I-methylene blue ye-ADHD: yini esihloliwe ngempela?

Akukafakazelwa ukuthi i-methylene blue iwukwelashwa okusebenzayo kwe-ADHD. Ukusesha okwenziwe kulokhu kubuyekezwa akutholanga isivivinyo esihlola ukuthi iyazithuthukisa yini izimpawu ze-ADHD kubantu ababhaliselwe ucwaningo betholakale benalesi simo. Izivivinyo kubantu ezivame ukucashunwa ziphathelene nenkumbulo, imisebenzi yokunaka yaselabhorethri, noma ukuthwebula izithombe zobuchopho kwamanye amaqembu abantu. Leyo miphumela ayikwazi ukufakazela ukuthi i-methylene blue isiza umuntu alawule ukwenza izinto ngaphandle kokucabanga, aqhubeke nomsebenzi, noma asebenze kangcono ene-ADHD.

Lo mehluko ubalulekile nasekuphepheni. Imithi eminingana ye-ADHD inezimo lapho kungafanele isetshenziswe khona ezihilela imithi evimbela i-monoamine oxidase, okuyisigaba semithi esihlobene nengozi yokusebenzisana kwe-methylene blue neminye imithi. Inzuzo engaqinisekile ayenzi inhlanganisela esetshenziswa njengesivivinyo ingabi nangozi.

Ukuhlolwa kokunaka akusona isivivinyo sokwelashwa kwe-ADHD

I-ADHD ihilela izimpawu eziphikelelayo nokuphazamiseka kokusebenza ezimweni ezihlukahlukene. Incazelo ye-CDC yokuxilonga ichaza ukuhlolwa komtholampilo okubheka umlando, ukuziphatha ezindaweni ezihlukahlukene, nezinye izincazelo ezingaba khona. Ukusabela kancane emsebenzini wekhompyutha akwanele ukufakazela ukuxilongwa. Ukusabela ngokushesha ngemva kokungenelela nakho akwanele, kukodwa, ukufakazela impumelelo yokwelashwa.

Isivivinyo se-ADHD kufanele sibhalise abantu abaxilongwe ngendlela efanele futhi silinganise imiphumela efanele. Lokhu kungahlanganisa izilinganiso zezimpawu eziqinisekiswe ukuthi ziyasebenza kanye nokusebenza esikoleni, emsebenzini, noma ekhaya. Kufanele futhi sihlukanise umphumela wokungenelela ezinguqukweni zokulala, emithini esivele isetshenziswa, kulokho okulindelwe, nasekuzilolongeni okuphindaphindiwe.

Cabanga ngemibuzo emibili: ingabe umuntu angasibona ngokunembe kakhudlwana isithombe asiboniswe muva nje, futhi ingabe lowo muntu angahlela futhi aqede imisebenzi yansuku zonke ngokungaguquguquki? Kokubili kuhilela amakhono okuqonda. Kodwa akuyona imiphumela engasetshenziswa ngokushintshana. Ukubuka kwethu kafushane ubufakazi be-methylene blue kubantu kusebenzisa lo mehluko ofanayo ezinzuzweni eziphakanyiswayo.

Lokho okwatholwa ngempela yisivivinyo sabantu abadala abaphilile

Ucwaningo lokuthwebula izithombe lwango-2016 olusebenzisa ukwabiwa ngokungahleliwe lukaRodriguez nozakwabo lwahlaziya abantu abadala abaphilile abangu-26, abaneminyaka engu-22 kuya ku-62. Lwaqhathanisa ukunikezwa kanye ngomlomo kwe-methylene blue yezinga le-USP ne-placebo enombala oluhlaza okwesibhakabhaka. Ukuhlolwa ngaphambi kokunikezwa kanye nangemva kwehora cishe kwahlanganisa umsebenzi wokugcina ukunaka, umsebenzi wenkumbulo yesikhathi esifushane, kanye ne-MRI yokusebenza kobuchopho. Ukuphazamiseka kwengqondo nokusetshenziswa muva nje kwemithi yokwelapha ukuphazamiseka kwengqondo kwakuyizizathu zokungafakwa ocwaningweni.

Izimpendulo ezabonakala ezithombeni zobuchopho zashintsha ezindaweni eziningana. Imiphumela yokuziphatha idinga ukuhlolwa ngokucophelela: ukuqhathaniswa kwesikhathi sokusabela emsebenzini wokunaka phakathi kwamaqembu ngokuhamba kwesikhathi kwakungabalulekile ngokwezibalo, ngo-P = .43. Iphepha labika ukuthuthuka okucishe kube ngu-7% ezimpendulweni ezinembile zokukhumbula ngaphakathi kweqembu le-methylene blue, kodwa umphumela ohambisanayo womehluko woshintsho phakathi kwamaqembu nawo wawungabalulekile ngokwezibalo, ngo-P = .09.

Umphumela obalulekile ngokwezibalo ngaphambi nangemva kokwelashwa eqenjini elilodwa awufakazeli inzuzo yokwelashwa ebalulekile ngokwezibalo uma kuqhathaniswa nelinye iqembu. Le miphumela isekela uphenyo olwengeziwe, kodwa ayibonisi inzuzo nge-ADHD. Lesi sivivinyo futhi asikwazi ukuphendula imibuzo ngokusetshenziswa okuphindaphindiwe, ngezingane, noma ngokuhlanganiswa nemithi ye-ADHD.

Uhlu oluseshekayo, oluhlanganisa nobufakazi obungekho

Vula uhlu locwaningo oluseshekayo ukuze uhlunge amarekhodi ngokweqembu labantu, umphumela, umbhali, noma isikhala sobufakazi. Luhlanganisa izixhumanisi zemithombo futhi luhlukanisa izivivinyo ezifanele zokunikeza umongo nomphumela wokusesha ongahambisani nombuzo.

Isivivinyo sikaTelch sabela ngokungahleliwe abantu abadala abangu-42 ababenokwesaba okukhulu kwezindawo ezivalekile ku-methylene blue noma ku-placebo ngemva kokuqeqeshwa ngokubhekana nalokho okwesatshwayo. Ukuhlolwa kwenkumbulo nokuhlolwa kokwesaba ngemva kwenyanga eyodwa kwakuphathelene nokufunda nokugcinwa kokwesaba enkumbulweni. Imiphumela yokwesaba yayincike ekutheni isikhathi sokubhekana nalokho okwesatshwayo sasiphele ngempumelelo engakanani. Lesi kwakungesona isivivinyo sezimpawu ze-ADHD, futhi asifakazeli inzuzo ejwayelekile yokunaka.

Omunye umphumela wokusesha ubonisa ukuthi kungani ukubala amaphepha kunganele. Embikweni wesigameko se-methemoglobinemia ofakwe ngaphansi kwe-PMID 27099330, i-ADHD yavela emlandweni wezokwelapha wesiguli. I-methylene blue yagwenywa ngenxa yokusoleka kokuntuleka kwe-G6PD, okwaqinisekiswa kamuva. Injini yokusesha ingathola womabili amagama ngisho noma iphepha lingenaso isivivinyo sokwelashwa esiwaxhumanisayo.

Uhlu luqopha ukusesha okuqondiswe kulo mbuzo okwenziwa ngoSepthemba 12, 2026, kusetshenziswa “methylene blue” noma “methylthioninium” kanye no-“ADHD” noma “attention deficit hyperactivity disorder.” I-PubMed yathola lowo mbiko wesigameko; i-ClinicalTrials.gov ayitholanga amarekhodi ahambisanayo. Ukusesha okubanzi kwahlinzeka ngezifundo zamakhono okuqonda ezinikeza umongo. Lokhu ukuhlolwa kobufakazi okwenziwe ngosuku oluthile, hhayi ubufakazi bokuthi lonke ucwaningo olungakashicilelwa noma olufakwe ngaphansi kwamanye amagama selutholakele. Umtapo wocwaningo unikeza umongo obanzi wezifundo.

Ukusebenzisana kwemithi kushintsha umbuzo osebenzayo

I-methylene blue ingavimbela i-monoamine oxidase. Imininingwane yomkhiqizo wayo womjovo onikezwa ngencwadi kadokotela ixwayisa nge-serotonin syndrome uma isetshenziswa nemithi esebenza ku-serotonin kanye nama-opioid. Kumuntu one-ADHD, lonke uhlu lwemithi lubalulekile, kuhlanganise nokwelashwa kokucindezeleka noma ukukhathazeka okuhambisana nayo.

1. Imikhiqizo ye-amphetamine: imininingwane ye-Adderall XR iyakwenqabela ukusetshenziswa nemithi evimbela i-MAO futhi isho ngokuqondile i-methylene blue efakwa emthanjeni. Ukunyuka komfutho wegazi okuyingozi kuyingozi eshiwo.
2. I-methylphenidate: imininingwane ye-Ritalin nayo iyakwenqabela ukwelashwa ngasikhathi sinye ngemithi evimbela i-MAO ngenxa yengozi yokunyuka komfutho wegazi okuyingozi.
3. I-atomoxetine: imininingwane ye-Strattera isho i-methylene blue efakwa emthanjeni esixwayisweni sayo esenqabela ukusetshenziswa nemithi evimbela i-MAO futhi ichaza ukusabela okungaba kubi kakhulu.

Le mininingwane yomkhiqizo ayizona izivivinyo zazo zonke izinhlobo ezithathwa ngomlomo ezitholakala kubathengi. Futhi ayifakazeli ukuthi inhlanganisela ethathwa ngomlomo iphephile. Isixwayiso se-TGA yase-Australia ngemikhiqizo ye-methylene blue ethathwa ngomlomo engabhalisiwe sikhuluma ngokuqondile ngokusebenzisana kwemithi okuyingozi. Yisa umkhiqizo uqobo, izinga lokugxila kwawo, kanye nohlu oluphelele lwemithi kumuntu okunikeza incwadi yomuthi noma kusokhemisi ngaphambi kokucabanga ukuwusebenzisa. Ungayeki ukwelashwa kwe-ADHD okunikezwe udokotela ukuze uzenzele isivivinyo se-methylene blue.

Uma ngemva kokuchayeka kuba nomkhuhlane, ukungahlaliseki okukhulu noma ukudideka, ukuqina kwemisipha, noma ukusabela okubhebhetheka ngokushesha, funa usizo lwezokwelapha oluphuthumayo. Ukubuka kafushane ukuphepha kuchaza ezinye izimo lapho kungafanele isetshenziswe khona kanye nemininingwane yokuchayeka okufanele iqoshwe.

Yibuphi ubufakazi obungashintsha impendulo?

Ucwaningo olulandelayo oluwusizo lungahlola uhlobo lomkhiqizo oluchazwe ngokucacile kubahlanganyeli abaxilongiwe, lusebenzise iqembu lokuqhathanisa, lunqume kusengaphambili imiphumela yezimpawu ze-ADHD nokusebenza, futhi lulandelele imiphumela emibi isikhathi esifanele. Imibuzo ephathelene nabantu abadala nezingane izodinga ubufakazi obuhlukene. Incazelo yokuthi isebenza kanjani kuma-mitochondria ayikwazi ukuvala lezo zikhala.

Ukunakekelwa osekwamukelwe sekuvele kunezindlela ezihlelekile zokuhlola nokuqapha, njengalezo ezise-zincomweni ze-NICE nge-ADHD. Ukungalawuleki kwezimpawu ngendlela egculisayo kuyisizathu sokubuyekeza lokho kunakekelwa nodokotela owelaphayo. Izifundo ezibuyekezwe lapha azisekeli ukufaka i-methylene blue esikhundleni sokwelashwa. Izimangalo ngezimo ezihlobene nokukhula zidinga ukuhlolwa kwazo kweqembu labantu nokungenelela, njengoba kuchazwe ekubuyekezweni kwethu kocwaningo lwe-methylene blue ne-autism.