Txog kev txwv tsis pub haus cawv, kev quav tshuaj thiab kev phiv: 10 cov lus nug tseem ceeb txog cov tshuaj tiv thaiv kev ntxhov siab

Antidepressants yog ib qho tshuaj siv ntau tshaj plaws hauv ntiaj teb. Muaj kev xav tias lawv tsuas yog siv los tiv thaiv kev nyuaj siab xwb, tab sis cov tshuaj no pab nrog ntau yam kev mob: kev ntxhov siab-phobic teeb meem, ntshai tawm tsam, chim siab plob tsis so tswj, mob ntev thiab mob migraines.

Dab tsi ntxiv tseem ceeb kom paub txog lawv? Cov kws tshaj lij hais tias. 

Alina Evdokimova, tus kws kho mob hlwb:

1. Cov tshuaj tiv thaiv kev nyuaj siab tshwm sim li cas thiab thaum twg?

Xyoo 1951, kev sim tshuaj tiv thaiv kab mob tau ua hauv New York. Cov kws tshawb fawb tau pom sai sai tias cov neeg mob noj cov tshuaj no tau pib muaj kev xav tsis zoo thiab lub zog ntau dhau, thiab qee tus ntawm lawv txawm pib cuam tshuam kev thaj yeeb nyab xeeb.

Xyoo 1952, tus kws kho mob Fabkis txoj kev puas siab puas ntsws Jean Delay tau qhia txog qhov ua tau zoo ntawm cov tshuaj no hauv kev kho kev nyuaj siab. Txoj kev tshawb no tau rov hais dua los ntawm Asmeskas kws kho mob hlwb - nws yog thaum xyoo 1953 uas Max Lurie thiab Harry Salzer tau hu cov tshuaj no "antidepressants."

2. Puas yog cov tshuaj tiv thaiv kev nyuaj siab ntawm lub sijhawm tshiab txawv ntawm lawv cov qub qub?

Lawv yog cov yam ntxwv los ntawm cov kev mob tshwm sim tsawg dua nrog kev ua haujlwm siab. Cov tshuaj antidepressants tshiab ua rau cov receptors ntawm lub hlwb "ntau lub hom phiaj", lawv qhov kev txiav txim yog xaiv. Tsis tas li ntawd, ntau cov tshuaj tiv thaiv kev nyuaj siab tshiab ua tsis tau tsuas yog ntawm serotonin receptors, tab sis kuj ntawm norepinephrine thiab dopamine receptors.

3. Vim li cas cov tshuaj tiv thaiv kev nyuaj siab muaj ntau yam tshwm sim?

Qhov tseeb, nws yog lus dab neeg hais tias muaj ntau ntawm lawv. Antidepressants muaj qhov nruab nrab ntau qhov kev mob tshwm sim raws li qhov paub zoo analgin.

Cov kev mob tshwm sim ntawm cov tshuaj tiv thaiv kev ntxhov siab yog vim lawv cov txiaj ntsig ntawm serotonin, norepinephrine, dopamine, nrog rau cov tshuaj histamine receptors, adrenoreceptors thiab cholinergic receptors hauv lub hlwb. Cia kuv muab qhov piv txwv uas kuv nyiam rau koj txog serotonin. Txhua leej txhua tus xav tias cov tshuaj no muaj nyob rau hauv lub hlwb. Tab sis qhov tseeb, tsuas yog 5% ntawm lub cev tag nrho cov serotonin nyob rau hauv lub hlwb! Nws feem ntau pom muaj nyob rau hauv qee lub paj hlwb ntawm lub plab zom mov, hauv platelets, hauv qee lub cev tiv thaiv kab mob.

Lawm, thaum noj tshuaj antidepressants, cov ntsiab lus ntawm serotonin nce tsis tau tsuas yog nyob rau hauv lub hlwb, tab sis kuj nyob rau hauv lub cev tag nrho. Yog li ntawd, thawj hnub ntawm kev nkag, xeev siab thiab plab tsis xis nyob yog ua tau. Tsis tas li ntawd, serotonin yog lub luag haujlwm tsis yog tsuas yog rau lub siab thiab ua haujlwm ntawm lub paj hlwb rau sab nraud stimuli, tab sis kuj yog ib qho inhibitory neurotransmitter, yog li, piv txwv li, cov kev mob tshwm sim nyob rau hauv daim ntawv ntawm kev txo qis libido.

Nws feem ntau siv li ib lub lis piam rau lub cev kom hloov mus rau cov ntsiab lus serotonin hloov.

4. Puas muaj peev xwm ua tau rau cov tshuaj tiv thaiv kev nyuaj siab?

Cov khoom uas ua rau muaj kev quav yeeb quav tshuaj muaj ntau tus yam ntxwv:

• uncontrollable cravings rau kev siv tshuaj

• kev loj hlob ntawm kev kam rau siab rau cov tshuaj (ib tas li ntawm cov tshuaj yuav tsum tau kom tau txais cov nyhuv),

• muaj cov tsos mob ntawm kev tshem tawm (tso tawm, hangover).

Tag nrho cov no tsis yog yam ntxwv ntawm antidepressants. Lawv tsis ua rau muaj kev nce siab hauv lub siab, tsis hloov kev nco qab, kev xav. Txawm li cas los xij, feem ntau cov kev kho mob nrog cov tshuaj tiv thaiv kev ntxhov siab yog ntev heev, yog li ntawd, yog tias kev kho mob cuam tshuam ua ntej, cov tsos mob mob yuav rov qab los dua. Feem ntau nws yog vim qhov no uas tib neeg ntseeg hais tias cov tshuaj tiv thaiv kev ntxhov siab yog kev quav tshuaj.

Anastasia Ermilova, tus kws kho mob hlwb:

5. Cov tshuaj tiv thaiv kev nyuaj siab ua haujlwm li cas?

Muaj ntau pawg ntawm cov tshuaj tiv thaiv kev nyuaj siab. Cov hauv paus ntsiab lus ntawm lawv txoj haujlwm yog ua raws li kev tswj hwm ntawm lub hlwb neurotransmitters - piv txwv li, serotonin, dopamine, norepinephrine.

Yog li, feem ntau "nrov" pawg ntawm cov tshuaj tiv thaiv kev nyuaj siab - SSRIs (xaiv serotonin reuptake inhibitors) - nce cov serotonin hauv cov synaptic cleft. Nyob rau tib lub sijhawm, cov tshuaj tiv thaiv kev ntxhov siab ua rau muaj kev ua haujlwm zoo ntawm lub siab tom qab, tab sis tsis ua rau muaj kev ntxhov siab.

Qhov thib ob tseem ceeb mechanism ntawm kev txiav txim yog kev ua kom cov neuronal loj hlob yam. Antidepressants pab tsim kev sib txuas tshiab hauv lub hlwb, tab sis cov txheej txheem no qeeb heev - yog li lub sijhawm ntawm kev noj cov tshuaj no.

6. Cov tshuaj tiv thaiv kev ntxhov siab puas kho tau tiag tiag lossis lawv tsuas yog siv tau rau lub sijhawm siv?

Cov nyhuv antidepressant tsuas yog tshwm sim los ntawm 2-4 lub lis piam ntawm kev nkag mus thiab ua kom lub siab nyob ruaj khov. Kev kho mob thawj zaug ntawm qhov teeb meem yog ua tiav kom txog rau thaum cov tsos mob ploj mus, tom qab ntawd rov qab los yog tiv thaiv tsawg kawg rau lub hlis - uas yog, tsim cov kev sib txuas ntawm neural heev uas "paub yuav ua li cas ua neej tsis muaj kev nyuaj siab thiab kev ntxhov siab."

Nrog rau kev rov qab los ntawm kev nyuaj siab, lub sijhawm ntawm kev kho mob yuav nce ntxiv, tab sis tsis yog vim qhov kev tsim ntawm kev vam khom rau cov tshuaj tiv thaiv kev ntxhov siab, tab sis vim yog cov yam ntxwv ntawm cov kab mob, kev pheej hmoo ntawm kev rov qab los thiab xav tau kev siv ntev dua ntawm " crutch" rau kev rov qab los.

Thaum kawg ntawm chav kawm ntawm kev kho mob, tus kws kho mob yuav maj mam txo qhov ntau npaum ntawm cov tshuaj tiv thaiv kev ntxhov siab kom tsis txhob tshem tawm cov tsos mob thiab tso cai rau cov txheej txheem biochemical hauv lub hlwb hloov mus rau qhov tsis muaj "Crutch". Yog li, yog tias koj tsis tso tseg kev kho mob ua ntej, ces koj yuav tsis tas yuav siv tshuaj tiv thaiv kev nyuaj siab dua.

7. Yuav ua li cas yog tias koj haus cawv thaum noj tshuaj tiv thaiv kev nyuaj siab?

Ua ntej ntawm tag nrho cov, nws yuav tsum tau nco ntsoov hais tias cawv muaj cov opposite nyhuv, uas yog "kev nyuaj siab". Nyob rau hauv cov lus qhia rau tag nrho cov tshuaj antidepressants, nws raug nquahu kom tso tseg cawv vim tsis muaj cov ntaub ntawv txhim khu kev qha ntawm kev sib cuam tshuam ntawm cov tshuaj no.

Hauv cov ntsiab lus yooj yooj yim: tsis muaj leej twg yuav muab cov lus teb rau koj thiab muaj kev lav phib xaub rau lo lus nug "nws puas tuaj yeem muaj ib khob cawv rau hnub so?" Nws tuaj yeem ua phem heev rau ib tus neeg uas muaj kev sib xyaw ua ke ntawm ib khob cawv thiab tsawg kawg ntawm cov tshuaj tiv thaiv kev ntxhov siab, thiab ib tus neeg nkag mus rau hauv binge thaum kho nrog kev xav "tej zaum nws yuav nqa nws lub sijhawm no" - thiab nws nqa nws (tab sis qhov no yog tsis yog).

Dab tsi tuaj yeem yog qhov tshwm sim? Siab surges, nce kev phiv, hallucinations. Yog li nws zoo dua los ua si nws nyab xeeb!

Oleg Olshansky, tus kws kho mob hlwb:

8. Cov tshuaj tiv thaiv kev nyuaj siab puas tuaj yeem ua rau muaj kev puas tsuaj tiag?

Kuv yuav hloov lo lus "nqa" mus "hu". Yog, lawv tuaj yeem - tom qab tag nrho, muaj kev phiv thiab contraindications. Cov tshuaj tiv thaiv kev ntxhov siab raug muab tshuaj rau qhov laj thawj zoo thiab tsim nyog. Thiab qhov no yog ua los ntawm tus kws kho mob uas yog lub luag haujlwm rau kev noj qab haus huv ntawm tus neeg mob: ob qho tib si raug cai thiab kev coj ncaj ncees.

Kuv yuav tsis sau dab tsi tuaj yeem tshwm sim los ntawm kev noj tshuaj tiv thaiv kev ntxhov siab - tsuas yog qhib cov lus qhia thiab nyeem kom zoo. Nws tseem yuav tau sau rau qhov feem pua ​​​​ntawm cov tib neeg muaj qhov no lossis qhov tshwm sim tsis zoo thiab nyob rau hauv cov xwm txheej twg nws yog kiag li tsis tuaj yeem coj lawv.

Qhov tseem ceeb tshaj plaws thaum muab tshuaj kho AD yog kom ntsuas tus neeg mob kom raug. Txhua yam tshuaj tuaj yeem tsim kev puas tsuaj. Kev kam rau tus kheej, qhov zoo ntawm cov tshuaj nws tus kheej thiab kev kuaj pom zoo ua lub luag haujlwm ntawm no.

9. Vim li cas cov tshuaj tiv thaiv kev nyuaj siab tsis yog tsuas yog rau kev nyuaj siab xwb, tab sis kuj rau lwm yam kev puas hlwb?

Muaj ntau txoj kev xav txog qhov ua rau muaj kev nyuaj siab. Qhov nrov tshaj plaws ntawm lawv yog raws li qhov tseeb tias ib tus neeg muaj qhov tsis txaus ntawm monoamines (neurotransmitters) - serotonin, dopamine thiab norepinephrine. Tab sis tib lub cev ntawm monoamines ua lub luag haujlwm tseem ceeb hauv kev txhim kho lwm yam kev mob.

10. Koj puas tuaj yeem noj tshuaj tiv thaiv kev ntxhov siab yog tias koj tsis muaj kev nyuaj siab, tab sis tsuas yog lub sijhawm nyuaj hauv koj lub neej?

Nws nyob ntawm seb lub xeev no "lub sijhawm nyuaj" tau coj tus neeg mus rau dab tsi. Nws yog txhua yam hais txog qhov nws xav li cas. Thiab tom qab ntawd tus kws kho mob tuaj rau kev cawm, leej twg tuaj yeem kuaj thiab ntsuas tus neeg mob. Lub sijhawm nyuaj tuaj yeem rub rau thiab qis mus rau qhov "hauv qab". Thiab antidepressants tuaj yeem pab koj ua luam dej. Txawm li cas los xij, qhov no tsis yog tshuaj ntsuab. Hloov koj lub neej tsis yog ib txwm yooj yim. Txawm li cas los xij, koj tsis tas yuav kuaj tus kheej.