Okufanele ukwazi ngaphambi kokushintsha ama-anti-depressants

Imfundo Yezempilo

Kwabaningi, ukunquma ukuthatha umuthi olwa nokucindezelwa kuyinto enkulu kakhulu. Uchitha isikhathi esiningi ucabanga ngayo, ulinganisa ubuhle nobubi bayo, futhi ukukhuluma nomhlinzeki wakho wezokunakekelwa kwempilo mayelana nezinketho , ngaphambi kokuthatha isinqumo sokuzama umuthi kadokotela.

Ukuthola ifayela le- kwesokudla i-anti-depressant ingadinga ukulinga nephutha elithile, ukulungiswa okuthile okuhle. Kungase kudingeke ukuthi ushintshe imishanguzo ngesikhathi esithile ukuthola okukusebenzela kahle. Uma ukhathazekile ngokuthi umuthi wakho wamanje awusebenzi ngendlela efanele, khuluma nodokotela wakho ngokushintsha imishanguzo yokulwa nezidakamizwa.

Izizathu ezivamile zokushintsha izidakamizwa zokucindezeleka

Esinye sezizathu ezivame kakhulu ukuthi abantu bashintshe imishanguzo yokudambisa imizwa ukuthi imithi yabo yamanje ayibasizi ngalutho. Ama-anti-depressants angasebenzi ngezindlela ezahlukahlukene.

1. Isikhathi

Ama-anti-depressants adinga isikhathi sokufinyelela ekusebenzeni kwawo okuphezulu. Ubude besikhathi bungashintsha.

Kuvama amasonto ayisithupha ukuhlinzeka ngokuqondisisa, ngandlela thile UGonzalo Laje, MD , MHSc, umqondisi eWashington Behavioral Medicine Associates kanye noprofesa osebenzisana nomtholampilo eGeorge Washington University.

2. Isikali

Uma i-antidepressant ingasebenzi ngemuva kwamasonto angaba yisithupha, kungaba ukuthi umthamo uphansi kakhulu. Xhumana nomhlinzeki wakho wezokunakekelwa kwempilo, ongakhuphula kancane kancane nangokucophelela umthamo. Uma ungazizwa ungcono uma uthatha umthamo ophakeme (noma ngisho nobukhulu), kungaba yisikhathi sokuxoxa ngokuzama enye into — noma ukufaka omunye umuthi.

3. Imiphumela emibi

Akuwona wonke umuntu oba nemiphumela engemihle, futhi abanye abantu bazimisele ukubekezelela okuthile okuqhamuka uma udla imishanguzo emithini uma kusiza ukudana kwabo. Kepha kwabanye abantu, imiphumela emibi njenge-a libido ephansi , umlomo owomile, noma isicanucanu kungamakheli wedili. Uma unenkinga yokubhekana nemiphumela emibi-kungahle kube yisikhathi sokuhlela i-aphoyintimenti nomhlinzeki wakho wezokunakekelwa kwempilo.

Ungazami ukuyeka noma ukushintsha imithi ngokwakho. Ungase ube nezimpawu ezithile zokuhoxa, ikakhulukazi uma uyeka ngokungazelelwe. Kuhlala kungcono njalo ukukhuluma nodokotela wakho mayelana [nokwenza] lezi zinguquko, kusho uDkt Laje.

Ukukhetha i-anti-depressant entsha ekulungele

Lapho-ke umbuzo uba: Yimuphi umuthi ongcono kakhulu ongashintshela kuwo? Kunezinto eziningi ongakhetha kuzo kulezi izigaba zama-anti-depressants :

• I-serotonin reuptake inhibitors ekhethiwe (SSRIs): Lesi sigaba sifaka imishanguzo ejwayelekile efana ne-Prozac (i-fluoxetine), i-Celexa (i-citalopram), i-Lexapro (i-escitalopram), i-Paxil (i-paroxetine), i-Zoloft (i-sertraline), ne-Viibryd (i-vilazodone).
• I-Serotonin ne-norepinephrine reuptake inhibitors (SNRIs): Lesi sigaba sibandakanya i-Effexor XR (venlafaxine), iPristiq (desvenlafaxine), iCymbalta (duloxetine), ne-Fetzima (levomilnacipran).
• I-Tricyclic antidepressants (TCAs): Ama-TCA yisigaba esidala se-antidepressant esinemiphumela emibi kakhulu kunama-anti-depressants amasha. Kubandakanya izidakamizwa ezifana neTofranil (imipramine), Elavil (amitriptyline), Pamelor (nortriptyline), neNorpramin (desipramine).
• I-Monoamine oxidase inhibitors (MAOIs): Ama-MAOIs esinye isigaba semithi esidala engasasetshenziswa njengezindlela zokwelapha zomugqa wokuqala, futhi afaka iNardil (phenelzine), Azilect (rasagiline), neParnate (tranylcypromine)
• Amanye ama-anti-depressants: Lesi sigaba sifaka imishanguzo engahle ingalingani kahle kwesinye isigaba, njenge-Wellbutrin (bupropion), eyi-norepinephrine-dopamine reuptake inhibitor (NDRI), ne-Desyrel (trazodone), eyaziwa njenge-serotonin antagonist ne-reuptake inhibitor (SARI ).

Zonke izidakamizwa zokulwa nokucindezeleka ziza nezinzuzo nokuhlaselwa phansi, ngakho-ke kungaba ngumbuzo wokuthi yini okukusebenzela kahle. Sivame ukuyofuna okuthile okunenani elincane lemiphumela emibi ngokujwayelekile, kusho udokotela wezifo zengqondo USamuel Mowerman, MD , Ilungu lobuhlakani e-University of Miami Miller School of Medicine.

NgokukaDkt. Mowerman, izici zohlobo oluthile lokudangala zizophinde zithinte ukukhetha. Isibonelo, uma nawe uhlushwa ukukhathazeka , Udokotela wakho angancoma i-anti-depressant enezinga lokuphumelela ekubhekaneni nokukhathazeka, futhi.

Udokotela wakho angakhetha ukukushintsha kusuka kwesinye isigaba se-anti-depressant uye kwesinye. Noma udokotela wakho angase asikisele ukuthi unamathele kumuthi ovela esigabeni esifanayo somuthi obukade uwuthatha. Isibonelo, uma usuvele uthatha i-SSRI eyodwa, udokotela wakho angase asikisele ukuzama enye. Ungahle ushintshe kusuka ku- I-Prozac uku Zoloft noma shintsha ukusuka kuZoloft uye ku- I-Lexapro .

Thola ikhadi lesaphulelo se-SingleCare

Ungayishintsha kanjani imishanguzo

Uma wenza ushintsho, kunezinqubo eziningi ezingahle zenziwe:

• Ukuhamba ngaphesheya kwesiphambano: Unciphisa umthamo wokuqala wemithi ngenkathi uqala umuthi omusha ngomthamo ophansi futhi uwukhulisa kancane kancane.
• Ukushintsha okuqondile: Lokhu kungabandakanya ukumisa umuthi wakudala bese uqala omusha ngosuku olulandelayo.
• Taper phansi uyeke, ngaphambi kokuqala umuthi omusha: Ukwehlisa kancane kancane inani le-anti-depressant yakho yasekuqaleni, bese uyeka ukulithatha ngokuphelele. Ngemuva kwalokho uqala okusha (kungaba ngosuku olulandelayo, noma emavikini ambalwa, kuya ngeseluleko somhlinzeki wakho wezokunakekelwa kwempilo).

Ukweqa isiphambano kuyindlela ejwayelekile ezimweni eziningi, kusho udokotela wezifo zengqondo ILindsay Israel, MD , isikhulu sezokwelapha e-Success TMS. Isibonelo, kuvame ukusetshenziswa lapho ushintshela i-SSRI emuthini kwesinye isigaba, njenge-SNRI, noma uma ushintshela kwenye i-SSRI uye kwenye. Kungani? Ngoba kuthatha isikhathi ukuthi umuthi wokuqala ushiye isistimu yakho, njengoba kuthatha isikhashana ukuthi umuthi omusha usebenze.

Ama-MAOIs nama-tricyclics yizigaba ezimbili ze-anti-depressants okufanele zisuswe kuqala ngesikhathi ukuze amazinga egazi aye kuziro ngaphambi kokuqala i-antidepressant entsha, kusho uDkt Israel.

I-cross-taper ikuvumela ukuthi ukhuphuke kancane kancane i-med entsha ngenkathi unciphisa eyokuqala kancane, okufanele isize ukunciphisa noma yiziphi izimpawu zalokho u-Israyeli akubiza ngokuthi yi-discontinuation syndrome ngenxa yokugqagqana, ikakhulukazi uma imithi inezinto ezifanayo, kusho uDkt Israel .

Izimpawu ezivamile ze ukuyeka syndrome kufaka phakathi ukukhathala, isicanucanu, ukuqwasha, i-vertigo, isiyezi, nenkungu.

Kuthatha isikhathi esingakanani ukuthi inqubo ye-cross-taper isebenze? Kuya ngokwengxenye yomthamo obewuthatha. Umthamo ophakeme ungathatha isikhashana. Ngokuya ngengxenye yempilo yemithi okukhulunywa ngayo kanye nomthamo wamanje, le taper yesiphambano ingathatha noma yikuphi kusuka ngesonto elilodwa kuye emavikini amane kuya kwayisithupha, kusho uDkt Israel.

Ungapheli amandla

Ekugcineni, inhloso yokushintsha imishanguzo yokuthithibalisa ukuthola umuthi okusebenzelayo.

Iseluleko sikaDkt Mowerman: Siphe isikhathi. Vumela umuthi omusha usebenze, uyanezela. Kungathatha isikhathi esithile ukukhuphukela kumthamo osebenza kahle kakhulu kuwe, noma ukuthola umuthi ofanele. Ungadikibali uma ungazizwa kahle ngokushesha noma kufanele uzame imiyalelo embalwa.

Futhi ungesabi ukukhuluma. Uma unemibuzo noma ukukhathazeka ngemiphumela emibi, qiniseka ukubuza. Isibonelo, ungabi namahloni ukuphakamisa noma yikuphi ukukhathazeka mayelana ne- umphumela we-antidepressant ku-sex drive yakho , Kusho uDkt. Mowerman. Zingokoqobo, futhi zivumelekile, ukukhathazeka.