Mishonga yenguva pfupi uye kwenguva refu inoshandiswa pakuzvidya mwoyo
Kana iwe uine chirwere chinokonzera kufunganya (GAD) iwe uchawanzogashira kusanganiswa kwekutaura kutaura uye chirongwa chemishonga. GAD inoratidzwa nezviratidzo zvisingagumi , kushushikana kwekunyanyisa uye kushungurudzika kusina kukwana kana kuti kwakaoma zvikuru kudarika kuzvidya mwoyo kunowanikwa nevanhu vakawanda. Zvidzidzo zvakawana kuti vazhinji ve 60 kusvika ku65 muzana yevaya vane GAD vanewo zvimwe zvirwere zvepfungwa pamwe chete nayo-kazhinji kacho kusanganiswa kwezvinotyisa zvinotyisa uye kuora mwoyo kukuru .
Mishonga yeGAD ikozvino inosanganisira benzodiazepines, antidepressants, uye azapirones.
Benzodiazepines
Benzodiazepines inoshanda mukuderedza kutyiswa kwezvinotyisa uye mufambiro wehuputi , pamwe chete nechinangwa chekutya kwekutya . Inoshandiswa kurapa zviratidzo zveGAD kwenguva pfupi apo zvirwere zvinodhaka zvinotora. Zvinodhaka mukirasi ino zvinosanganisira Klonopin (clonazepam), Ativan (lorazepam), uye Xanax (alprazolam).
Kunyange zvazvo benzodiazepines inokurumidza kukurumidza, inenge hafu yevarwere vanowana zviratidzo zvekudzorera pavanenge vabva pamishonga uye vanachiremba vakawanda vanotenda kuti varwere vanovawana vanogona kukurira kushivirira kumushonga. Kana imwechete yakakonzerwa nehutachiona yakagadzikana, chirwere che benzodiazepine chinoderera zvishoma nezvishoma kusvikira chinogona kumira zvakachengeteka.
Benzodiazepines inokonzera sedation uye inogonawo kuwedzera inowira, uye inokonzera kuvhiringidzika uye zvinetso zvepamusoro kune vakwegura. Munhu anoshanda nemichina yakasimba angavewo murombo.
Nhoroondo yekudhakwa kana doro kana kushandisa zvinodhaka kungave kusabvumirana nekushandisa benzodiazepine.
Antidepressants
Kune makirasi akasiyana-siyana evanhu vanodzvinyirira avo vanogona kushandiswa kubata GAD. Iyi mishonga inogona kutora mavhiki kuti iite. Nokuti zvinodhaka zvinopedzisira zvishoma nezvishoma kupfuura benzodiazepines, zvinowanzotarisirwa pamwe chete ne benzodiazepine panguva yekurapa kwokutanga.
- Sarudzo yeSerotonin Reuptake Inhibitors (SSRIs): Chikoro ichi chinosanganisira Lexapro (escitalopram), Paxil (paroxetine), Prozac (fluoxetine), uye Zoloft (sertraline). Iyo migumisiro yemaSRRI yakanyanya kuderera kupfuura yea tricyclic antidepressants (TCAs). SSRIs inobereka mashoma emagumisiro emwoyo uye kuderera kudhura uye sedation kupfuura maTCA.
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) : Chikoro ichi chinosanganisira Cymbalta (duloxetine) uye Effexor (venlafaxine), iyo inogona kushandiswa kuGAD. Vanonzi vanobudirira se-SSRIs uye ndeyokutanga kurapa kweGAD.
- Tricyclic Anodzvinyirira (TCAs) : Tofranil (imipramine) inowanzoshandiswa kurapa kushushikana. Zvimwe tricyclic zvinodhaka zvakawanikwa kuti zvinobudirira mukurapa chirwere chinotyisa chinosanganisira Pamelor (nortriptyline), Norpramin (desipramine), uye Anafranil (clomipramine). Tricyclics, kusiyana ne benzodiazepines, inoda chete miviri yezuva rimwe chete yemishonga. Vanodzidza zvakanaka uye vanobatsirawo kuchengetedza kusaora mwoyo, izvo zvinowanzokonzera kutyisa chirwere. Zvisinei, TCAs inogona kuita manzwiro akafanana nekutya kwekutya . Varwere vane chirwere chinotyisa chinowanzonyanya kunetseka kune tricyclics; vamwe vanogona kuve nokuita basa (kugadzikana kushungurudzika, kutsamwa, uye kusazorora) pakutanga kwekurapa. Kazhinji, kurapwa neTCA kunotanga nehana yakaderera yakawedzerwa munguva. Vamwe vanachiremba vanoratidzira kuti murwere aparadzise chirwere chacho, pamwe nehuwandu hwemishonga inotorwa vasati vavata, zvichiita kuti zvirwere zvakawanda zviitike apo murwere ari kurara. Chimwe chinhu chikuru chakaipa che tricyclics ndechokuti dzimwe nguva inobereka miviri yechiratidzo (yakadai sechezziness uye moyo palpitations) pamwe nekuwedzerwa kuwedzerwa uye kuwedzerwa.
- Monoamine Oxidase Inhibitors (MAOIs) : Mishonga iyi yakawanikwa ichibudirira zvikuru mukurapa kushungurudzika kwepfungwa, kusanganisira panic disorder uye social phobia . Kune, zvisinei, zvakadaro, mamwe matambudziko akaoma nemishonga iyi. Vanhu vanotora MAOIs vanofanira kuva nekudya kunogadziriswa nekuda kwechinhu chinonzi tyramine chinowanikwa mune zvimwe zvokudya. Kubatana pakati pe tyramine neMaOIs kunogona kukonzera dambudziko rehutachiona rinoratidzwa nekuwedzera kunoshamisa kweropa.
Azapirones
Buspirone inogona kushandiswawo kubata GAD. Zita reBuSpar harisisiri pamusika, asi zviwanikwa zvinogona kuwanikwa.
Buspirone inonoka kuita uye inoda mavhiki mashoma kuti atange kushanda. Buspirone haisi kukonzera sedation se benzodiazepines uye haitungamiri kuzvidzora zvinodhaka.
> Sources:
> Kuzvidya Mwoyo Matambudziko: Mhando, Kuziva nekurapa. NIH MedlinePlus. https://medlineplus.gov/magazine/issues/summer15/articles/summer15pg6-8.html.
> Generalized Anxiety Disorder: Kana Kushungurudzika Kunobvisa Kudzora. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad/index.shtml.
> Greist JH. Chirwere Chekunyanya Kunetseka (GAD). http://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/generalized-anxiety-disorder-gad#v1025319.
> Mishonga. Kuzvidya Mwoyo uye Kuora Mumizhonga Association of America. https://www.adaa.org/finding-help/treatment/medication.