Yimiphi Imibukiso Yokucwaninga
I-Amitriptyline i-antidepressant ethandwa kakhulu etholakala kuphela kwifomu ejwayelekile e-US Ithengiswa ukuthengiswa ngaphansi kwegama lohlobo Elavil.
U-Amitriptyline uhlukaniswa njenge-tricyclic anti-depressant. Sekuyiminyaka, odokotela abathile baye bacabanga ukuthi kuyindlela yokwelapha yangaphambili ye- fibromyalgia nesifo esingapheliyo sokukhathala ( ME / CFS ). Noma kunjalo, lokhu kwenzeka okuningi kusuka ekusetshenzisweni kwecala-nephutha kunezifundo zomtholampilo.
Eminyakeni yamuva, ikakhulukazi ngokutholakala kokwelashwa kwe-FDA-avunyelwe i-fibromyalgia, ukusetshenziswa kwe-amitriptyline yalezi zifo kuye kwehla. I-Amitriptyline isamanje, kodwa ngezinye izikhathi isetshenziswe njengomuthi wokubhekisela ekufundeni ukwelashwa kwe-fibromyalgia, kanti odokotela abaningi basalokhu bebeka lezi zimo.
Indlela Esebenza ngayo
I-Amitriptyline nezinye izidakamizwa ze-tricyclic kucatshangwa ukuthi zandisa inani le-neurotransmitters serotonin ne-norepinephrine engqondweni yakho engayisebenzisa. Benza lokhu ngokunciphisa inqubo ebizwa ngokuthi "i-reuptake," yilapho amangqamuzana akhethekile athola ama-neurotransmitter asetshenzisiwe ukuze aphinde asetshenziswe kwenye indawo.
Amanye ama-anti-depressants, okuthiwa i-reuptake inhibitors, asebenzisa izindlela ezahlukene zokufeza umphumela ofanayo.
I-Serotonin ne-norepinephrine bakholelwa ukuthi ihlukunyezwa kokubili fibromyalgia ne-ME / CFS.
Futhi Bheka:
- Ukuqonda ukubuyisa kabusha
- I-Serotonin ku-Fibromyalgia & ME / CFS
- I-Norepinephrine ku-Fibromyalgia & ME / CFS
I-Fibromyalgia
Ukubuyekezwa kuka-2012 kwe-amitriptyline ye-fibromyalgia kwakukusho lokhu ekusetshenzisweni kwezidakamizwa ku-fibromyalgia:
U-Amitriptyline ube yindlela yokwelapha yokuqala yokuhlukunyezwa kwe-neuropathic iminyaka eminingi. Iqiniso lokuthi ayikho ubufakazi obungenabulungiswa obuhle bokuthola umphumela omuhle, kuyadumaza, kodwa kufanele kube nokulinganisela emashumini eminyaka yokwelashwa okuphumelelayo ezigulini eziningi ezinezinhlungu ze-neuropathic noma i-fibromyalgia. (Moore, et al, ngezansi.)
Ukubuyekezwa kuyaqhubeka ukuthi ukuvezwa kokusebenza kwayo kuwukukhathazeka ngoba izifundo zamuva zibonisa kuphela abantu abancane abazamile bazoba nomphumela wokuphumula owanelisayo.
Okunye ukubuyekezwa ngalowo nyaka, owahlanganisa ne-antilopressants duloxetine kanye ne-milnacipran, wathi:
Inombolo encane yeziguli zithola ukukhululeka kwesibonakaliso esinokuthi akukho noma imiphumela emibi embi. Kodwa-ke, inani eliphawulekayo leziguli liyehla ukulahla ukwelashwa ngenxa yemiphumela emibi engenakulibazeka noma isipiliyoni kuphela ukukhululeka kwezimpawu, okungahambisani nemiphumela emibi. (Hauser, Wolfe et al, ngezansi.)
Ukubuyekezwa kuka-2011 (u-Clemons, et al, ngezansi) waphetha ngokuthi i-amitriptyline ayifanele ithathwe njengezinga legolide le-fibromyalgia ngenxa yokulinganiselwa kwezifundo ezenziwe.
Kodwa-ke, ngo-2011, ukubuyekezwa kwezigaba zezidakamizwa ze-fibromyalgia (Smith, et al, ngezansi) kusho ukuthi i-amitriptyline yayifana nezidakamizwa ezivunyelwe yi-FDA - i-Lyrica (pregabalin), i-Cymbalta (duloxetine) no-Savella (milnacipran) uma wafika ebuhlungu nasekukhathaleni.
Abanye odokotela bangakhetha i-amitriptyline ngezizathu ezimbalwa:
- Umlando wayo omude wokusetshenziswa, futhi
- Izindleko zayo eziphansi ziqhathaniswa nezidakamizwa ze-FDA ezivunyelwe i-fibromyalgia.
Isibonelo, ukunikezwa kwenyanga eyodwa kwe-amitriptyline yama generic kungabiza phakathi kwama-dollar angu-15 no-$ 65, kuye ngesilinganiso. Phakathi naleso sikhathi, ukunikezwa kwezinyanga ezilodwa ze-Cymbalta (duloxetine), i-Lyrica (pregabalin), noma i-Savella (i-milnacipran) iqala cishe ngo-$ 125 futhi ingaba u-$ 180. (Lokhu kungashintsha njenge-duloxetine yama generic emakethe.)
Isifo Sokuphelelwa Isifo Sokugcina
I-Amitriptyline inomlando omude wokusetshenziswa kwe-ME / CFS, futhi naphezu kokuntuleka kwezifundo zemitholampilo nangenxa yezinto zangempela zomhlaba zokubheka ngcono. Ucwaningo oluncane kakhulu lwenziwe.
Ucwaningo olwenziwe ngo-2012, nokho, lubheke i-amitriptyline ye-ME / CFS futhi lithola ukuthi yilodwa kuphela phakathi kwama-antidepressants amaningi ahlolwe ukuthi avimbele ukukhululwa kwe-mast-cell yama- cytokines angama -inflammatory, okukholelwa ukuthi abe nendima ku-ME / CFS.
Isilinganiso
Kubantu abadala, i-amitriptyline yesilinganiso esingajwayelekile ingaba ngo-40 mg kuya ku-150 mg ngosuku. Ngokuvamile ihlukaniswe ngamanani amaningi.
Kungathatha isikhathi eside njengenyanga ukuze ubone izinguquko ngenxa yale mithi.
Qiniseka ukuthi ulandela imiyalelo kadokotela wakho ngokuthatha le mithi. Uma ufuna ukuyeka ukuyithatha, ungayeki ngokuzumayo. Buza udokotela wakho ngezindlela ezifanele zokususa kulo muthi.
Okuqhamuka uma udla imishanguzo
Njengawo wonke ama-anti-depressants, ithatha isixwayiso mayelana nengozi eyengeziwe yokuzibulala noma ukuzama kwabantu abangaphansi kweminyaka engu-24 ubudala.
U-Amitriptyline unolwazi olude lwemiphumela emibi. Imiphumela emibi evamile ihlanganisa:
- Ukungaqiniseki,
- Ama-nightmares,
- Ukucabangela noma ukuhlanza,
- Kunzima ukuchama,
- Ukuqokwa,
- Ukujuluka ngokweqile,
- Izinguquko zesisindo noma ukudla,
- Izinguquko ku-sex drive noma ikhono lokulala ocansini,
- Ubuhlungu, ukushisa noma ukushaywa ngezandla noma izinyawo.
Uma unemiphumela emibi elandelayo, kufanele ushayele udokotela wakho ngokushesha:
- Ukukhuluma kancane, kunzima ukukhuluma,
- Ukuphelelwa amandla,
- Ukuntula noma ukuphazamiseka kwesilungu,
- Ukuhlukunyezwa kwesifuba,
- Ukushaya kwenhliziyo okungavamile,
- Ukushisa okunamandla noma imifantu,
- Ukuvuvukala kobuso nolimi,
- Isikhumba noma amehlo aphuzi,
- Ama-muscle spasms emhlathini, entanyeni nasemhlane,
- Ukuthuthumela okungalawuleki,
- Ukusuka okungavamile noma ukulimala,
- Ukuzizwa,
- Ama-hallucinations.
Ngenxa yokuthi le mithi ikwandisa inani eliningi le-serotonin, kufanele ugweme ezinye izidakamizwa ezikhuphula i-serotonin futhi zifunde izimpawu zokuphendula okungenzeka zibulale: i-Serotonin Syndrome.
Njengazo zonke izidakamizwa, kubalulekile kuwe nodokotela wakho ukuba ulinganise izingozi ngezinzuzo bese unquma ukuthi yiziphi izifo ezifanelekile kuwe.
Imithombo:
Clemons A, et al. I-Journal ye-psychopharmacology yomtholampilo. 2011 Jun; 31 (3): 385-7. I-Amitriptyline ne-prochlorperazine inhibithali ehamba phambili yokukhululwa komuntu osuka kumuntu wesisindo somuntu: ukufaneleka okungenzeka ku-syndrome engapheliyo.
Hauser W, Petzke F, et al. I-Rheumatology (Oxford.) 2011 Mar; 50 (3): 532-43. Ukuphumelela kokuqhathanisa nokwamukelwa kwe-amitriptyline, i-duloxetine ne-milnacipran ku-fibromyalgia syndrome: ukubuyekezwa okuhlelekile ngokuhlaziywa kwe-meta.
Hauser w, Wolfe F, et al. Izidakamizwa ze-CNS. 2012 Apr 1; 26 (4): 297-307. Indima yama-anti-depressants ekuphathweni kwe-fibromyalgia syndrome: ukubuyekezwa okuhlelekile nokuhlaziywa kwemeta.
Moore RA, et al. Idatha yeCochrane yokubuyekeza okuhlelekile. 2012 Dec 12; 12: CD008242. Amitriptyline for ubuhlungu neuropathic kanye fibromyalgia kubantu abadala.
U-Okea, udokotela wasekhaya waseRamerican. 2010 Oct 15; 82 (8): 901-904. I-Milnacipran (Savella) ye-fibromyalgia.
Smith B, et al. Ukuhlolwa kwamaKlasi weDrug. Ngo-2011 Umhlahlandlela Wezidakamizwa Zezidakamizwa: Izidakamizwa ze-Fibromyalgia: Umbiko Wokugcina Wokuqala.
Ukuphathwa kwe-US nokuDrug. Amitriptyline Izaziso Zokuphepha. Ifinyelele ngo-Septhemba 2014.