Hais txog Trycyclic Antidepressants rau Bipolar Teeb Meem thiab Kev Nyuaj Siab
Koj tus kws kho mob tej zaum yuav tau pom zoo siv cov tshuaj tiv thaiv kab mob tricyclic antidepressant los kho koj txoj kev nyuaj siab, kev puas siab puas ntsws, lossis lwm yam mob xws li mob. Cov tshuaj no ua haujlwm licas? Cov tshuaj twg yog qhov pom tias cov tshuaj tua kab mob tricyclic antidepressants, thiab dab tsi yog ib qho kev mob tshwm sim uas koj yuav tsum paub?
Dab tsi yog Tricyclic Antidepressants?
Tricyclic antidepressants tau nyob ntev ntev, nrog rau cov tshuaj thawj zaug hauv hoob kawm ntawm antidepressants tau tsim nyob rau xyoo 1950.
Txawm hais tias cov tshuaj tshiab (feem ntau muaj tsawg dua kev phom sij thiab qis dua dhau ntawm overdose) tam sim no muaj, tricyclic antidepressants tseem muaj chaw nyob rau hauv kev kho mob ntawm kev puas siab puas ntsws, kev nyuab siab, thiab lwm yam mob xws li mob ntev.
Thawj thawj zaug ntawm cov tshuaj tiv thaiv kev mob siab Tricyclic, Tofranil (imipramine) yog ib qho tseem ceeb heev thiab pab tau cov kws kho mob kom paub lawv lub tswv yim txog kev ntxhov siab li cas. Tricyclic antidepressants muaj npe rau cov qauv ntawm ntau cov tshuaj hauv chav kawm - cov tshuaj yog tsim los ntawm peb lub voj ntawm atoms.
Yuav Ua Li Cas Tricyclic Antidepressants Ua Hauj Lwm?
Txij li thaum nrhiav tau ntawm cov tshuaj tua kab mob tricyclic antidepressants, peb tau kawm ntau ntxiv txog kev siv cov tshuaj tsis txaus ntawm lub hlwb nyob hauv ntau lub sijhawm ntawm kev nyuaj siab. Qhov no yuav tsis tsim ceeb rau cov neeg uas tau nyob nrog kev nyuaj siab, raws li lawv tau pom tias qhov kev nyuaj siab tshwm sim txawm tias thaum txhua yam hauv lub neej zoo li yuav zoo.
Muaj cov phooj ywg thiab tsev neeg nkag siab txog qhov kev nyuab siab ntawm kev nyuaj siab thiab lwm cov kev mob hlwb puas pab tau, kom lawv tsis txhob hais lus phem xws li "cia li rub tawm ntawm nws." Cov lus xws li cov no tsis txawv qhov txawv ntawm qhov qhia ib tus neeg muaj ntshav qab zib thiab ntshav siab uas tsis muaj ntshav qab zib kom qis qeeb.
Kev sib txuas lus ntawm cov paj hlwb txawv hauv lub paj hlwb siv qhov chaw ntawm cov tshuaj hu ua neurotransmitters . Cov tshuaj no tso tawm los ntawm qhov kawg ntawm ib qho paj hlwb, mus rau hauv ib qho chaw nruab nrab ntawm lub hlwb (tus synapse), thiab tom qab ntawd coj mus rau tom qab lub paj hlwb ua ib txoj kev xa cov ntaub ntawv.
Tricyclic antidepressants ua haujlwm los ntawm kev ua kom cov neurotransmitters serotonin thiab norepinephrine (los ntawm kev tiv thaiv koj lub cev los ntawm kev rhuav tshem cov tshuaj no.) Txij li thaum lawv nce theem ntawm ob leeg ntawm cov neurotransmitters, lawv raug txiav txim siab "dual action" antidepressants.
Ntxiv nrog rau cov kev mob hauv serotonin thiab norepinephrine, tricyclic antidepressants kuj ua haujlwm los thaiv qhov kev txiav txim ntawm lwm cov neurotransmitter, acetylcholine .
Hauv kev sib thooj ntawm cov kab mob antidepressants tricyclic, qee cov tshiab antidepressants ua haujlwm feem ntau los ntawm lawv cov kev ua rau serotonin. Piv txwv, cov tshuaj serotonin reuptake inhibitors (SSRI's) xws li Prozac (fluoxetine) nce qib ntawm serotonin nyob rau hauv lub hlwb tab sis tsis txog theem ntawm norepinephrine. (Qhov kev nqis tes ntawm cov tshuaj tua kab mob siab ntsig yog qhov tob tshaj qhov no, yog li qhov piv txwv no yog siv sib piv yooj yim.)
Zuag qhia tag nrho, nws tau xav tias cov qib siab ntawm serotonin thiab norepinephrine hauv lub hlwb ua rau kom zoo dua tuaj.
(Xav paub ntau ntxiv txog Chemistry ntawm kev nyuaj siab .)
Cov Kev Mob Dab Tsi yog Tricyclic Antidepressants siv?
Cov tshuaj antidepressants Tricyclic tej zaum yuav raug sau rau hauv "daim ntawv lo" lossis "tshem tawm daim ntawv lo." Cov ntawv sau qhia muaj xws li cov tshuaj uas tam sim no FDA tso cai. "Tshem tawm ntawm daim ntawv" siv ntau cov tshuaj muaj feem ntau, thiab hais txog kev siv cov tshuaj uas tau pom zoo los ntawm FDA, tab sis rau qhov sib txawv dua li qhov uas tau pom zoo lawm.
Cov ntawv sau qhia txog kev siv tshuaj tua kab mob tricyclic muaj xws li:
- Kev nyuaj siab
- Obsessive compulsive teeb meem
Tshem tawm cov ntawv sau rau kev siv tshuaj tua kab mob tricyclic muaj xws li:
- Mob ntev xws li Elavil mob ntev mob
- Phantom mob plab
- Bedwetting (enuresis)
- Migraine mob taub hau kev tiv thaiv
- Bulimia
- Panic tsis meej
- Kev puas siab puas ntsws bipolar
- Mob pruritis (khaus)
- Mob hiccups
- Pw puas ntsoog teebmeem (doxepin yog FDA tau pom zoo rau insomnia)
- Tsis chim siab plob tsis so tswj hlwb
Cov kws kho mob sib txawv li cas lawv tau sau cov tshuaj xws li "cov ntawv pov thawj" no, tshwj xeeb tshaj yog thaum muaj mob tswj thiab mob txaj, ntau cov kev tshawb fawb los txhawb txoj kev siv no.
Ntev li cas nws yuav siv cov tshuaj no mus ntev npaum li cas?
Tricyclic antidepressants, zoo li lwm cov tshuaj tiv thaiv kev noj qab haus huv, feem ntau siv ob peb lub lis piam (feem ntau rau 6 rau yim lub lis piam) ua ntej lawv ua hauj lwm los txo kev nyuab siab. Vim li no, cov kws kho mob feem ntau xav kom noj tshuaj ntxiv mus ob peb rau peb lub hlis ua ntej hloov mus rau lwm hom tshuaj. Yog vim li cas ho xav tias yog tag nrho cov tshuaj no siv sij hawm los kho cov tshuaj muaj yees hauv lub hlwb. Qhov no tsis txhais hais tias tsis muaj dab tsi uas koj tuaj yeem ua thaum tos. Coob tus neeg nrhiav lwm cov kev kho mob xws li kev kho mob hlwb pab kho rau tej yam kev mob xws li kev nyuaj siab thiab kev puas siab puas ntsws, thiab tej zaum yuav pib muaj cov kev mob tshwm sim rau kev nyuab siab ua ntej kev sib kho "hauv plab".
Tshuaj Kho Npe raws li Tricyclic Antidepressants
Qee cov tshuaj uas tau muab cais ua rau muaj kev tiv thaiv kev noj qab haus huv tricyclic muaj xws li:
- Elavil (amitryptyline)
- Ascendin (amoxapine)
- Anafranil (clomipramine)
- Pamelor (nortryptyline)
- Norpramin (desipramine)
- Tofranil (imipramine)
- Vivactil (protryptyline)
- Surmontil (trimipramine)
- Sinequan (doxepin)
Cov Kev Mob Teebmeem ntawm Tricyclic Antidepressants
Txawm hais tias txhua yam ntawm cov tshuaj tiv thaiv kab mob tricyclic me ntsis txawv ntawm lwm tus, lawv sib koom zoo tib yam mob. Cov kev mob tshwm sim muaj xws li:
- Qhov ncauj qhuav
- Cem quav
- Kev tsaug zog (qee cov tshuaj yuav tsum tau muab rau cov tshuaj loog)
- Kauj taub hau
- Qab qab los noj mov
- Qhov hnyav nce (tej zaum tseem ceeb)
- Blurry qhov muag
- Kev hloov ntawm kev ua haujlwm ntawm kev sib deev
Yog tias koj tau muaj qhov tsis zoo rau Tegretol (carbamazepine), los yog lwm cov tshuaj kho mob yav dhau los, xyuas kom koj qhia qhov no rau koj tus kws kho mob yog hais tias nws xav hais tias koj yuav siv tus mob tricyclic antidepressant.
Tsis tas li ntawd, muaj cov lus qhia txog cov me nyuam muaj teeb meem thaum lawv niam tau siv cov tshuaj tua kab mob tricyclic tom kawg ntawm lub cev xeeb tub. Tricyclics dhau mus ua kua mis. Yog tias koj cev xeeb tub, noj niam mis los yog npaj kom cev xeeb tub, sib tham txog cov txiaj ntsig zoo li ntawm kev pheej hmoo ntawm kev siv tshuaj tua kab mob tricyclic nrog koj tus kws kho mob.
Kev Sib Tham nrog Tshuaj Tricyclic Antidepressants
Qee cov kev mob tshwm sim ntawm kev siv tshuaj tua kab mob tricyclic antidepressants tuaj yeem sib zog ua los ntawm lwm cov tshuaj. Koj tus kws kho mob yuav tsum paub lwm yam tshuaj koj noj, nrog rau cov tshuaj kws kho mob, cov tshuaj yuav tom khw, thiab cov tshuaj noj. Piv txwv li:
- Tricyclics tuaj yeem ua rau mob plawv dhia ceev ceev - ua rau lub plawv dhia ceev ceev, phom sij lossis ploj tsis zoo. Cov tshuaj kws ua rua qhov mob zuj zug muaj xwsle amphetamines, tshuaj noj, tshuaj noj, tshuaj noj, hab tshuaj noj ntsws.
- Cov tshuaj tsaug zog, tshuaj tiv thaiv kab mob ntsws, cov leeg mob, cov tshuaj tua kab mob, cov tshuaj tua dej cawv thiab cov dej cawv muaj peev xwm ua rau cov sedative ntawm tricyclics.
Lwm cov yeeb tshuaj uas tuaj yeem tsim teebmeem thaum muaj tus mob tricyclic antidepressants muaj xws li, tab sis tsis txwv rau:
- Cov tshuaj noj hlwb
- Ntshav-thinning tshuaj
- Cov tshuaj rau cov thyroid overactive
- Tagamet (cimetidine)
- Qee cov tshuaj ntshav siab
Thaum kawg, qhov teebmeem loj, kuj yuav tshwm sim thaum muaj cov tshuaj antidepressants tricyclic nrog lwm hom antidepressants uas hu ua MAO ua kom tsis muaj teeb meem , lossis thaum hloov ntawm ib qho mus rau lwm qhov. Noj ob hom tshuaj no ua ke lossis ob lub lim tiam ntawm ib leeg yuav ua rau lub cev kub hnyiab, ntshav siab, qaug zog, thiab tuag. Koj tus kws kho mob yuav muab lawv ua ke, tab sis qhov teeb meem no yuav tsum yog nyob hauv tus kws kho mob ze lub luag haujlwm.
Cov kab hauv qab ntawm Antidepressants
Txawm hais tias muaj ntau yam tshuaj tshiab antidepressant tshuaj uas ua haujlwm rau ntau tus neeg, feem ntau nrog rau cov kev mob tshwm sim, cov tshuaj no tseem muaj feem xyuam hauv kev kho kev nyuaj siab. Yog li, lawv kuj muaj peev xwm tswj tau cov tsos mob ntawm kev nyuaj siab uas tsis tau tswj rau cov tshuaj tshiab. Ntxiv rau, lawv tshwm sim kom muaj lub luag haujlwm nyob rau hauv kev kho mob ntawm tej yam kev mob xws li mob ntev.
Uas hais tias, tricyclic antidepressants yuav tsum tau siv nrog kev ceeb toom rau cov neeg laus vim lawv phiv profile, tshwj xeeb tshaj yog sedative thiab anticholinergic phiv xws li kiv taub hau, qhov muag plooj, thiab cem quav.
Txawm hais yam tshuaj twg uas koj tau hais, nws tseem ceeb heev uas koj yuav tsum koom tus neeg koom tes hauv koj txoj kev kho mob thiab tawm tswv yim rau koj cov kev xav tau kev kho mob. Tham nrog koj tus kws kho mob yog tias koj cov tsos mob tsis nrog koj cov tshuaj, thiab hais txog cov kev mob tshwm sim uas koj tau ntsib. Txhua tus neeg txawv, thiab tib txoj kev uas koj tus kws kho mob paub hais tias koj xav li cas nrog koj cov tshuaj yog tias koj qhia koj cov kev xav. Tej yam mob xws li kev puas siab puas ntsws bipolar thiab kev nyuab siab yog ib qho nyuaj rau kev tswj thiab feem ntau yuav tsum tau qee cov kev ntaus los yog tsis tuaj yeem nrhiav qhov kev kho mob zoo. Tsis tau nrog lub sijhawm, muaj coob tus neeg muaj peev xwm tau txais kev tiv thaiv zoo ntawm lawv cov tsos mob nrog tsawg phiv.
Cov Cim Ceeb Toom Txog Kev Tua Yus Cuas
Nyob rau txhua qhov kev sib tham txog kev nyuaj siab, nws yuav tsum tsis pom txog kev tua tus kheej. Hmoov tsis, kev tua tus kheej thiab kev tua neeg tuag yog nyob deb ntawm cov neeg muaj kev nyuaj siab. Yog tias koj lossis tus neeg koj hlub tau ntsib kev nyuaj siab, kev puas siab puas ntsws bipolar, lossis muaj kev puas siab ntsws, xyuas cov cwjpwm ntawm kev tua tus kheej . Thiab paub tias muaj kev pabcuam sijhawm 24 xuaj moos rau ib hnub, xya hnub ib lim tiam. Hu rau National Suicide Prevention Hotline yog tias koj muaj kev txhawj xeeb txhua.
Qhov chaw:
Aarts, N., Noordam, R., Hofman, A., Tiemeier, J., Stricker, B., thiab L. Visser. Qhia Kev Qhia Tias Yus Tus Kheej rau Kev Siv Tshuaj Antidepressant Siv Hauv Pawg Neeg Nyob Hauv Nruab Nrab ntawm Nruab Nrab Hnub nyoog thiab Cov Laus. Thoob Ntiaj Teb Phau Ntawv Qhia Pharmacology . 2016. 38 (5): 1311-7.
Caldwell, P., Sureshkumar, P., thiab W Wong. Tricyclic thiab Lwmyam Tshuaj Rau Txoj Kev Yooj Yim hauv Menyuam. Cochrane Database ntawm Kev Ntsuam Xyuas Qhov Ntsuas . 2016. 20 (1): CD002117.
Jobski, K., Schmedt, N., Kollhorst, B., Krappweis, J., Schink, T., thiab E. Garbe. Cov Cwj Pwm thiab Tshuaj Yeeb Siv Cov Qauv ntawm Cov Laus Cov Kev Tiv Thaiv Kev Tawm Tsam Lawm hauv Tebchaws Yelemees. European Journal of Pharmacology . 2017. 73 (1): 105-113.