Fa'avasegaga o Fualaau Fa'asaga i le Mafaufau: O se Taiala Atoatoa
O vailaʻau faʻasaga i mafaufauga o se vasega o vailaʻau e faʻaaogaina e pulea ai faʻailoga o faʻalavelave faʻalemafaufau, e aofia ai le schizophrenia, schizoaffective disorder, ma, i nisi tulaga, bipolar disorder. O lo latou faʻaaogaina e toe foʻi i le ogatotonu o le 20 seneturi, ma ua i ai ni atinaʻe taua i le aoga ma le faʻaitiitia o aʻafiaga. O lenei tusiga e faʻamoemoe e tuʻuina atu se taʻiala atoatoa i le faʻavasegaina o vailaʻau faʻasaga i mafaufauga, e taulaʻi i lo latou talafaasolopito, ituaiga, faiga o gaioiga, ma aʻafiaga.
Talafaasolopito o le Faaaogaina o Vaila'au Fa'a'ole'ole
Na amata le talafaasolopito o vailaʻau faʻapsychotic i le vaitau o le 1950 ina ua maua le chlorpromazine, lea e manatu o se vailaʻau faʻapsychotic tupulaga muamua (masani faʻapsychotic). O lenei mauaina na saunia ai le ala mo le atinaʻeina o vailaʻau e mafai ona faʻaitiitia ai faʻailoga o le psychosis e ala i le faʻaitiitia o le faʻasesēina, faʻaaliga, ma le faʻalavelaveina o mafaufauga. E ui ina aoga, o vailaʻau faʻapsychotic tupulaga muamua e masani ona fesootaʻi ma aʻafiaga taua, e aofia ai faʻailoga extrapyramidal e pei o le gatete, faʻamaʻaʻa, ma le tardive dyskinesia.
Fa'avasegaga o Antipsychotics
E mafai ona fa'avasegaina vaila'au fa'asaga i mafaufau e fa'avae i le tele o auala eseese, o le sili ona taatele e fa'avae i lo latou gaosiga ma le faiga o le gaioiga.
1. Vailaau Fa'a'au'au Fa'apsychotic o le Tupulaga Muamua (Masani)
Uiga o uiga
O vailaʻau antipsychotic o le tupulaga muamua, e taʻua foʻi o vailaʻau masani, e faʻaaogaina muamua e togafitia ai faʻailoga lelei o le schizophrenia, e pei o le faʻaaliga o mea sese ma le faʻasesēina o mafaufauga. Latou te galulue e ala i le poloka o le dopamine D2 receptors i le faiʻai, lea e talitonuina o loʻo aʻafia i le atinaʻeina o faʻailoga o le mafaufau.
Faʻataʻitaʻiga o Fualaau Faʻasaina
– Chlorpromazine: O le uluai vailaau fa'apsychotic na maua.
– Haloperidol: O se tasi o vailaʻau faʻapsychotic masani e masani ona faʻaaogaina.
– Fluphenazine: E masani ona faʻaaogaina mo le faʻamaʻi tumau o le schizophrenia.
Fa'ailoga Samping
E tele a'afiaga o vaila'au fa'apsychotic masani, e feso'ota'i tele lava ma le extrapyramidal system:
– A'afiaga i Fafo o le Pyramid: E aofia ai le gatete, ma'a'a o maso, ma le tetete o maso e le mafai ona taofiofia.
– Tardive Dyskinesia: O gaioiga e le'i mafaufauina e fa'asolosolo malie ona atia'e pe a fa'aaogaina mo se taimi umi.
– Fa'amoe ma le Orthostatic Hypotension: Isi aafiaga e masani ona tutupu.
2. Vailaau Fa'a'au'au Fa'alemafaufau o le Tupulaga Lua (E le Masani)
Uiga o uiga
O vailaʻau faʻapsychotic o le tupulaga lona lua, poʻo vailaʻau faʻapsychotic atypical, na faʻalauiloa mai i le vaitau o le 1990 ma ua manatu o se alualu i luma taua i togafitiga faʻapsychotic. I le faʻaopoopoga i le poloka o dopamine receptors, o vailaʻau faʻapsychotic atypical e taulaʻi foʻi i serotonin (5-HT2A) receptors, ma maua ai ni faʻamanuiaga faʻaopoopo i le taulimaina o faʻailoga leaga ma faʻailoga tau mafaufau o le schizophrenia.
Faʻataʻitaʻiga o Fualaau Faʻasaina
– Clozapine: O le uluai antipsychotic atypical ma e masani ona manatu i ai o le sili ona aoga, aemaise lava mo tulaga o tete'e.
– Risperidone: E masani ona faʻaaogaina mo le schizophrenia ma le bipolar disorder.
– Olanzapine: E lelei lona aogā ma ona aafiaga.
– Quetiapine: E iai sona sao i le togafitia o le fa'aletonu o le mafaufau ma o se vaila'au e fesoasoani i le fa'aitiitia o le atuatuvale.
Fa'ailoga Samping
E sili atu ona fiafia i vailaau antipsychotic atypical ona e itiiti lo latou lamatiaga o aafiaga i fafo atu o le pyramidal, ae e le o sao mai ai ni aafiaga:
– Fa'atupuina o le Mamafa: O se aafiaga masani ma tāua tele lea, e feso'ota'i ma le lamatiaga o le metabolic syndrome.
– Ma'isuka Mellitus: O nisi o vailaau antipsychotic atypical e ono fa'ateleina ai le lamatiaga o le maua i le ma'isuka ituaiga 2.
– Aafiaga Itua o le Metabolism: E aofia ai le si'itia o le cholesterol ma triglycerides.
Faiga Fa'atino
E galue vailaʻau faʻasaga i mafaufau e ala i auala eseese e aʻafia ai neurotransmitters i le faiʻai:
– Dopamine: O le tele o vailaʻau faʻapsychotic e galulue e ala i le polokaina o dopamine receptors, aemaise lava le ituaiga D2. O lenei poloka e fesoasoani e pulea ai faʻailoga lelei o le psychosis.
– Serotonin: O vailaau antipsychotic atypical e taulaʻi i serotonin receptors (aemaise lava le 5-HT2A), lea e fesoasoani e faʻaitiitia ai faʻailoga leaga o le schizophrenia ma aafiaga i fafo atu o le pyramidal.
– Glutamate: E iai foʻi se manatu e faʻapea o le le lelei o le faiga o le glutamate atonu e iai sona sao i le schizophrenia, ma o loʻo faia nisi suʻesuʻega e atiaʻe ai ni vailaʻau e faʻatatau i lenei faiga.
Fa'aoga Fa'afoma'i
O le faʻaaogaina o vailaʻau faʻapsychotic i faiga faʻafomaʻi e manaʻomia ai le mataʻituina ma le faʻaeteete. O le filifiliga o vailaʻau faʻapsychotic e faʻavae i luga o le talaaga o le maʻi, talaʻaga faʻafomaʻi, tali atu i togafitiga muamua, ma le mafai ona onosaʻi i aafiaga e ono aʻafia ai.
1. Sikofenia:
– Fa'ailoga Fa'afuase'i: E masani ona amata i vaila'au fa'apsychotic e mafai ona tu'uina atu i le gutu pe tuiina fo'i.
– Tausiga: Sini mo se taimi umi e puipuia ai le toe tupu ma faaleleia atili ai le tulaga lelei o le olaga.
2. Fa'aletonu o le Bipolar:
– Mania Fa'afuase'i: E masani ona fa'aaogaina vaila'au fa'aitiitia le mafaufau e pei o le olanzapine ma le risperidone.
– Tausiga o Lagona: O nisi vailaau antipsychotics e le masani ai e faʻaaogaina foi o ni vailaʻau e faʻamautu ai lagona.
3. Fa'aletonu o le Schizoaffective:
– O le faʻaaogaina o vailaau antipsychotics atypical e masani ona sili ona lelei pe a tuʻufaʻatasia faʻailoga o le lagona ma faʻailoga o le schizophrenic.
Luʻitau ma le Lumanai
E ui lava ina ua aumaia e vailaʻau faʻafomaʻi ni alualu i luma taua i le togafitia o le psychosis, ae o loʻo tumau pea luʻitau. E masani ona faʻaitiitia le tulaga lelei o le olaga o tagata mamaʻi ona o aʻafiaga faaletino ma le metabolism. O loʻo faʻaauau pea suʻesuʻega e suʻesuʻe ai vailaʻau e faʻaleleia atili ai aʻafiaga.
O nisi o lumanaʻi manuia i le atinaʻeina o vailaʻau faʻapsychotic e aofia ai le suʻesuʻeina o:
– Foma'i Fa'afoma'i i le Vasega o le Mafaufau: O le fa'aaogaina o tekinolosi fa'atonutonu o le neura e le afaina ai le tino e suia ai le gaioiga o le fai'ai.
– Togafitiga o Kenera: Su'esu'ega i tulaga tau kenera ma epigenetic ina ia malamalama ai i le fa'avae fa'aletino o fa'ama'i mafaufau ma vaila'au e mafai ona taula'i sa'o i nei faiga.
I'uga
O vailaʻau e teteʻe atu i le mafaufau o se vaega taua tele i le puleaina o faʻalavelave faʻalemafaufau. E ui ina ua latou faia ni alualu i luma taua i le togafitia o gasegase e iai le schizophrenia ma faʻalavelave faʻatasi, ae o lo latou filifilia ma le faʻaaogaina e tatau ona pulea ma le faʻaeteete e fomaʻi tomai faapitoa ina ia faʻateleina ai aogā ma faʻaitiitia ai aʻafiaga. E tele folafolaga o le lumanaʻi, ma o suʻesuʻega o loʻo faʻaauau pea e faʻamoemoe e faʻaleleia atili ai le tulaga lelei o le olaga mo gasegase e iai faʻalavelave faʻalemafaufau.
