I-methylene blue ye-ADHD: yintoni eye yaphononongwa ngokwenene?

I-methylene blue ayikamiselwa njengonyango olusebenzayo lwe-ADHD. Ukukhangela okwenziwe kolu hlaziyo akufumananga luvavanyo olujonga ukuba iyaziphucula na iimpawu ze-ADHD kubantu ababhaliswe benolu xilongo. Iimvavanyo ebantwini ezidla ngokucatshulwa ziphathelele inkumbulo, imisebenzi yengqalelo yaselebhu, okanye ukufota ingqondo kwamanye amaqela abantu. Ezo ziphumo azinakuqinisekisa ukuba i-methylene blue inceda umntu alawule ukwenza izinto ngaphandle kokucinga, aqhubeke nomsebenzi, okanye asebenze ngcono ene-ADHD.

Lo mahluko ukwabalulekile kukhuseleko. Amayeza amaninzi e-ADHD anemiqathango ethintela ukusetyenziswa kwawo kunye nezithinteli ze-monoamine oxidase, udidi lwamayeza olunxulumene nomngcipheko wokusebenzisana kwe-methylene blue namanye amayeza. Inzuzo engaqinisekanga ayenzi ukudityaniswa kwezinto ngokulingwayo kungabi nabungozi.

Uvavanyo lwengqalelo alulovavanyo lonyango lwe-ADHD

I-ADHD ibandakanya iimpawu eziqhubekayo kunye nokuphazamiseka kokusebenza kwiimeko ezahlukeneyo. Inkcazelo ye-CDC ngoxilongo ichaza uhlolo lwezonyango oluqwalasela imbali, indlela yokuziphatha kwiindawo ezahlukeneyo, kunye nezinye iinkcazelo ezinokubakho. Ukusabela kancinane kumsebenzi wekhompyutha akunakuqinisekisa uxilongo. Ngokunjalo, ukusabela ngokukhawuleza emva kongenelelo akunakuqinisekisa kukodwa ukuba unyango luphumelele.

Uvavanyo lwe-ADHD luya kufuneka lubhalise abantu abaxilongwe ngokufanelekileyo luze lulinganise iziphumo ezifanelekileyo. Ezi zinokuquka imilinganiselo yeempawu eqinisekisiweyo nendlela umntu asebenza ngayo esikolweni, emsebenzini, okanye ekhaya. Kuya kufuneka kwakhona lwahlule isiphumo songenelelo kweenguqu zokulala, kumayeza asele esetyenziswa, kwizinto ezilindelweyo, nakukuziqhelanisa okuphindaphindiweyo.

Qwalasela imibuzo emibini: ingaba umntu angawubona ngokuchanekileyo ngakumbi umfanekiso osandul’ ukuboniswa, kwaye ingaba loo mntu angayilungelelanisa aze ayigqibe rhoqo imisebenzi yemihla ngemihla? Yomibini ibandakanya ukusebenza kwengqondo. Ezi ayizoziphumo ezinokusetyenziswa endaweni yezinye. Isishwankathelo sethu sobungqina nge-methylene blue ebantwini sisebenzisa kwaloo mahluko kuzo zonke iinzuzo ezicetywayo.

Oko kwafunyanwa ngokwenene luvavanyo kubantu abadala abasempilweni

Isifundo sikaRodriguez noogxa bakhe sango-2016 sokufota ingqondo, esinamaqela abelwe ngokungakhethiyo, sahlalutya abantu abadala abasempilweni abayi-26, abaneminyaka engama-22 ukuya kuma-62. Sathelekisa ukunikezelwa kube kanye ngomlomo kwe-methylene blue ekumgangatho we-USP kunye ne-placebo enombala oluhlaza okwesibhakabhaka. Uvavanyo olwenziwa ngaphambi kokunikezelwa kwayo nakwiyure emalunga nenye emva koko lwaluquka umsebenzi wengqalelo eqhubekayo, umsebenzi wenkumbulo yexesha elifutshane, kunye ne-MRI yokusebenza kwengqondo. Ukuphazamiseka ngokwengqondo nokusetyenziswa kutshanje kwamayeza onyango lwengqondo yayizizizathu zokungabandakanywa.

Iimpendulo eziboniswe kukufota ingqondo zatshintsha kwiindawo ezininzi. Iziphumo zokuziphatha zifuna ukutolikwa ngononophelo olungakumbi: uthelekiso lwexesha lokusabela kuvavanyo lwengqalelo phakathi kwamaqela ngokuhamba kwexesha aluzange lubaluleke ngokweenkcukacha-manani, nge-P = .43. Iphepha labika ukuphucuka okumalunga ne-7% kwiimpendulo ezichanekileyo zenkumbulo ngaphakathi kweqela le-methylene blue, kodwa umahluko ohambelana noko phakathi kwamaqela nawo wawungabalulekanga ngokweenkcukacha-manani, nge-P = .09.

Isiphumo esibalulekileyo ngokweenkcukacha-manani xa kuthelekiswa ngaphambi nasemva kwiqela elinye asiqinisekisi ukuba unyango lunenzuzo ebalulekileyo xa luthelekiswa nelinye iqela. Ezi ziphumo zixhasa uphando olungakumbi, kodwa azibonisi nzuzo kwi-ADHD. Uvavanyo alunakuphendula nemibuzo ephathelele ukusetyenziswa okuphindaphindiweyo, abantwana, okanye ukudityaniswa namayeza e-ADHD.

Uluhlu oluphendlekayo, oluquka ubungqina obungekhoyo

Vula uluhlu lwezifundo oluphendlekayo ukuze uhluze iirekhodi ngokweqela labantu, isiphumo, umbhali, okanye isikhewu kubungqina. Luquka amakhonkco emithombo luze lwahlule iimvavanyo ezifanelekileyo ezinika imvelaphi kwisiphumo sokukhangela esingahambelaniyo nombuzo.

Uvavanyo lukaTelch lwabela ngokungakhethiyo abantu abadala abayi-42 ababenoloyiko olukhulu lweendawo ezivaliweyo ukuba bafumane i-methylene blue okanye i-placebo emva koqeqesho lokujongana nento eyoyikwayo. Uhlolo lwenkumbulo nohlolo loloyiko emva kwenyanga enye lwalunxulumene nokufunda nokugcinwa koloyiko. Iziphumo zoloyiko zazixhomekeke kwindlela iseshoni yokujongana nento eyoyikwayo eyaphela ngayo ngempumelelo. Olu yayingelovavanyo lweempawu ze-ADHD, kwaye aluqinisekisi inzuzo ngokubanzi kwingqalelo.

Esinye isiphumo sokukhangela sibonisa ukuba kutheni ukubala amaphepha ophando kunganelanga. Kwingxelo yetyala le-methemoglobinemia efakwe kwisalathiso njenge-PMID 27099330, i-ADHD yavela kwimbali yezonyango yesigulana. I-methylene blue ayizange isetyenziswe ngenxa yokukrokrelwa kokunqongophala kwe-G6PD, okwathi kamva kwaqinisekiswa. Injini yokukhangela inokufumana omabini la magama kwanaxa iphepha lingenalo naluphi na uvavanyo lonyango oluwadibanisayo.

Uluhlu lurekhoda ukukhangela okujoliswe kulo mbuzo okwenziwa ngoSeptemba 12, 2026, kusetyenziswa “methylene blue” okanye “methylthioninium” kunye no-“ADHD” okanye “attention deficit hyperactivity disorder.” I-PubMed yafumana loo ngxelo yetyala; i-ClinicalTrials.gov ayifumananga zirekhodi zihambelanayo. Ukukhangela okubanzi kwafumana izifundo zokusebenza kwengqondo ezibonelela ngemvelaphi. Olu luhlolo lobungqina olunomhla, hayi ubungqina bokuba kufunyenwe zonke izifundo ezingapapashwanga okanye ezifakwe kwizalathiso ngendlela eyahlukileyo. Ithala lophando libonelela ngomxholo obanzi wezifundo.

Ukusebenzisana kwamayeza kutshintsha umbuzo ophathelele ukusetyenziswa

I-methylene blue inokuthintela i-monoamine oxidase. Inkcazelo yayo yenaliti efumaneka ngomyalelo kagqirha ilumkisa nge-serotonin syndrome xa isetyenziswa namayeza achaphazela i-serotonin kunye nee-opioid. Kumntu one-ADHD, lonke uluhlu lwamayeza lubalulekile, kuquka unyango lokudakumba okanye ixhala elikhoyo kunye nayo.

1. Iimveliso ze-amphetamine: inkcazelo ye-Adderall XR iyakuthintela ukusetyenziswa kunye nezithinteli ze-MAO kwaye iyikhankanya ngokucacileyo i-methylene blue efakwa emthanjeni. Ingxaki engxamisekileyo yoxinzelelo lwegazi oluphezulu yinkxalabo ekhankanyiweyo.
2. I-methylphenidate: inkcazelo ye-Ritalin nayo iyakuthintela ukusetyenziswa ngaxeshanye nonyango ngezithinteli ze-MAO ngenxa yomngcipheko wengxaki engxamisekileyo yoxinzelelo lwegazi oluphezulu.
3. I-atomoxetine: inkcazelo ye-Strattera ikhankanya i-methylene blue efakwa emthanjeni kumqathango wayo othintela ukusetyenziswa kunye nezithinteli ze-MAO kwaye ichaza ukusabela okunokuba yingozi kakhulu.

Ezi nkcazelo azizovavanyo lwazo zonke iintlobo zemveliso ethathwa ngomlomo ezithengelwa ukusetyenziswa ngabathengi. Kananjalo aziqinisekisi ukuba ukudityaniswa kwemveliso ethathwa ngomlomo namanye amayeza kukhuselekile. Isilumkiso se-TGA yase-Australia malunga neemveliso ze-methylene blue ezingabhaliswanga ezithathwa ngomlomo sithetha ngokukodwa ngokusebenzisana kwamayeza okuyingozi. Yisa imveliso kanye ocinga ukuyisebenzisa, iqondo loxinzelelo lwayo, kunye noluhlu olupheleleyo lwamayeza kumbhali wemiyalelo yamayeza okanye kusokhemesti ngaphambi kokucinga ukuyisebenzisa. Musa ukuyeka unyango lwe-ADHD olumiselweyo ukuze wenze uvavanyo lwe-methylene blue ngokwakho.

Ukuba emva kokuyisebenzisa okanye kokudibana nayo kuba nomkhuhlane, ukuphazamiseka okukhulu okanye ukudideka, ukuqina kwezihlunu, okanye ukusabela okuya kusiba mandundu ngokukhawuleza, funa uncedo lwezonyango olungxamisekileyo. Isishwankathelo sokhuseleko sichaza eminye imiqathango ethintela ukusetyenziswa nolwazi malunga nokudibana nayo olufanele ukurekhodwa.

Bubuphi ubungqina obunokutshintsha impendulo?

Isifundo esilandelayo esiluncedo siya kuvavanya imveliso echazwe ngokucacileyo kubathathi-nxaxheba abaxilongiweyo, sisebenzise into yokuthelekisa, sichaze kwangaphambili iziphumo zeempawu ze-ADHD nezokusebenza, size silandelele iziphumo ezingathandekiyo ixesha elaneleyo. Imibuzo ephathelele abantu abadala nabantwana iya kufuna ubungqina obahlukeneyo. Inkcazelo yendlela yokusebenza ephathelele i-mitochondria ayinakuzalisa ezo zikhewu.

Unyango olusele lumiselwe sele luneendlela ezicwangcisiweyo zohlolo nokubeka esweni, ezifana nezo zikwi-ngcebiso ze-NICE nge-ADHD. Ukungalawuleki ngokwanelisayo kweempawu sisizathu sokuphinda kuhlolwe olo nyango kunye nengcali yezonyango enyanga umntu. Izifundo ezihlaziywe apha azixhasi ukuthatha indawo yalo nge-methylene blue. Amabango malunga neemeko ezinxulumeneyo zokukhula afuna olwawo uhlolo lwamaqela abantu nongenelelo, njengoko kuchaziwe kuhlaziyo lwethu lophando nge-methylene blue ne-autism.