Ziziphi iimpawu zophando
I-Amitriptyline yinto ethandekayo yokuxhatshazwayo ekhoyo kuphela kwifomu ejwayelekile e-US Yayisetyenziselwa ukuthengiswa phantsi kwegama legama Elavil.
U-Amitriptyline uhlelwa njenge-tricyclic antidepressant. Kwiminyaka, oogqirha baye bacinga ukuba yonyango lokuqala lwe- fibromyalgia kunye nesifo esingapheliyo sokugula ( ME / CFS ). Nangona kunjalo, oku kwenzeka ngokubanzi ukusuka kokusetyenziswa kwesilingo kunye neeposiso kunezifundo zeklinikhi.
Kwiminyaka yakutshanje, ingakumbi ngokufika kwe-FDA-avunyelwe unyango lwe-fibromyalgia, ukusetyenziswa kwe-amitriptyline kulezi zifo kuye kwehla. I-Amitriptyline isesekho, nangona kunjalo, ngamanye amaxesha isetyenziswe njengesigqirha sokubhekisela kwizifundo zonyango lwe-fibromyalgia, kwaye oogqirha abaninzi basoloko bayibeka le miqathango.
Ingaba isebenza kanjani
I-Amitriptyline kunye nezinye izidakamizwa ze-tricyclic zicingelwa ukuba zonyusa inani le-neurotransmitters serotonin kunye ne-norepinephrine ukuba ingqondo yakho ingayisebenzisa. Benza oku ngokunciphisa inkqubo ebizwa ngokuthi "i-reuptake," yilapho iiseli ezikhethekileyo zithatha i-neurotransmitters ezisetyenzisiweyo ukuze zisebenzise kwakhona kwenye indawo.
Amanye ama-antidepressants, abizwa ngokuba yi-reuptake inhibitors, zisebenzisa iindlela ezahlukeneyo zokuphumeza umphumo ofanayo.
I-Serotonin kunye ne-norepinephrin zikholelwa ukuba zichithwe kwi-fibromyalgia kunye ne-ME / CFS.
Kwakhona Qaphela:
- Ukuqonda iReuptake
- I-Serotonin kwi-Fibromyalgia & ME / CFS
- I-Norepinephrine e-Fibromyalgia & ME / CFS
Fibromyalgia
Ukuhlaziywa kwe-amitriptyline ye-2012 ye-fibromyalgia kwakukho oku kuthetha ukusetyenziswa kweziyobisi kwi-fibromyalgia:
I-Amitriptyline iye yonyango lokuqala lweentlungu ze-neuropathic iminyaka emininzi. Inyaniso yokuba akukho bungqina obungenakulungelelaniswa ngempembelelo enokusidimaza, kodwa kufuneka ilandelelaniswe neminyaka emininzi yonyango oluphumelelayo kwizigulane ezininzi ezineentlungu zesifo se-neuropathic okanye i-fibromyalgia. (Moore, et al, ngezantsi.)
Ukuhlaziywa kuyaqhubeka kuthi ukugqithiswa kokusebenza kwayo kukuxhalabisa kuba uphando lwangoku nje lubonisa abantu abancinci kuphela abazameyo baya kuba neentlungu eziyanelisayo.
Olunye uphando kulo nyaka, olubandakanya i-antilopressants duloxetine kunye ne-milnacipran, lathi:
Inani elincinci lezigulane lifumana uncedo oluphawulekayo lwezonyango ngaphandle kweminye emibi. Nangona kunjalo, inani eliphawulekayo lezigulana liyeka ukuyeka ukunyanga ngenxa yeemiphumo ezingathintekiyo okanye amava kuphela ukukhululeka kweempawu, ezingenakugqithisa iziphumo ezimbi. (Hauser, Wolfe et al, ngezantsi.)
Ukuhlaziywa kuka-2011 (uClemons, et al, ngezantsi) waphetha ngokuthi i-amitriptyline ayifanele ithathwe njenge-gold-standard for fibromyalgia ngenxa yokunciphisa izifundo ezaye zaqhutywa.
Nangona kunjalo, ngo-2011, ukuhlaziywa kweeklasi zamachiza kwi-fibromyalgia (i-Smith, et al, ngezantsi) yatsho ukuba i-amitriptyline yayifana nezidakamizwa ezivunywe yi-FDA-i-Lyrica (pregabalin), i-Cymbalta (duloxetine) kunye no-Savella (milnacipran) xa Kwaba buhlungu kunye nokukhathala.
Abanye oogqirha banokukhetha i-amitriptyline ngezizathu ezibini:
- Umlando wayo omdala wokusetyenziswa, kunye
- Ixabiso layo eliphantsi lifaniswa neziyobisi ze-FDA ezivunyiweyo ze-fibromyalgia.
Ngokomzekelo, ukunikezelwa kweenyanga ezi-one-amitriptyline kungadala phakathi kwe-$ 15 ne-$ 65, kuxhomekeke kumyinge. Okwangoku, uncedo lwenyanga olulodwa lweCymbalta (duloxetine), iLyrica (pregabalin), okanye i-Savella (milnacipran) iqalisa malunga ne-$ 125 kwaye inokufikelela kwi-$ 180. (Oku kungatshintsha njenge duloxetine yesizukulwana ezayo kwimarike.)
Isifo Sokunyamekela Isifo esingapheliyo
I-Amitriptyline inomlando omdala wokusetyenziswa kwe-ME / CFS, kwakhona nangona kungabikho kwezifundo zeklinikhi nangenxa yezinto ezibonakalayo zokuphucula ihlabathi. Uphando oluncinane luye lwenziwe.
Uvavanyo olwenziwa ngo-2012, nangona kunjalo, lujonge i-amitriptyline kwi-ME / CFS kwaye lufumene ukuba nguyena kuphela phakathi kwezidalwa ezixhatshazwayo ezivavanyayo ezivimbela ukukhululwa kwe-cell-cell ye- cytokines engama -inflammatory, okukholelwa ukuba iyadlala indima kwi-ME / CFS.
Isistim
Kubantu abadala, i-amitriptyline i-dosage ingaba i-40 mg ukuya kwi-150 mg ngosuku. Ikwahlukana ngokubanzi ngamanani amaninzi.
Ingathatha ixesha elide nje ngenyanga ukuba uqaphele utshintsho ngenxa yile ngcaciso.
Qinisekisa ukuba ulandele imiyalelo yakho ugqirha ngokuthatha le mayeza. Ukuba ufuna ukuyeka ukuyithatha, musa ukuyeka ngokukhawuleza. Buza ugqirha wakho malunga nendlela efanelekileyo yokukhutshwa kwesi siza.
Imiphumela
Njengazo zonke iintsholongwane zokuxhatshazwa, zithatha isilumkiso malunga nobungozi bokuzibulala okanye iinzame kubantu abangaphantsi kweminyaka engama-24 ubudala.
I-Amitriptyline ineloluhlu olude lweziphumo ezibi. Iziphumo eziqhelekileyo ziquka:
- Ukungaqiniseki,
- U kuhamba,
- Isihlunu okanye ukuhlanza,
- Unzima ukuchama,
- Ukutyunjwa,
- Ukujuluka okukhulu,
- Utshintsho lwesisindo okanye isondlo,
- Utshintsho kwi-sex drive okanye amandla okulala ngesondo,
- Ubuhlungu, ukutshisa okanye ukubetha ezandleni okanye ezinyaweni.
Ukuba unayo nayiphi na imiphumo emibi elandelayo, kufuneka ubize ugqirha wakho ngokukhawuleza:
- Ukuthetha okufutshane, ubunzima bokuthetha,
- Ukutyhafa,
- Ubuthathaka okanye ukuphazamiseka kwesilungu,
- Ukutyumza intlungu yesifuba,
- Intliziyo engavumelekanga,
- Ukuqhaqhaqhaqha okanye imingxuma,
- Ukukhupha ubuso kunye nolwimi,
- Isikhumba ephuzi okanye amehlo,
- Iimfudu zomsipha emlanjeni, entanyeni nasemva,
- Ukuthungula okungalawulwayo,
- Ukuphaphaza okungavamile okanye ukutyumza,
- Ukuxhamla,
- Hallucinations.
Ngenxa yokuba eli lonyango landa inani elisezantsi le-serotonin, kufuneka ugweme ezinye iziyobisi ezongeza i-serotonin kwaye zifunde iimpawu zempendulo yokufa: iSerotonin Syndrome.
Njengaye naziphi na iziyobisi, kubalulekile kuwe kunye nogqirha wakho ukuba ulinganise ingozi malunga neenzuzo kwaye unqume ukuba zeziphi unyango olufanelekileyo.
Imithombo:
Clemons A, et al. Umbhalo we-psychopharmacology yekliniki. 2011 Juni; 31 (3): 385-7. I-Amitriptyline kunye neprochlorperazine inhib proimflammatory mediator ukukhululwa kumntu osisigxina somntu: ukufaneleka okusemandleni ukugula okungapheliyo.
UHauser W, uPetzke F, et al. I-Rheumatology (i-Oxford.) Ngo-2011 Mar; 50 (3): 532-43. Ukuqhathaniswa kokusebenza kunye nokwamkeleka kwe-amitriptyline, i-duloxetine kunye ne-milnacipran kwi-fibromyalgia syndrome: ukuphononongwa ngokuchanekileyo kunye nokuhlaziywa kwemeta.
Hauser w, Wolfe F, et al. Iziyobisi zeNCS. 2012 kuMeyi 1; 26 (4): 297-307. Indima yeengxaki zokudandathelanisa ekulawuleni i-fibromyalgia syndrome: ukuphononongwa ngokuchanekileyo kunye nokuhlaziywa kwemeta.
Moore RA, et al. Isiseko seenkcukacha zeCochrane zokuphononongwa ngokuchanekileyo. 2012 Umhla wama-12; 12: CD008242. Amitriptyline ngeentlungu ze-neuropathic kunye ne-fibromyalgia kubantu abadala.
Okea, udokotela wasekhaya waseRamerica waseMelika. 2010 u-Oktobha 15; 82 (8): 901-904. IMilnacipran (Savella) ye-fibromyalgia.
USmith B, et al. Iikhompyutheni zeeDrug. Ngo-2011 kuMva. Ukuhlaziywa kweKlasi yeziDakamizwa: Iziyobisi zeFibromyalgia: I-Final Original Report.
US Food & Drug Administration. Amitriptyline Izaziso zoKhuseleko. Ufikelele ngoSeptemba 2014.