Ci gaba da maganin ƙwaƙwalwa: Jagorar mai farawa zuwa sakamako masu illa

Bayanin Magunguna

Idan ku, kamar ni, kuna fama da matsakaici zuwa babbar damuwa, tashin hankali na yau da kullun, ko ma cutar bipolar, da alama mai ba ku likita ya ba ku magani na antidepressant. Zan iya gaya muku daga gogewa cewa waɗannan kwayoyi na iya canza rayuwa. Tare da maganin maganganu, magungunan kashe ciki na iya magance alamun bayyanar da ke hana ku rayuwa cikakke. Zasu iya 'yantar da kai daga baƙin ciki, tsoro, ɓacin rai, da sauran bayyanannun abubuwa waɗanda ke tsoma baki cikin aiki, makaranta, da alaƙar kai.

Akwai nau'o'i da yawa na magungunan rigakafin cutar, kuma duk suna aiki ta hanyoyi daban-daban. Amma wani abu daya da suke da shi shine cewa suna canza kasancewar wasu sinadarai a kwakwalwarka. Wannan abu ne mai kyau, ta hanyoyi da yawa, saboda yana taimaka wajan magance damuwar ku ko damuwar ku. Amma kamar dukkan magunguna, yana iya haifar da sakamako masu illa kuma.

Teamungiyar likitoci da masana harhada magunguna sun taimaka ƙirƙirar wannan cikakkiyar jagorar game da maganin ƙwaƙwalwar ƙwaƙwalwa da kuma illolin da ke tattare da cutar.

Menene nau'ikan maganin rage damuwa?

Magungunan antidepressants magunguna ne na likita waɗanda ke kula da alamun cututtukan ciki na asibiti, wasu rikicewar damuwa, rikicewar yanayi, da dysthymia (ko matsanancin damuwa na kullum). Dukansu suna aiki ta hanyar gyara rashin daidaiton sinadarai na ƙwayoyin cuta a cikin kwakwalwa waɗanda ke da alaƙa da canje-canje a yanayi da ɗabi'a.

Magungunan antidepressants daban-daban suna sa ido kan ƙwayoyin cuta masu canzawa a cikin kwakwalwa da tsarin juyayi, in ji Justin Hall, MD, wani likitan mahaukata tare da Bakan Kiwon Lafiya a Annapolis, Maryland. Serotonin shine mafi yawan masu niyyar watsa labarai wanda ke da alaƙa da damuwa da damuwa.

Serotonin an yi niyya ne saboda neurotransmitter ne wanda yawanci yake haɗuwa da baƙin ciki. Wannan sinadarin yana da ayyuka daban-daban a jikin mutum . Yawancin likitoci da mutane suna kiransa sinadarin farin ciki, saboda an san shi yana ƙara farin ciki da kuma jin daɗin rayuwa. Amma kuma yana iya shafar narkewar abincinka, motsin hanji, ƙwaƙwalwar ajiya, bacci, da sauran abubuwa.

Azuzuwan magungunan antidepressant sun hada da:

• Mai zaɓin maganin serotonin reuptake (SSRI)
• Serotonin-norepinephrine reuptake mai hanawa (SNRI)
• Tricyclic antidepressant (TCA)
• Monoamine oxidase mai hanawa (MAOI)
• Serotonin antagonist da reuptake mai hanawa (SARI)
• Maganin antypical

Kowane ɗayan waɗannan azuzuwan, har ma da magungunan da ke cikinsu, suna shafar matakan ƙwayoyin cuta da yawa zuwa wani digiri na daban, in ji Alam Hallan, Pharm.D., Daraktan kantin magani na Babban asibitin Guelph a Ontario, Kanada.

Saboda wannan dalili, duk marasa lafiya suna buƙatar tsarin kulawa daban-daban. Mafi kyawun wakili ga wani mai haƙuri shi ne abin da ya fi dacewa a gare su, Dr. Hallan ya ce. Yawancin marasa lafiya yawanci suna farawa tare da SSRIs ko SNRIs. Idan basu amsa wadancan magungunan ba, to zasu iya gwada TCAs ko atypicals. MAOI an keɓe su don maganganu masu tsayayya sosai saboda wasu mahimman hulɗa.

Masu zaɓin maganin serotonin da aka zaɓa (SSRIs) da Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Dukansu SSRIs kuma SNRIs an tsara su don magance baƙin ciki da wasu rikicewar damuwa. Suna aiki ne ta hanyar niyya sinadarai a cikin kwakwalwarka da ake kira neurotransmitters. Lokacin da kwakwalwarka ta aika da sakonni daga sel guda zuwa wani, kamar su ji daɗin wannan labarin, ko kuma wannan fim ɗin abin dariya ne, waɗannan saƙonnin suna tafiya tare da taimakon masu ba da labari.

SSRIs suna ƙaddamar da kwayar cuta mai suna serotonin, kuma SNRIs suna niyya duka serotonin da norepinephrine. A yadda aka saba, yayin da kwakwalwarka ke aika sakonni daga wata jijiyar zuwa wani, mai aiko sakon ya fitar da wata 'yar karamar kwayar cuta don daukar sakon, to sai ya sake dawo da sakonnin bayan isar da sakon.

SSRI antidepressants suna aiki ta hanyar toshe reabsorption (ko reuptake) na serotonin a cikin kwakwalwarku, bayan ta isar da saƙonninta na farin ciki. Saboda haka, kwakwalwarka zata sami karin sinadarin serotonin don isar da sako mai dadi. Magungunan antidepressants da aka fi amfani dasu, ana ɗaukar SSRIs mafi inganci tare da ƙananan tasirin sakamako. Wasu misalan sun hada da Celexa (citalopram), Lexapro (escitalopram), Paxil (paroxetine), Prozac (fluoxetine) da Zoloft (sertraline).

Hakanan, SNRIs suna haɓaka matakan serotonin da norepinephrine a cikin kwakwalwarku.

Norepinephrine wani ɗan adam ne wanda ke taka rawa wajen daidaita yanayin. Wasu misalan SNRI sun haɗa da Cymbalta (duloxetine), Effexor (venlafaxine), da Pristiq (desvenlafaxine).

Magungunan maganin tricyclic (TCAs)

Tricyclic (ko tetracyclic) antidepressants sun kasance wasu daga cikin farkon magungunan antidepressants da aka haɓaka. Suna da kyau sosai, amma kuma sun zo tare da wasu sakamako masu illa, don haka ana maye gurbin su gaba ɗaya da sababbin magunguna sai dai idan SSRIs ko SNRIs basa aiki.

Magungunan antidepressants na Cyclic suma suna toshe reuptransmitters serotonin da norepinephrine, suna ƙara matakan waɗannan ƙwayoyin sunadarai biyu a cikin kwakwalwa. Koyaya, TCAs na iya shafar wasu ƙananan ƙwayoyin cuta kuma, wannan shine dalilin da yasa suke da ƙarin illa masu yawa. Misalan TCAs sun haɗa da amitriptyline da amoxapine.

Monoamine oxidase masu hanawa (MAOIs)

Kamar sauran, monoamine oxidase masu hanawa (MAOIs) aiki ta hanyar shafi neurotransmitters. Musamman, MAOIs suna shafar dopamine, serotonin, da norepinephrine, waɗanda gabaɗaya ana kiransu monoamines. Akwai kuma wani sinadari a cikin kwakwalwa wanda ake kira monoamine oxidase, wanda ke cire wadancan masu shigar da cutar. MAOI suna aiki ta hanyar hana monoamine oxidase, sabili da haka barin yawancin waɗannan ƙwayoyin cuta su zauna a cikin kwakwalwa.

Waɗannan sune farkon magungunan antidepressants, waɗanda aka haɓaka a cikin 1950s. Sun kasance masu tasiri wajen magance manyan cututtukan ciki. Koyaya, kamar TCAs, suna zuwa da sakamako mai yawa. Akwai hulɗar miyagun ƙwayoyi masu haɗari da yawa tsakanin MAOIs da wasu magunguna, yana mai da wuya a iya magance mutanen da ke da matsalar rashin tabin hankali tare da sauran yanayin kiwon lafiya. Wasu misalan sun haɗa da Nardil (phenelzine) da Marplan (isocarboxazid).

Serotonin antagonist da reuptake masu hanawa (SARIs)

Serotonin antagonist da reuptake masu hanawa (SARIs) an yarda da FDA a matsayin magungunan antidepressant, amma an fi amfani dasu da lakabi kamar taimakon bacci. Kamar SSRIs, suna yin aiki ta hana reuptake serotonin. Amma kuma suna aiki a matsayin masu adawa, suna hana wani mai karɓar maganin serotonin da ake kira 5HT2a, wanda ke toshe aikin furotin mai ɗaukar serotonin.

Wasu misalan SARI sun haɗa da Desyrel (trazodone) da Serzone (nefazodone).

Magungunan antypical

Magungunan maganin rashin kwazo kamar yadda suke yi ne-ba na al'ada bane. Wannan yana nufin cewa basu dace da kowane ɗayan azuzuwan magungunan ƙwaƙwalwar ba, kuma suna aiki ta hanyoyi na musamman. Kodayake babu wata hanyar da za a iya takaita yadda wadannan kwayoyi ke aiki, isa ya ce duk sun canza kayan aikin wasu kwakwalwa a kwakwalwarka, gami da dopamine, serotonin, da / ko norepinephrine. Wasu misalai na magungunan rashin damuwa sune Wellbutrin (bupropion) da Remeron (mirtazapine).

Fahimtar illolin dake tattare da maganin kashe kumburi

Duk da yake akwai nau'ikan tasirin da ke tattare da shan shan kwayoyi na iya haifar da su, waɗannan su ne na kowa:

• Rage nauyi ko riba
• Matsalolin jima'i, gami da asarar sha'awar jima'i, rashin karfin al'aura, da sauransu
• Rashin bacci
• Bacci
• Gajiya
• Ciwon kai
• Ciwan
• Bakin bushe
• Duban gani
• Maƙarƙashiya
• Dizziness
• Gaggawa
• Rashin fushi
• Tashin hankali
• Bugun zuciya mara tsari

Ban da waɗannan, akwai illoli masu tsayi da gajere na magungunan rage damuwa.

Hanyoyi masu tsayi na antidepressants

Yayinda yawancin cututtukan cututtukan antidepressant na ɗan gajeren lokaci ne, akwai fewan kaɗan da zasu daɗe - waɗannan mawuyacin tasirin suna da wuya kuma ana iya sarrafa su ta hanyoyi da yawa, dalla-dalla a ƙasa. Abubuwan da ke iya haifar da dogon lokaci sun haɗa da canjin nauyi, matsalolin jima'i, rashin bacci, bacci, da kasala.

Karuwar nauyi

Dalilin karuwar nauyi yayin shan antidepressants na dogon lokaci bashi da tabbas. Yana iya zama cewa marasa lafiyar da suka ɗan ci kaɗan yayin da suke baƙin ciki sun sami sha'awar dawowa da magani, Dokta Hallan ya ba da shawarar, ko magungunan na iya haifar da canji a cikin tasirinsu. A mafi yawan lokuta, matsakaita ya kai kimanin fam biyar ko makamancin haka a kowace shekara.

Wasu karatuttukan likitanci sun nuna cewa yin amfani da antidepressants na dogon lokaci na iya ƙara haɗarin cututtukan da ke da alaƙa da ƙimar nauyi, kamar rubuta ciwon sukari na 2 .

Idan sarrafa wannan tasirin tare da abinci da motsa jiki bai yi aiki ba, Dr. Hallan ya ba da shawarar gwada sabon magani. Duk waɗannan kwayoyi suna aiki daban a cikin mutane daban-daban, don haka magani ɗaya bazai haifar da sakamako iri ɗaya a cikin kowa ba, koda kuwa an san shi da yawa don haifar da wannan tasirin na musamman.

Rashin jin daɗin jima'i

Harkokin ilimin jima'i gabaɗaya sakamako ne na gama gari wanda zai iya haifar da mutane dakatar da magungunan su duk da cewa suna yin kyau akan maganin, Dokta Hall ya ce.

A zahiri, kusan rabin duk marasa lafiya da ke ɗaukar SSRI na iya fuskantar wasu lahani na jima'i, gami da rage yawan motsawar jima'i, rage ikon yin inzali, bushewar farji, ko rashin kuzari.

Duk da yake sauran illolin ba su daɗe, waɗannan tasirin na jima'i na iya ci gaba a duk tsawon lokacin da mai haƙuri ke shan antidepressants. Koyaya, bai kamata su zama masu rauni ko haɗari ba. Idan sun kasance masu damuwa har zuwa inda kuka fi so kada ku sha magani, Dokta Hall ya ba da shawarar yin magana da likitanku game da rage sashi, shan magani a wani lokaci daban na rana, ko sauya zuwa wani magani daban.

Matsalar bacci

Bambanta daga magani zuwa magani da haƙuri zuwa haƙuri, yawancin masu maganin rage damuwa suna haifar da wahala da bacci — ko dai rashin bacci ko kuma bacci. Idan kun fuskanci wannan tasirin, Dokta Hall ya bada shawarar sanya lokutan magungunan ku gwargwadon yadda suke shafar barcin ku: Idan kwayar cutar ku ta sa ku bacci, ku sha kafin bacci. Idan ya hana ka bacci, karba da safe. Yawanci, farkawa ko sakamakon bacci na miyagun ƙwayoyi zai lalace bayan awanni da yawa.

Sakamakon sakamako na ɗan gajeren lokaci na maganin rage damuwa

Duk da yake mutane da yawa ba su da alamomin cutar a kan maganin ƙwaƙwalwar ƙwaƙwalwa, ba al'ada ba ce don fuskantar sakamako mai illa na gajeren lokaci wanda zai ɗauki daysan kwanaki ko weeksan makonni. Wadannan na iya hada da tashin zuciya, ciwon kai, bushe baki, gani mara kyau, maƙarƙashiya, da fushi ko haushi.

Ciwan

Nausea yana faruwa a kusan 25% na marasa lafiya na antidepressant. Yawanci yakan fara ne kai tsaye bayan fara magani kuma yakan ɓace bayan kamar makonni biyu ko uku. Koyaya, yana wanzuwa cikin magani kusan kashi ɗaya bisa uku na waɗannan mutanen. Nausea ya fi zama ruwan dare tare da venlafaxine da SSRIs fiye da abubuwan da basu dace ba kamar bupropion, mirtazapine, ko reboxetine. Hakanan za'a iya sarrafa shi ta hanyar ɗaukar meds ɗinka akan cikakken ciki.

Ciwon kai

Nazarin da aka buga a mujallar Clinical Therapeutics gano cewa ciwon kai shine cutar da aka fi sani da mutane 40,000 waɗanda kwanan nan suka fara shan magungunan ƙyama. Waɗanda suka ɗauki TCAs da SSRIs sun fi waɗanda suka ɗauki SNRIs ko ɓarna don fuskantar ciwon kai. Koyaya, mutane da yawa suna haɓaka haƙuri don waɗannan abubuwan illa, kuma suna tafiya bayan ɗan gajeren lokaci.

Bakin bushe

Kwarewa bushe baki ? Wannan na iya kasancewa saboda magungunan a takaice suna hana fitowar ruwan jikinka. TCAs suna iya haifar da bushe baki fiye da SSRIs.

Dr. Hallan ya bada shawarar shan nonon kankara, shan shan ruwa akai-akai, cingam, amfani da mints, ko kuma goge hakora.

Matsalar hangen nesa

Mutanen da basu da hangen nesa suna bayyana shi a matsayin rashin kaifi ko tsabta ga hangen nesa. Rashin gani ya zama sananne tare da TCAs. Hakanan mutane na iya fuskantar ƙonawa, ƙaiƙayi, da jajayen ido, ko jin zafi a cikin ido. Bugu da kari, wasu mutane sun ce idanunsu sun fi saurin haske.

Idan kuna shan magungunan kashe rai kuma kuna fuskantar rashin gani, da farko kuyi gwajin ido don kawar da wasu matsalolin hangen nesa. Hakanan kuna iya gwada amfani da dusar ido da danshi don sanya idanunku danshi. Yi magana da mai ba ka sabis game da canza ɗinka idan wannan tasirin ya ci gaba fiye da weeksan makonni.

Maƙarƙashiya

Neurotransmitter serotonin yana da ayyuka da yawa banda sanya ka cikin farin ciki-zai iya shafar motsin hanjin ka, shima, saboda serotonin yana nan a cikin hanjin ka. Wasu lokuta, wasu SSRIs da TCAs na iya haifar da maƙarƙashiya a cikin gajeren lokaci. Marasa lafiya na iya sarrafa shi ta amfani da kayan shafawa, shan ruwa da yawa, da kuma cin fiber.

Dizziness

Rashin nutsuwa ya fi zama ruwan dare tare da TCAs da MAOI fiye da sauran nau'ikan maganin antidepressants. Dalilin da yasa wadannan magungunan a wasu lokuta suke haifar da dizzness saboda zasu iya rage karfin jininka. Dokta Hall ya ba da shawarar shan magungunan ku a lokacin kwanciya don taimakawa sarrafa wannan tasirin.

Jin haushi ko damuwa

Duk rashin jin daɗi da damuwa suna da illa mai tasiri na masu maganin ƙwaƙwalwa, amma suna faruwa ne a cikin ƙaramin marasa lafiya. Dalilin shine mai yiwuwa yana da alaƙa da serotonin. Kamar yadda muka riga muka gani, ƙananan matakan serotonin a cikin kwakwalwa na iya haifar da baƙin ciki da damuwa, wanda shine dalilin da ya sa waɗannan magunguna duk suna aiki don haɓaka matakan serotonin ta wata hanya. A kwanakin farko na jiyya, jikinka yana aiki kan daidaita matakan serotonin ka, wanda ke sa su canzawa. Wannan na iya haifar da ɗan gajeren tashin hankali na ƙara damuwa ko damuwa. Yayinda matakan serotonin naku suka kara samun kwari, wadannan alamun ya kamata su ragu.

Sakamakon sakamako	SSRI	SNRI	TCA	MAOI	SARI	Wellbutrin	Remeron
Karuwar nauyi	X		X	X	X		X
Rashin jima'i	X	X	X	X	X
Matsalar bacci	X	X	X	X	X	X	X
Ciwan	X	X	X	X	X	X	X
Ciwon kai	X	X	X	X	X	X	X
Bakin bushe	X	X	X	X	X	X	X
Matsalar hangen nesa	X	X	X	X	X	X	X
Maƙarƙashiya		X	X	X	X	X	X
Dizziness	X	X	X	X	X	X	X
Rashin fushi	X	X	X	X	X		X
Tashin hankali	X	X	X	X		X	X
Gumi mai yawa		X	X	X		X
Fitsarin ciki		X	X	X
Pressureananan hawan jini		X	X	X	X

M sakamako masu illa na antidepressants

Ya zuwa yanzu, duk abubuwan da muka tattauna game da su ba su da wata illa, koda kuwa sun kasance masu damuwa. Akwai, duk da haka, ƙananan ƙananan ba su da yawa, amma kuma suna da tsanani, illa masu illa da ke iya faruwa yayin shan antidepressants. Sun hada da kashe kansa, cututtukan serotonin, da hyponatremia.

Abin farin ciki, waɗannan illolin haɗari ba su da yawa, kuma haɗarin sun fi yawa a cikin watan farko na jiyya.

Tunani na kashe kansa

Mafi yawan lokuta, masu kwantar da hankula suna taimakawa rage duk alamun cututtukan ciki, gami da kisan kai. Koyaya, ƙananan marasa lafiya marasa ƙarfi-galibi samari-suna fuskantar babban haɗarin ƙaruwar ƙaddarar kisan kai.

A cewar Dr. Hallan, wannan yana faruwa ne kawai a cikin takamaiman yanayi. Misali, mai baƙin ciki ƙwarai wanda ba shi da magani yana iya fuskantar tunanin kashe kansa. Amma alamun alamun ɓacin ransa kusan kare shi daga yin aiki da waɗancan tunane-tunan saboda suma suna sa shi jin matuƙar gajiya da rashin kuzari. Da zarar ya fara jiyya, kuzarinsa da gajiyarsa na iya haɓaka kawai don ba shi ƙarfin da zai bi kan ra'ayinsa na kashe kansa.

Don kauce wa wannan tasirin, ya kamata ku raba duk wani tunanin kisan kai da kuka yi tare da mai ba da lafiyar ku kafin fara magani.

Ciwon Serotonin

Cutar Serotonin cuta ce ta gaggawa na barazanar rai wanda ke faruwa a cikin ƙananan marasa lafiya, in ji Dokta Hallan. Yana da haɗari na musamman ga waɗanda suke kan magungunan serotonergic fiye da ɗaya. Ofungiyar alamun sun haɗa da tashin hankali, rawar jiki, zufa, da kuma hauhawar jini. Certainaukar wasu ƙarin abubuwa, kamar St. John's Wort, na iya ƙara haɗarin wannan yanayin.

Idan kun sami waɗannan alamun yayin ɗaukar antidepressant, nemi taimakon likita nan da nan. Zasu dakatar da kayan aikinka, su bada jami'ai masu juyawa, kuma zasu taimaka maka gudanar da alamomin ka.

Hyponatremia

Hyponatremia wani mummunan sakamako ne mai illa kuma ana ganin sa a cikin 1 cikin marasa lafiya 2,000 da ke ɗaukar SSRI, Dr. Hallan yayi bayani. Dangane da karancin sinadarin sodium a cikin jini, ana zaton hyponatremia zai kasance ne saboda karuwar samar da sinadarin 'diuretic hormone', wanda ke sanya jiki rike ruwa, don haka narkar da yawan sinadarin sodium a jiki, in ji shi. Marasa lafiya, musamman tsofaffi marasa lafiya, waɗanda ke cikin haɗari ya kamata a kula dasu ta amfani da gwajin gwaji.

Alamar janyewar cututtukan ciki

Sai dai idan kuna fuskantar tasirin haɗari na masu kwantar da hankali kuma sun shawarci likitan ku, ba kyau ba ne ku daina amfani da su turkey mai sanyi. Dakatar da maganin kashe kumburi zai iya haifar da alamun janyewar, kamar su:

• Tashin hankali
• Rashin barci ko mafarki mai ma'ana
• Kai buzzing
• Ciwon kai
• Dizziness
• Gajiya
• Alamun mura kamar na mura
• Ciwan
• Rashin fushi

Idan har ya zama dole ku daina amfani da magungunan kashe rai, ko ma canza yadda kuke sha, yana da mahimmanci kuyi magana da mai samar muku da farko. Shi ko ita na iya ba ku jadawalin da za ku yaye kanka daga shan magani saboda ku rage girman bayyanar cututtuka.