, et al. "I-Tribune-Blind Trial Trial of Topiramate for therapy of Comorbid Cocaine and Deprecience." Ukusetyenziswa kweziyobisi kunye noTywala 1 Novemba 2013.
Inkukhu C, kunye no-al. "I-Topiramate yokuCima ukuThuza: i-Randomized, i-Placebo-Controlled, i-Study Pilot." Ucwaningo lweNicotine noTubawa ngo- Septemba 2013.