Luqala njani ulutsha ukuthatha amayeza e-Antipsychotic

Kubhalwe kakuhle ukuba inani labantwana abathetha amayeza antipsychotic ayenyuka. Oku kujongwe ngokubanzi njengento engalunganga kunye nomqondiso wokusetyenziswa gwenxa kwamayeza. Ngokwenyani, nangona kunjalo, bekukho idatha encinci yokusixelela ukuba la mayeza asetyenziswa kakhulu, kungekudala okanye ukuba ukonyuka kubonisa unyango olufanelekileyo nolusemthethweni lwabantwana abaneengxaki ezinzulu zokuziphatha. Amayeza e-Antipsychotic aphuhliswa ukunyanga abantu abadala abanezifo eziphambili zengqondo ezinje nge-schizophrenia kunye ne-bipolar disorder. Kule minyaka idlulileyo, ukusetyenziswa kwabo kuye kwanda ukuya kumaqela amancinci nakwizinye izifo ezinje nge-autism, i-ADHD, kunye nokuphikiswa kokuchasana nokuphikisana. Kuba la mayeza athwala umngcipheko wezinto ezinje ngokutyeba kakhulu, isifo seswekile, kunye nokuphazamiseka kokuhamba, kuye kwakho uhlolisiso olongezelelekileyo lokujonga ukuba zisetyenziswa ngendlela eyiyo na.

Omnye wemisebenzi yam kukuhlala kwikomiti yelizwe yaseVermont ebizwa ngokuba yiVermont Psychiatric Medication yaBantwana neQela lokuGada eliQhelekileyo leQela. Umsebenzi wethu kukujonga kwakhona idatha enxulumene nokusetyenziswa kwamayeza abagqirha bengqondo kulutsha lwaseVermont kunye nokwenza izindululo kwindlu yethu yowiso-mthetho nakwezinye iiarhente zikarhulumente. Kwi-2012, besibona ukonyuka okufanayo ekusetyenzisweni kwamayeza njengaye wonke umntu, kodwa besisokola ukwenza ingqiqo yezi datha zinomdla. Amalungu eKomiti athambekele ekubeni angathandabuzeki kunyango lwengqondo luvakala i-alamu ngelixa amalungu athambekele ngakumbi kunyango ecinga ukuba oku kunyuka kunokuba yinto elungileyo njengoko uninzi lwabantwana abadinga unyango belufumene. Konke kuvunyelwene, nangona kunjalo, ukuba ngaphandle kokomba nzulu kancinci, ngekhe sazi.

Ikomiti yethu igqibe, emva koko, ukuba into esiyifunayo yayiyidatha enokuthi isixelele kancinci malunga nokuba kutheni kwaye njani aba bantwana besebenzisa la mayeza. Ngenxa yoko, senza uphando olufutshane olwathunyelwa kummiselo wawo onke amayeza anikezela ngengqondo akhutshwe kwiMedicaid iVermont yomntwana ongaphantsi kweminyaka eli-18. kunyanzelekile ngokufuna ukugqitywa ngaphambi kokuba amayeza (izinto ezinje ngeRisperdal, iSeroquel, kunye ne-Abilify) anokuphinda azaliswe.

Idatha esiyifumeneyo ibinomdla kakhulu kwaye emva koko sigqibe kwelokuba kufuneka sizame ukupapasha oko sikufumene kwiphephancwadi elidumileyo. Inqaku, elibhalwe ndim kunye nabanye abaqeqeshiweyo abazinikeleyo abasebenza kule komiti, liphume namhlanje kwiphephancwadi iPediatrics.

Sifumene ntoni? Nazi ezinye zezinto eziphambili .....

• Uninzi lwabamayeza amayeza e-antipsychotic ayingobantu abagula ngengqondo, malunga nesiqingatha sokuba ngoononophala kunyango lokuqala njengoogqirha babantwana okanye oogqirha bosapho.
• Inani labantwana abangaphantsi kweminyaka emi-5 ubudala abathatha amayeza e-antipsychotic asezantsi kakhulu (iVermont isenokwahluka kancinci apha).
• Rhoqo, ugqirha onoxanduva ngoku lokugcina amayeza antipsychotic ayinguye owaqala ekuqaleni. Kwiimeko ezinjalo, isigunyaziso sangoku esihlala sikhona (malunga neepesenti ezingama-30) asazi ukuba loluphi uhlobo lonyango lwengqondo oluye lwazanywa ngaphambi kwesigqibo sokuqala iyeza lokuthomalalisa ingqondo.
• Ezona zifo zixhaphakileyo zixhomekeke kunyango yayiziphazamiso zemood (ezingabandakanyi ukuphazamiseka kwengqondo) kunye ne-ADHD. Ezona mpawu ziqhelekileyo zijolise kubundlongondlongo kunye nokungazinzi kwemood.
• Kwiimeko ezininzi, amayeza e-antipsychotic asetyenziswa kuphela emva kwamanye amayeza kunye nezinye iindlela zonyango ezinganyangekiyo (njengokucebisa) ezingakhange zisebenze. Nangona kunjalo, uhlobo lonyango olwaluzanyiwe kaninzi lwalungeyonto efana nonyango lokuziphatha, indlela ebonakalisiweyo ukuba iyasebenza kwiingxaki ezinje ngokudelela kunye nobundlongondlongo.
• Oogqirha benza umsebenzi olungileyo wokugcina umkhondo wobunzima bomntwana ukuba wayethatha iyeza lokuthintela ukungakhathali, kodwa kuphela malunga nesiqingatha sexesha ababesenza umsebenzi waselebhu okhuthazwayo ukukhangela imiqondiso yezilumkiso zezinto ezifana neswekile.
• Mhlawumbi okona kubaluleke kakhulu, sidibanise izinto ezininzi zophando ukuzama ukuphendula umbuzo wehlabathi jikelele wokuba umntwana ulimala kangaphi ngokuthatha iyeza lokuthomalalisa ubuchwephesha ngokwendlela yezona ndlela zibalaseleyo. Sisebenzise iingcebiso ezipapashiweyo kwiAmerican Academy of Child and Adolescent Psychiatry kwaye safumanisa ukuba, Izikhokelo zokuziphatha ezilungileyo zilandelwe kuphela malunga nesiqingatha sexesha. Kulwazi lwethu, eli lixesha lokuqala ukuba le pesenti iqikelelwe xa kufikwa kubantwana nakwii-antipsychotic. Xa iyeza "lisilele" ingoyena mkhwa ulungileyo, esona sizathu siqhelekileyo yayikukuba i-labwork yayingekenziwa.
• Sikwajongile ukuba kangangexesha elingakanani iyeza lalisetyenziswa ngokokubonisa kwe-FDA, nokuseta kokusetyenziswa okucothayo. Iziphumo - 27%.

Ukudibanisa konke oku, sifumana umfanekiso ocacileyo wento enokwenzeka. Kwangelo xesha, ezi ziphumo aziziboleki ngokulula kwizandi ezikhawulezayo malunga nabantwana abangalunganga, abazali abangalunganga, okanye oogqirha abangalunganga. Esinye isiphumo esiqinisekisayo kukuba ayibonakali ngathi la mayeza asetyenziswa ngokungaqhelekanga ekuziphatheni okucaphukisayo. Nokuba uxilongo lubonakala ngathi luyinto encinci efana ne-ADHD, idatha yethu ibonakalise ukuba eyona ngxaki kujoliswe kuyo ihlala inento efana nobundlongondlongo bomzimba. Kwangelo xesha, kunzima ukuba neqhayiya malunga nokulandela iingcebiso zokuziqhelanisa nesona siqingatha sexesha, ngakumbi xa sasinesisa malunga nokuba sasikhona. Kwingxoxo yethu, sigxila kwiindawo ezine ezinokunceda ukuphucula imeko. Okokuqala, abagcini banokufuna izikhumbuzo ezingaphezulu (i-elektroniki okanye enye indlela) ukubenza bafumane umsebenzi okhuthazwayo onokubonisa ukuba lixesha lokuyeka okanye ubuncinci ukunciphisa amayeza. Okwesibini, oogqirha abaninzi baziva bebambekile kuba khange baqalise amayeza kwasekuqaleni kodwa ngoku banoxanduva kwaye abazi ukuba bangayeka njani. Ukufundisa oogqirha abanonophelo lokuqala malunga nendlela kunye nokwenza nini oku kunokunciphisa inani labantwana abathatha amayeza antipsychotic ngokungapheliyo. Okwesithathu, sidinga itshathi yezonyango engcono elandela abaguli kufutshane.Ukuba ucinga ngomntwana okhuliswa ngabazali abangengobakhe, ovela kwenye indawo kurhulumente uye komnye, kulula ukucinga ukuba kunzima kangakanani ngoku kugqirha wenyanga ukuba azi ukuba kwakukhe kwazanywa ntoni ukunceda lo mntwana. Okwesine, kufuneka senze ukuba unyango olusekwe kubungqina lufumaneke ngakumbi, olunokuthi lithintele abantwana abaninzi ukuba bafike kwinqanaba lokuba iyeza lokuthintela ukungathathi hlangothi liqwalaselwe.

Ngokombono wam, amayeza e-antipsychotic ngenene anendawo kunyango, kodwa baninzi kakhulu abaya kuloo ndawo ngokukhawuleza. Oku kuwa kudlulileyo, ndangqina kwikomiti edibeneyo yase-Vermont yowiso-mthetho malunga neziphumo zethu zokuqala. Ikomiti yethu iya kudibana kwakhona kungekudala ukuze ithathe isigqibo ngamanyathelo athile esingathanda ukuwancomela ngokulandelayo. Ithemba lethu lelokuba amanye amazwe aza kwenza iiprojekthi ezifanayo ukuqinisekisa ukuba la kunye namanye amayeza asetyenziswa ngokukhuselekileyo nangokufanelekileyo kangangoko.

@copyright nguDavid Rettew, MD

UDavid Rettew ngumbhali wobushushu babantwana: Ukucinga okutsha malunga nomda phakathi kweempawu kunye nokugula kunye nonyango lomntwana kugqirha wengqondo nakwisebe labantwana kwiYunivesithi yaseVermont College of Medicine.

Mlandele kwi @PediPsych kwaye uthanda iPediPsych kuFacebook.