Cov tshuaj siv rau lub sijhawm luv thiab ntev mus yuav raug siv rau kev ntxhov siab
Yog tias koj muaj kev meem txom siab ntsws (GAD) koj yuav tau txais kev sib tham txog kev sib tham thiab kev kho tshuaj. GAD yog cov tsos mob ntawm kev mob , kev txhawj xeeb thiab kev nyuab siab uas tsis muaj qhov tsis zoo los yog ntau dua li qhov kev txhawj xeeb ntawm neeg feem coob. Cov kev tshawb fawb tau pom tias ntau li 60 txog 65 feem pua ntawm cov neeg mob GAD kuj muaj lwm yam kev puas siab puas ntsws nrog nws-feem ntau zaus ua ke ntawm kev puas tsuaj thiab kev nyuab siab loj .
Kev kho rau GAD tam sim no muaj benzodiazepines, antidepressants, thiab azapirones.
Benzodiazepines
Benzodiazepines yuav pab txo kom txhob muaj kev phom sij thiab phobic tus cwj pwm , nrog rau lub sij hawm anticipatory ntawm ceeb ntshai . Lawv siv los kho cov tsos mob ntawm GAD rau ib lub sij hawm luv luv thaum cov antidepressants noj tshuaj. Cov tshuaj hauv hoob no muaj xws li Klonopin (clonazepam), Ativan (lorazepam), thiab Xanax (alprazolam).
Thaum lub sij hawm benzodiazepines ua sai sai, kwv yees li ib nrab ntawm cov neeg mob tau tshem tawm cov tsos mob thaum tshem tawm ntawm cov tshuaj thiab ntau cov kws kho mob ntseeg tau hais tias cov neeg mob uas txais lawv yuav tsim muaj kev kam rau tshuaj. Thaum cov tshuaj antidepressant noj tshuaj, cov tshuaj benzodiazepine tsawg dua qeeb kom txog thaum nws nres tau zoo.
Benzodiazepines ua rau ua kom loog thiab tej zaum kuj nce ntog, thiab ua rau muaj kev ntxhov siab thiab kev nco teeb meem hauv cov laus. Ib tug neeg ua haujlwm nrog cov tshuab hnyav kuj yog ib tus neeg tsis muaj npe.
Lub keeb kwm ntawm kev haus cawv lossis kev quav yeeb tshuaj yuav yog ib qho kev siv contradindication rau benzodiazepine.
Antidepressants
Muaj ntau chav kawm ntawm antidepressants uas siv tau los kho GAD. Cov tshuaj no tuaj yeem siv lis piam mus siv tau. Vim hais tias antidepressants ua qeeb qeeb dua benzodiazepines, feem ntau lawv tau sau nrog ib lub tshuaj benzodiazepine thaum pib kho thawj zaug.
- Xaiv Serotonin Reuptake Inhibitors (SSRIs): Chav kawm no muaj xws li Lexapro (escitalopram), Paxil (paroxetine), Prozac (fluoxetine), thiab Zoloft (sertraline). Cov kev mob tshwm sim ntawm SSRIs yog cov mob hnyav dua li cov neeg ntawm Tricyclic antidepressants (TCAs). SSRIs ua rau cov kev mob plawv tsis zoo thiab tsawg dua qhov hnyav nce thiab sedation dua li cov TCAs.
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) : Chav kawm no muaj xws li Cymbalta (duloxetine) thiab Effexor (venlafaxine), uas yuav siv tau rau GAD. Lawv pom tias zoo li SSRIs thiab yog thawj qhov kev kho mob rau GAD.
- Tricyclic Antidepressants (TCAs) : Tofranil (imipramine) feem ntau siv los kho kev ntxhov siab. Lwm yam tshuaj muaj yees siv uas tau pom tias yuav ua rau kev kho mob tsis zoo yog Pamelor (nortriptyline), Norpramin (desipramine), thiab Anafranil (clomipramine). Tricyclics, tsis zoo li benzodiazepines, yuav tsum tau tsuas yog ib zaug txhua txhua hnub ntawm cov tshuaj. Lawv zoo kawm thiab pab tiv thaiv kev nyuaj siab, uas feem ntau tuaj yeem ua rau muaj kev ntxhov siab. Txawm li cas los xij, TCAs yuav ua rau muaj kev xav zoo ib yam li ceeb ntshai . Cov neeg mob uas muaj kev ntxhov siab yog feem ntau heev rau cov xwm txheej tricyclics; ib txhia yuav muaj kev ua kom (kev ntxhov siab, kev tsiv siab, thiab kev pw tsis tsaug zog) thaum pib kev kho mob. Feem ntau, kev kho mob nrog ib tug TCA pib nrog ib koob tshuaj tsawg dua uas tau nce lub sijhawm. Qee lub clinicians qhia tias tus neeg mob phua lub koob tshuaj, feem ntau ntawm cov tshuaj noj ua ntej yuav mus pw, yog li ua rau muaj ntau cov kev mob tshwm sim thaum tus neeg mob pw tsaug zog. Ib qho kev tsis zoo ntawm tricyclics yog tias lawv qee zaum ua rau cov kev mob plawv (xws li kiv taub hau thiab plawv palpitations) nrog hnyav nce thiab sedation.
- Monoamine Oxidase Inhibitors (MAOIs) : Cov tshuaj no tau pom tias zoo heev rau kev kho mob ntawm kev ntxhov siab, xws li ntshai tsis meej thiab kev phobia . Muaj, txawm li cas los xij, tej yam kev phom sij ntawm cov tshuaj no. Cov neeg uas noj cov tshuaj MAOIs yuav tsum muaj kev txwv tsis pub noj haus vim yog cov tshuaj hu ua tyramine uas muaj nyob hauv cov khoom noj. Kev sis raug zoo ntawm tyramine thiab MAOIs tuaj yeem precipitate hypertensive teebmeem los ntawm kev ua kom pom ntxiv nyob rau hauv ntshav siab.
Azapirones
Buspirone kuj tseem siv tau los kho GAD. Lub npe ntawm BuSpar yog tsis nyob rau hauv lub khw, tab sis cov generics kuj muaj.
Buspirone qeeb ua rau qeeb thiab xav tau ob peb lub lis piam mus noj tshuaj. Buspirone tsis ua kom zoo li lub benzodiazepines thiab nws tsis ua rau kev quav tshuaj yeeb.
> Qhov chaw:
> Kev ntxhov siab vim: Cov Hom Tshuaj, Kev Ntses thiab Kev Kho Mob. NIH MedlinePlus. https://medlineplus.gov/magazine/issues/summer15/articles/summer15pg6-8.html.
> Kev Txhawj Xeeb Kev Puas Siab Ntsws: Thaum Muaj Kev Nyuaj Siab Tshaj Tawm. Lub Koom Haum Lub Tebchaws ntawm Kev Puas Siab Puas Ntsws. https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad/index.shtml.
> Greist JH. Generalized Kev Puas Tsuaj Siab (GAD). http://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/generalized-anxiety-disorder-gad#v1025319.
> Tshuaj. Ntxhov Siab thiab Kev Ntxhov Siab Txog Tebchaws Meskas. https://www.adaa.org/finding-help/treatment/medication.