躁鬱旅程

文章標題 : Re: 慢慢分享不藥而癒獲得平靜的方法文章發表於 : 2014-02-03 19:27 星期一 

 
引用slow 寫:
我想，憂鬱和躁狂交替出現，不管掛哪一個精神科醫師的診都會被判罹患躁鬱症。
而且從民國93年七月起，我持續看的精神科醫師是大醫院的名醫，
他除了曾多次眼見我的憂鬱狀態也是我躁狂發作住院時的病房醫師，我想他不會是了解不夠深入的醫生。
若是您去翻閱精神科醫師所寫的書籍資料中有談到關於躁鬱症的部份，
都會提到Lithium(鋰鹽)是治療躁鬱症的主要用藥。
而且我的精神科醫師曾告訴我說「鋰鹽是用來保護我的腦袋用的」，
他所受的教育就是這樣教他的（但他所受的精神藥學背後的贊助者是誰？是富可敵國的藥廠。），
但我看的氣學理論醫師群告訴我那個藥的氣很緊，對我有害無益。
（甚至有醫師說吃久了我的腦袋就壞了，而且後來發生的狀況就是這樣）

版友patty在版上『 Re: 慢慢部落格分享 發表於 : 2011-07-19 0:53』中跟我分享關於遲發性異動症的資料：
「遲發性不自主運動 (Tardive Dyskinesia : TD)

TD是抗精神病藥物所引起追體外徑(EPS)副作用中最棘手的一種，

她是因長期服用抗精神病藥物所引起長期或永久性異常的不自主運動」 ，
我後來得知文章出處是來自於台北市精神科健保特約診所－澄心診所（http://www.7headlines.com/article/show/345540749），
文中有提到「TD的盛行率從0.5﹪~40﹪皆有報告，
林信男等(1980)在台北地區慢性病房所做調查獲得知盛行率為4.5﹪。
美國的研究顯示服用抗精神病藥超過一年者，約10﹪~20﹪會出現此副作用。」

還有幾個月前我的美國朋友給了我一篇關於鋰鹽的醫學資料，
生活忙碌又拖拖拉拉加上英文沒有很好的我，直到幾個禮拜前才拿出來看，我正在慢慢翻譯中。
依我對該資料文意的大概理解，其內容正符合我看的持續學習氣學醫療理論的醫師群所告訴我的：
「我服用的藥物會讓我產生我現在有或曾有與時好時壞的症狀。」
資料所寫的符合我這兩年來所經歷的（大概的情形也多我部落格中的2012病中書信提及，有些難以啟齒的部份待我克服心中掛慮後我會全盤托出）
而且這個醫學研究資料是十幾二十年前就研究出來的，資料說明那藥物是毒，會毒害我的腦子，造成不可彌補的棘手問題。
而我的精神科醫師卻不只一次告訴我說：「那藥可以保護我的大腦。」勸我穩定持續服藥。

有位常與我見面的美國朋友見了我這兩三年來的狀況

符合她看到的資料，她跟我分享 

因為朋友給我的資料無法直接複製貼上，以致在理解全文後我得逐字打字，所以花了一點時間

且因為全文是英文，我怕po上來沒什麼人會看，而我英文沒有很好只能說懂文義，

所以我正在找人協助翻譯成中文，因為要我翻譯，我怕翻得不好，若翻得與原義有出入，那就罪過了

文章是關於精神科用來治療躁鬱症的主要用藥Lithium(鋰鹽）具有毒害性的研究探討。

文章出處：books.google.com.tw/books?isbn=0826129358
書名Brain-Disabling Treatments in Psychiatry: Drugs, Electroshock, and the Psychopharmaceutical Complex
    By Peter Roger Breggin

以下是我拿到的資料，與大家分享，希望對有相同問題的病友有幫助，不要步我的後塵。

（最下面有我用中文描述與文章所提相符合的症狀）

SPELLBINDING AND IATROGENIC HELPLESSNESS AND DENIAL

The previously cited research by Judd demonstrates how professionals utterly fail to see lithium-induced disabilities that are obvious to friends and detectable with psychological testing. Due to medication spellbinding, patients themselves have difficulty evaluating their mental status on lithium. Toxicity often creeps up slowly over many days or weeks so that their judgment is impaired in an almost imperceptibly gradual manner. In fact, patients cannot be relied on to notice when they are becoming severely toxic, even though the symptoms include marked gastrointestinal disturbances, tremor, and disturbed mental functions. Instead of relying on the perceptions of patients, blood levels must be carefully monitored and the patients carefully watched.
In keeping with this medication spellbinding effect, normal volunteers on small doses suffer impairments of their reflexes but do not realize or acknowledge the impairment ( Linnoila et al., 1974 ). Lithium patients who report no side effects often have grossly obvious tremors. The failure of patients on maintenance therapy to notice their own neurologic defects clearly demonstrates that lone-term treatment with lithium is medication spellbinding.

TOXICITY TO THE CENTRAL NERVOUS SYSTEM

The Production of Cognitive Deficits

It is now generally accepted that lithium can impair intellectual function. For example, Shaw et al. ( 1978 ) found impairments of memory and hand motor speed on lithium. In Manic- Depressive Illness, a book written wholly from a biopsychiatric perspective, Frederick Goodwin and Kay Jamison ( 1990 ) nonetheless concluded that lithium does cause serious cognitive impairments. They summarized much of the literature up to that time and decalred,

Since the drug’s primary action is mediated through the central nervous system, it is not surprising that lithium can cause cognitive impairments of varying types and degrees of severity. Indeed, memory problems are among the side effects of lithium treatment that patients report most frequently. Although affective illness itself contributes both to cognitive deficits and complaints about such deficits, it is important to bear in mind that impairment of intellectual functioning caused by lithium is not uncommaon and, in many patients, leads to noncompliance. Creativity can also be affected. ( p.706 )
More recently, Stip et al. (2000) summarized the literature on lithium – induced memory problems: “ Several studies have shown cognitive impairment in short-term memory, long- term memory and psycho-motor speed in bipolar patients taking lithium.” Their study aimed at testing the effect of lithium in normal subjects in a double-blind, 3-week study. They found that lithium-treated volunteers had long-term memory deficits on recalling words compared to the placebo group.

Acute Organic Brain Syndromes

Considering how vigorously lithium is promoted as relatively free of overpowering mental effects, it is surprising how many cases of toxic delirium during routine lithium therapy were reported soon after the drug came into use ( Johnson te al., 1968; Mayfield te al., 1966; Prien et al.,1972; Shopsin et al.,1971; Strayhorn et al.,1977). Prien et al.(1972) found that almost one-third of the patients in their highly active category suffered “severe” reactions, including several with toxic confusion described as “ disorientation, confusion, lack of continuity of thought, and reduced comprehension.” Lithium is highly neurotoxic.

SILENT: Irreversible Lithium-Induced Neurotoxicity

In 1987, Adityanjee discussed so-called lithium poisoning and made an observation that remains true today: ” There is a general lack of awareness about irreversible and untreatable complications of lithium treatment despite evidence to the contrary.”

Originally, it was thought that, except in extreme cases, lithium-induced neurotoxicity was reversible. However, it eventually became apparent that many patients develop irreversible brain damage and dysfunction, often involving the cerebellum (Grignon et al., 1996). In the last two decades, researchers have defined a syndrome of irreversible lithium-effectuated neurotoxicity (SILENT). Adityanjee et al.(2005) reviewed the literature from 1965 to 2004 for cases of lithium neurotoxicity with persistence of sequelae for at least 2 months after cessation of treatment. They found 90 cases of SILENT, with persistent cerebellar dysfunction as the most commonly reported persistent aftereffect. These chronically disabled patients may need “ physical rehabilitation for gait ataxia, speech training for dysarthria, and cognitive training for dementia and memory impairments” (p.47) The most cause, according to the authors, is “demyelination caused by lithium in multiple sites in the nervous system, including the cerebellum.” Not surprisingly, lithium toxicity can also cause chronic neuropsychological changes, including impaired memory, attention, executive control functions, and visuospatial deficits ( Brumm et al.,1998).

Irreversible neurotoxicity can occur at relatively low serum doses. Lang and Davis (2002) described “ the case of a 44 year old man who presented with a two-month history of dysarthria, ataxia and leg weakness whilst on maintenance lithium for bipolar disorder.” He had significant cerebellar and pyramidal dysfunction. His serum lithium was 1.5 mmol/L, a moderate elevation for this patient. His recovery was only partial, leaving him mainly with cerebellar ataxia. The authors warned about the insidious onset of persistent neurotoxicity during routine treatment.

Neurotoxic Effects in Low-Dosage Maintenance Therapy

Branchey et al,( 1976) published a follow-up of patients on long-term lithium maintenance (6 months to 7 years). Only 10 of 36 were “ free of neurologic symptoms,” even with the low maintenance doses employed. Four of 36 patients had parkinsonian symptoms at a “ low level of severity.”

The production of the myelin sheath is called myelination

這裡是一張神經髓鞘的說明圖 （我不知如何貼上）

Demyelination
Demyelination is the loss of the myelin sheath insulating the nerves. When myelin degrades, conduction of signals along the nerve can be impaired or lost and the nerve eventually withers. This results in diverse symptoms determined by the functions of the affected neurons. It disrupts signals between the brain and other parts of the body; symptoms differ from patient to patient.
Typical symptoms include:

• blurriness in the central visual field that affects only one eye, may be accompanied by pain upon eye movement
（這症狀我有；眼睛高壓，酸脹不適與疼痛感，持續疲勞狀態）
• double vision
• loss of vision/hearing
• odd sensation in legs, arms, chest, or face, such as tingling or numbness (neuropathy)
（這症狀我有；全身爬蟲感、酸麻感、疼痛或麻木無感對冷熱感不明顯知覺麻痺，

詳情可見部落格文章2012年病中書信 http://slowslow7.pixnet.net/blog/post/157813154）
• weakness of arms or legs（這症狀我有，全身無力，尤其是手腳力氣喪失）
• cognitive disruption, including speech impairment and memory loss
（這症狀我有；現在說來還很難啟齒，我還沒克服心理障礙，等我準備好了，我會寫出來）
• heat sensitivity (symptoms worsen or reappear upon exposure to heat, such as a hot shower)
• loss of dexterity

（這症狀我有；我的手腳反應變慢很不靈活，去學做粘土勞作時連五歲的小女孩都曾笑我怎麼這麼慢）

• difficulty coordinating movement or balance disorder

（ 這症狀我有；我動作不協調 、走路搖搖晃晃是常態）

• difficulty controlling bowel movements or urination

(這症狀我有，偶會在短時間內頻尿（半小時內可以跑廁所三四次））
• fatigue（這症狀我有；疲勞幾乎如影隨形，沒做什麼就累了）

gait ataxia: （這症狀我有；曾有行走困難，到現在只是步行失調，走路走不快，搖搖晃晃，想走快點動作會變很怪異。）
People with cerebellar ataxia may initially present with poor balance, which could be demonstrated as an inability to stand on one leg or perform tandem gait. As the condition progresses, walking is characterized by a widened base and high stepping, as well as staggering and lurching from side to side.[1]Turning is also problematic and could result in falls.

dysarthria:
（這症狀我有；我從從小到大的口齒伶俐、聲若洪鐘，變成說話遲緩（好幾秒鐘才吐得出一個字）和說話結巴的大舌頭、有時想說話卻說不出來、說話聲音很小聲、語調平板、沒辦法控制的音調改變（娃娃音），這些都是曾出現過的症狀，還好現在程度已降低和出現的頻率也降低了）

a condition in which problems occur with the muscles that help one talk; this makes it very difficult to pronounce words. It is unrelated to any problem with understanding cognitive language.[3] Any of the speech subsystems (respiration, phonation, resonance, prosody, and articulation) can be affected, leading to impairments in intelligibility, audibility, naturalness, and efficiency of vocal communication.
Individuals with dysarthria may experience challenges in the following:
• Timing
• Vocal quality
• Pitch
• Volume
• Breath control
• Speed
• Strength
• Steadiness
• Range
• Tone[1][4]
Examples of specific observations include a continuous breathy voice, irregular breakdown of articulation, monopitch, distorted vowels, word flow without pauses, and hypernasality.[4]