Ilaaj aur dawaein

Menopause ke liye SSRIs aur depression ki doosri dawaein

Yeh dawaein kya hain, NICE aur Pakistan Menopause Society menopause ki alamaat ke liye in ke baare mein kya kehte hain, aur yeh kaise poochein ke nuskha kis cheez ke liye hai.

Is safhe par
  1. Lafz aur hidayat
  2. Yeh kya hai
  3. Hidayat mein kya likha hai
  4. Ilaaj ke baare mein hidayat kya kehti hain
  5. Doctor ko kab dikhayen
  6. Doctor se poochne ke sawal
  7. Deen aur ghar wale
  8. Is par nazar rakhein
  9. Aam sawal
  10. Milte julte mauzuaat
  11. Hawale

Aap paseenon, raat teen baje aankh khul jane aur be wajah rone ke baare mein baat karne gayin. Wapas depression ki dawa ka nuskha le kar aayin. Agar yeh jaana pehchana lagta hai to yeh safha aap ke liye hai, aur yeh sawal bhi ke woh nuskha tha kis cheez ke liye.

Lafz aur hidayat

English
Antidepressants
In naamon se bhi dhoonda jata hai
SNRIs, antidepressants for hot flushes, antidepressants for hot flashes
Urdu
ڈپریشن کی دوا
Roman Urdu
depression ki dawa
  • NICE NG23 kehta hai ke sirf vasomotor symptoms ke liye SSRIs, SNRIs ya clonidine ko mamool ke taur par pehle darje ke ilaaj ke taur par na diya jaye (sifarish 1.5.4). Vasomotor symptoms yani hot flush aur raat ke paseene.
  • Menopause ke saath aane wali udaasi ke liye NICE NG23 kehta hai ke depression ki un alamaat ko kam karne ke liye HRT par ghaur kiya jaye jo depression ki tashkhees ki had tak na pohanchti hon aur menopause ki doosri alamaat ke aas paas hi shuru hui hon (1.5.21).
  • Pakistan Menopause Society ki 2026 ki sifarishaat SSRIs aur SNRIs ko un baghair hormone wali dawaon mein ginti hain jo tab istemal ho sakti hain jab HRT theek na ho ya aurat ise na lena chahe, aur depression ki dawa ko darmiyane se shadeed mood ke maslon ke liye rakhti hain, kisi specialist ke dekhne ke baad (khulasa; section 7.2).
  • British Menopause Society likhti hai ke menopause ki alamaat ke liye di jane par yeh dawaein aksar apne license se hat kar istemal hoti hain, aur yeh ke in mein se kuch ka tamoxifen se takrao hota hai.

Yeh kya hai

SSRIs, yani selective serotonin reuptake inhibitors, aur SNRIs, yani serotonin and norepinephrine reuptake inhibitors, depression ki dawaon ke do qareebi khandaan hain. British Menopause Society likhti hai ke in mein se kuch bechaini mein bhi madad karti hain.

Yeh menopause ke ilaaj mein bhi nazar aati hain, do alag wajhon se. Kuch hot flush aur raat ke paseenon ke liye baghair hormone wale ilaaj ke taur par istemal hoti hain. Aur darmiyani umar ki kuch auraton ko yeh us udaasi ya bechaini ke liye di jati hain jo un ki menopause ki doosri alamaat ke aas paas hi shuru hui.

Yeh do alag kaam hain. Aap ka nuskha in mein se kaun sa kaam kar raha hai, yehi pehla sawal hai.

Hidayat mein kya likha hai

Hot flush aur raat ke paseenon ke liye baghair hormone wale ilaajon ki Pakistan Menopause Society ki table (Table 11) do SSRIs, paroxetine aur escitalopram, aur do SNRIs, venlafaxine aur desvenlafaxine, ke naam leti hai.

British Menopause Society ki doctoron ke liye guide bhi yehi khandaan ginti hai, kuch ehtiyaton ke saath. Jab wajah menopause ki alamaat hon to yeh dawaein aksar apne license se hat kar istemal hoti hain. SSRIs ke side effects mein matli, chakkar aana, shuru mein thore arse ke liye bechaini ka barh jana, aur jinsi side effects shamil hain. Paroxetine chhaati ke cancer ki dawa tamoxifen ka asar kam kar sakti hai, aur BMS kehti hai ke is ke saath fluoxetine se bhi bachna chahiye. Woh venlafaxine ko tamoxifen lene wali auraton ke liye shayad sab se mehfooz intikhab kehti hai.

European Menopause and Andropause Society (EMAS) khoon ki chiknaiyon ke baare mein aik baat mazeed kehti hai: sertraline aur paroxetine khoon mein triglycerides barha sakti hain, aur venlafaxine bhi khoon ki chiknaiyan barha sakti hai.

Ilaaj ke baare mein hidayat kya kehti hain

Hot flush par NICE NG23 saaf hai: woh kehta hai ke sirf vasomotor symptoms ke liye SSRIs, SNRIs ya clonidine ko mamool ke taur par pehle darje ke ilaaj ke taur par na diya jaye (1.5.4). Hot flush ke liye in hidayat ki pehli sifarish HRT dena hai (1.5.1).

Mood par NG23 do haalaton ko alag karti hai. Us udaasi ke liye jo depression ki tashkhees tak nahin pohanchti aur menopause ki doosri alamaat ke aas paas hi shuru hui, woh HRT (1.5.21) aur menopause ke liye khaas CBT (1.5.22) par ghaur karne ka kehti hai. Jis aurat ko depression hai ya ho sakta hai, us ke liye woh doctoron se kehti hai ke menopause ki hidayat aur depression ki hidayat donon saath le kar chalein (1.5.23).

Pakistan Menopause Society ki sifarishaat bhi isi taraf ishara karti hain. Woh SSRIs aur SNRIs ko tab ke liye rakhti hain jab HRT theek na ho ya aurat ise na lena chahe, aur depression ki dawa ko darmiyane se shadeed mood ke maslon ke liye, kisi specialist ke dekhne ke baad (7.2). Jin auraton ko chhaati ka cancer ho chuka hai, un ke liye woh kehti hain ke hot flush ke liye venlafaxine jaisi kisi SNRI par ghaur kiya ja sakta hai (7.1.2).

Yeh baat yahan kyun aham hai

Rawalpindi ke Benazir Bhutto Hospital mein depression ka ilaaj karwane wali 45 se 55 saal ki 250 auraton ke aik audit ne, jo 2024 mein aik conference mein pesh kiya gaya, paya ke 78% mein perimenopause ki wazeh alamaat thin jin par kisi ki nazar nahin gayi, aur 82% ka ilaaj depression ki dawaon se ho raha tha (Gul, 2024). EMAS bari tasveer dikhati hai: perimenopause mein 45 se 68% auraton mein depression ki alamaat hoti hain, jabke is se pehle ke saalon mein 28 se 31% mein.

Is ka yeh matlab nahin ke depression ki dawa aap ke liye ghalat hai. Ho sakta hai yeh bilkul theek dawa ho, khaas taur par agar aap ko depression hai. Is ka matlab yeh zaroor hai ke yeh mere mood ke liye hai ya mere menopause ke liye? aik bilkul theek sawal hai, aur aap yeh pooch sakti hain.

Kya Pakistan mein milta hai?

Haan. Hot flush aur raat ke paseenon ke liye baghair hormone wale ilaajon ki Pakistan Menopause Society ki 2026 ki table (Table 11) do SSRIs, paroxetine aur escitalopram, aur do SNRIs, venlafaxine aur desvenlafaxine, ke naam leti hai, aur har aik ke saath woh brand jo yahan bikte hain.

Doctor ko kab dikhayen

Agar aap depression ki dawa le rahi hain aur aap ko lagta hai ke perimenopause bhi is tasveer ka hissa ho sakta hai, to is par baat karne ke liye appointment lein. Apni alamaat ka record saath le jayen; alamaat ka score is ka aik tareeqa hai.

Kuch bhi badalne se pehle us doctor se baat karein jis ne aap ki depression ki dawa likhi. PMS ki table likhti hai ke yeh dawaein band karte waqt aahista aahista kam ki jati hain.

PMS ki sifarishaat shadeed depression aur khud ko nuqsaan pohanchane ke khatre ko un baaton mein ginti hain jin ki doctor ko jaanch karni chahiye ya aage bhejna chahiye (Table 4).

Doctor se poochne ke sawal

  1. Yeh dawa mere mood ke liye hai, ya mere hot flush ke liye?
  2. Kya meri alamaat perimenopause ki ho sakti hain, aur kya hum ne in ke liye HRT ki baat ki hai?
  3. Agar HRT mere liye theek nahin, to aap yehi raasta kyun tajweez kar rahe hain?
  4. Main tamoxifen leti hoon. Kya is se yeh badalta hai ke in mein se kaun si dawa mere liye theek rahe gi?
  5. Agar main kabhi ise chhorna chahoon to hum yeh mehfooz tareeqe se kaise karein ge?
  6. Mera cholesterol zyada hai. Kya yeh dawa is par asar daal sakti hai?

Deen aur ghar wale

Bohat se gharon mein depression ki dawa ka naam hi aik aisa bojh rakhta hai jo blood pressure ki goli nahin rakhti. Kuch auratein log kya kahein ge ke dar se ise lene se inkaar kar deti hain. Kuch chup chaap leti rehti hain aur kabhi kisi ko nahin batatin. Donon baatein samajh mein aati hain.

Kuch auraton se kaha jata hai, ya woh khud se kehti hain, ke udaasi ka matlab hai ke un ka imaan kamzor ho gaya hai. Yeh uthane mein bhaari aur zabaan par lane mein mushkil baat hai. Agar imaan ke sawal bhi aap par bojh bane hue hain to koi aalim jis par aap bharosa karti hain, is baat cheet ka hissa ho sakta hai. Dawa ki baat aap ke doctor se karne ki hai.

Is par nazar rakhein

  • Roshara ka alamaat ka score chand minute mein 27 alamaat ko number deta hai, account ke baghair. Kul number apni appointment par saath le jayen. Alamaat ka score shuru karein
  • “Main kahan hoon?” us mor ko naam deta hai jis par aap shayad hain. Chhe sawal. Main kahan hoon? Shuru karein
  • Tracker mein roz ka haal likhein, aur yeh bhi ke us se zara pehle kya hua tha. Is ke liye muft account chahiye. Tracker kholein

Aam sawal

Agar mujhe lagta hai ke meri alamaat perimenopause ki hain to kya main apni depression ki dawa band kar doon?
Kuch bhi badalne se pehle us doctor se baat karein jis ne yeh dawa likhi. Pakistan Menopause Society ki table likhti hai ke paroxetine aur venlafaxine band karte waqt aahista aahista kam ki jati hain (Table 11). (Hawala: Pakistan Menopause Society, Good Clinical Practice Recommendations for Menopause Care in Pakistan (JSOGP 16(2), 28 April 2026))
Aur agar mujhe waqai depression ki tashkhees hui ho?
To donon baatein laagu hoti hain. NICE NG23 doctoron se kehta hai ke menopause ki hidayat ke saath baron mein depression par NICE ki hidayat bhi saamne rakhein (1.5.23). Depression aik asal tashkhees hai, aur is ka ilaaj aham hai. (Hawala: NICE NG23, Menopause: identification and management (last updated 15 April 2026))
Main pehle se sertraline leti hoon. Kya is se mere hot flush kam hon ge?
Shayad nahin. America ki The Menopause Society ko trials mein sertraline aur fluoxetine se bas halka sa farq mila, jo ittefaq bhi ho sakta tha, is liye woh hot flush ke liye in mein se kisi ki sifarish nahin karti. Ise khud se band na karein; poochein ke kya aap ke hot flush ko alag ilaaj chahiye. (Hawala: The Menopause Society (then The North American Menopause Society), The 2023 nonhormone therapy position statement, Menopause 2023;30(6):573-590)

Milte julte mauzuaat

Hawale

  1. NICE NG23, Menopause: identification and management (last updated 15 April 2026)Hissa: 1.5.1 to 1.5.4, Vasomotor symptoms; 1.5.21 to 1.5.23, Depressive symptoms · 1 October 2026 ko khola gaya
  2. Pakistan Menopause Society, Good Clinical Practice Recommendations for Menopause Care in Pakistan (JSOGP 16(2), 28 April 2026)Hissa: Summary; Table 4; 7.1.2; 7.2; Table 11 · 1 October 2026 ko khola gaya
  3. British Menopause Society, Tool for Clinicians: Prescribable alternatives to HRT (reviewed March 2026)Hissa: Introduction; SSRIs; SNRIs · 1 October 2026 ko khola gaya
  4. Gul N. Identifying perimenopausal symptoms in women diagnosed with depression: a focused audit at a tertiary care hospital. BJPsych Open 2024;10(S1):S234 (conference abstract)Hissa: Results · 1 October 2026 ko khola gaya
  5. The Menopause Society (then The North American Menopause Society), The 2023 nonhormone therapy position statement, Menopause 2023;30(6):573-590Hissa: Prescription therapies: SSRIs and SNRIs · 15 October 2026 ko khola gaya
  6. European Menopause and Andropause Society, Menopause Essentials 2026: Depression (July 2026)Hissa: Introduction · 15 October 2026 ko khola gaya
  7. European Menopause and Andropause Society, Menopause Essentials 2026: Cholesterol and menopause treatments (July 2026)Hissa: Non-hormonal therapies (for vasomotor symptoms) and lipids · 15 October 2026 ko khola gaya