Tricyclic antidepressants: Ntchito, zopangidwa wamba, komanso zambiri zachitetezo

Zambiri Zamankhwala

Mndandanda wa Tricyclic antidepressants | Kodi tricyclic antidepressants ndi chiyani? | Momwe amagwirira ntchito | Ntchito | Mitundu | Ndani angatenge mankhwala opatsirana pogonana a tricyclic? | Chitetezo | Zotsatira zoyipa | Mtengo

Matenda okhumudwa, omwe amadziwikanso kuti vuto lalikulu lachisokonezo (MDD), zimakhudza pafupifupi 7% ya akulu ku US mchaka chapadera-izi zimamasulira anthu opitilira 16 miliyoni. Matenda okhumudwa ndi omwe amachititsa kuti anthu azilemala ku US kwa anthu azaka zapakati pa 15 ndi 44.

Matenda okhumudwa zimatha kuyambitsa zizindikilo zomwe zimakhala zochepa mpaka zochepa ndipo zimakhudza moyo wanu watsiku ndi tsiku, kuphatikiza kugona, kudya, ndi kugwira ntchito. Kuti apezeke ndi vuto la kukhumudwa, ena mwa awa zizindikiro zaumoyo ayenera kukhalapo kwa milungu iwiri:

• Kudzimva wokhumudwa, wodandaula, wopanda pake, wopanda chiyembekezo, wopanda pake, wokwiya, wosakhazikika, wolakwa, wopanda pake, wopanda chochita
• Kutaya chisangalalo
• Kutopa ndi mphamvu zochepa
• Kuyankhula ndikuyenda pang'onopang'ono
• Mavuto ndi chidwi ndi kukumbukira
• Zosokoneza tulo, monga kusowa tulo kapena kugona kwambiri
• Kulakalaka / kusintha kwa kulemera
• Ululu wopanda chifukwa chakuthupi
• Malingaliro / machitidwe ofuna kudzipha

Anthu ambiri ali ndi ndondomeko yothandiziratu yothanirana ndi kukhumudwa, komwe kungaphatikizepo upangiri ndi mankhwala. Mankhwala osokoneza bongo amalembedwa kawirikawiri (ndi wamisala kapena woyang'anira wamkulu) kuti athetse kukhumudwa.

Tricyclic antidepressants ndi gulu la mankhwala akuchipatala omwe amavomerezedwa ndi a FDA (United States Food and Drug Administration) ndipo amagwiritsidwa ntchito kuthana ndi zofooka. Pitirizani kuwerenga kuti mudziwe zonse za tricyclic antidepressants, kapena TCAs.

Mndandanda wa tricyclic antidepressants
Dzina Brand (dzina generic)	Avereji ya ndalama	Kusungidwa kwa SingleCare	Dziwani zambiri
Anafranil (clomipramine)	$ 360 pa 100, 25 mg makapisozi	Pezani makuponi a clomipramine	Zambiri za Clomipramine
Asendin (amoxapine)	$ 48 ya mapiritsi 60, 25 mg	Pezani ma coupon amoxapine	Zambiri za Amoxapine
Elavil (amitriptyline)	$ 28 kwa mapiritsi 30, 25 mg	Pezani amitriptyline coupon	Zambiri za Amitriptyline
Norpramin (desipramine)	$ 63 pa mapiritsi 100, 10 mg	Pezani makuponi a desipramine	Zambiri za Desipramine
Pamelor, Aventyl (kumpoto chakumadzulo)	$ 43 pa 30, 25 mg makapisozi	Pezani makuponi a nortriptyline	Zambiri za Nortriptyline
ZamgululiSinequan, Silenor, Zonalon (doxepin)	$ 19 pa 30, 10 mg makapisozi	Pezani makuponi a doxepin	Zambiri za Doxepin
Surmontil (trimipramine)	$ 633 kwa 60, 50 mg makapisozi	Pezani makuponi a trimipramine	Zambiri za Trimipramine
Tofranil (imipramine)	$ 28 pa 100, mapiritsi a 10 mg	Pezani makuponi a imipramine	Zambiri za Imipramine
Vivactil (protriptyline)	$ 175 ya mapiritsi 100, 5 mg	Pezani ma coupon a protriptyline	Zambiri za Protriptyline

Kodi tricyclic antidepressants ndi chiyani?

Pali mitundu yambiri ya antidepressants, kuphatikiza ma SSRIs (serotonin reuptake inhibitors osankhidwa) monga fluoxetine, SNRIs (serotonin-norepinephrine reuptake inhibitors), ma TCAs (ofotokozedwa munkhaniyi), antidepressants atypical, ndi MAOIs (monoamine oxidase inhibitors).

Tricyclic antidepressants (TCAs) adayambitsidwa koyamba mu 1959 kuti athetse kukhumudwa. Ma TCA ndi othandiza ngati ma SSRIs odziwika bwino, koma ma TCA amayambitsa zovuta zina ndipo amakhala ndi malire ochepetsa bongo komanso kawopsedwe. Chifukwa chake, ma TCA samasankhidwa ngati chithandizo choyamba cha kukhumudwa. Komabe, amagwiritsidwabe ntchito kuthana ndi kukhumudwa nthawi zambiri, ndi zina zomwe zafotokozedwa pansipa.

Kodi tricyclic antidepressants amagwira ntchito bwanji?

Ma TCA amachita ma neurotransmitters osiyanasiyana kuti athandizire zizindikilo zapanikizika. Amaletsa serotonin ndi norepinephrine reuptake, yomwe imathandizira kukweza malingaliro. Ma TCA amathandizanso pama receptor osiyanasiyana, kuphatikiza cholinergic, muscarinic, ndi histaminergic receptors. Kuyanjana ndi ma receptor awa kumathandizira pazotsatira zoyipa za TCAs.

Ngakhale si chithandizo choyamba cha kukhumudwa chifukwa cha zovuta zawo zambiri, ma TCA atha kukhalabe chithandizo chothandiza kwa odwala ena omwe ali ndi vuto lazovuta kapena zina.

Kodi ma tricyclic antidepressants amagwiritsidwa ntchito bwanji?

Tricyclic antidepressants amagwiritsidwa ntchito kukhumudwa (kusokonezeka kwakukulu, kapena MDD). Ma TCA osiyanasiyana atha kugwiritsidwa ntchito pazizindikiro zosiyanasiyana, ndipo dokotala akhoza kudziwa zambiri zakugwiritsa ntchito kwa ma TCA.

Ma TCA nthawi zina amagwiritsidwa ntchito osalemba pazifukwa zina, monga:

• Migraine kupewa
• Kupweteka kosatha
• Ululu wa neuropathic kapena kupweteka kwa mitsempha (matenda ashuga amitsempha, matenda amisempha)
• Mantha / nkhawa chisokonezo
• Matenda osokoneza bongo
• Kusowa tulo
• Fibromyalgia

Komanso, imipramine imawonetsedwa kuti imachiritsa akumwa m'mabedi mwa ana azaka 6 kapena kupitilira apo. Clomipramine amawonetsedwa kuti amachiza OCD, kapena matenda osokoneza bongo .

Mitundu ya tricyclic antidepressants

Ngakhale ma TCA ndi gulu la opanikizika, amatha kugawidwa m'magulu potengera kapangidwe kake, zochita zawo, ndi zotsatirapo zake. Ma TCA amaonjezera kuchuluka kwa serotonin ndi norepinephrine. Amakhalanso otsutsana ndi alpha cholinergic, muscarinic, ndi histaminergic receptors.

TCA ili ndi mphete zitatu (tricyclic), yokhala ndi amine wachiwiri kapena wamaphunziro apamwamba.

Amine achiwiri

Amine achiwiri amakhudza kwambiri norepinephrine. Izi zikuphatikizapo desipramine, nortriptyline, ndi protriptyline.

Mankhwala apamwamba

Ma amino apamwamba amakhudza kwambiri serotonin. Izi zimaphatikizapo amitriptyline, clomipramine, doxepin, imipramine, ndi trimipramine.

Ndani angatenge mankhwala opatsirana pogonana a tricyclic?

Kodi amuna amatha kumwa mankhwala opatsirana pogonana a tricyclic?

Amuna achikulire amatha kutenga ma TCA, bola ngati sangagwere m'modzi mwamagawo omwe ali pansipa kapena kumwa mankhwala omwe angagwirizane ndi TCA.

Kodi azimayi amatha kumwa mankhwala opatsirana pogonana a tricyclic?

Amayi achikulire amatha kutenga ma TCA, bola ngati atagwera m'modzi mwamagawo omwe ali pansipa kapena kumwa mankhwala omwe angagwirizane ndi TCA. Komabe, ma TCA amatha kuyambitsa zofooka zobadwa nazo, motero azimayi omwe ali woyembekezera kapena kukonzekera kutenga pakati ayenera kufunsa omwe amawapatsa zaumoyo pazokhudza kukhumudwa ndi upangiri wa zamankhwala.

Kodi ana angatenge mankhwala opatsirana pogonana a tricyclic?

Ma TCA ali osagwiritsidwa ntchito kawirikawiri mwa ana ndi achinyamata chifukwa sizothandiza monga njira zina, monga ma SSRIs. Ma TCA amakhalanso ndi zovuta zina kuposa ma SSRIs ndi ma anti-depressants ena.

TCA itha kukhala njira yothanirana ndi kukhumudwa m'badwo uno ngati njira zina sizinagwire ntchito. Komabe, wothandizira zaumoyo yekha ndi amene angadziwe ngati TCA ingakhale yotetezeka, poganizira mbiri yazachipatala ya wodwalayo, zizindikilo zake, ndi mankhwala ena omwe wodwalayo akutenga omwe amatha kulumikizana ndi TCA.

Kodi achikulire amatha kumwa mankhwala opatsirana pogonana a tricyclic?

Ma TCA ali ndi zovuta zambiri zomwe zingakhale zovuta. Okalamba amakhudzidwa kwambiri ndi zotsatirazi. Komanso, achikulire amatha kumwa mankhwala ambiri omwe amatha kuyanjana ndi ma TCA.

Pulogalamu ya Zolinga Za Mowa Pazomwe Mungagwiritse Ntchito Mankhwala Osayenera Mwa Achikulire Achikulire akuti achikulire ayenera kupewa mankhwala opatsirana pogonana a tricyclic chifukwa cha zovuta zina, kuphatikiza chisokonezo, mkamwa wouma, kudzimbidwa, kusungunuka, komanso kuwopsa kwa poizoni. Komanso, orthostatic hypotension (kutsika kwa magazi poyimirira, komwe kumatha kuwonjezera chiopsezo chakukomoka ndi kugwa) ndi chiopsezo.

Kodi ma tricyclic antidepressants ndi otetezeka?

Tricyclic antidepressants akukumbukira

Palibe zokumbukira za TCAs.

Zoletsa za Tricyclic antidepressants

Musatenge tricyclic yodetsa nkhawa ngati:

• Khalani ndi mavuto amtima kapena mbiri yamabanja yamavuto amtima, monga kutalikitsa kwa QT kapena kufa mwadzidzidzi kwamtima
• Wakhala ndi vuto la hypersensitivity ku mankhwala a TCA
• Tengani SSRI, SNRI, kapena MAOI (monoamine oxidase inhibitor) antidepressant-kugwiritsa ntchito TCA ndi MAOI kuyenera kupatulidwa ndi masiku osachepera 14. Kuphatikiza kwa imodzi mwa mankhwalawa ndi TCA kumatha kuonjezera ngozi matenda a serotonin . Mankhwala ena amalumikizananso ndi ma TCA ndikuwonjezera chiopsezo cha matenda a serotonin, chifukwa chake onaninso bwino mankhwala anu.
• Khalani ndi khungu lotseka khungu
• Khalani ndi mbiri yakugwa
• Khalani ndi vuto pokodza
• Khalani ndi mavuto a chiwindi

Musamwe mowa mukatenga TCA. Kuphatikiza kwa TCA ndi mowa kumatha kukulitsa zovuta zina ndikupangitsa zowonjezera. Zotsatirazi zimatha kuphatikizira kupuma (kupuma kumatha kuchepa kapena kuyimilira) komanso kupsinjika kwamitsempha yapakati (CNS), komwe kumatha kuyambitsa chizungulire, kuwodzera, komanso kufooka.

Ma antidepressants onse, kuphatikiza ma TCA, ali ndi chenjezo lakuda , ndilo chenjezo lamphamvu kwambiri lofunidwa ndi FDA. Ma anti-depressants atha kubweretsa chiopsezo chowonjezeka chodzipha ndi malingaliro. Ngakhale izi zimachitika kwambiri mwa ana, achinyamata, komanso achikulire, anthu onse omwe amamwa mankhwala opatsirana ayenera kuyang'aniridwa mosamala pakusintha kwamakhalidwe ndi malingaliro ofuna kudzipha.

Chifukwa ma TCA sagwirizana ndi zovuta zina zamankhwala kapena mankhwala, onetsetsani kuti mwalankhula ndi dokotala. Uzani dokotala wanu za zamankhwala zomwe muli nazo komanso mankhwala omwe mumamwa kuti athe kuwunika momwe angayendere ndi mankhwala. Onetsetsani kuti muphatikize mankhwala onse akuchipatala, owonjezera mavitamini ndi zakudya.

Kodi mungamwe mankhwala opatsirana pogonana a tricyclic muli ndi pakati kapena mukuyamwitsa?

Ma TCA sakhala otetezeka panthawi yapakati. Zitha kuvulaza mwana wosabadwayo mwa mawonekedwe a diso, khutu, nkhope, ndi khosi. Clomipramine yakhala ikugwirizananso ndi zolakwika za mtima. Funsani akatswiri azachipatala anu kuti akupatseni upangiri wa zamankhwala okhudzana ndi ma TCA ndi kuyamwitsa.

Kodi tricyclic antidepressants imayang'aniridwa ndi zinthu?

Ayi, mankhwala opatsirana pogonana a tricyclic sali zinthu zolamulidwa .

Zotsatira zoyipa za tricyclic zodetsa nkhawa

Ma TCAs si chisankho choyamba chamankhwala opsinjika chifukwa amayambitsa zovuta zina. Pomwe zotsatira zoyipa Zimasiyana mosiyanasiyana ndi mankhwala komanso payekha, zina mwazovuta zoyipa za tricyclic antidepressants ndizo:

• Chizungulire
• Kukhazikika
• Kudzimbidwa
• Pakamwa pouma
• Masomphenya olakwika
• Kusokonezeka
• Kusunga kwamikodzo
• Kuthamanga kwa mtima
• Kuthamanga kwa magazi mukayimirira kuchokera pansi kapena pansi (orthostatic hypotension)
• Kuchuluka kwa njala ndi kunenepa

Chifukwa ma TCA amatha kuyambitsa mavuto amtima, adotolo amayang'ana mtima wanu asanalembe TCA. Ma TCA amatha kuyambitsa zovuta zina monga

• Kutalikitsa kwa QT
• VFib
• Imfa yadzidzidzi yamtima (mwa odwala omwe ali ndi matenda amtima omwe alipo)

Zomwe zimayambitsa ma TCA ndizochepa. Ngati mukumva zizindikiro zosafunikira monga ming'oma, kupuma movutikira, kapena kutupa kwa nkhope, milomo, kapena lilime, pitani kuchipatala mwadzidzidzi nthawi yomweyo.

Ili si mndandanda wathunthu wazotsatira. Zotsatira zina zoyipa zimatha kuchitika. Lankhulani ndi dokotala wanu za zovuta zomwe mungayembekezere kuchokera ku chithandizo cha TCA.

Kodi tricyclic antidepressants amawononga ndalama zingati?

Tricyclic antidepressants ndiotsika mtengo kwambiri, makamaka popeza amapezeka mu mawonekedwe achibadwa. Inshuwaransi zambiri zimaphimba ma TCA mu mawonekedwe achibadwa. Mutha kugwiritsa ntchito yaulere Khadi la SingleCare kusunga mpaka 80% pamankhwala opatsirana pogonana a tricyclic, ndi mankhwala ena azamankhwala ndi ma Refill, kuma pharmacies omwe akutenga nawo mbali.