Jabka - waa maxay? Dajiye iyo murugada

Modern "Hadaba" Xawliga ah ee nolosha, durdur aan dhammaadka lahayn ee macluumaadka qofka u baahan yahay in ay la tacaalaan maalin walba, iyo sidoo kale qaar kale oo badan, wax badan oo ka mid ah arrimo xun keeni xaqiiqada ah in jirkaaga iyo maskaxdaada ma taagnaan karo. Hurdo la'aan iyo stress, cillad iyo isgaarsiinta, waxaa inta badan iska indho, iyo inta badan maanshaynay baxay by daroogada ama walxaha kale oo awood leh, ugu danbeyn keeni cudurada adag sida, sida daal chronic syndrome (Habboon) iyo murugo kala duwan. Sida laga soo xigtay saadaasha ah falanqeeyayaasha murugada caafimaad sannad th 20 ee qarnigii this in tirada xaaladaha dhaafo madaxda qarnigii labaatanaad - cudurrada faafa iyo cudurrada nidaamka wadnaha. In halganka xanuunada niyad, daawooyin kala duwan oo ay labada ku salaysan qaybaha dabiiciga ah iyo isku dardaro. Jabka - waa maxay? Waxa ay yihiin iyo in daawooyinkan ku bogsiiyaan depression ama loo fududeeyo astaamaha ay kaliya? Maxay yihiin faa'iidooyinka iyo dhibaatooyinka daroogada oo kale ah? Maqaalkani waxa uu isku dayi doonaa in aan ka jawaabo kuwan oo kale su'aalo ku saabsan saamaynta lidka diiqadda ka mid ah isticmaalka iyo cawaaqibta soo dhaweynta.

Waa maxay?

Sida magacaba ka muuqata, murugada (sidoo kale loo yaqaan timoleptikov) - a daawooyinka psychotropic ka shaqeeya dhanka ah calaamadaha niyad. Thanks to daawooyinkan walaaca kordhay iyo walwalka shucuureed xad-dhaaf ah, firfircooni la'aan iyo feejignaan xumo, hurdo la'aan si weyn u dhimay ama xataa gebi ahaan ku ba'aan. U sabab ah kooxdan oo ah daroogada waa labada kala duwan ee qaab-dhismeedka kiimikada iyo halabuurka, iyo hab ay of talaabo.

Sidee u shaqeeyaan?

Aynu u wajihi, anti-niyadjabka - in uu yahay: burburinta jidhka ama caawin garaacayeen soo gunaanadeen aadanaha. Bal aynu eegno sida daroogada, kuwaas oo ka shaqayn. maskaxda aadanaha ka kooban yahay hannaanka ah neurons - unugyada dareenka, si joogto ah u fulineynin war isdhaafsi ka dhexeeya iyaga. Waayo gudbinta macluumaadka u baahan walxaha Rasuul gaar ah - neurotransmitters, cabaar dhex daloolka bannaan ee synaptic dhexeeya neurons. cilmi Modern garto in ka badan 30 neurotransmitters kala duwan, laakiin in horumarinta iyo dabcan murugada leeyihiin "toos ah" habdhaqanka saddex kaliya iyaga ka mid ah: serotonin, noradrenaliin (norepinephrine) iyo dopamine. Sida laga soo xigtay xogta cilmi-baarista, murugada waxay dhacdaa marka dhexgalka ee neurons oo duurka ku jiro hoos u dhac weyn taranta of neurotransmitters. Saamaynta of murugada waxaa loogu talagalay kordhaya tirada dhexdhexaadiyayaal khuseeya iyo caadi ah ee dheelitirka lagmamaarmaanna u ah maskaxda.

A yar oo taariikh

Ka hor inta Socota tixgelinta kooxaha casriga ah iyo noocyada kala duwan ee lidka diiqadda, si kooban sharaxaad taariikhda ay daahfurka.

Ilaa qarnigii labaatanaad ka, niyad-jabka iyo xaaladaha kala duwan ee ka waalan oo leh calaamado la mid ah ayaa lagu daweeyey diyaarinta geedaha kala duwan. Si aad u "dhigay niyadda" isticmaalaa noocyo kala duwan oo isugu darey xiiso leh, kaas oo ka mid ah caffeine, ginseng ama wakiillo ka opiates. jitters "dejiyo" isku dayay cusbada bromine ama daawooyinka oo ku salaysan Valerian. Sidoo kale isticmaalaan noocyada kala duwan ee layliyada iyo daaweynta dabiiciga ah kuwaas oo wax ku oolnimada ayaa aad u hooseeya.

In hore 50-mada ay daroogada "Promethazine" la abuuray by qarnigii labaatanaad, waxaa markii hore loo isticmaalo suuxinta inta lagu guda jiro qalliinka. Pharmacologists isku dayeen in ay kor inhibitory iyo saamaynta inhibitory of daroogada, oo sababtay in ay 1951 helay "chlorpromazine", kaas oo si weyn loo isticmaalaa in ku dhaqanka caafimaad, daaweynta niyadjabka. Maanta, daroogada taas waxaa loo yaqaan "chlorpromazine".

In dabayaaqadii 60-mada ay dhakhtar Swiss qarnigii la soo dhaafay ee, bukaanada lechivshimi qaaxada, waxaa astaan u saamayn dhinac aan caadi ahayn ka mid ah daroogada this sida "Iproniazid". Bukaan-socodka waxaa la helo, ayaa Qolol niyadda. Tartiib tartiib u bilaabeen inay in la isticmaalo si dhab ah maskaxda sida qaaxada, waxa uu ka caawiyay aad u yar. Ilaa waqti isku mid ah cilmi-German Ronald Kun helay daroogada "Imipramine".

Furitaanka of timoleptikov ugu horeysay keentay in horumarka deg deg ah ee cilmi-pharmacological in arrintan iyo abuurka daroogada cusub si looga hortago astaamaha iyo sababaha jabka.

kala soocidda casri ah

Iyada oo ku xidhan nooca saamaynta uu leeyahay isticmaalka daawooyinka murugada on murugada ee bukaanka, waxay u qaybsan yihiin sida soo socota:

Intaa waxaa dheer, waxaa jira kala soocidda ku salaysan sida saamaynta lidka diiqadda saamayn habka lagmamaarmaanna u ah ee jidhka bini'aadamka,

• murugada Tricyclic - timoanaleptiki tricyclic.
• MAOIs - Monoamine inhibitors oxidase:

- karin ( "tranylcypromine," "phenelzine");

- karo ( "Pirazidol", "Moclobemide").

• SSRI - xushay reuptake inhibitors serotonin;
• IOZSIN - reuptake inhibitors serotonin iyo noradrenaliin,
• NaSSAs - murugada serotonergic noradrenergic oo gaar ah.

Sidoo kale, waxaa jira tiro ka mid ah daroogada niyad jabka oo aan loo saarin karaa in mid ka mid ah kooxahaas.

TCA: murugada tricyclic, waa maxay?

Daroogooyinka kooxaha tricyclic sida "Nortriptyline", "Imipramine" iyo "Amiltriptilin" magaceeda ka giraanta carbon xaafuun sababaya helay. Dawooyinkan niyad jabka caawin kordhiyo tirada neurotransmitters maskaxda sida norepinephrine (noradrenaliin) iyo serotonin (hormone farxad). Taana waxaa lagu gaarayaa by yaraynta heerka isticmaalka unugyada dareemeyaasha - neurons.

Sababo la xaqiiqada ah in marka la helo daawooyinkaan ayaa xiran ma aha oo kaliya neurotransmitters loo baahan yahay, waxaa jira saamaynta badan dhinaca kala duwan. murugada Tricyclic group keeni karaan dhibaatooyinka soo socda:

• feejignaan xumo;
• dawakhsanaan;
• lalabo,
• afka oo qalala,
• itaaldarro,
• wareer;
• dardargelinta heerka garaaca wadnahaaga - ka garaaca,
• calool;
• awoodba hoose iyo libido;
• walwalka ama walaaca.

daawooyinka waxaa badanaa dhakhtar soo qoray oo ku jira meesha ugu horeysay, tan iyo markii ay ah kuwa ugu bartay iyo saamaynta ay u isticmaalaan si fiican u yaqaan.

MAOIs - inhibitors oxidase Monoamine

Diyaarinta "Iproniazid" furo mid ka mid ah kuwii hore ka, iyo sidoo kale dawooyinka kale ee kooxdan, sida "isocarboxazid," "tranylcypromine" joogsada monoamine reaction enzyme oxidase, ku jira dhammaato dareemaha. Sababo la this, neurotransmitters in mas'uul ka our niyadda yihiin, sida serotonin, noradrenaliin iyo tyramine, aan la dumiyey oo si tartiib ah ururayaa in maskaxda.

The murugada inta badan qoray, MAOIs ee niyad-jabka atypical, ama marka daroogada group tricyclic uma iman oo waxba ma ay leeyihiin saamayn la doonayo. Faa'iidada of this group of daroogada waa xaqiiqda ah in aanay saamayn baaxad weyn, iyo on lid ku ah, kicin geeddi socodka maskaxda.

Iyo sidoo kale daawooyinka tricyclic, MAOIs lahayn waxyeelo weyn aysan ku aadanaha - saamayn murugada yimaado dhowr toddobaad kadib marka ay bilaabaan soo dhaweynta.

Sababo la xaqiiqada ah in MAO leedahay waxyeelo badan (oo sidoo kale diyaar fal la daawooyinka qufaca iyo hargabka caadiga ah, oo ka cadhaysiinina kartaa quruxsan naf-gooyada ah ee dhiig karka), laakiin sidoo kale sababta oo ah cuntada si cadaalad adag marka ay maamusho qoro daawooyin sida dhif ah, marka daaweyn kale ma aysan caawinin.

serotonin reuptake inhibitors

Waxaan baaro koox ka mid ah TCAs iyo MAOIs - waxa ay inta badan dhawaan la furay iyo daroogada si fiican u bartay. Laakiin "jir" qarniga ee lidka diiqadda ayaa si tartiib tartiib ah bedelay daroogada dheeraad ah oo casri ah in loo joojiyo tallaabada of neurotransmitters, aan oo dhan, laakiin kaliya hal - serotonin, ka hortagga neurons ay la wareegeen dambe. Tani waxay kordhisaa-fiirsashada iyo leedahay saamayn ku daweyn. Si ka mid ah daawooyinka casriga ah sida SSRI sida "fluoxetine", "sertraline", "Zoloft", "Paroxetine" iyo kuwa kale. In group this daroogada xusay waxyeellooyin yar, oo iyana ma ay aad u badan saamayn jidhka bini'aadamka.

reuptake inhibitors serotonin iyo noradrenaliin

Tani waa maandooriye xad cusub, kaas oo iska leh ee daawooyinka murugada qarnigooda saddexaad. Waxay bilaabeen soo saara ee bartamihii 90-mada ay qarnigii XX. Daroogooyinka sida "Cymbalta", "Effexor" block reuptake ee serotonin ma aha oo kaliya, laakiin sidoo kale noripinefrina, laakiin daawooyin sida "Wellbutrin" iyo "Zyban" looga hortago soo laabashada norepinephrine iyo dopamine.

waxyeelo daroogada ee kooxdan waa uga yar yahay kan kale, oo ay ka muujiyay halkii imaanshada. Ka dib markii la helo daawooyinka murugada, abuuray oo ku saleysan inhibitors sida "duloxetine" iyo "BUPROPION", waxaa laga yaabaa in la kordhiyo miisaanka iyo cillad yar gudbikaraa oo galmada.

Noradrenergic iyo serotonergic gaar murugada - NaSSAs

Kale oo ka mid ah kooxaha casriga yihiin daawooyinka lidka diiqadda NaSSA in hoos u dhigi ama xataa joojiso qabashada synapses noradrenaliin of unugyada dareenka, markaa si ay kordhaan ay fiirsashada. daawooyin sida "Remeron" "Lerivon" "Serzon" fuliyaan ku furid ah serotonin receptors.

Daawada in kooxdan ay jiraan waxyeelo fudud sida xun sida hurdo, afka oo qalala, rabitaanka cuntada oo kordhay iyo miisaan la xiriira faa'iido. Cancel murugada kooxdan qaadataa meel aan wax dhib ah oo waaweyn.

Ka sokow kooxaha aasaasiga ah ee kor ku lidka diiqadda, waxaa jira tiro ka mid ah daroogada oo aan loo saarin karaa in mid ka mid ah. Waxay ku kala duwan yihiin Halabuurka kiimikada iyo hab garoomada labada. Tani, tusaale ahaan, daawooyin sida "BUPROPION", "Hypericin", "Tianeptine", "Nefazodone" iyo kuwo kale oo badan.

hababka kale

Maanta, khubaro shisheeye sii kordheysa loo isticmaalo daweynta daawooyinka murugada in uu saameyn ku neurotransmitters iyo ma on neurotransmitters, laakiin on xaaladda nidaamka hormoonada jidhka, sida qanjidhada, hypothalamus oo pituitary qanjirka adrenal. Qaar ka mid ah daawooyinkan, sida "Aminoglutethimide" iyo "ketokonazol" joogsada adrenal Avv Hoormoonka loo yaqaano Cortisol, laakiin waxay leeyihiin waxyeellooyin badan oo ay leeyihiin saamayn taban ku leh nidaamka hormoonada jidhka ah.

Kooxda labaadna waxaa caadi ahaan loo gudbiyaa antalarmina ku Doodeen receptor isu geeyo sifooyinka wanaagsan oo ay leeyihiin dejisa iyo murugada.

Waxa intaa dheer in daaweyn pharmacological dalalka niyad, sii kordheysa yihiin farsamooyinka loo isticmaalo sida hypoxia go'aysa normobaric iyo plasmapheresis, therapy iftiinka, iyo sidoo kale kuwo kale oo badan in la yareeyo astaamaha iyo calaamadaha kamuhimsan.

Pro iyo con

Inta badan kuwa qaatay murugada, heshiiyaan in ay tahay daawooyinka aad wax ku ool ah, gaar ahaan haddii ay qaaday waqti isku mid ah ay sameeyeen Dabcan takhasus ah therapy. Waa in la xusuustaa in kuwan daroogada iyo qiyaasta u magacaabi karta takhtar, hoostooda control oo ay leeyihiin si aad u qaadato. Ha ka filin horumar deg dega ah. Sida caadiga ah, dareenka rajo iyo khasaaro of xiisaha nolosha, iyo sidoo kale feejignaan xumo, arxandarro iyo murugo maraan 3-4 toddobaad kadib marka ay bilaabaan maamulka systemic.

Mid ka mid ah khasaaraha ugu weyn ee daroogada waa xaqaasi syndrome lidka diiqadda, taas oo u muuqato la joojiyo af badan oo caasiyoobay oo ay gelitaanka.

Sidee loo codsadaa?

1. Haddii aad cudurka cudurka wadnaha, kelyaha ama cudurka beerka hubi inaad u sheegto dhakhtarkaaga.

2. murugada si gaar ah u dhaqmaan, si takhasuska xuli doona daroogada ah in ku haboon yahay si gaar ah kuu.

3. Xaaladaha qaarkood, mid ka mid ah daawada kuma filna, dhaqtarkaada ayaa kuu qoraya laga yaabaa in soo dhaweynta isku mar ah oo kala duwan (dejisa iyo murugada, jirada dhimirka iyo wax kasta oo daroogo anticonvulsant). Iyadoo ku salaysan ogaanshaha iyo la socodka xaaladda degaaankaaga, takhasus u leh soo xuli doona daawooyinka in awoodi doonaan in ay midba midka kale la dhamaystiro oo aan saamayn taban ku leh jidhka bini'aadamka yeelan doonaan.

4. ma Waad joojin kartaa daawooyinka lidka diiqadda si lama filaan ah oo aan la tashanaya takhasus u leh, maadaama ay tani sii dari kara kooraska murugada iyo sababi noocyo kala duwan oo dareen-celin jir xun.

5. Dad badan oo weydii haddii ay macquul tahay in ay ka wada cabbi murugada iyo khamriga. All tilmaamo in daawooyinka lagu tilmaamay in ay tahay si cad aan la aqbali karin, sababtoo ah waxa ay keeni kartaa dhaawac weyn u habka dareemayaasha jirka, ama dhimasho.

bixitaanka ama qabatin leh?

Haddii ay sidaa tahay, haddii aad qaadato daawooyinka murugada muddo dheer, ka dibna, sababtu wax kasta, oo jir- joojiyay, waxay keeni kartaa raaxo, sida dhaqanka dareen aan degganayn, daal, muruq xanuun, wareer. Dhammaan astaamahan loo yaqaan lidka diiqadda joojiyo syndrome. Taasi waa sababta dhakhtarrada talineynaa tartiib daawada loo yareeyo daawada helay iyo in sidaas la sameeyo iyada oo ay kormeerayaan ku takhasusay. xirfadlayaasha Kaliya caawin kartaa caawin raaxo, isagoo ka soo gaaray ka normotonics lagama maarmaan iyo diyaar garowga ku saleysan dhirta. Haddii daroogada la dhuujinayso qaaday, ka dibna uu balan ku harin joojiyo, la joojiyo sida murugada waxay keeni kartaa hurdo la'aanta, welwelka kordhay, iyo dhibaatooyin la xiriira nidaamka wadnaha. Intaa waxaa dheer, calaamadaha soo socda ayaa dhici kara:

• baqo aan sabab lahayn;
• calaamadaha hargabka oo kale,
• lalabo, matag,
• maroojis iyo xanuun in mareenka caloosha iyo mindhicirka,
• luma isuduwidda, iyo vertigo;
• qarow,
• gariirka Addinka.

halkii ay ka gunaanad

Laga soo bilaabo dhammaan qodobada kor ku xusan, waxaa lagu soo gabagabeyn karaa in daawooyinka noocan oo kale ah, sida antidepressants, ay yihiin kuwo xoog leh oo aad u halis ah, inay yihiin daawooyin casri ah oo la qabsan kara niyad-jabka. Si kastaba ha ahaatee, ka hor intaadan bilaabin qaadashada, hubi inaad la tashatid takhasus leh - dhakhtar dhimir ama cilmi nafsi yaqaan, kuwaas oo awoodi doona inay ogaadaan nooca cudurka uu yahay adiga iyo daawooyinka ay kaa caawinayaan sidii ay ula qabsan lahaayeen.