Chizvarwa ichangobva pakati Anti-kuora mwoyo. Antidepressants: Ndezvipi zviri nani? Anodzokorora vanachiremba mitengo

Nhasi, kuora mwoyo hakugadziri vanhu vakuru chete, asiwo vana nevechiri kuyaruka. Ichi chirwere uye nzira dzokugadzirisa nayo zvinopihwa kune dzakawanda tsvakurudzo dzevanyori uye nhamba yakawanda yezvinyorwa nemabhuku. Kana iwe ukashandura kubva "nesayenzi" kune mutauro wakawanda, kuora mwoyo ndiko kurashikirwa kwesimba uye chido chokurarama. Zviratidzo zvechirwere ichi hazvibatsiri uye nguva dzose zvinotyisa, kushushikana uye kuneta, kutadza uye kuora.

Mazuva ano mishonga yemapurisa inopa vanodzvinyirira vechizvarwa chekupedzisira kurwisana nechirwere ichi. Ndezvipi zvizvarwa zve thymoleptics (izvo zvinonzi zvinoreva kushanda pakurwisana nekuora mwoyo) zviriko nhasi, chii chavari pamwe uye kuti chakasiyana sei kune mumwe, chii chinoshandiswa pakuita kwavo? Iyi nyaya nezvimwe zvichakurukurwa munyaya yawakatumira.

Ndezvipi zvinorwisa zvinodhaka?

Aya ndiwo mishonga, zvichiita kuti zvigone kuderedza zviratidzo uye kunyange kudzivirira kuora mwoyo. Nzira huru yekuita kwavo inangwa yekugadzirisa basa rehupenyu hwehuropi hwehupi hwehupi. Nhengo dzemasero, zvikamu zvaro, dzinogara dzichibatanirana nemhando dzakasiyana-dze-neurotransmitters. Maererano nedzidziso imwechete, kushungurudzika kwepfungwa kunoitika apo, muuropi, nokuda kwezvikonzero zvakasiyana-siyana, uwandu hwomurevereri kana kuti biogenic amine zvakaderedzwa zvikuru: dopamine, norepinephrine, kana serotonin. Zvinodzvinyirira zvechizvarwa chekupedzisira, pamwe chete nevose vakambotanga, vane gadziriro yekugadzirisa nekugadzirisa zvirongwa zvehupenyu hwehuropi kuburikidza nekuchinja huwandu hweimwe kana imwe biogenic amine.

Ndezvipi?

Mukuwedzera kune chokwadi chokuti mazuva ano zvinodhaka zvinopesana nazvo zvinobatsira kutsungirira zviratidzo zvekuora mwoyo, dzinowanzoshandiswa kubvisa matambudziko akadaro:

• Marwadzo akasiyana-siyana ezvisizvo zvisingazivikanwi;
• Vanoshayiwa chido kana kurara;
• Kunyanya kuneta kana kurasikirwa kwesimba;
• Kutya kana manzwiro ekunyanya kunetseka;
• Kutya kwekutya kana kufunganya;
• Matambudziko ekufungidzirwa kana kuyeuka.

Zvizvarwa zvevanhu vanodzvinyirira

Usati watarisa kuti zvizvarwa zvakadini zvemishonga inopesana nokuora mwoyo zvakasikwa nhasi, zvakakosha kuyeuka kuti zvinodzvinyirira zvakawanikwa chete pakati pezana remakore rechi20. Kusvika iye zvino, zvichienderana nenguva yezvakagadzirwa uye kutanga kwekushandisa mumakiriniki ekuita, pamwe chete nekuita kwevanhu vanorwisa mweya, ndiyo tsika yekupa zvizvarwa zvina zvemishonga iyi.

Kugadzirira kwechizvarwa chokutanga

Chizvarwa chekutanga, chakawanikwa mumakore makumi mashanu ezana remakore rapfuura, chinomiririrwa ne tricyclic thymoleptics yecclic action (TCA). Zvinosanganisira mishonga yakadaro: "Amitriptyline" (antidipressant, iyo yekutanga yekuti yakazaruka) uye zvigadzirwa zvayo, uyewo magadzirira "Nefazodon", "Anafranil" uye "Melipramine." Izvi zvinokonzera reuptake ye norepinephrine, zvichidaro zvichiwedzera kuiswa kwayo. Zvisinei, maTCA akavharidzirwa kwete norepinephrine (norepinephrine) chete, asi dzimwe nhengo dzese dzeurotransmiteri dziri munzira dzavo, izvo zvakatungamirira kuwandu hwakawandisa hwemigumisiro yakaipa, kunyanya yakadai sokukwira kwakasimba kwehutano hweropa uye kuwedzerwa kwemaitiro emwoyo. Kugadzirira kweboka iri kunonyanyisa, uye mikana yekuwedzerwa kudarika mumashandisirwo avo yakakwirira kwazvo, ndicho chikonzero ivo vashoma chaizvo vanoshandiswa mukurapa kushungurudzika kwemazuva ano nhasi.

Mukuwedzera, chizvarwa chokutanga chezvinodhaka izvo zvisingashandiswi nhasi, zvine irreversible monoamine oxidase (MAO) inhibitors, iproniazide, Tranylcipromin, Isocarboxazide. Chiito chavo chinoenderana nekudzingwa kwebasa rekushongedzwa kwemagunha emakumbo europi, sechikonzero chekusungirwa kwe serotonin uye norepinephrine kuwedzera.

Chizvarwa Chechipiri Mishonga

Chizvarwa chechipiri, kusiyana nekutanga, chinosarudzwa, asi chinopera simba pamadziro eurotransmitter uye neurons ivo pachavo. Inosanganisira tetracyclic isinganzwisisiki (MAO-B) uye inoshandiswa (MAO-A) monoamine reuptake inhibitors, inomiririrwa nemishonga yakadai se "Lerivon", "Ludomil", "Pyrazidol" nevamwe. Pamusana pekuti ivo pavakatorwa, zvakawanda zvakakomba migumisiro yakaitika, uyewo nekuda kwekubatana nemishonga yakasiyana siyana uye kusagadziriswa kwemigumisiro, zvinodhaka zveboka iri zvinoshandiswa zvakanyanya zvishoma. Mu pharmacy zvinenge zvakaoma kuwana vanodzvinyirira kubva muboka re monoamine reuptake inhibitors. Asi mune dzimwe nguva vanowanikwa pasi pemamwe mazita ekutengeserana. Saka, nyanzvi dzinotaura kuti mishonga "Ludomil" ndiyo mahwendefa mamwechete "Maprotiline", mutengo, muiti uye nyika ndeyevo chete.

Chizvarwa chechitatu

Vatsvakurudzi vemazuva ano vakaona kuti vanenge vanopindirana makumi matatu vanobatanidzwa mubasa reuropi uye nervous system, asi vatatu chete avo vanobatanidzwa mukuora mwoyo: serotonin, dopamine uye norepinephrine (norepinephrine). Chizvarwa chechitatu chinosanganisira serotonin reuptake inhibitors (SSRIs), inomiririrwa neanowanzoshandiswa mazuva ano ekurwisa mweya, zvakadai saZoloft, Citalopram, Prozac, Cipralex, Paroxetine, Plizil, nezvimwewo. Iyi mishonga inodzivirirwa kwete vatsigiri vose, asi chete-serotonin. Nokumanikidzwa kwehutachiwana, ivo vari pasi pezvizvarwa zvinotanga kushandiswa kwemishonga, asi vane zvishoma zvinogadzirisa kupfuura zvimwe zvinotangira. Mishonga yose yeSSRI inobudirira zvikuru uye inofanira kuregererwa nevarwere zvese zvakaenzana. Zvisinei, pane mumwe nomumwe wedu muviri une maitiro ake pachawo, uye ndeyekuti iyo nhamba uye simba remigumisiro ichave yakasiyana pane imwe neimwe. Vanachiremba vanotaura kuti migumisiro yakawandisa yakawandisa yakawanda yekutsvaga chizvarwa chechitatu chemishonga kusuruvara, chirwere, neusea nekuzvidya mwoyo.

Mariro yeSRRIs inodhura zvikuru. Saka, nokuda kwechirwere chinonyatsozivikanwa uye chakashandiswa zvikuru "Tsitalopram", mutengo mu pharmacy, zvichienderana nechitarisiko chiri pasi parinobudiswa, chinogona kusiyana kubva pa870 kusvika 2,000 rubles.

Anodzvinyirira zvechizvarwa chechina

Zvinosanganisira zvinodhaka zveboka reSIOZSiN (selective inhibitors reuptake ye serotonin uye norepinephrine). Izvi ndizvo zvinotapukisa zvechizvarwa chekupedzisira, zvakadai semishonga "Simbalta", "Milnacipran", "Remeron", "Efferor", iyo inodzivisa kubatwa kwe norepinephrine uye serotonin. Kugadzirira "Zyban" uye "Velbutrin" havabatanidzi neserotonin, asi vanochengetedza dopamine uye norepinephrine. Kuburikidza kwemishonga inonzi yeboka iri yakatanga chete pakati pemakore makumi mapfumbamwe nemazana emakore ekupedzisira, uye gore roga roga kune mishonga yakawanda uye yakawanda.

Vanachiremba havagoni kutaura zvakananga kuti iri muboka iri kuti kune zvakanakisisa zvinodhaka, zvinenge zvisingabviri, nokuti pakurapwa kwemarudzi akasiyana-siyana ekudengenyeka kwepfungwa, mishonga inosarudzwa mumwe nomumwe, ichifunga nezvehutano hwehutano hwemumwe murwere.

Inozivikanwa mazuva ano timolesterics

Kuziva zvinokonzerwa nemishonga yezvinodhaka zveboka iri mumutambo wenheyo, inofanira kuyeukwa kuti zvose zvinokwanisika - zvose zvakanaka uye zvisina kunaka - migumisiro ichave yakatarisika uye inongororwa chete nemunhu anokwanisa-chiremba. Zvichipa zvose zvakasarudzika uye kufungidzira, ndiye chiremba anokwanisa kunyatsorongedza avo vanodzvinyirira avo vanonyatsokwanisa kubatsira munyaya yako, neine madhara. Muchiitiko chekuti pane matambudziko apo paunotora mishonga yakatemwa, ndiye chiremba anotarisira uyo achakwanisa kugadzirisa kana kushandura regimen yerapa. Nhasi, vashandi vakawanda vanotaurira kuvarwere vane kushungurudzika kwezvinodhaka zvinodhaka kubva muboka reSerotonin uye norepinephrine reuptake inhibitors, izvo zvinobudirira izvo zvakaedzwa muitiro. Mishonga yakadai saMilnacipran, Fluxen (Fluoxetine), Duloxetine, Velaxin (Venlafaxine) ndiyo inonyanya kuenzaniswa uye inoshandiswa zvakanyanya kushandiswa kwezvinorwara zvechizvarwa chezvino. Chimbofunga zvakanyanya kufanana mukurapa kushungurudzika kwekutambudzika kwema timoleptics.

Mushonga we "Flucosetin"

Izvi zvinodhaka ndeimwe yevamiriri vekutanga veboka reSSRI, rinosanganisira zvose zvinorwisa zvinodhaka uye zvinokurudzira. Mushonga we "Fluxen", inonzi antidepressant "Fluoxetine", inobatsira kuderedza kuzvidya mwoyo uye kushushikana, kunoderedza kunzwa kwekutya uye kunowedzera mafungiro. Kunyanya kushandiswa, mukufunga kwekuita masayendisiti, munyaya dze asthenic kushushikana kwekutambudzika nekusava nehanya, uye pamwe nokuora mwoyo kwekusiyana kwakasiyana uye zvinyorwa zvisingatauriki. Izvi zvinoshandiswawo mukurapa bulimia. Anodzvinyirira Fluoxetine yakatanga kunyorerwa muna 1974 muUnited States, uye mumakore gumi apfuura yakauya pakutanga kunotengeswa muUnited States, kunze kweimwe zita rimwe rekutengeserana - Prozac. MuRussia, iyi mishonga inowanzoshandiswa, uye vashandi vakawanda vanosimbisa kuti ndeye murwere kana kuti ma generics avo vanopiwa kuvarwere vari pasi pemamiriro ezvinhu akasiyana-siyana.

Mushonga we "Paroxetine"

Uyu ndiye mumiriri akasimba weboka re selective inhibitors yekusarudza kushandiswa kwe serotonin, iyo inowanzoshandiswa mukurapa kushungurudzika uye kuora mwoyo. Nhasi mishonga, iyo inoshandiswa inoshandiswa iyo iyo paroxetine, yakawanda kwazvo. Iyi ndiyo mishonga yeRussia "Adeptress" kubva ku "Veropharm", chirwere "Plizil" kubva kuCroatia kambani yePliva, mapiritsi eHungarian "Reksetin" kubva kuna Gedeon Richter nevamwe vakawanda. Pasinei nezita rechirwere "Paroxetine", kuongororwa pamusoro paro, zvose muvarwere uye vanachiremba, vanonyanya kunaka.

Mishonga yekugadzirira "Velbutrin"

Zviri nani kuzivikanwa se "Ziban" kana "Know-Smok". Nhengo inoshandiswa yemishonga yose mitatu ndeye bupropion hydrochloride, iyo inowedzera kuwanda kwedopamine uye norepinephrine muuropi. Zvinodhaka nezvipembenene izvi zvinoshandiswa kwete kungogadzirisa zviratidzo zvekuora mwoyo, asiwo zvinobatsira kukunda migumisiro yepfungwa yekurega nicotine. Mushonga uyu unowedzera mafungiro uye unowedzera kugona. Kuongororwa kwevaya vakabvisa nicotine kukanganisa nemishonga yakadai saVelbutrin, NoemSmok naZiban, vataure nezvekushanda kwakanyanya kwemishonga iyi panguva yekurega.

Mushonga we "Simbalta"

Chirwere chechizvarwa chechina chezvinodhaka, izvo zvinodzivisa kuwedzerwa kwe norepinephrine uye serotonin, zvichiitika zvinotakura kubata zvishoma kwe dopamine. Ichi chemishonga, iyo inoshandiswa inoshandiswa iyo inonzi duloxetine, inopesana chaizvo, kana ichienzaniswa nedzimwe mishonga inorwisa zvirwere, kukurumidza kwekuita. Maererano nezvose vanachiremba nevarwere, kujekesa kwakasimba kwekudzivirira kunoratidzwa nekuguma kwekutanga-kutanga kwevhiki yechipiri yekugamuchirwa. Mukuwedzera, ichi chinodhaka chinoratidzirwa nekufananidzwa kwechiito uye nekushandiswa kwayo. Zvisinei, kune boka revarwere, maererano nekudzokorora kwechiito chemuti uyu, kana zvichiitika, chakanyanya kusimba. Sezvatotaurwa, humwe humwe hunhu hwemaitiro ehupenyu hwemagetsi hunowanzoita kuti mumwe kana mumwe mishonga inorayirwa nachiremba angasave nemugumisiro unotarisirwa.

Zvinodhura zvakadini?

Mazuva ano zvakaoma kutaura pamusoro pemitengo yemishonga. Izvi zvinokonzerwa nekuti yemusika wemari hauna kunyatsogadzikana, uye mishonga inodzvinyirira itsva inowanzobva kune vatorwa vokunze avo vane mutengo uri muEuro. Ndicho chikonzero tafura iri pasi apa inoratidza huwandu hwepamusoro uye huwandu hwekutengeswa mumaruble, sezvo zvisingakwanisi kuenzana navo. Mimwe yemishonga yakagamuchirwa kare inotengeswa pamatengo ekare, uye mitsva inowanikwa yakawanda inodhura.

Kana kuona tafura nokungwarira, uchaona kuti haana wechipiri-chizvarwa madhiragi, kureva MAOIs (monoamine reuptake FIs). Iyi haisi chikanganiso. The ndechokuti antidepressants izvi zvakawanda kusingafadzi nemishonga uye kusapindirana zvinodhaka vakawanda havasi kushanda kushandiswa munyika dzokuEurope. The US kashoma kushandiswa mishonga "isocarboxazid" "Ugenelzin" uye "tranylcypromine," uye munyika yedu - mushonga "Nialamide". Zvose pamusoro mishonga dziripo chete pasi pokudzora nenyanzvi chepfungwa.

tafura Izvi zvinoratidza pachena kuti "chaiwo" tricyclic antidepressants mutengo yekudyidzana kuvatumwa mishonga vatsva vari SSRI uye SIOZSiN. Saka, kutaura pamusoro soro Kuwanikwa inoshanda antidepressant mishonga kuti vakawanda vemo hatifaniri. Zvisinei, chiremba anogona kubatsira kusarudza kudhura mushonga zvakafanana ehupfumi, anonzi Generic.

Kudyidzana nevamwe zvinodhaka

Antidepressants ingashanda nevamwe zvinodhaka, kunyange avo dzinoita tive vakachengeteka uye toziva. The kupfuura achishingaira ichi neruremekedzo timoanaleptiki tricyclic uye monoamine oxidase FIs, asi kugadzirira mapoka SSRIs uye SIOZSiN kashoma kushamwaridzana nevamwe mishonga. Chero zvazvingava, kana chiremba prescribes iwe chero mishonga kuti mwoyo, iva nechokwadi kuti uzive kana iwe unogona chokubatanidza kugamuchirwa kwavo nokushandiswa nemimwe mishonga, Mishonga zvokuwedzera, uye kunyange teas uye mishonga infusions.

Alcohol uye antidepressants

Sezvo chinoshamisa sezvachinonzwika, asi vanhu vakawanda vanoda kubvuma timoleptikov zvikonzero zvakasiyana-siyana, kubvunza kakawanda sei zvinoita nokubatanidza nzira zvinwiwa "doro" uye mahwendefa nokuora mwoyo. Kuti tipindure mubvunzo uyu nyore: Kana uchida kutora ngozi dzavo hwepfungwa uye utano, uye zvichida upenyu, edza nayo! Chokwadi kuti doro uye Anti-kuora mwoyo vane chakakomba zvainoita nechepakati tsinga uye uropi, uye ichi kumanikidza kaviri zvinogona kukanganisa zvose "Mission Control Center", kureva, uropi uye nhengo uye mugadziriro rikaudza pake. Kana kwete chokubatanidza - kusarudza kubvuma iwe uye chete iwe.

pachinzvimbo mhedziso

Hazvina zvakafanira kufunga uye "mutsimba" pamusoro, antidepressants vane nani uye tibudirire. Kana uchifunga kuti mumwe zuva kunova kuoma kurarama pane yapfuura mumwe, simba hakuna kukwana kunyange kupfuura nyore uye zvisingakoshi, bvunza nyanzvi! chiremba wako anogona kuziva mamiriro ako uye varayire anodiwa kurapwa, kusarudza zvakakodzera zvikuru nemishonga kwamuri. Haikwanise chete kuva Anti-kuora mwoyo. Arsenal mushonga yanhasi rakanyatsojeka rakakura: rakasiyana-siyana psychotherapy, kurovedza muviri uye jekiseni, kufema unyanzvi uye mumuviri kurapa.