Impilo yengqondo yamaMama, ukhuseleko lweMithi yiMibandela ebalulekileyo
Oomama abakhulelweyo ngenkathi bethatha i-anti-depressant baphoqelelwe ukwenza ukhetho olunzima. Ngaba kufuneka bayeke ukuthabatha amachiza abo ukuze baqinisekise impilo yengane yabo, okanye ngaba kufuneka baqhubeke bethatha i-anti-depressant yabo ukuqinisekisa ukuba abaxinezelekanga? Kukho ubuchule kunye nokuqhelana ngamnye.
Mngcipheko
Ngelixa i-SSRIs - iklasi lokuxhatshazwayo elibandakanya iziyobisi iPzac (i-fluoxetine), i-Zoloft (sertraline), i-Luvox (i-fluvoxamine), i-Paxil (i-paroxetine), i-Celexa (citalopram) ne-Lexapro (escitalopram) - ithathwa njengekhuselekile ngexesha lokukhulelwa , kukho ubungqina obubonakalayo bokuthi abaphelelanga ngokupheleleyo.
Uphando olupapashwe ngoFebruwari 9, 2006, umxholo weNew England Journal of Medicine ubukele iintsana eziqhubekile zengcinezelo yomshukela wegazi, apho, kwiimeko ezinqabileyo, zingabhubhisa. Bafumanisa ukuba xa kuthelekiswa neentsana ezingazange zivelise le nkathazo, oomama babenokuthi bathathe la mayeza ngexesha lokukhulelwa kwangaphambili. Ababhali bacetyisa ukuba ukuxhamla olu lwalamano lubangelwa, iintsana ezibonakaliswe kwi-SSRIs ekukhulelweni kwexesha elide ziza kuba zihlandlo ezithandathu ukufumana iPPHN kunabantwana abangenayo. Nangona ingozi eyongeziweyo ibaluleke kakhulu, isaguqulela kwiintsana ezilishumi elinesibini ukuya kweyeshumi elinesibini kwi-1000 kumntwana omnye ukuya kubini kwi-1000 ukuba i-SSRIs ayisebenzisi. Ababhali bachaza ukuba ama-99 ekhulwini kwabasetyhini abhenela kwelinye lala mayeza emva kokukhulelwa baya kuzisa umntwana ongenakuchaphazeleka yi-PPHN.
Olunye uphando, olupapashwe kwincwadi ka-Februwari 2006 ye- Archives of Pediatrics kunye ne-Adolescent Medicine , yabona ukuba phantse enye yesithathu yabantwana abanomama abathatha ii-SSRI ngexesha lokukhulelwa kwabo bafumana i-neonatal abstinence syndrome.
Iintsana ezifumana le syndrome zinempawu ezifana nokukhala ngokukhawuleza, ukuthuthumela, ukulala ngokuphazamiseka, iingxaki zesisu, kunye ne-hypertonicity, okwenyuka ngokungavamile kwithoni ye-muscle. Nangona kungekho ncedo olungonyango olufunekayo kule syndrome, alukhathazi kumntwana.
Uphando ngoku lukhangeleka alubonakali naluphi na umngcipheko ophezulu okhuselekileyo wokutshatyalaliswa kwe-fetal emva kokuchasana kwi-SSRIs okanye ezinye iintsholongwane ezichasayo.
Nangona iziphumo zingahambelani, ezinye izifundo zibonisa ubungozi obuninzi bokuzalwa kwezilwanyana eziphantsi.
Ingozi yoxinzelelo
Kucacile ukuba kukho iingozi ezinxulumene nokusetyenziswa kakubi kwexesha lokukhulelwa, kodwa ukukhathazeka kwengqondo kamama kufuneka kuqwalaselwe. Ngethuba ukukhulelwa kwakuye kucatshangelwa ukubonelela ukukhuselwa nokudakumba, oku kuye kwaboniswa ukuba akunyaniseki. Abasetyhini abayeke ukufumana imishanguzo yabo banokuthi bafumane ukuphindaphindiwe kwengcinezelo yabo kunabesifazana abahlala kwiyeza zabo.
Abanye abaphandi bacacisa ukuba ukwanda kwe-hormone yoxinzelelo lomama kunokunikela umngcipheko kumntwana okhulayo. Uphando olwenziwe kwi-American Academy of Child and Adolescent Psychiatry yintlanganiso ka-Sheila M. Marcus kunye nabo basebenzisana nabo baphendule lo mbuzo kwiqela lamaqela angama-53 angama-baby-infant.
Phakathi kweziphumo zabo, njengoko kuchazwe kuMedPage Namhlanje:
- Abantwana boomama abanenkxalabo enkulu bazalwa ngoomyinge weeveki ezingama-35.6 xa kuthelekiswa neeveki ezingama-39.4 ngoomama abangenayo imbali yokudakumba.
- Igalelo legazi lezinsana ezizalwe koomama ogxininisekile lune-hormone ye-cortisol eyingozi, nangona umahluko phakathi kwamanqanaba abo kunye namanqanaba ezelwe oomama abaphantsi kobungozi abengabalulekanga. Njengoko iqela lokuhlola lincinci, isampuli enkulu yeintsana kuyimfuneko ukuqinisekisa ukuba yintoni na, ukuba kukho na, ithetha ukuba le nto ingaba nayo.
- Ukukhula kweenqwelo-mveliso kwakulindeleke ukuba kube lula, nangona kwakhona akuzange kufinyelele kwizinga elibalulekileyo.
Ukudandatheka kukuza kwengozi enkulu yokuba unina azinyamekele okanye azive efuna ukuzibulala. USusan (kungekhona igama lakhe langempela), ilungu leforum yethu yoluntu, wayezimisele ukwenza konke okusemandleni ukuqinisekisa ukuba impilo yakhe yintsana. Wadla ngokufanelekileyo, wayesebenzisa, akazange aphuze okanye angabambi, akazange aphelelwe yinto yokuqokwa kwamagqirha, kwaye wayeka ukuthatha izidandlululo zakhe "nje ukuba bangalimaza umntwana".
Ngenyanga yesixhenxe yokukhulelwa kwakhe, waqala ukucinga ukuba mhlawumbi umyeni wakhe kunye nosana bebeya kuba ngcono ngaphandle kwakhe. Ngelo xesha, uthi, "Iingcamango zam zinengqiqo. Ndandicinga ukuba ndingumthwalo kumyeni wam ngenxa yokudakumba kwam kwaye umntwana wam kuba ngcono xa ephakanyiswa ngumntu engenazo iingxaki." Isicwangciso sakhe, uthi, kwakufuneka ulinde de usana luzalwe aze azibulale. Emva kokuba umntwana ezalwe kwaye waqala ukuthabatha u-Prozac, wathi, "Ndandimangaliswe kukuba ndicinga ngezinto ezinjalo kwaye ndikholelwa ukuba baqonda."
Ngaba Ufanele Uyeke Ukuthatha I-Anti-Depressant?
Kule ngongoma, akukho mpendulo ecacileyo kulo mbuzo. Ukuxinwa kweengxaki kunye nokuxinezeleka okungaphendulwanga kubini ubunobungozi bokungabikho kwimpilo yengane. Isigqibo kufuneka senziwe kwimeko-nge-sizathu ukuba ingaba inzuzo kumama kunye nentlalo yabantwana iyaphaya naluphi na umngcipheko ovela kwi-anti-depressant. Oomama kufuneka baqhagamshelane noogqirha babo ukuze bafumane ulwazi olutsha lwezokwelapha kunye neengcebiso ngaphambi kokuba benze isigqibo. Oomama abakhethiweyo ukuyeka unyango lwabo ngexesha lokukhulelwa kufuneka bathathe isifundo kumava kaSusan kwaye baqinisekise ukuba baneenkqubo ezifanelekileyo zokuxhasa xa bexinekile.
Imithombo:
Chambers, Christina D. et. al. "I-Serotonin-Reuptake Inhibitors ekhethiweyo kunye neengozi yoxinzelelo lwe-Pulmonary Hypertension yeNtsana." I- New England Journal of Medicine 354.6 (2006): 579-587.
Cohen LS, et. al. "Ukuphindaphinda kokuxinezeleka okukhulu ngexesha lokukhulelwa kwabasetyhini abagcina okanye banqanda unyango oluxhatshazwayo." I- JAMA 295.5 (2006): 499-507.
I-Einarson, iTrand A. Einarson "Ukuxhatshazwa kweNtsholongwane emitsha ekuKhulelweni kunye neRhafu yeMali eNgundoqo: I-Meta-Analysis yeZifundo eziPhathelene nokuFanisa." I- Pharmacoepidemiol Drug Saf 14,14 (2005): 823-7.
Levinson-Castiel, uRachel, kunye. al. "Ukuthinteka kweNonatal Effects After Utero Exposure to Serotonin Reuptake Inhibitors Ekhethiweyo: Iphikisanayo." I- Arch Pediatr Adolesc Med 160.2 (2006): 855-856.
UMarcus SM, et al. Uxinzelelo lwe-Perinatal: I-Neuroendocrine kunye neempembelelo zokuziphatha kwi-I-Neonate "i- American Academy of Child and Adolescent Psychiatry 33 (2006) A16.
Oberlander TF, kunye. al. Iziphumo ze-Neonatal Emva kokuboniswa kokubeleka kwe-Serotonin Reuptake Inhibitor e-Anti-depressants ekhethiweyo kunye nokuxinezeleka koMama Ukusebenzisa iinkcukacha zezempilo ezixhaswe ngabantu. "U- Arch Gen Psychiatry 63.8 (2006): 898-906.