Lus Qhia thiab Tshwm Sim Cov Lus Qhia Txog MAOIs
Monoamine oxidase inhibitors yog ib chav kawm ntawm cov tshuaj tiv thaiv antidepressants uas tau tsim hauv xyoo 1950. Lawv ua haujlwm zoo rau kev kho tus mob kev nyuab siab , tsis pom kev ntshai , thiab lwm yam kev ntxhov siab . Txawm hais tias lawv muaj feem xyuam zoo li cov tshuaj serotonin reuptake inhibitors (SSRI) thiab tricyclic antidepressants (TCAs), lawv siv tsawg dua vim kev noj haus cov kev tiv thaiv thiab kev pheej hmoo ntawm kev phiv tshuaj thaum sib xyaw nrog qee yam tshuaj.
Piv txwv ntawm MAOIs Muaj xws li:
- Phenelzine (nardil)
- Tranylcypromine (parnate)
- Isocarboxazid (marplan)
- Selegiline (emsam)
Emsam daim tawv nqaij (daim tawv nqaij) uas yog siv ib zaug txhua hnub. Hom kev tswj no tej zaum yuav tsis tshua muaj peev xwm ua rau muaj teeb meem ntawm kev noj zaubmov uas cuam tshuam nrog qhov ncauj ntawm kev khiav dej num.
Yuav ua li cas MAOIs Ua Haujlwm
Nws ntseeg hais tias lub hlwb muaj ntau pua hom ntau hom tshuaj xa tuaj ( neurotransmitters ) uas ua raws li cov neeg sawv cev ntawm cov hlwb sib txawv . Cov tshuaj xaib no yog molecular tshuaj uas tuaj yeem ua rau muaj kev xav, kev ntshaw, kev ntxhov siab, kev pw tsaug zog, lub plawv dhia, qhov kub, kev ua phem, kev ntshai thiab ntau lwm yam kev xav thiab lub cev. Monoamine oxidase (MAO) yog ib qho enzyme uas ua rau me me los yog lov peb cov neurotransmitters nrog kev xav thiab ntxhov siab:
- Serotonin , uas plays lub luag haujlwm hauv kev hloov kev ntxhov siab, kev xav, kev pw tsaug zog, kev ntshaw, thiab kev ua plees ua yi.
- Norepinephrine , uas cuam tshuam rau kev pw tsaug zog thiab kev quab yuam, ntseeg tias kev sib raug zoo rau txoj kev sib ntaus sib tua-los-kev sib tw .
- Dopamine , uas cuam tshuam lub zog ntawm lub cev thiab tseem ntseeg tias yuav koom nrog hauv kev txhawb zog, kev qhuas, kev txhawb zog thiab kev coj cwj pwm. Ntau txoj kev xav ntawm kev puas siab ntsws xav tias dopamine plays lub luag haujlwm hauv cov kev mob hlwb .
MAOIs txo cov kev ua ntawm lub enzyme MAO. Tsawg MAO tau tshwm sim hauv qib siab ntawm norepinephrine, serotonin, thiab dopamine hauv lub hlwb. Cov txiaj ntsim ntawm cov kev nce no nce zoo siab tuaj thiab muaj kev cuam tshuam los tiv thaiv cov teeb meem.
Feem Ntau Cov Kev Los Ntawm MAOIs
- Txo kev pw tsaug zog / tsis txaus ntsig
- Xeev
- Zawv plab
- Qhov ncauj qhuav
- Kub siab (ntshav siab)
- Hypotension (tsis tshua muaj ntshav siab)
- Kauj taub hau
- Qhov hnyav nce
- Edema (dej tuav)
- Kev sib deev tsis sib deev
- Mob leeg
- Tsis muaj zog
- Tsis meej pem
Daim ntawv no tsis yog txhua yam, thiab tej zaum koj yuav muaj lwm yam kev phiv tsis hais ntawm no. Koj yuav tsum tshaj tawm txhua yam kev siv tshuaj kho mob rau koj tus kws kho mob.
Tyramine-Hloov Tawg Kub Hlwb
Tyramine yog ib qhov chaw muaj nyob hauv ntau cov khoom noj . Qhov chaw no muaj kev nyhav ntawm ntshav siab thiab tswj hwm los ntawm MAO enzyme. Thaum tus MAO enzyme yog inhibited (piv txwv li, thaum noj ib qho MAOI), tyramine tuaj yeem ncav cuag theem siab, ua rau muaj ntshav siab. Thaum noj cov tshuaj MAOI, nws yuav tsum tsis txhob noj cov zaub mov thiab haus dej hauv tyramine kom tsis txhob muaj ntshav siab heev.
Lwm Yam Kev Dagmeej thiab Kev Cuam Tshuam Contraindications
Ua ntej pib MAOI txoj kev kho, qhia koj tus kws kho mob yog tias koj muaj ib qho mob nram no:
- Kab mob raum (kab mob raum)
- Qaug dab peg
- Kab mob (piv txwv li, lub plawv nres yav dhau los, kab mob hauv lub plawv)
- Hyperthyroidism
- Kub siab (ntshav siab)
- Ntshav qab zib
Qhia tag nrho koj cov chaw kho mob uas koj tau siv MAOI. Qhov no suav nrog cov kws kho mob, kws kho mob cov kws kho mob, kws kho hniav, thiab lwm tus kws kho mob.
Txhob noj tshuaj tsis tas koj tus kws kho mob pom zoo.
Serotonin Syndrome
Cov kab mob siab serotonin nyob rau hauv lub hlwb muaj peev xwm ua rau muaj mob hnyav heev li hu ua serotonin syndrome . Qhov tsis tshua muaj tus mob no feem ntau yog tshwm sim ntawm kev sib raug zoo ntawm ob lossis ntau hom tshuaj uas ua rau lub hlwb serotonin theem.
Txawm tias qee cov tshuaj yuav tom khw, xws li St. John's Wort, tuaj yeem ua rau serotonin syndrome yog tias sib xyaw nrog MAOIs. Yuav kom txo tau txoj kev pheej hmoo ntawm serotonin syndrome, MAOIs yuav tsum tsis txhob noj nrog SSRIs los yog TCAs. Nws raug pom zoo hais tias lwm yam kev kho mob antidepressant tsis pib txog 10 mus rau 14 hnub tom qab kev txiav tawm ntawm MAOI.
MAOIs thiab Cev xeeb tub
Cov kev tshawb fawb ntawm kev xeeb tub thiab MAOI kho yog tsawg. Nws raug nquahu kom MAOI kho kom zoo thaum lub sijhawm cev xeeb tub. Yog tias koj mob siab lossis cev xeeb tub, nws yog qhov zoo tshaj los tham txog cov kev txaus ntshai thiab cov txiaj ntsim ntawm MAOI kev kho mob nrog koj tus kws kho mob.
MAOI Discontinuation Syndrome
Qee cov neeg tau qhia txog cov tsos mob zoo li cov tsos mob thaum txo los sis txiav kev siv tshuaj MAOI. Nws ntseeg tias cov tsos mob ntawm no yog tshwm sim ntawm lub hlwb ua kom tswj tau serotonin thiab norepinephrine ntau ntau tom qab hloov ceev.
Cov kev mob tshwm sim uas tshwm sim thaum lub sij hawm tsis ua haujlwm ntawm kev kho MAOI muaj xws li:
- Xeev
- Mob taub hau
- Mob ib ce
- Kauj taub hau
- Fais fab-zoo li kev xav hauv lub caj dab thiab lub taub hau
Txawm hais tias tag nrho cov tsos mob no tsis ntseeg tias yuav muaj kev puas tsuaj, lawv muaj peev xwm ua rau kev xav tsis meej. Tsis txhob txo lossis txiav tsis tu MAOI kho yam tsis tau txais kev pabcuam koj tus kws kho mob.
MAOIs thiab Kev Sib Haum Yus
Kev sib koom tes ntawm kev xav txog kev tua neeg , tshwj xeeb tshaj yog cov tub ntxhais hluas, nrog kev kho mob antidepressant, yog qhov chaw ntawm kev mloog thiab kev tsis sib haum xeeb nyob rau hauv xyoo tas los. Nyob rau hauv kev teb rau cov kev txhawj xeeb uas tshwm sim hauv cov ntaub ntawv tshawb fawb thiab cov kev tshawb fawb, US Food thiab Drug Administration (FDA) tau tshaj tawm cov lus hauv xyoo 2007. Lub FDA tawm tswv yim hais tias cov tshuaj noj txhua yam tshuaj tiv thaiv antidepressant qhia tau ceeb toom rau lawv cov khoom hais txog kev tsim kev kub ntxhov kev xav thiab kev coj tus cwj pwm ntawm cov laus, hnub nyoog 18 txog 24, thaum pib kho.
Li ntawd, nyob deb, soj ntsuam ntawm tsis pom ib lo lus teb tseem ceeb txog kev tiv thaiv kev tua tus kheej. Rau feem coob ntawm cov neeg, antidepressants txo kev nyuaj siab thiab txo cov kev pabcuam thiab tsis muaj kev vam meej uas siv lawv lub neej niaj hnub. Tab sis, rau ib feem pua tsawg ntawm cov neeg noj tshuaj antidepressants, qhov no kuj tsis yog qhov tseeb. Yog tias koj txhawj xeeb txog qhov teeb meem no, qhib nrog koj tus kws kho mob thiab tsis txhob ntshai nug.
Qhov chaw:
> Antidepressant Kev Siv Cov Me Nyuam, Cov Tub Ntxhais Hluas, thiab Cov Neeg Laus. Kev hloov kho rau Cov Khoom Labeling. US Food thiab Drug Administration. Tsib Hlis 2, 2007.
> Kaplan MD, Harold I. thiab Sadock MD, Benjamin J. Synopsis ntawm Psychiatry, Yim tsab 1998 Baltimore: Williams & Wilkins.