Uma ungazi ngalesi sikhathi, ubuhlungu nokucindezeleka kuyahlobene kakhulu. Ngokwe-athikili eyanyatheliswa ku- US Pharmist ngo-2009, izimpawu zale mibandela emibili ziyaqhubeka. Lesi sihloko sibika ngemininingwane evela ku-National Health and Nutrition Examination Survey III ekutholeni ukuthi kufike ku-10% wabantu abacindezelekile okuhlangenwe nakho, okuyi-90% okubika ukuthi banezinhlungu.
Lesi sihloko siyaqhubeka sithi isisekelo sezinto eziphilayo sokucindezeleka singumdlali ongaba yilokho okubhekene nobuhlungu obungapheli. Ngenxa yalesi sizathu, izidakamizwa zokucindezeleka zingenza uhlobo oluphumelelayo lwemithi yezintambo ezingapheli noma ubuhlungu bokubuyela emuva.
Eqinisweni, izidakamizwa ezidinga ukucindezeleka ziye zafakazelwa ngempumelelo ezinhlobonhlobo ezihlukahlukene zobuhlungu obungapheli, kuhlanganise nosizi lwezinzwa, ubuhlungu bomzimba obuhlobene nokucindezeleka, kanye ne-fibromyalgia, ngokusho kwalesi sihloko. Abalobi bathi amakilasi ahlukene e-antidepressant ayasebenza ngezinhlobo ezahlukene zobuhlungu.
Izinhlobo ze-tricyclic anti-depressants ezichazwe ubuhlungu be-nerve zihlanganisa amitriptyline, nortriptyline, desipramine, kanye nezinkinga zokucindezeleka zinoveli bupropion, venlafaxine, ne-duloxetine (igama lohlobo lwe-Cymbalta.)
Mayelana ne-Tricyclic Antidepressants
I-Tricyclic anti-depressants yilasilasi lemithi elamukelwe yi-FDA yokuphatha ukucindezeleka. Nakuba i-FDA ingabamukeli njengokwelashwa ubuhlungu, odokotela ngezinye izikhathi bayayibhalela ngalolu hlelo noma kunjalo. (Lokhu kubizwa ngokuthi yi- off-label echaza). Uma izidakamizwa zokudambisa izidakamizwa zithathwa ngenxa yobuhlungu bezinzwa , zifana ne- adjuvant , okungukuthi, kuya kumtholampilo omkhulu wemithi
Uma uthatha i-tricyclic anti-depressant ngenxa yobuhlungu, i-dose yakho cishe izobe isezansi kunokuthi uyithatha ukucindezeleka.
Okuqhamuka uma udla imishanguzo
Izinhloso ze-tricyclic anti-depressants azigcini ekucindezelekeni nasebuhlungu. Lezi zidakamizwa zithinta inani lezinhlelo zomzimba. Ngenxa yalokhu, uhla lwemiphumela emibi ingenzeka.
Imithelela emibi ingase iphathwe (umlomo owomile, ukuqothulwa, ukulala) noma ukungathí sina (ukushaya kwenhliziyo okusheshayo, ukuhlukumeza kwe-glaucoma, ingozi eyengeziwe yokwehluleka, ukubiza abambalwa.) Kubalulekile ukuthi uxoxisane ngobuqotho nodokotela wakho nganoma yikuphi nezinye izimo ongase ube nazo ukuze akwazi ngokunquma ukuthi lolu hlobo lwemithi yobuhlungu lungcono yini kuwe.
Njengoba kushiwo ngenhla, amanye ama-anti-depressants amanoveli asebenza kahle ekulawuleni ubuhlungu be-back neuropathic . Izindaba ezinhle ukuthi zingase zibe nemiphumela emibi kakhulu kunezinye izinhlobo ze-tricyclic anti-depressants. Ngokwehla, amanye ama-antidepressionants amanoveli ahloswe kakhulu ekusebenzisaneni kwamakhemikhali okuhlobene nokucindezeleka, ngaphandle uma ubuhlungu bubangelwa inkinga engokwengqondo engaphansi, lezi zidakamizwa zingase zingasebenzi ekunciphiseni.
Ebizwa nangokuthi imithi yokulwa ne-anti-seizure, ezinye izinhlobo zemithi ehlunguzayo e- adjuvant esetshenziselwa ukwelashwa ubuhlungu obungapheli yilabo abaklasini le-anticonvulsant. Imishanguzo yokulwa ne-anti-seizure ye-back back pain isebenza mayelana nama-anti-depressants kodwa iza nezixwayiso ezihlukile zokuphepha nezimpande. Lolu hlobo lwezidakamizwa lungenza ukhetho oluhle kubantu abadala kanye nabasebekhulile ngoba ukukhathazeka kokuphepha kuncane kunezinkinga zokucindezeleka.
Imithombo:
Maizels, Morris, MD, & McCarberg, Bill, MD (2005). Izidakamizwa kanye nezidakamizwa ze-Antiepileptic for Chronic Non-Cancer Pain. I-American Family Physician, 71. http://www.aafp.org/afp/20050201/483.html
UGould, uHarry J., III, MD. Ukuqonda ubuhlungu: Yikuphi ukuthi kungani kufezeka, nokuthi kulawulwa kanjani. I-New York: Idemo, 2007. Phrinta
Fink, K., MD, Izinsizakalo Zokuhlinzeka Ngomqondisi. I-National Rehabilitation Hospital, eWashington, DC. Ifoni Ingxoxo. Mashi 9, 2009.
U-Moultry, A., PharmD, MS; I-Poon, I. I-PharmD, i-BCPS, i-CGP. Ukusetshenziswa Kwezinkinga Zokucindezeleka Zokuhlupheka Okungapheli. US Pharmist. Iwebhusayithi ye-2009.Medscape. http://www.medscape.com/viewarticle/704975