Cov tshuaj kho kev ntxhov siab thiab phiv tshuaj

Zoo Siab

• Xaiv serotonin reuptake inhibitors
• SSRI phiv
• Serotonin-norepinephrine reuptake inhibitors
• SNRI phiv
• Tricyclic cov tshuaj tiv thaiv kev ntxhov siab
• Cov kev mob tshwm sim TCA
• Norepinephrine thiab dopamine reuptake inhibitors
• NDRI phiv
• Monoamine oxidase inhibitors
• MAOI phiv
• Tshuaj ntxiv ntshav lossis ntxiv tshuaj ntxiv rau
• Lwm cov tshuaj tiv thaiv kab mob

Txheej txheem cej luam

Kev kho rau kev puas siab ntsws loj (tseem hu ua kev nyuaj siab loj, chaw kho mob kev nyuaj siab, kev nyuaj siab unipolar, los yog MDD) yog nyob ntawm tus neeg thiab qhov mob loj ntawm tus mob. Txawm li cas los xij, cov kws kho mob feem ntau pom cov txiaj ntsig zoo tshaj plaws thaum ob leeg siv tshuaj kho mob, xws li tshuaj tiv thaiv kev ntxhov siab, thiab kev kho mob hlwb tau siv ua ke.

Tam sim no, ntau tshaj ob-kaum os tshuaj tiv thaiv kab mob siab muaj nyob rau.

Tshuaj tiv thaiv kev nyuab siab ua tiav rau kev kho kev nyuaj siab, tab sis tsis muaj ib qho tshuaj qhia tau muaj txiaj ntsig zoo tshaj plaws - nws nyob ntawm tus neeg mob thiab tus kheej li cas. Koj yuav tsum tau noj cov tshuaj kom tsis tu ncua rau ntau lub lis piam txhawm rau kom pom cov txiaj ntsig thiab saib xyuas qhov tshwm sim.

Nov yog cov tshuaj tiv thaiv kev ntxhov siab feem ntau thiab lawv cov kev mob tshwm sim feem ntau.

Xaiv serotonin reuptake inhibitors

Txoj kev qhia txog kev kho tus mob kev nyuab siab yog pib rau daim ntawv yuav tshuaj rau serotonin reuptake inhibitor (SSRI).

Thaum lub hlwb tsis ua cov serotonin txaus, lossis nws tsis tuaj yeem siv cov serotonin uas twb muaj lawm, cov tshuaj hauv lub hlwb yuav tsis sib luag. SSRIs ua haujlwm hloov qib ntawm serotonin hauv lub hlwb.

Tshwj xeeb, SSRIs thaiv qhov reabsorption ntawm serotonin. Los ntawm kev thaiv qhov rov coj mus ua dua tshiab, cov neurotransmitters tuaj yeem xa thiab tau txais cov lus tshuaj lom neeg zoo dua. Qhov no tau xav los ua kom muaj kev hloov siab dua uas muaj kev cuam tshuam ntawm serotonin thiab txhim kho cov tsos mob kev nyuaj siab.

Cov SSRIs uas nquag muaj xws li:

• fluoxetine (Prozac)
• citalopram (Celexa)
• paroxetine (Paxil)
• sertraline (Zoloft)
• escitalopram (Lexapro)
• fluvoxamine (Luvox)

SSRI phiv

Feem ntau cov kev mob tshwm sim los ntawm cov neeg uas tau siv cov SSRIs muaj xws li:

• teeb meem plab zom mov, suav nrog raws plab
• xeev siab
• qhov ncauj qhuav
• nyob tsis tswm
• mob taub hau
• pw tsis tsaug zog los sis nkees nkees
• tsawg zuj zus kev sib deev muaj siab thiab nyuaj ncav lub orgasm
• erectile kawg
• kev ntxhov siab (jitteriness)

Serotonin-norepinephrine reuptake inhibitors

Qee zaum hu ua Serotonin-norepinephrine reuptake inhibitors (SNRIs) qee zaum hu ua dual reuptake inhibitors. Lawv ua haujlwm los ntawm thaiv cov khoom reuptake, lossis rov kho dua, ntawm serotonin thiab norepinephrine.

Nrog ntxiv cov serotonin thiab norepinephrine ncig hauv lub hlwb, lub hlwb cov tshuaj muaj kuab yuav rov pib dua, thiab cov neurotransmitters xav kom sib txuas lus tau zoo dua. Qhov no tuaj yeem txhim kho mus ob peb vas thiab pab daws cov tsos mob ntawm kev ntxhov siab.

Cov tshuaj SNRI feem ntau muaj xws li:

• venlafaxine (Effexor XR) Kev Siv Tshuaj
• desvenlafaxine (Pristiq)
• duloxetine (Cymbalta)

SNRI phiv

Feem ntau cov kev mob tshwm sim los ntawm cov neeg uas tau siv cov SNRIs suav nrog:

• nce hws
• nce ntshav siab
• lub plawv dhia
• qhov ncauj qhuav
• lub plawv dhia ceev
• teeb meem plab zom mov, feem ntau cem quav
• hloov pauv hauv qab los noj mov
• xeev siab
• kiv taub hau
• nyob tsis tswm
• mob taub hau
• pw tsis tsaug zog los sis nkees nkees
• txo qis libido thiab teeb meem ncav lub orgasm
• kev ntxhov siab (jitteriness)

Tricyclic cov tshuaj tiv thaiv kev ntxhov siab

Tricyclic antidepressants (TCAs) tau tsim tawm xyoo 1950, thiab lawv tau nyob nrog kev siv tshuaj tiv thaiv ntxov tshaj plaws los siv los kho kev nyuaj siab.

TCAs ua haujlwm los ntawm thaiv cov khoom reabsorption ntawm noradrenaline thiab serotonin. Qhov no tuaj yeem pab lub cev ua kom ntev li ntawm lub zog-txhawb cov txiaj ntsig ntawm noradrenaline thiab serotonin nws tso tawm ntawm lub cev, uas tuaj yeem txhim kho mus ob peb vas thiab txo qhov tshwm sim ntawm kev nyuaj siab.

Ntau tus kws kho mob tau sau npe rau TCAs vim tias lawv xav tias muaj kev nyab xeeb dua li cov tshuaj tshiab.

Feem ntau cov tshuaj TCA muaj xws li:

• amitriptyline (Elavil)
• Tshuaj imipramine (Tofranil)
• doxepin (Sinequan)
• cov tshuaj trimipramine (Surmontil)
• clomipramine (Anafranil)

Cov kev mob tshwm sim TCA

Cov kev mob tshwm sim los ntawm hom tshuaj tiv thaiv kev ntxhov siab zoo li yuav ua mob nyhav. Tus txiv neej muaj kev cov kev mob tshwm sim tsawg dua li cov poj niam.

Feem ntau cov kev mob tshwm sim los ntawm cov neeg uas tau siv TCAs suav nrog:

• hnyav
• qhov ncauj qhuav
• qhov muag plooj
• tsaug zog
• lub plawv dhia ceev lossis lub plawv dhia tsis xwm yeem
• tsis meej pem
• zais zis muaj teeb meem, suav nrog nyuaj rau tso zis
• cem quav
• poob ntawm kev sib deev muaj siab

Norepinephrine thiab dopamine reuptake inhibitors

Tam sim no tsuas yog ib qho NDRI yog FDA pom zoo rau kev ntxhov siab.

• kev tsim kho (Wellbutrin)

NDRI phiv

Feem ntau cov kev mob tshwm sim los ntawm cov neeg uas siv cov NDRI muaj xws li:

• qaug dab peg, thaum noj cov koob siab kawg
• ntxhov siab
• hyperventilation
• kev tshee
• kev ntxhov siab (jitteriness)
• txob taus
• tshee
• teeb meem pw tsaug zog
• nyob tsis tswm

Monoamine oxidase inhibitors

Monoamine oxidase inhibitors (MAOIs) yog cov tshuaj uas feem ntau tau hais tseg tsuas yog thaum ob peb lwm yam tshuaj noj thiab kev kho mob tau ua tsis tiav.

MAOIs tiv thaiv lub hlwb los ntawm kev rhuav tshem cov tshuaj norepinephrine, serotonin, thiab dopamine. Qhov no tso cai rau lub hlwb kom tswj hwm qib siab ntawm cov tshuaj no, uas yuav ua rau muaj kev cuam tshuam zoo siab thiab txhim kho kev sib txuas lus neurotransmitter.

Cov MAOI feem ntau muaj xws li:

• phenelzine (Nardil)
• selegiline (Emsam, Eldepryl, thiab Deprenyl)
• tranylcypromine (Parnate)
• isocarboxazid (Marplan)

MAOI phiv

MAOIs muaj ntau yam kev mob tshwm sim, ntau yam ntawm lawv qhov hnyav thiab cov phom sij. MAOIs tseem muaj peev xwm ua kom muaj kev phom sij sib cuam tshuam nrog cov zaub mov thiab cov tshuaj yuav tom khw.

Feem ntau cov kev mob tshwm sim los ntawm cov neeg uas siv MAOIs suav nrog:

• nruab hnub pw tsaug zog
• insomnia
• kiv taub hau
• ntshav siab
• qhov ncauj qhuav
• kev tshee
• hnyav
• txo qis kev sib deev muaj siab lossis muaj teeb meem ncav lub orgasm
• erectile kawg
• zais zis muaj teeb meem, suav nrog nyuaj rau tso zis

Tshuaj ntxiv ntshav lossis ntxiv tshuaj ntxiv rau

Txog kev kho kom tiv thaiv kev nyuaj siab los yog rau cov neeg mob uas tseem muaj cov tsos mob uas tsis tau kho, tej zaum yuav tau noj tshuaj lwm yam tshuaj.

Cov tshuaj ntxiv no feem ntau siv los kho lwm cov kev puas siab puas ntsws thiab muaj cov tshuaj tiv thaiv kev ntxhov siab, tswj kev ntxhov siab, thiab tshuaj tiv thaiv kab mob.

Cov piv txwv ntawm cov tshuaj tiv thaiv kev puas tsuaj uas tau pom zoo los ntawm Chaw Tswj Xyuas Khoom Noj thiab Tshuaj (FDA) rau kev siv ntxiv cov tshuaj rau kev nyuaj siab muaj xws li:

• aripiprazole (Txom Nyem)
• quetiapine (Seroquel)
• olanzapine (Zyprexa)

Cov kev mob tshwm sim ntawm cov tshuaj ntxiv no tuaj yeem zoo ib yam li lwm cov tshuaj tiv thaiv kab mob.

Lwm cov tshuaj tiv thaiv kab mob

Cov tshuaj Atypical, lossis cov uas tsis haum rau lwm cov tshuaj, suav nrog mirtazapine (Remeron) thiab trazodone (Oleptro).

Qhov tseem ceeb tshwm sim los ntawm cov tshuaj no yog nkees nkees. Vim tias ob yam tshuaj no tuaj yeem ua rau qaug zog, lawv ib txwm noj thaum hmo ntuj kom tiv thaiv kev saib xyuas thiab tsom teeb meem.