Kungani le mithi inikeza okunye okunye kwezidakamizwa ze-ADHD zendabuko
Eziningi zezidakamizwa ezitholakalayo zokwelapha ukunakekelwa kokungaboni kahle (ADHD) ezifana ne- Adderall noma i-Ritalin kuyizinto ezikhuthazayo, yingakho iStrattera, isidakamizwa esingavuseleli lesi simo, siphume.
I-FDA ivumile i-Strattera (i-atomoxetine) ukuphatha i-ADHD kubantu abadala nabantwana abangaphezu kweminyaka eyisithupha. Lokhu akusiyo imithi yokuqala engeyona eyakhayo ye-ADHD, noma kunjalo.
Ama-antidepressants, kuhlanganise ne-Wellbutrin (bupropion hydrochloride) kanye ne-tricyclics, njenge-Desipramine ne-Imipramine, sekuye kwacatshangwa ukuthi imithi yomugqa wesibili. Ngezinye izikhathi zisetshenziselwa lapho izikhuthazi ezimbili noma ngaphezulu zingasebenzi, ziphikisana noma zenza imiphumela emibi kakhulu.
Ngokuvamile izifo zokucindezeleka azibhekwa njengeziphumelelayo njengezikhuthazayo, noma kunjalo. Futhi le mithi ayisona i-FDA evunyelwe ukuphatha i-ADHD, ngakho isimangalo sikaStattera sokuba 'imithi yokuqala engalawulwayo i-FDA-avunyelwe ukuphatha i-ADHD' kuyiqiniso ngokweqiniso.
Kungani iStrattera iphuma ngaphandle
Nakuba ziziwa kabanzi ukuthi ziphephile futhi zisebenzayo, izikhuthazo ezifana ne-Adderall no-Ritalin sezilokhu zinegama elibi futhi abazali abaningi balwa no-Ritalin futhi behluleka ukubeka izingane zabo ngendlela evuselelayo. Ngakho uma kungeyona into evuselelayo, iStrattera isebenza kanjani? Kucatshangwa ukuthi 'kuyinto inhibitor enamandla ye-presynaptic norepinephrine transporter,' okwenza ukuba i-norepinephrine engaphezulu ibe khona ukuze kwandiswe ukunakekelwa nokulawula ukungabi namandla nokungacabangi.
Njengezikhuthazo, akukaziwa ukuthi uStattera usebenza kanjani, noma kunjalo.
Ucwaningo oluningi lukhombisa ukuthi iStrattera iphephile futhi isebenza kahle. Enye yalezi zifundo, "i-Atomoxetine ne-Methylphenidate Treatment ku-Children ene-ADHD: i-Prospective, Randomized, Open-Label Trial," 1 eqhathaniswa neStrattera noRitalin.
Lezi zingane ezine-ADHD, okungu-228 kubo bonke, zathola iStrattera noma iRitalin ngamasonto ayishumi, kanti labo abathatha iStrattera batholakala ukuthi banesifo sokunciphisa 'nokubekezelelana' okwakungalinganiswa nalokhu okubanjwe noRitalin.
Isixwayiso sokuzibulala iStrattera
Nakuba kungenjalo, i-FDA ixwayise ngengozi enkulu yokucabanga yokuzibulala ezinganeni nasezinsheni eziphathwa ngeStrattera. Ngokuqondile, njengeminye imithi eminingi yengqondo, i-FDA ithi iStattera 'ingakhuphula imicabango yokuzibulala noma ukuzama ukuzibulala ezinganeni kanye nentsha,' nokuthi abazali kufanele babize udokotela wengane yabo uma ingane yabo ikhona:
- Imiqondo emisha noma eyengeziwe yokuzibulala
- Izinguquko zemizwelo noma yokuziphatha, kufaka phakathi ukucasula noma ukukhathazeka
Lesi sixwayiso asisho ukuthi ingane yakho ayikwazi ukumiswa iStrattera noma ukuthi kufanele ime ukuthatha iStrattera uma yenza umsebenzi omuhle olawula izimpawu zakhe ze-ADHD futhi ungabangeli imiphumela emibi. Esikhundleni salokho, inzuzo yokuthatha i-Strattera kufanele ilinganiswe nezingozi ezingase zivele ezidakamizwa. Futhi izingane ezithatha i-Strattera kufanele zigcinwe ngokucophelela ngokubhebhetheka komzimba, ukucabanga okuzibulala noma ukuziphatha noma izinguquko ezingavamile ekuziphatheni, ikakhulukazi ezinyangeni ezimbalwa zokuqala ukwelashwa noma uma isilinganiso sishintshwa.
Njengoba kungabhekwa njengento elawulwayo, i-Strattera izotholakala ngegciwane elivamile. Lokhu kusho ukuthi odokotela bangakwazi ukuyibiza ngokuthi ikhemisi futhi banganikeza ama-refills, ngokungafani nokugqugquzela nezinye izinto ezilawulwayo, ezidinga isimiso esisha semithi njalo ngenyanga. Futhi udokotela wakho wezingane uzoba nesampuli etholakalayo ukuze ingane yakho izame.
Ucwaningo lwe-Strattera
Izifundo zokuqala zaseStrattera zabonisa enye yezinto eziphuthumayo kule mithi kusukela ngokungafani neyodwa kanye ngosuku, ukuvuselela isikhathi eside, i-Strattera inikezwe kabili ngosuku. Ngesikhathi esisodwa ukuhlolwa kwesifo kuye kwabuye kwafundwa futhi, futhi wabonisa ukuthi 'ukuphathwa kwe-atomoxetine yansuku zonke kuyindlela ephumelelayo yokwelashwa kwezingane nentsha ene-ADHD.'
Futhi kuze kube manje, akekho olunye ucwaningo olubonisa ukuthi iStrattera isebenza kangcono noma inezimbangela ezimbalwa kunezingcindezi. Njengemisusa, imiphumela emibi ye-Strattera yayihlanganisa nokudla okuncane, isicanucanu, ukuhlanza, ukhathala nokugulisa isisu. Futhi izingane eziningi zalahlekelwa isisindo ezinyangeni ezimbalwa zokuqala ngemuva kokuqala iStrattera. Kodwa-ke, izifundo ezimbalwa zesikhathi eside, lapho izingane zithatha khona iStrattera isikhathi esingaphezu konyaka, zabonisa ukuthi lezi zingane zenza isisindo kahle futhi ukuphakama kwabo kwanda futhi. Njengoba ukungabi nesisindo esimpofu ngokuvamile kuyinkinga ezinganeni ezithatha ukuvuselela, lokhu kutholwa yizindaba ezinhle futhi iStrattera ingaba yinto ehlukile kulabo bantwana.
Futhi, i-Strattera ikhiqizwa nge-cytochrome P450 2D6 (i-CYP 2D6) endleleni yesibindi, ngakho-ke kungenzeka ukuthi kuyoba nokusebenzisana neminye imithi, njengePaxil (paroxetine), i-Prozac (i-fluoxetine) ne-quinidine. Umkhiqizi uphinde ululeke ngokuqapha lapho enikeza ingane bobabili i-albuterol (okungavamile ukwenza) neStrattera, ngakho-ke le mithi ingase ingabi ikhetho elihle kubantwana abane-ADHD abane-asthma. Futhi njengoba i-Strattera ingakhuphula ingcindezi yegazi nengane yenhliziyo, kufanele isetshenziswe ngokucophelela ezinganeni ezinomfutho wegazi ophakeme , izinga lokushaya inhliziyo (tachycardia) noma isifo senhliziyo noma isifo senhliziyo.
Enye iphuzu ukuthi i-Strattera itholakala kuphela njenge-capsule, futhi ngokungafani ne-Adderall XR, engavulwa futhi ifafazwe ekudleni, ikwaziswa ukuthi i-Strattera ithathwe ngokuphelele.
Ngakho-ke ngenkathi uthola ukwelashwa okusha kwezingane ezine-ADHD yizindaba ezikwamukelekile futhi ezithakazelisayo, kuze kube yilapho kwenziwa olunye ulwazi ukuze kuboniswe ukuthi i-Strattera ivikelekile noma iphumelele kunokuba ivuselele, akufanele neze ugijime kumhlengikazi wezingane ukuze ushintshe imithi.
Noma kunjalo, i-Strattera ingaba yinto enhle kakhulu kubantwana abanenkinga yokuthola isisindo ngenkathi bethatha isisusa, baneminye imiphumela emibi, noma uma izimpawu zabo ze-ADHD zilawulwa kahle.
Imithombo:
I-Atomoxetine ne-methylphenidate yokwelapha ezinganeni ezine-ADHD: isilingo esingaba khona, esingahleliwe, esivulekile-ilebula. Kratochvil CJ - J Am Acad Child Adolesc Psychiatry - 01-Jul-2002; 41 (7): 776-84.
Ukunakekelwa kwe-atomoxetine yansuku zonke kwezingane kanye nentsha yokunakekelwa kokukhathazeka kokugula okungahle kwenzeke: isifundo esilawulwa ngokungahleliwe. UMichelson D - Am J Psychiatry - 01-Nov-2002; 159 (11): 1896-901.