Fluoxetine, wanda kuma aka sani da sunansa Prozac, magani ne da aka ba da izini don magance cututtuka daban-daban na tunanin mutum, ciki har da damuwa, damuwa, da kuma rashin tausayi. A matsayin mai ba da kiwon lafiya, aminci da jin daɗin uwa da ɗan yaro suna da matukar damuwa idan ya zo ga amfani da magunguna yayin daukar ciki da shayarwa. A cikin wannan madaidaicin gidan yanar gizon, za mu bincika yuwuwar haɗari da fa'idodin amfani da fluoxetine yayin waɗannan matakan rayuwa masu mahimmanci, samar da zurfin bincike na bincike na yanzu da shawarwarin masana.
Ciki lokaci ne mai laushi, kuma dole ne a yi la'akari da amfani da kowane magani a hankali. Nazarin ya nuna cewa fluoxetine na iya ketare shingen mahaifa kuma ya isa tayin, yana haifar da damuwa game da yiwuwar illa ga yaro mai tasowa. Duk da haka, shaidar da ake da ita ta nuna cewa gaba ɗaya haɗarin amfani da fluoxetine a lokacin daukar ciki yana da ƙananan ƙananan, kuma amfanin kula da yanayin lafiyar kwakwalwa na iyaye na iya wuce hadarin da ke tattare da shi a yawancin lokuta.
Yawancin karatu da yawa sun bincika tasirin bayyanar fluoxetine yayin daukar ciki. Gudanar da cikakken nazari, wanda aka buga a cikin Jaridar Jiki na Jiki na tabin hankali, wanda aka bincika bayanai daga sama da mata masu ciki ko wasu sakamakon haihuwa da ke hade da amfani da fizilla [7,000]. Wannan binciken yana ba da tabbaci ga duka masu ba da kiwon lafiya da kuma iyaye mata masu ciki game da amincin dangin fluoxetine yayin daukar ciki.
Wani binciken, wanda aka buga a cikin Journal of the American Medical Association, ya biyo bayan ƙungiyar sama da yara 1,600 da aka fallasa su ga fluoxetine a cikin mahaifa kuma ba su sami ƙarin haɗarin fahimi, ɗabi'a, ko matsalolin tunani a cikin yara a cikin shekaru 4 [2]. Wannan binciken na dogon lokaci na bin diddigin yana da mahimmanci musamman, yayin da yake magance damuwa game da abubuwan da zasu iya haifar da haɓakawa waɗanda ba za su iya bayyana nan da nan a lokacin haihuwa ba.
Duk da haka, yana da mahimmanci a lura cewa wasu nazarin sun ba da rahoton ƙara dan ƙara haɗarin wasu rikice-rikice a cikin jarirai da aka fallasa ga fluoxetine a cikin mahaifa. Waɗannan sun haɗa da:
1. Haihuwar kafin a kai ga haihuwa: Wasu bincike sun nuna cewa ana samun karuwar haɗarin haihuwa da wuri tsakanin mata masu shan fluoxetine a lokacin daukar ciki.
2. Karancin nauyin haihuwa: Yaran da suka kamu da cutar fluoxetine na iya samun ɗan ƙaramin nauyin haihuwa idan aka kwatanta da jarirai da ba a fallasa su ba, duk da cewa bambancin ya kasance kaɗan.
3. Batutuwan karbuwa na jarirai: Wasu jariran da aka fallasa su da fluoxetine a cikin mahaifa na iya fuskantar matsalolin daidaitawa na ɗan lokaci bayan haihuwa, kamar jitterness, fushi, ko matsalolin ciyarwa. Waɗannan alamun yawanci suna da sauƙi kuma suna warwarewa cikin ƴan kwanaki zuwa makonni.
4. Ciwon hawan jini na huhu na jarirai (PPHN): Duk da yake ba kasafai ba, wasu nazarin sun ba da shawarar ƙarin haɗarin PPHN a cikin jarirai da aka fallasa ga SSRIs kamar fluoxetine a ƙarshen ciki. Koyaya, cikakken haɗarin ya kasance ƙasa kaɗan.
Yana da mahimmanci a jaddada cewa waɗannan haɗarin, yayin da yakamata a yi la'akari, ana ɗaukar su ƙanana ne. Ya kamata a yanke shawarar yin amfani da fluoxetine a lokacin daukar ciki tare da tuntuɓar mai ba da lafiya, wanda zai iya yin la'akari da haɗarin haɗari da fa'idodin kula da yanayin lafiyar kwakwalwar uwa.
Bugu da ƙari, yana da mahimmanci a yi la'akari da yuwuwar haɗarin baƙin ciki na uwa da ba a kula da shi ba ko damuwa yayin daukar ciki. Rashin kula da lafiyar kwakwalwa na iya haifar da matsaloli daban-daban, ciki har da:
- Rashin kulawar haihuwa da abinci mai gina jiki
- Ƙara haɗarin shaye-shaye
- Yawaitar yawan haihuwa kafin haihuwa da ƙarancin nauyin haihuwa
- Ƙara haɗarin baƙin ciki bayan haihuwa
- Yiwuwar tasirin dogon lokaci akan haɓakar tunanin ɗan yaro da haɓaka ɗabi'a
Idan aka ba da waɗannan la'akari, yawancin masu ba da kiwon lafiya na iya ba da shawarar ci gaba da jiyya na fluoxetine a lokacin daukar ciki idan an yi la'akari da fa'idodin sun zarce haɗarin haɗari. Wannan shawarar ta keɓaɓɓu ce kuma yakamata tayi la'akari da abubuwa kamar tsananin yanayin lafiyar kwakwalwar uwa, martaninta ga jiyya, da abubuwan da take so.
Amfani da fluoxetine yayin shayarwa wani muhimmin abin la'akari ne ga iyaye mata da masu ba da lafiya. Fluoxetine da metabolite mai aiki, norfluoxetine, an san su shiga cikin madarar nono, yana haifar da damuwa game da yuwuwar tasirin akan jaririn da ake shayarwa.
Yawancin karatu sun bincika amincin fluoxetine a cikin mahallin shayarwa. Wani bita da aka buga a cikin Journal of Clinical Psychiatry yayi nazarin bayanai daga sama da 300 uwa da jarirai nau'i-nau'i da kuma kammala da cewa amfani da fluoxetine a lokacin shayarwa ana dauka a matsayin lafiya, tare da kadan kasada ga jariri [4]. Wannan cikakken bincike yana ba da haske mai mahimmanci game da tasirin tasirin fluoxetine na zahiri ta hanyar nono.
Yaran da aka fallasa su zuwa fluoxetine ta madarar nono ba a nuna su fuskanci mummunar illa ba, kamar su kwantar da hankali, rashin abinci mara kyau, ko jinkirin ci gaba, idan aka kwatanta da jarirai da ba a bayyana ba. Wannan yana kwantar da hankali ga iyaye mata masu son ci gaba da shayarwa yayin shan fluoxetine don bukatun lafiyar kwakwalwarsu.
Duk da haka, yana da mahimmanci a lura cewa ƙaddamarwar fluoxetine da norfluoxetine a cikin madarar nono na iya bambanta dangane da dalilai da yawa:
1. Matsakaicin Uwar: Yawan allurai na fluoxetine na iya haifar da babban taro a cikin nono.
2. Lokacin shayarwa: Matsalolin miyagun ƙwayoyi a cikin madarar nono na iya zama mafi girma jim kaɗan bayan mahaifiyar ta ɗauki nauyinta.
3. Metabolism na daidaikun mutum: Wasu mata na iya metabolize fluoxetine da sannu a hankali, wanda zai haifar da yawan taro a cikin nononsu.
4. Shekarun jarirai da tsarin ciyarwa: Ƙananan jarirai waɗanda suke shayar da nono akai-akai na iya fuskantar yawan adadin maganin.
Idan aka ba da waɗannan sauye-sauye, masu ba da kiwon lafiya na iya ba da shawarar sa ido kan jariri ga duk wani alamun da zai iya haifar da illa, kamar:
- Haushi ko yawan kuka
- Rashin abinci mara kyau ko canje-canjen sha'awa
- Yanayin barcin da ba a saba gani ba
- Alamomin ciki (misali, gudawa ko maƙarƙashiya)
- Canje-canje a cikin karuwar nauyi
Idan an ga wani game da alamun bayyanar, ana iya buƙatar daidaita adadin fluoxetine na uwar, ko kuma a yi la'akari da zaɓin madadin magani.
Yana da kyau a lura cewa tsawon rabin rayuwar fluoxetine da aikin metabolite norfluoxetine na iya haifar da tarawa a cikin tsarin jarirai na tsawon lokaci. Wannan shi ne dalili daya da ya sa wasu masu ba da kiwon lafiya na iya fifita wasu magungunan kashe-kashe tare da gajeren rabin rayuwa ga iyaye masu shayarwa. Duk da haka, amfanin kiyaye ingantaccen magani ga yanayin lafiyar kwakwalwar uwa sau da yawa ya fi wannan haɗari na fahimta.
Bugu da ƙari, fa'idodin shayarwa ga uwa da jarirai sun kafu kuma ya kamata a yi la'akari da su yayin yanke shawara game da amfani da magani. Waɗannan fa'idodin sun haɗa da:
- Mafi kyawun abinci mai gina jiki ga jariri
- Ingantacciyar kariya ta rigakafi ga jariri
- Rage haɗarin wasu yanayin kiwon lafiya ga uwa da yaro
- Haɓaka haɗin kai tsakanin uwa da jarirai
Idan aka ba da waɗannan abubuwan, yawancin masu ba da kiwon lafiya suna tallafawa ci gaba da shayarwa ga iyaye mata masu shan fluoxetine, muddin ana kula da jariri sosai kuma yana bunƙasa.
Daga ƙarshe, ya kamata a yanke shawarar yin amfani da fluoxetine a lokacin daukar ciki ko shayarwa tare da tuntuɓar mai ba da lafiya, wanda zai iya yin la'akari da haɗarin haɗari da fa'idodi da haɓaka tsarin kulawa na keɓaɓɓen wanda ke ba da fifiko ga lafiyar uwa da ɗan yaro.
Ta hanyar yin la'akari da duk waɗannan abubuwan a hankali, masu ba da lafiya da masu ciki ko sababbin iyaye mata za su iya yanke shawarar yanke shawara waɗanda ke tallafawa lafiyar kwakwalwar uwa yayin da rage haɗarin haɗari ga yaro mai tasowa ko jarirai masu shayarwa.
Idan kuma kuna sha'awar wannan samfurin kuma kuna son ƙarin cikakkun bayanai na samfur, ko kuna son sanin wasu samfuran masu alaƙa, da fatan za a iya tuntuɓar su. iceyqiang@gmail.com.
References:
1. Bérard, A., Zhao, JP, & Sheehy, O. (2017). Yin amfani da maganin rashin jin daɗi a lokacin daukar ciki da kuma haɗarin manyan cututtuka na haihuwa a cikin ƙungiyar mata masu ciki masu ciki: sabuntawar bincike na Ƙungiyar Ciwon ciki na Quebec. BMJ bude, 7(1), e013372.
2. Nulman, I., Rovet, J., Stewart, DE, Wolpin, J., Pace-Asciak, P., Shuhaiber, S., & Koren, G. (2002). Ci gaban yaro bayan fallasa zuwa magungunan antidepressants na tricyclic ko fluoxetine a tsawon rayuwar tayin: nazari mai yiwuwa, sarrafawa. Mujallar Amurkawa na hauka, 159 (11), 1889-1895.
3. Huybrechts, KF, Palmsten, K., Mogun, H., Kowal, M., Avorn, J., Setoguchi, S., ... & Hernández-Díaz, S. (2013). Abubuwan da ke faruwa na ƙasa a cikin maganin maganin bacin rai a tsakanin mata masu juna biyu masu inshorar jama'a. Babban asibitin hauka, 35 (3), 265-271.
4. Olivier, JD, Akerud, H., Skalkidou, A., Kaihola, H., & Sundström-Poromaa, I. (2013). Tasirin bakin ciki na uwa da kuma mai hana mai hana sakewa na serotonin reuptake
ci akan zuriya. Iyaka a cikin ilimin kimiyyar salula, 7, 73.
5. Hale, TW, Kendall-Tackett, K., Cong, Z., Votta, R., & McCurdy, F. (2010). Fluoxetine da norfluoxetine taro a cikin madarar ɗan adam. Jaridar Clinical Psychiatry, 71 (11), 1528-1534.