Contraindications rau kev siv cov tshuaj antidepressants
Kev siv cov tshuaj antidepressants yog ib txoj hauv kev zoo los kho ntau yam kev mob hlwb, xws li kev nyuaj siab, kev ntxhov siab, thiab kev puas siab puas ntsws obsessive-compulsive. Txawm li cas los xij, tsis yog txhua tus neeg muaj kev nyab xeeb siv cov tshuaj no. Ib yam li lwm yam tshuaj, cov tshuaj antidepressants muaj cov kev tsis pom zoo lossis cov mob uas ua rau lawv siv muaj kev pheej hmoo. Hauv tsab xov xwm no, peb yuav tham txog ntau yam kev tsis pom zoo rau kev siv cov tshuaj antidepressants, suav nrog cov mob tshwj xeeb, kev sib cuam tshuam ntawm cov tshuaj, thiab cov pej xeem tshwj xeeb uas yuav tsum xav txog.
1. Tej Yam Mob
A. Kev Mob Bipolar
Kev siv tshuaj tiv thaiv kev nyuaj siab rau cov tib neeg uas muaj kev puas siab puas ntsws bipolar tuaj yeem ua rau muaj kev ntxhov siab. Yog li ntawd, yog tias ib tug neeg raug kuaj pom tias muaj kev puas siab puas ntsws bipolar, kev siv tshuaj tiv thaiv kev nyuaj siab yuav tsum tau ua tib zoo saib xyuas thiab feem ntau xav tau kev saib xyuas los ntawm kws kho mob. Kev kho mob ua ke nrog cov tshuaj tswj kev xav xws li lithium lossis anticonvulsants feem ntau raug pom zoo kom tsis txhob muaj qhov kev pheej hmoo no.
B. Kab mob qaug dab peg
Qee cov tshuaj antidepressants, xws li bupropion, tau pom tias txo qhov kev qaug dab peg. Qhov no ua rau muaj kev pheej hmoo rau cov tib neeg uas muaj keeb kwm qaug dab peg lossis lwm yam kev mob qaug dab peg. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum qhia rau koj tus kws kho mob txog txhua yam keeb kwm qaug dab peg ua ntej pib kho mob antidepressants.
C. Kab Mob Plawv
Rau cov neeg mob uas muaj mob plawv xws li mob plawv coronary lossis mob plawv dhia tsis xwm yeem, kev siv qee yam tshuaj antidepressants yuav tsis zoo. Cov tshuaj tricyclic antidepressants (TCAs) xws li amitriptyline thiab nortriptyline tuaj yeem ua rau mob plawv hnyav dua. Hauv cov mob no, cov kws kho mob yuav ceev faj dua thaum sau tshuaj thiab xaiv cov tshuaj antidepressants uas muaj kev nyab xeeb dua rau cov mob plawv, xws li SSRIs (Selective Serotonin Reuptake Inhibitors).
2. Kev Sib Cuam Tshuam ntawm Cov Tshuaj
Cov tshuaj tiv thaiv kev nyuaj siab tuaj yeem cuam tshuam nrog ntau yam tshuaj, uas tuaj yeem ua rau muaj kev pheej hmoo ntawm cov kev mob tshwm sim lossis txo qhov ua tau zoo ntawm kev kho mob. Qee qhov kev cuam tshuam uas yuav tsum paub txog suav nrog:
A. MAOIs thiab SSRIs
Kev siv cov tshuaj monoamine oxidase inhibitors (MAOIs) ua ke nrog SSRIs tuaj yeem ua rau muaj serotonin syndrome, uas yog ib qho mob uas yuav ua rau tuag taus nrog rau cov tsos mob xws li tsis nyob twj ywm, tshee hnyo, tawm hws ntau dhau, lub plawv dhia ceev ceev, thiab kev hloov pauv ntawm lub hlwb. Yog li ntawd, yuav tsum zam kev sib xyaw ua ke no, thiab yuav tsum muaj lub sijhawm txiav tawm thaum hloov ntawm ib hom tshuaj mus rau lwm hom tshuaj.
B. Cov tshuaj tiv thaiv kev ntshav txhaws
Cov neeg mob uas noj cov tshuaj anticoagulants xws li warfarin yuav tsum ceev faj nrog SSRIs thiab SNRIs, vim tias cov tshuaj no tuaj yeem ua rau muaj kev pheej hmoo ntawm kev los ntshav. Qhov kev sib cuam tshuam no tshwm sim vim tias cov tshuaj antidepressants tuaj yeem cuam tshuam rau cov metabolism anticoagulant, yog li ua rau lub sijhawm prothrombin ntev dua thiab ua rau muaj kev pheej hmoo ntawm kev los ntshav hauv plab hnyuv.
C. Cov Tshuaj Tiv Thaiv Kev Puas Siab Puas Ntsws
Yuav tsum ceev faj thaum siv cov tshuaj antidepressants nrog cov tshuaj antipsychotic, xws li risperidone lossis haloperidol. Qhov kev siv ua ke no tuaj yeem ua rau muaj kev pheej hmoo ntawm cov kev mob tshwm sim xws li cov tsos mob extrapyramidal (EPS) thiab neuroleptic malignant syndrome, uas ob qho tib si yuav tsum tau kho mob tam sim ntawd.
3. Hnub nyoog thiab cov yam ntxwv ntawm cov pej xeem
A. Cov Menyuam Yaus thiab Cov Hluas
Txawm hais tias qee cov tshuaj antidepressants, xws li fluoxetine, tau txais kev pom zoo rau kev siv rau cov menyuam yaus thiab cov hluas, muaj kev pheej hmoo ntawm kev xav tua tus kheej hauv pawg hnub nyoog no. Yog li ntawd, kev siv tshuaj antidepressants rau cov menyuam yaus thiab cov hluas yuav tsum tau ua nyob rau hauv kev saib xyuas ze los ntawm tus kws kho mob hlwb menyuam yaus.
B. Cov Neeg Laus
Rau cov neeg laus, kev hloov pauv tshuaj thiab kev tso zis feem ntau txo qis, uas tuaj yeem ua rau muaj kev pheej hmoo ntawm cov kev mob tshwm sim. Ntxiv mus, cov neeg laus feem ntau noj ntau yam tshuaj rau lwm yam mob, ua rau muaj kev pheej hmoo ntawm kev sib cuam tshuam tshuaj. Kev hloov kho koob tshuaj thiab kev xaiv cov tshuaj tiv thaiv kev nyuaj siab uas muaj kev nyab xeeb dua yog cov kauj ruam tseem ceeb hauv kev kho cov neeg hnub nyoog no.
C. Cov Poj Niam Cev Xeeb Tub thiab Cov Poj Niam Pub Mis
Kev siv tshuaj tiv thaiv kev nyuaj siab thaum cev xeeb tub thiab pub niam mis tuaj yeem ua rau muaj kev pheej hmoo rau tus menyuam hauv plab lossis tus menyuam mos. Piv txwv li, qee cov tshuaj tiv thaiv kev nyuaj siab SSRI tau txuas nrog kev pheej hmoo ntawm kev muaj teeb meem plawv hauv plab thaum siv thaum lub sijhawm peb lub hlis thawj zaug. Yog li ntawd, kev sab laj nrog kws kho mob poj niam thiab kws kho mob hlwb yog qhov tseem ceeb ua ntej txiav txim siab siv tshuaj tiv thaiv kev nyuaj siab thaum cev xeeb tub thiab pub niam mis.
4. Cov Mob Hlwb thiab Kev Siv Tshuaj Yeeb Tsis Zoo
A. Keeb Kwm ntawm Kev Siv Tshuaj Yeeb
Cov tib neeg uas muaj keeb kwm siv tshuaj yeeb dej cawv ntau dhau, tshwj xeeb yog qee yam kev siv tshuaj yeeb dej cawv thiab benzodiazepines, muaj feem yuav ua rau lawv quav tshuaj antidepressant ntau dua. Piv txwv li, bupropion paub tias muaj peev xwm ua rau qee tus neeg siv tshuaj yeeb dej cawv ntau dhau. Yog li ntawd, kev xaiv cov tshuaj antidepressant kom zoo thiab kev saib xyuas zoo yog qhov tseem ceeb.
B. Kev Noj Tsis Zoo
Rau cov tib neeg uas muaj teeb meem kev noj mov xws li anorexia nervosa lossis bulimia, kev ceev faj yog qhov tseem ceeb thaum siv cov tshuaj antidepressants uas tuaj yeem cuam tshuam rau kev noj mov thiab qhov hnyav, xws li mirtazapine. Kev saib xyuas ze thiab kev kho mob ntau yam uas muaj tus kws kho mob hlwb thiab tus kws noj haus feem ntau yog qhov tsim nyog.
Xaus
Yuav tsum ceev faj siv cov tshuaj antidepressants thiab xav txog ntau yam kev tsis pom zoo. Cov no suav nrog cov mob tshwj xeeb, kev sib cuam tshuam ntawm cov tshuaj, thiab cov yam ntxwv ntawm tib neeg thiab kev puas siab puas ntsws. Txawm hais tias cov tshuaj antidepressants muaj txiaj ntsig zoo rau kev tswj hwm cov teeb meem kev puas siab puas ntsws, kev paub txog cov kev tsis pom zoo no yog qhov tseem ceeb kom txo qhov kev pheej hmoo ntawm cov kev mob tshwm sim thiab xyuas kom meej tias cov txiaj ntsig zoo tshaj plaws ntawm kev kho mob.
Thaum koj muaj teeb meem kev noj qab haus huv ntawm lub hlwb, peb xav kom koj mus ntsib kws kho mob ua ntej koj pib, hloov, lossis tsum tsis txhob siv tshuaj antidepressants. Tsuas yog siv txoj kev sib koom ua ke thiab ceev faj xwb thiaj li yuav pab tau koj kom koj cov tshuaj antidepressants muaj txiaj ntsig ntau tshaj plaws thiab txo tau cov kev pheej hmoo.
