Isidakamizwa sethu sesibili se-FDA-Approved
I-Cymbalta (i-duloxetine) i-FDA-evunyelwe i- fibromyalgia , ukucindezeleka, ukuphelelwa yisifo sikashukela, nokuhlukunyezwa okungapheli kwesishukela.
Ukwamukelwa kwawo ngo-2008 kwenzeni nje ukuthi yisidakamizwa sesibili esivunyelwe ukwelapha i-fibromyalgia. Ifomu elijwayelekile litholakala e-US
I-Cymbalta nezinye izidakamizwa ezivunyelwe, i- Lyrica (pregabalin) no- Savella (milnacipran) , zibhekwa njengezokwelapha zokuqala ze-fibromyalgia.
Lokhu kusho ukuthi bayanconywa ngaphambi kwanoma yimiphi imithi. Zisebenza kahle kwabanye kepha hhayi wonke umuntu. Kwabanye abantu, babangela imiphumela emibi engaba yingozi noma engathandeki ngokwanele yokwenza abantu bahambe kubo. Kwabanye, azisebenzi nje kahle.
(Lokhu akuyona eyingqayizivele ku-Cymbalta. Akukho ukwelashwa okulodwa okusizayo sonke lesi sifo.)
Yisiphi i-Cymbalta
I-Cymbalta ihlukaniswa njenge-SNRI noma i-serotonin norepinephrine reuptake inhibitor. Kusho ukuthini lokho?
I-Serotonin ne- norepinephrin yizinzwa ze-neurotransmitters (izithunywa zamakhemikhali ebuchosheni bakho.) I-Serotonin ihileleke ekujikelezeni kokulala nokuphuza ubuhlungu. I-Norepinephrine ikusiza uzizwe uqaphile futhi unesithakazelo futhi udlala indima enkumbulweni.
Zombili lezi zinzwa ze-neurotransmitters zikholelwa ukuthi zihlukunyezwa nge-fibromyalgia, okusho ukuthi asinakho okwanele noma lokho esinakho akusetshenziswanga ngokuphumelelayo ngobuchopho bethu. Ngandlela-thile, singasebenzisa okuningi.
I-Cymbalta nezinye i-SNRIs azifaki i-serotonin ne-norepinephrine kububilini bethu, kodwa bayenza itholakale isikhathi eside, okuyisisekelo esinomthelela owodwa njengokungeza okuningi. Ukwenza lokho, bephuza inqubo ebizwa ngokuthi i-reuptake lapho amaseli akhethekile ebuchosheni bakho asula khona i-serotonin esebenzayo ne-norepinephrin ngemuva kokuthi isetshenziselwe ukuthumela imilayezo kusuka kwenye i-neuron kuya kwenye.
(Kunjenge-neurotransmitter yi-imvilophu esele ihlezi ngemuva kokuvula i-imeyili yakho.) Ukugcina i-neurotransmitter isikhathi eside kusenza ubuchopho bakho buyisebenzise ngokwengeziwe.
I-Cymbalta ye-Fibromyalgia
Izivivinyo eziningi zemitholampilo zibonisa ukuthi i-Cymbalta inganciphisa ubuhlungu be-fibromyalgia, kokubili ngaphandle kokucindezeleka komzimba. Ucwaningo lubonisa ukuthi lesi sidakamizwa siyaqhubeka sisebenza okungenani ngonyaka owodwa.
Abacwaningi abaqondi kahle ukuthi lo muthi usebenza kanjani. Kodwa-ke, isifundo se-2015 (Wang) sikhombisa ukuthi kunciphisa izibonakaliso zokuhlunguphaza okungezansi ezibangelwa umonakalo wezinzwa (ubuchopho.) Ubuhlungu obunye bokubuhlungu kwe-fibromyalgia ukuthi kuhilela ukuphelelwa yisifo senhliziyo emanzini amancane eduze kwesikhumba sakho. Uma kuyiqiniso, kungakho ukuthi i-Cymbalta ivame ukuphumelela ngokumelene nobuhlungu bethu.
Kulolu cwaningo, i-Cymbalta yabonakala ukunciphisa izinhlobo ezimbili zobuhlungu obufana ne-fibromyalgia: i-hyperalgesia ne-allodynia. I-Hyperalgesia yilokho "kuguqula ivolumu" yobuhlungu bethu, kuyilapho i-allodynia ubuhlungu ezintweni ngokuvamile ezingabangeli ubuhlungu, njengokucindezela okukhanya.
Isilinganiso
Isilinganiso se-Cymbalta esinconywe singama-60 mg, sithathwe kanye ngosuku. Ngokuvamile kuqalwe ku-30 mg ngosuku bese kwanda ku-60 mg ngemuva kwesonto.
Amanani aphakeme kunalokhu akukholelwa ukuthi ayasebenza kakhulu ku-fibromyalgia, futhi ahlobene nengozi ephezulu yemiphumela emibi.
Abantu abafuna ukuyeka ukuthatha lesi sidakamizwa kufanele bakhulume nodokotela wabo ngendlela efanele yokuyeka kancane kancane; ukuyeka ngokuzumayo kuyingozi. Udokotela wakho angase akwazi ukukusiza unciphise izimpawu zokuhoxiswa.
Okuqhamuka uma udla imishanguzo
I-Cymbalta ihlotshaniswa nemiphumela emibi eminingi engenzeka. Lokho okufanele ubike kudokotela wakho ngokushesha kuhlanganisa:
- Ukusabela okwe-allergic (ukuqhuma, ukuwasha noma ukuvuthwa, ukuvuvukala kobuso, izindebe noma ulimi),
- Ukucindezelwa kwegazi kuguquka,
- Ukudideka,
- Ukuzivocavoca kanye / noma ukulahlekelwa ibhalansi,
- Ukukhuluma okusheshayo, imizwa ejabule, noma izenzo ezingenakulawula,
- Okusheshayo, ukushaya kwenhliziyo okungavamile,
- Fever,
- Ama-hallucinations noma ukulahlekelwa othintana noqobo,
- Ukuzizwa,
- Uhudo, ukuhlanza,
- Imicabango yokuzibulala noma enye imizwelo ishintsha,
- Umchamo omnyama,
- Ukusuka okungavamile noma ukulimaza.
Imiphumela emibi ye-Cymbalta engadingi ukunakekelwa kwezokwelapha ihlanganisa:
- Umbono ophundlekile,
- Izinguquko zokudla,
- Izinguquko ku-sex drive noma ukusebenza,
- Izinwele,
- Ukujuluka okukhulu,
- I-nausea.
Ingabe I-Cymbalta Ikulungele Wena?
Uma unesithakazelo ekuzameni i-Cymbalta, khuluma nodokotela wakho. Qinisekisa ukuthi ulinganisisa ngokucophelela izinzuzo nezingozi futhi ubheke noma yikuphi ukusebenzisana okungalungile nezinye izidakamizwa ozithathayo.
Kungumqondo omuhle, nganoma imuphi imithi, ukuba nohlu lwemiphumela emibi ekhona. Ungase ufune ukuvumela abantu abasondelene nawe bazi ngemiphumela emibi kakhulu, njengokubamba ukushona, ukulahlekelwa othintana neqiniso, noma imicabango yokuzibulala, ukuze bazi ukuthi kwenzekani, uma kungenzeka.
Imithombo:
U-Arnold LM, et al Umagazini wezitholampilo zobuhlungu. 2009 Jul-Aug; 25 (6): 461-8. Ukuqhathaniswa kokusebenza nokuphepha kwe-duloxetine yokwelapha i-fibromyalgia kwiziguli ezinokuphikisana ngaphandle kokucindezeleka okukhulu okucindezelekayo.
Choy EH, ne-al al Clinical rheumatology. 2009 Sep; 28 (9): 1035-44. Ukuphepha nokubekezelelana kwe-duloxetine ekwelapheni iziguli ezine-fibromyalgia: ukuhlaziywa okuhlanganisiwe kwedatha kusuka kuvivinyo ezinhlanu zemitholampilo.
Hauser W, et al. Ucwaningo lwe-Arthritis & therapy. 2014 Jan 17; 16 (1): 201. Ukubuyekezwa kwemithi yokwelashwa e-fibromyalgia syndrome.
Izincwadi ze-NIH CHA. 04-5326
Uceyler N, et al. Ubuchopho. 2013 Jun; 136 (Pt 6): 1857-67. I-fiber encane pathology kwiziguli ezine-fibromyalgia syndrome.
Wang CF, et al. I-anesthesia ne-analgesia. 2015 Aug; 121 (2): 532-44. Izenzo zendawo nezesistimu ze-duloxetine e-allodynia kanye ne-hyperalgesia esebenzisa imodeli yobuhlungu besikhumba somlenze wesikhumba.