Kodi ketamine ndi 'mankhwala ozunguza bongo'?

Zambiri Zamankhwala

Zikuwoneka kuti sizokayikitsa kuti ketamine, mankhwala osokoneza bongo komanso osangalatsa omwe amadziwikanso kuti Special K, angagwiritsidwe ntchito ngati mankhwala opsinjika maganizo - koma chochokera ku mankhwalawa, esketamine, wavomerezedwa posachedwa ndi US Food and Drug Administration (FDA) ya Matenda osagonjetsedwa. Ndipo kafukufuku akuwonetsa kuti ketamine imatha kukhala yothandiza pakukhumudwa kwakukulu komanso kwakanthawi.

Matenda okhumudwa ndi amodzi mwamatenda omwe amapezeka mdziko muno, omwe amakhudza ena 17.3 miliyoni Akuluakulu aku America, atero National Institute of Mental Health. Zizindikiro zakukhumudwa zitha kuphatikizira izi:

• Kukhalabe wokhumudwa, wopanda chiyembekezo komanso wopanda chiyembekezo
• Kuchepetsa mphamvu, kapena kutopa
• Kusakhazikika
• Zovuta kukhazikika
• Kulakalaka kudya ndi kugona

Anthu omwe ali ndi Matenda osagonjetsedwa , mtundu wa kukhumudwa komwe kumakhalapobe ngakhale kugwiritsa ntchito mitundu iwiri yosiyana ya antidepressants pamlingo wokwanira kwakanthawi kokwanira. Kuphatikiza pakuthandizira kupsinjika kwa mankhwala, ketamine akuyamikiridwa ndi omwe ali m'magulu azamisala monga osintha pochiza kukhumudwa ndi zovuta zina zam'maganizo, monga nkhawa , matenda osokoneza bongo (OCD) , matenda ochititsa munthu kusinthasintha zochitika , ndi post traumatic stress disorder (PTSD) .

Ketamine ndi chiyani?

Ketamine ndi mankhwala osokoneza bongo omwe nthawi zina amagwiritsidwa ntchito ngati mankhwala ochepetsa kupweteka pang'ono. Amagwiritsidwanso ntchito ngati tranquilizer ndi psychedelic club mankhwala. Mankhwala osokoneza bongo amakupangitsani kuti musalumikizane ndi thupi lanu komanso malingaliro anu. Ketamine ali mgulu lomwelo la mankhwala monga phencyclidine (PCP) ndipo atha kukhala ndi zovuta zofananira. Amagwiritsidwa ntchito mobwerezabwereza ngati mankhwala oletsa kupweteka m'zipatala za ziweto ndipo, nthawi zina, m'malo azipatala.

Malinga ndi National Institute on Kugwiritsa Ntchito Mankhwala Osokoneza bongo , poyerekeza kwambiri, ketamine imatulutsa malingaliro ngati maloto ndi kuyerekezera zinthu m'maganizo. M'mlingo wochepa, imatha kusokoneza kukumbukira kwanu, chidwi chanu, komanso luso lanu logwira ntchito. Zotsatira zina zoyipa zimakhudza kuthamanga kwa magazi komanso kupuma.

Ikagwiritsidwa ntchito ngati mankhwala, ketamine amabayidwa mu mnofu kapena kupatsidwa kudzera m'mitsempha. Imalepheretsa olandila a NMDA kuti athandize kuzindikira, ndichifukwa chake imagwiritsidwa ntchito nthawi zambiri popanga opaleshoni. Pogwiritsidwa ntchito mosangulutsa, nthawi zambiri amakola, kusuta, kapena kumeza ndipo nthawi zambiri zimapangitsa munthu kudzimva kukhala wokondwa, wokondwa, womasuka, ndipo nthawi zina amachotsedwa m'matupi awo.

Kodi ketamine imagwiritsidwa ntchito bwanji pakukhumudwa?

Kafukufuku apeza kuti mankhwala a ketamine ndi othandiza polimbana ndi kukhumudwa zomwe zakhala zikulimbana ndi mankhwala opatsirana pogonana, mankhwala olankhulira, komanso mankhwala amagetsi. Malinga ndi kafukufuku waposachedwa mu Zolemba za Care Managed & Specialty Pharmacy , m'modzi mwa anthu atatu omwe ali ndi vuto lalikulu la kukhumudwa (MDD), vuto lokhumudwa kwambiri lomwe limadziwika ndikumverera kosatha kwachisoni, kusowa chiyembekezo, komanso malingaliro ofuna kudzipha, ali ndi kukhumudwa kosagwirizana ndi mankhwala.

Pogwiritsidwa ntchito pochiza kukhumudwa, kuchepa kwa ketamine (kotsika poyerekeza ndi mankhwala ogwiritsira ntchito ochititsa dzanzi) kumaperekedwa m'njira imodzi: mwa kulowetsedwa kapena kupopera mphuno. Zonsezi zitha kuperekedwa kuzipatala kapena m'maofesi azachipatala ndipo zonsezi zimapereka mpumulo mwachangu ku kukhumudwa kwakukulu, ngakhale kuli kofunikira kuti pakhale chithandizo chobwerezabwereza.

Matenda a Ketamine

Racemic ketamine nthawi zambiri imagwiritsidwa ntchito mu infusions. Kusakaniza ketamine kwagwiritsidwa ntchito osalemba kwa kukhumudwa kosalekeza kwa zaka zingapo. Amaperekedwa kuchipatala kudzera pa IV m'manja. Zipatala zina zimakhala ndi akatswiri azaumoyo; ena satero koma adzagwira ntchito limodzi ndi dokotala wanu. Odwala nthawi zambiri amayamba ndikulowetsedwa katatu pasabata ndipo pang'onopang'ono amachepetsa chiwerengerocho mpaka atatsala pang'ono kulowetsedwa pamwezi. Mayeso ang'onoang'ono azachipatala awonetsa kuti kulowetsedwa kwa ketamine kumatha kusintha zizindikiritso zamkati mwa maola awiri kapena anayi, ndikumapumula kwakukulu m'maola 24.

Kupopera kwa mphuno kwa Esketamine

Mu Marichi 2019, a FDA adavomereza esketamine (mankhwala omwe amapezeka mu ketamine) opsinjika ndi mankhwala kwa akulu. Mankhwalawa, omwe amagulitsidwa pansi pa dzinalo Kulondola , amaperekedwa kudzera pamphuno kudzera pa kutsitsi ndipo amagwiritsidwa ntchito limodzi ndi mankhwala opatsirana tsiku ndi tsiku. Kulondola amapatsidwa kawiri mlungu uliwonse kwa milungu inayi yoyambirira, kamodzi pamlungu mwezi wamawa, kamodzi sabata kapena kamodzi pamasabata awiri. Chifukwa cha chizolowezi chomwa mankhwala osokoneza bongo a ketamine komanso kuthekera kwake kuchitira nkhanza-kuphatikiza kukhazikika komwe mankhwalawa amayambitsa-mankhwalawa amangogwiritsidwa ntchito m'malo azachipatala moyang'aniridwa ndi akatswiri azaumoyo. Sichingagwiritsidwe ntchito popita kunyumba. Odwala amadzipatsa okha mankhwala amphuno ataphunzitsidwa ndi akatswiri azaumoyo kenako amayang'aniridwa kwa maola osachepera awiri asanatuluke kuchipatala.

Ngakhale Spravato imagwiritsa ntchito mankhwala ochepa a esketamine, akadali mankhwala amphamvu. Zimabwera ndi Chenjezo Loyeserera pozindikira zoyipa monga kuweruza kolakwika komanso kuvutika kuyang'ana pambuyo poyang'anira. Odwala ndi omwe amawapatsa mankhwala akuyenera kusaina chomwe chimadziwika kuti Fomu Yolembetsa Odwala, ponena kuti onse omwe ali ndi vutoli amadziwa kuti mankhwalawa amachititsa kuti azisungunuka ndipo odwala sayenera kuyendetsa kapena kugwiritsa ntchito makina olemera tsiku lomwe alandire chithandizo. M'malo mwake, odwala amayenera kukwera kunyumba kuchokera kuchipatala komwe amapatsidwa mankhwala. Kuyesedwa kwakanthawi kwakanthawi kwakanthawi kochepa kwapeza kuti mankhwalawa ndi otetezeka, komabe sizoyenera kwa aliyense amene ali ndi vuto losagwiritsa ntchito kuthamanga kwa magazi kapena matenda amitsempha, popeza odwalawa atha kukhala pachiwopsezo chachikulu cha zovuta monga matenda amtima ndi sitiroko. Sitiyeneranso kugwiritsidwa ntchito ndi ana, anthu omwe ali ndi mbiri ya psychosis, amayi apakati, azimayi omwe akufuna kukhala ndi pakati, kapena azimayi omwe akuyamwitsa.

Kuphatikiza pa kukhala wogwira ntchito, Spravato, monga adalowetsa ketamine, yawonetsa kuti ikuchita mwachangu. Pomwe kupsinjika kwachikhalidwe, monga serotonin reuptake inhibitors (SSRIs) Prozac ndipo Lexapro , Zitha kutenga milungu ingapo kuti zigwire ntchito, Spravato imagwira ntchito kuti ithetse kukhumudwa pakangopita maola mpaka masiku. Umenewo ndi mwayi waukulu kwa aliyense amene akuvutika maganizo kwambiri, koma makamaka kwa iwo amene angakhale kuti akudzipha.

Pafupifupi magawo awiri mwa atatu mwa odwala omwe ali ndi vuto lalikulu lachisokonezo amakhala ndi kusintha kwakukhala ndi chizindikiritso patadutsa maola atatu, akuti William Coryell , MD, wolemba wa Mabuku a Merck komanso pulofesa wa zamisala ku University of Iowa's Carver College of Medicine. Kwa ambiri, komabe, zotsatirazi zimachepa kwambiri masiku angapo otsatira. Pachifukwa ichi, mankhwala angapo amagwiritsidwa ntchito ndipo izi zimapindulitsa odwala ambiri.

Dr. Corywell akuchenjeza za kuyesera ketamine yosangalatsayi kuti muchepetse kukhumudwa.Zotsatira za antidepressant zimawoneka kuti zimangogwira ntchito pamlingo winawake wa mankhwala ochepetsa ululu, akuti. Ntchito zosangalatsa zimatha kupitilira izi ndipo pali chiopsezo chachikulu chakuzunzidwa.

Nchiyani chimapangitsa ketamine kukhala yogwira mtima?

Matenda okhumudwa ndimatenda am'magazi omwe amayambitsidwa ndi ma neurotransmitters, omwe amatumiza mankhwala muubongo omwe amatha kuwongolera momwe akumvera, kugona, kapena ntchito zina. Akatswiri sadziwa kwenikweni momwe ketamine kapena esketamine ku Spravato imagwirira ntchito kuti ichepetse kukhumudwa kwakukulu, koma amaganiza kuti itha kukhala ndi chochita ndi momwe amaletsa neurotransmitter glutamate kuti isalumikizane ndi cholandirira china (chotchedwaN-methyl-D-aspartate, kapena NMDA)pamitsempha.Esketamine asanayambe kupezeka, mankhwala omwe amavomerezedwa kuti azigwiritsidwa ntchito ngati mankhwala opatsirana pogonana adayamba chifukwa cha kusintha kwa ma neurotransmitters serotonin, norepinephrine, ndi dopamine, akufotokoza Dr. Coryell. Mosiyana ndi izi, Esketamine, imagwira ntchito makamaka pazotsatira zake pa neurotransmitter glutamate.Ochita kafukufuku akutenga zomwe akudziwa za ketamine ndikuyang'ana njira zomwe angapangire ma glutamate inhibitors omwe alibe zovuta zoyipa za ketamine.

Kodi ketamine ndiyabwino kugwiritsa ntchito kupsinjika ndi nkhawa?

Kugwiritsa ntchito ketamine kwa nthawi yayitali sikunafufuzidwe bwino, koma mgwirizano ndiwoti ndizotheka kugwiritsa ntchito kwakanthawi kochepa. Zotsatira zoyipa, zomwe sizimangodutsa maola ochepa, zimaphatikizapo:

• Kusinza
• Chizungulire
• Nseru
• Kudzipatula
• Kukwera kwa magazi
• Masomphenya olakwika
• Zomverera za thupi, monga kumverera kwachilendo kapena zolanda

Kodi ndingapeze kuti ketamine?

Ngati mukukumana ndi vuto losatha, kukhumudwa kwakukulu komwe sikukusintha ndi mankhwala omwe muli nawo, lankhulani ndi omwe amakuthandizani. Pali zipatala zolowetsa padziko lonse lapansi zomwe zimapereka ketamine ndi lamulo la dokotala, koma izi zimawerengedwa kuti ndizopanda ntchito. Mphuno yotsekemera Spravato ndiye mankhwala okhawo ovomerezeka ndi ketamine omwe amavomerezedwa ndi FDA omwe amapezeka kuti athe kupsinjika ndi mankhwala. Amapezeka kuzipatala zokha komanso kudzera m'maofesi azachipatala-ndipo mtengo wake ndiwokwera, kuyambira $ 600- $ 800 pamlingo umodzi wa ketamine, atero Dr. Coryell. Ma infusions ndi ofanana pamtengo.

Chenjezo lomaliza: Musayese kuchotsa ketamine mumsewu. Ketamine ndi mankhwala olamulidwa ndipo akatswiri azachipatala amafunika kudziwa mlingo woyenera ndikuwunika zomwe zingachitike, zina zomwe zingakhale zoyipa kwambiri.