Ukuqwalasela ngokugqithiseleyo ukhuseleko lwee-Antidepressants njengeZoloft ngexesha lokukhulelwa
Uxinzelelo lwezonyango luyinkxalabo enkulu yeemeko ezichaphazela abantu ngokwahlukileyo. Ngokwe-Matshi ye-Dimes, malunga no-1 kwabahlanu abafazi abakhulelweyo banemiqondiso yokudandatheka. Ukuxinezeleka ngexesha lokukhulelwa kunokuchaphazela umama nomntwana. Kukho umngcipheko ophezulu wezonyango ezifana ne- preeclampsia kwiimama ezidandathekileyo, kwaye kunomngcipheko omkhulu wokuba umama akanakuyinyamekela ngokufanelekileyo, akayi kudibanisa nomntwana wakhe, okanye angayi kubakho ukutyelelwa kokunyamekela kokubeleka.
AmaMama aba noxinzelelo xa bekhulelwe bangaba mngcipheko omkhulu wokudakumba kwesithuba . Phakathi kwabantu, iimpawu kunye nemiphumo yokudandatheka okungaphendulwanga kunokuqala ukusuka kwi-mild to severe.
Ukuhlola nokuPhatha uxinzelelo ngexesha lokukhulelwa
Uninzi kunje, kukho ukwanda kwenzalo kwingcamango yokujonga abafazi abakhulelweyo ukuba bacindezeleke kwaye banike uncedo apho kuyimfuneko. Uncedo lunokubandakanya inkxaso kunye neengqondo, okanye kwezinye iimeko, amayeza. Kodwa abaninzi abafazi bayazibuza ukuba imithi yokuxhatshazwayo ikhuselekile ngexesha lokukhulelwa. Ukongezelela, oomama abajongene nokudandatheka ngaphambi kokukhulelwa badla ngokuzibuza ukuba ukhuselekile ukuba bahlale kwiyeza zabo ngexesha lokukhulelwa. Ngelishwa, impendulo ayilula "ewe." Kukho ezinye iingozi zokusebenzisa izidandatheko ngexesha lokukhulelwa. Le mngcipheko kufuneka ilinganiswe kwimeko yecala ngokubhekiselele kwimingcipheko yokungasebenzisi izidandlululo ngexesha lokukhulelwa.
Ukhuselo lwabaxinzelelekileyo ngexesha lokukhulelwa kunye neengozi yokutshatyalaliswa komtshato
Izidakamizwa ezisetyenziswa ngokuqhelekileyo ziwela kwiindidi ze-tricyclic antidepressants (TCAs) (njengamagama amatye eTofranil no-Elavil) kunye ne-serotonin reuptake inhibitors (SSRIs) ekhethiweyo (njengegama lomgama iZoloft kunye neProzac). Zimbini iiklasi zonyango zihlala ziqhubeka ngokukhulelwa xa umama ezisebenzisa zikhulelwa, kwaye ngamanye amaxesha zichazwe kwabasetyhini abakhulelweyo abanokuxinezeleka okukhulu ngexesha lokukhulelwa.
Ii-TCA ziye zadlula ixesha elide kune-SSRI kwaye ziye zafundiswa ngokubanzi, nangona uphando olungakumbi lufunekayo nakwiindidi zombini.
Ubungqina obukhokelayo bubonisa ukuba ukuboniswa kokubili kwi-SSRIs kunye ne-TCAs kunokudibana neempawu zokurhoxisa kwiintsana ezisandul 'ukuzalwa, kodwa ezi zimpawu zihlala zihamba emva kwexesha kwaye zingabhubhisi ubomi okanye zingonakalise ixesha elide. Uphando ngeempembelelo zexesha elide kunye neziphene zokuzalwa zixutywe, ngakumbi kwi-SSRIs.
Umbuzo wokungcungcutheka komngcipheko kuye kwaba ngquzulwano. Ubungqina obuphathelele ukhuseleko lwe-SSRIs, ngokukodwa, luxutywe kunye nezifundo ezininzi ezineesampula ezincinci (inani elincinci labathathi-nxaxheba); Nangona kunjalo, uphando olukhulu lwango-2010 lwalubonisa ukuba i-SSRI isebenzisayo kwi- trimester yokuqala ibonakala ijongene nokunyuka kwama-68% engozini yokukhulelwa kwesisu. Akukho nxu lumano phakathi kwe-SSRI kunye nokukhulelwa komzimba kuye kwabonakaliswa, kodwa ngokwemvelo ukufunyanwa kukukhathazayo kubafazi abaninzi kunye noogqirha babo. Akukho bubungqina obuqhagamshelana nokusetyenziswa kwe-TCAs ekukhulelweni kwengozi yokukhulelwa kwesisu.
Ngaba Ufanele Uthabathe I-Anti-pressressant While While pregnant?
Naluphi na uphando oludibanisa iingcinezelo zokuxhatshazwa kwegazi, ukukhubazeka kokuzalwa, okanye ezinye iingxaki, kubalulekile ukuhlenga isizathu sokufumanisa.
Ngaphandle kokunxibelelana kwamanani phakathi kwe-TCA okanye i-SSRI ukuvezwa kunye neengxaki ezahlukahlukeneyo, kunokuba nzima ukufumanisa ngokuqinisekileyo ukuba le nkunkuma yintoni eyabangela umphumo ongekhoyo. Kungenzeka ukuba le nkunkuma inobungozi ekuveliseni iintsana, kodwa kunokwenzeka ukuba abafazi abakwiimithi ezixinzelelekileyo bexinezelekile kakhulu ukusuka ekuqaleni kwaye kukho imeko yezinto eziphilayo okanye eziphathekayo kula ma mama ukuba zilandelelanise ukulungiswa okufunyenweyo kwisifundo .
Kwakhona kubalulekile ukuhlola ubunzima bezonyango ngokubhekiselele kwimingcipheko yokungabi nonyango. Nakuphi na ukwanda kwengozi kwintsana kunokuba yingozi, nangona ingozi ebanzi iyinto encinci.
Nangona kunjalo, uphando lubonisa ukuba ukudakumba kubangelwa ukuphinda kukhulelwe, xa kukho ukhuseleko oluphezulu kumama abashiya amayeza abo - ngokokuba oogqirha bahlala bexhala ukukhuthaza ukuba omama bayeke unyango lwabo, ngokukodwa banike ubungqina obunzima bokubeka ingozi ekusebenziseni izidakamizwa xa bekhulelwe. Ukuxinezeleka kokungaxakali xa ukhulelwe kudibaniswa nobungozi obuninzi kubo bobabini kunye nosana, kuxhomekeke kubukhulu bexinzelelo, ngoko kuba ngumbuzo woluphi uhlobo lweengozi olukhulu. Impendulo mhlawumbi iyaxutyushwa ngokucokisekileyo kunye nodokotela wakho.
Iingxabano zokuSebenzisa uxinzelelo ngexesha lokukhulelwa
Njengoko kuchaziwe ngasentla, ukudandatheka okungaphendulwanga kubangela ingozi ecacileyo kumama olindelekileyo kunye nosana. Oomama abaxinezelekileyo abanako ukuhamba ngethuba lokutyelela ngokunyanzelekileyo, banokungena ekusebenziseni kakubi iziyobisi, abanako ukuxakishwa kunye neentsana zabo, kwaye banokuthi bangabandezeleka ngenxa yokuxinezeleka kwangemva kokubeleka kwazo zonke izinto ezinokuchaphazela amandla omama okunyamekela umntwana ngaphambi kokuba emva kokuzalwa.
Uninzi lwaphando oluya kumhla alubonakali olubi kakhulu lwexesha elide elijongene nokusetyenziswa kwe-TCA okanye i-SSRI yokudandathelanisa ngexesha lokukhulelwa, nangona ubungqina buxutywe. Umngcipheko ophezulu kakhulu ubonakala ngathi iintsana ezisandul 'ukuzalwa zikwazi ukufumana ukuyeka ukutshatyalaliswa kwesifo ngexesha lokuzalwa, kunye nokukhala ngokugqithiseleyo, ukukhala, ukunyamezela, kunye nokukhathazeka - kodwa iimpawu zivame ukuhamba kwiiveki ezimbini.
Ezinye iingxelo zibonise umngcipheko ophezulu wemeko ebizwa ngokuba yingcinezelo yomshukela wentsholongwane yintsana (PPHN) kwiintsana ezichazwe kwi-SSRI xa ukhulelwa. I-PPHN ingaba yinto enzulu, kodwa ingozi enkulu yeso simo iphantsi nakwiintsana ezityhila, ngoko ke oogqirha banokugqiba isigqibo sokuba ukuqhubeka nokusetyenziswa kweziyobisi kunokuba ngaphezu komngcipheko. Ezinye iingxelo zibonisa ingozi yokwanda kwentliziyo yesisu kunye nokusetyenziswa kwe-paroxetine (Paxil), kodwa kwakhona, umngcipheko jikelele uhlala phantsi kunye nabamama abakhulelweyo ngelixa usebenzisa i-Paxil banokukhetha ukuqhubeka nokusetyenziswa kweziyobisi.
Uninzi uphando alubonakalisi iingxaki zokuziphatha okanye ezinye igalelo elide kwixesha elide kubantwana abaye bavezwa kwiinkcenkceshe ezinxamnye ne-utero, nangona uphando oluthe lufunekayo. Kodwa uphando alunakho ngokukhawuleza kwimiphumo yokuziphatha kwexesha elide kubantwana abazalwa ngamama ngokudandatheka okungaphendulwanga, kwaye kuyacaca ukuba ukudandatheka okungaphendulwanga kungaxhatshazwa ngokulinganayo okanye kunobungozi kunokuba kufakwe imithi yokuxhatshazwayo.
Nangona uphando lwango-2010 lubonise ukuba ukusetyenziswa kwe-SSRI ekukhulelweni kwakuxhomekeke kwenyuka kwe-68% engozini yokukhulelwa kwesisu , kunokunyanzeliswa ukuba ukwanda kwengozi kunokugqithiswa ngamancedo okusebenzisa izidandlululo. Ukuba uwonkewonke unomngcipheko we-15% wokutshatyalaliswa komzimba, ukunyuka kwe-68% kwengozi kuya kuthetha ukuba ingozi ye-25% yokungabikho kokusweleka komzimba kwabasetyhini basebenzisa amayeza. AmaMom eneembali zokudakumba okukhulu angenza isigqibo kunye kunye noogqirha babo ukuba umngcipheko uhlala uvumelekile. Kufuneka kugcinwe engqondweni ukuba umbutho ekufundweni uhlala ungqinelana kungekho bu bungqina bokuba iziyobisi ze-SSRI zijongene nobungozi bokungcoliswa komzimba.
Iingxabano zokulwa nokuxhatshazwa kwexesha lokukhulelwa
Kwiphepha le-flip, abaninzi abanamama balindele ukujonga iinkcukacha zokhuseleko kwaye banqume ukuba nayiphi na ingozi eyongeziweyo kwiintsana zabo - kungakhathaliseki ukuba encinci - ayimkelekanga. Nangona iimpawu ze-neonatal behavior syndrome zidlulileyo, iimpembelelo ezinjengeentliziyo ezinokukhubazeka kunye ne-PPHN zinokuba nemiphumo emide. Abanye besetyhini banokuvakalelwa ukuba ukuba zabo iintsana zihlakulele ezi ngxaki, abayi kuze bakwazi ukuvuma ukuba iingxaki ezinokuthi zithintelwe.
Ngokufanayo, oomama abaphazamiseka xa besetyenziselwa i-SSRI baze bafunde ukuxhamla okunokwenzeka phakathi kwe-SSRIs kunye nokuphuphuma kwesisu kungafumana ithuba lokungabikho komngcipheko wokuphuphuma komzimba ngokulinganayo. Uphando lubonisa ukuba umama onomlando weengqondo odlulileyo unomngcipheko ophezulu wokuxinezeleka okanye ukuphazamiseka kwengxaki emva kokusweleka komzimba , kwakhona, ngoko ingozi eyongeziweyo yokutshatyalaliswa komama kumama ekuphathweni nge-SSRI akufanele ihoywa.
Ekugqibeleni, imibuzo ihleli phezu kweenzuzo zokuxhatshazwa kweengxaki zokudandatheka - uphando luye lwaxutyushwa ekusebenzeni kweziyobisi ngaphaya kwe placebo yokudandatheka okungekho nzima. Abanye abasetyhini abathatha i-anti-depressants banokukwazi ukulawula ukuxinezeleka kwabo ngaphandle kweyeza, nangona abo abanokudakumba okukhulu bangakwazi ukuhlangabezana nonyango ngaphandle kokonyango.
Apho le Ndaba ibeka khona
Akukho zimpendulo ezilula. Ikhondo elifanelekileyo lezenzo mhlawumbi lihluka ngumntu. Umama ogxininisekile kwaye ongakaze afune ukuzibulala angagqiba isigqibo sakhe ngedokotela lakhe ukuze azame ukuphuma kumachiza akhe. Kodwa ngokuchaseneyo, kumama onomlando wokuzama ukuzibulala ongakhange uphuculwe kwi-psychotherapy kwaye ngubani ekugqibeleni ozinzile kwiyeza elinoxinzelelo, ingozi yokuyeka unyango ingaba ngaphezu kweengozi zokuqhubeka unyango.
Njengokuba kukho ezininzi iinkalo zezempilo, abafazi kufuneka baxoxe ngeenzuzo kunye nobungozi bobabini izifundo zentsebenzo kunye noogqirha babo. Abasetyhini abasele bexinzeleleke kwaye abaxhalabele ngemiphumo yeliyobisi ngexesha lokukhulelwa kufuneka bathethe kakuhle oogqirha ngaphambi kokukhulelwe, njengokuba isilingo sokuyeka iigulana sinokuthi senziwe ngcono phambi kokukhulelwa. Abasetyhini abakhulelweyo ngelixa bexinzeleleka ku-anti-stress should not stop their medication ngaphandle kokubonisana noogqirha babo-nokuba ngaba le nkunkuma iya kugqitywa, kungenokuba ngcono ukunciphisa i-dose kunokunciphisa i-turkey ebandayo. Ugqirha wakho unokukwacebisa ngamacandelo enkxaso okanye kwezinye izilwanyana ezingezizo zonyango kwindawo enokukunceda ukuba uphathe imeko yakho.
Kwaye ekugqibeleni, abafazi abagqibayo ukuqhubeka nokunyanga amayeza ngexesha lokukhulelwa akufanele bazive benetyala ngokwenza njalo. Ukunyanga unyango lwezoxinzelelo kungekhona umlingiswa, kwaye nokuba ngumama olungileyo kuthetha ukunyamekela ngokwaneleyo ukuze ukwazi ukusebenza nokunyamekela umntwana wakho ngaphambi nangemva kokuzalwa. Nangona ukukhulelwa komzimba okanye ukukhulelwa komnye ukukhulelwa kwenzeka xa uthabatha u-anti-depressants, unxibelelwano alukho nto ecacileyo ukuba kufuneka uthathe i-anti-depressants yeyona nto imbangela-ngokulinganayo okanye ngaphezulu ukuba kukho enye ingcaciso. Okwangoku, ulungelelanisa iintlobo zokugweba kwaye ungacingi ukuba kufuneka uzilungiselele ukhetho lwakho kunoma ubani. Nangona iimbono ezininzi ezinomdla ngaphandle kwesi sihloko, wena kunye nogqirha wakho usemgangathweni ophezulu wokukwazi okulungileyo kuwe.
Imithombo:
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