Ke phapang efe pakeng tsa SSNRI le SNRIs le li-NRIs?
Ho na le pherekano e mabapi le mantsoe a SSNRI le SNRI. Phapang ke efe pakeng tsa serotonin-norepinephrine reuptake inhibitors (SSNRIs) le norepinephrine inhibitors (SNRIs) e khethollang, hona na mantsoe ana a ka sebelisoa ka tsela e sa tšoaneng?
SSNRIs le SNRIs - The Confusion ka Melao
SNRI e emela ka bobeli serotonin-norepinephrine reuptake inhibitor le serotonin-norepinephrine reuptake inhibitor.
SSNRI e eme feela bakeng sa serotonin-norepinephrine reuptake inhibitor empa e sebelisoa ka tsela e ts'oanang le SNRI hona joale le ka seoelo e se sebelisang e le mong. Joale ho boetse ho na le li-inhibitor tse norepinephrine reuptake tse khethollang, tseo hangata li bitsoang NRIs.
Hape ho na le SSRIs
Empa karolo e 'ngoe ea meriana, SSRIs kapa selectional serotonin reuptake inhibitors , e ka etsa hore sena se ferekane le ho feta. SSRI e kenyelletsa meriana e kang Prozac, Paxil, Zoloft, le Celexa. Joaloka le SSNRIs kapa SNRIs, li ka fokotsa mania ho batho ba nang le lefu la ho ferekana kelellong 'me hangata ha li sebelisoe feela.
Mosebetsi oa SSNRI le SNRIs
Mosebetsi oa SSNRIs kapa SNRIs ka ho thibela phetoho ea li-neurotransmitters , lik'hemik'hale tse fetisang melaetsa ka bokong. Reuptake inhibitors e sebetsa ka ho thibela phetoho ea lik'hemik'hale ka liseleng tseo ba neng ba li patiloe, ka katleho eketsa lenane la lik'hemik'hale tse teng ka synapse (le ho khona ho kopanya sele e latelang ea methapo ea ho romella molaetsa.) Ka mantsoe a mang, reuptake inhibitor e ne e tla sebetsa ka tsela e tšoanang le ho hlakola tšebeletso ea litšila e rometsoeng ho ea nka litšila.
Leha ho le joalo, tabeng ena, "litšila" ke k'hemik'hale e etsang karolo ea bohlokoa ho khethollang le ho laola maikutlo.
SSNRIs (kapa SNRIs) e thibela serotonin ka bobeli (ka linako tse ling e bitsoa "lik'hemik'hale") le norepinephrine, e hlahisang ho ntlafatsa maikutlo.
Lithethefatsi tsa mofuta ona li kenyelletsa:
- Sekhopalta (duloxetine) se sebelisoa ho phekola ho tepella maikutlo, boloetse bo bakoang ke ho tšoenyeha ka bongata (GAD) le mefuta e meng ea bohloko.
- Effexor (venlafaxine) e sebelisetsoa ho tšoara ho tepella maikutlo, GAD, bothata ba ho tšoha le ho tšoenyeha ha sechaba .
- Savella (milnacipran) ke selective serotonin-norepinephrine reuptake inhibitor e amohelehang ho tšoara fibromyalgia.
- Pristiq (desvenlafaxine) e amoheleha ho phekola ho tepella maikutlo .
- Fetzima (levomilnacipran) e lumelloa ho phekola ho tepella maikutlong.
Litla-morao tsa SNRIs
Litla-morao tse tloaelehileng lia fapana pakeng tsa batho ba fapaneng empa li kenyeletsa:
- Sehlōhō
- Ho rohakana
- Molomo o omileng
- Ho otloa ke mpa
- Mokhathala
- Hlooho ea hlooho
- Ho tlosoa ha 'mele
- Litabeng tsa thobalano
- Ho tšoenyeha
- Ho thata ho robala
- Ho lahleheloa ha takatso ea lijo
Norepinephrine Reuptake Inhibitors (NRIs) e khethollang
Li-NRIs ke meriana e thibelang reuptake ea norepinephrine empa e se ke ea eketsa reuptake ea serotonin bokong. Li sebelisoa bakeng sa maloetse a kang tlhokomelo ea tlhokomelo / lefu la ho kula (ADHD), ho tepella maikutlong le ho tšoenyeha. Meriana e tloaelehileng e kenyeletsa:
- Strattera (atomoxetine) e sebelisetsoa ho phekola ADHD.
- Ludiomil (maprotiline) e sebelisetsoa ho tepella le ho tšoenyeha.
Litla-morao tsa NRI
Litla-morao tse tloaelehileng tsa NRI li kenyeletsa:
- Bofubelu ba letlalo
- Hives
- Ho hlatsoa
- Rash
- E-ba le pelo e sa tloaelehang
- Litabeng tsa thobalano
- Mokhathala kapa bofokoli
- Pono e fosahetseng
- Ho tlosoa ha 'mele
- Letlalo le nang le leseli le khanyang
- Ho otloa ke mpa
SNRIs ka Bipolar Disorder
SNRI e ka sebelisetsoa batho ba nang le lefu la ho ferekana kelellong, empa ho na le maikutlo a hore tšebeliso ea bona e lokela ho lekanyelitsoe ho sebelisoa nako e khutšoanyane bakeng sa khatello ea maikutlo ea ho ferekana kelellong. Liphuputso tse ling li fumane li-anti-depressants, tse kang SNRI tse thusang mokhoeng ona, leha ho le joalo, ka kakaretso, ho sebelisa batho ba nang le bothata ba ho tepella maikutlo ka lebaka la ho tepella maikutlo ho ferekanyang maikutlo ha ho bonahale eka ho na le tšusumetso e kholo historing ea tlhaho ea lefu lena. Sena ke 'nete esita le ha se sebelisoa ka meriana e matlafatsang maikutlo kapa meriana ea antipsychotic. Ka lehlakoreng le leng, tšebeliso ea nako e telele ea SNRIs (kapa SSRIs) e eketsa kotsi ea mania kapa hypomania e bakoang ke ho imeloa kelellong .
Ho Tepella Maikutlo-Ho Etsa Hore Motho a Ikutloe a e-na le Bothata ba ho Ferekana kelellong
Joalokaha ho boletsoe, ho tepella maikutlo ho kang SNRIs ho ka hlahisa sekheo sa batho ho batho ba nang le lefu la ho ferekana kelellong. Haeba u e-na le lefu la ho ferekana kelellong kea kula , ho ka etsahala hore u hloka ho ba le maikutlo a mabeli kapa a antipsychotic hape haeba ngaka ea hau e buella meriana e loantšang maikutlo.
Meriana e Meng e Sebelisetsoang ho Ferekanya Bipolar Disorder
Ho na le mefuta e meng e 'maloa ea meriana eo hangata e sebelisetsoang ho phekola lefu la ho ferekana kelellong. Tsena li kenyelletsa:
Mood Stabilizers
Joaloka lebitso lena le hlalosa, boikutlo bo tsitsitseng ba maikutlo bo thusa ho boloka maikutlo a tsitsitseng le ho thusa ho thibela ho ba le lipapali tsa manic kapa hypomanic. Meriana e seng mekae e sebelisoang e le li-stabilizers ke li-anticonvulsants tse sebelisetsoang batho ba nang le sethoathoa hape. Lintho tse ling tse tloaelehileng tse tsitsitseng maikutlo ke tsena:
- Lithium
- Depakote (divalproex sodium)
- Tegretol (carbamazepine)
- Lamictal (lamotrigine)
Litla-morao tse ka khonehang tsa maikutlo a tsitsitseng a ikutloa a nyoriloe, a halefile a bile a halefile, a tšoaroa, a sutumelloa ke puo, a ruruha, a thothomela, a fetola pono, a senyeheloa ke pelo, a tlameha ho ntša metsi a mangata hangata, ho hlophisa le ho hlola.
Anti-Psychotics
Meriana ea antipsychotic (e ka 'nang ea e -ba ea antipsychotic kapa ea antipyychotic e sebetsang hantle ) e ka eketsoa kapa e nkeloa sebaka ke mekhoa ea hau ea phekolo haeba u ntse u e-na le mathata a maikutlo a hao a le tlaase haholo kapa a phahameng haholo. Mehlala ea li-antipsychotics e kenyelletsa:
- Risperdal (risperidone)
- Geodon (ziprasidone)
- Zyprexa (olanzapine)
- Abilify (aripiprazole)
- Latuda (lurasidone)
Litla-morao tsa li-antipsychotics li ka kenyelletsa khatello e tlaase ea mali, pono e hlakileng, ho ba le botenya, ho ba le boima ba 'mele, ho oela, ho otsela, molomo o omileng, ho hlatsa, litlolo kapa ho thothomela. palo e tlaase ea lisele tsa mali le ho ferekane ka mpeng.
Meriana e thibelang ho tšoenyeha
Haeba o na le bothata ka ho tšoenyeha le / kapa boroko ba hau, setsebi sa bophelo bo botle ba kelello se ka u fa meriana e khahlanong le matšoenyeho e bitsoang benzodiazepine ho thusa. Tse tloaelehileng li kenyelletsa:
- Xanax (alprazolam)
- Klonopin (clonazepam)
- Valium (diazepam)
- Ativan (lorazepam)
Litla-morao tsa meriana e thibelang ho tšoenyeha e ka kenyelletsa pherekano, ho otsela, ho fokola, mathata a phefumolohang, lipuo tse senyehileng le mathata a ho kopanya. Hangata li nkoa pele libethe li u thusa ho robala, leha ho le joalo, e le hore u se ke ua hlokomela liphello tsena.
Lentsoe le Tsoang ho
Le hoja SNRIs e ka thusa batho ba nang le khatello ea kelello, karolo ea bona ea ho phekola ho tepella maikutlo e tsamaeang le lefu la ho ferekana kelellong ha ho hlaka haholoanyane. Ka lefu la ho ferekana kelellong, meriana ena e lokela ho sebelisoa feela e kopane le maikutlo a ho feto-fetoha maikutlong kapa meriana ea antipsychotic, ebe ke nako e khutšoaane bakeng sa khatello ea kelello e matla ea ho ferekana kelellong ha e nahana hore melemo e tla feta likotsi.
Liphuputso li bontša hore tšebeliso ea nako e telele, ho phaella ho matla a ho thibela mania kapa hypomania, e ka fella ka liphello tse futsanehileng bakeng sa batho ba nang le lefu la ho ferekana kelellong. Ha e le hantle, motho e mong le e mong ea tšoeroeng ke lefu la ho ferekana kelellong o fapane, 'me setsebi sa mafu a hau sa maikutlo se ka' na sa nka hore nako e telele ea meriana ena e tla u tsoela molemo ka bomong.
Lisebelisoa:
Frye, M., McElroy, S., Prieto, M. et al. Sesosa sa Kotsi ea Meriana ea Serotonin Transporter Gene Variants e Amanang le Lefu la ho Tepella Maikutlo le Matšoafo. Journal of Clinical Psychiatry . 2015. 76 (2): 174-80.
McGirr, A., Vohringer, P., Ghaemi, S., Lam, R., le L. Yatham. Tšireletseho le Ts'ebetso ea Sehlopha sa Bobeli Sehlahisoa se Amanang le Kelello ea Mohatelli ka Mood Stabilizer kapa Antipsychotic ea Atypical e Phelang Maikutlo a Bipolar Depression: Tlhahlobo e Hlophisitsoeng le Meta-Analysis ea Liteko Tse sa Lebelloang tsa Li-Placebo. Lancet Psychiatry . 2016. 3 (12): 1138-1146.
Vardi, K., Warner, J., le N. Philip. Liphello tsa Tšebeliso ea ho Tepella Maikutlo le ho Tšoenyeha ho Psychiatric Rehospitalization ka ho Tepella Maikutlo ho Bipolar. Annals ea Clinic Psychiatry . 2014. 26 (3): 207-16.
Vieta, E., le M. Garriga. Ho loantša ho tepella maikutlo ho fokolang maikutlong. Lancet Psychiatry . 2016. 3 (12): 1095-1096.