广州抑郁症| 还不如不吃药？抗抑郁药停用会出现这些糟糕的戒断反

抑郁症是以而持久的心境低落为主要临床特征。

说白了，就是各种负面情绪，长期的。

抗抑郁药所致的戒断反应

抗抑郁药开始使用以来，就有关于抗抑郁药停用出现戒断反应的报道，但是一直以来这种反应被临床医师低估了。

近来，尽管还存在争论，但停用抗抑郁药后出现抗戒断反应的观点被普遍接受，我们不能忽视它的存在。

2002年发生在美国加利福尼亚州的一场诉讼案件使生产帕罗西汀的厂家Glaxo Smithkline公司修改了帕罗西汀的药品说明书。美国35名患者起诉了Glaxo Smithkline公司，理由是服用帕罗西汀后出现了戒断反应或戒断综合征。这场诉讼后，Glaxo Smithkline公司修改了帕罗西汀的药物说明书，特别是提到了帕罗西汀的“停药反应”的危险性。

之后其他SSRIs药(包括舍曲林、西酞普兰、氟伏沙明、氟西汀等)也清楚的被发现有相似的戒断反应，至少有50篇文章报道了SSRIs药物的这一反应，有的病人甚至为此反应而要求住院。

但目前许多SSRIs药的药物使用说明书没有提出药物发生戒断反应可能性的警告。1990年英国药品集提出了抗抑郁药能引起戒断反应的警告。但抗抑郁药所致戒断反应几乎没有系统的研究，甚至许多临床医师都不知道抗抑郁药戒断反应的存在。由于缺乏相关研究，抗抑郁药戒断反应的发病率尚不清楚，另外，抗抑郁药戒断反应仅仅是一个使人痛苦的症状反应还是提示一个疾病的先兆还不清楚，尚需进一步研究。研究也显示舍曲林、帕罗西汀、文拉法新的戒断反应较氟西汀多见。

戒断反应的临床表现

综合一些研究结果，抗抑郁药戒断反应可出现以下一些症状：

1.胃肠道症状：如恶心、呕吐、厌食、腹泻、腹部不适等

2.流感样症状：发热、肌肉痛、疲劳、寒战、头痛、头晕、眩晕等。

3.睡眠障碍：石棉、噩梦、生动梦境、昏睡等。

4.感觉障碍：电击感、麻刺感、感觉倒错(例如：把冷感觉为热)等。

5.运动障碍：肌张力障碍、协调障碍、步态障碍、震颤等。

6.情感障碍：情绪低落、焦虑、容易发脾气、坐立不安、惊恐、躁狂等。

7.其他症状：如记忆和注意集中困难，身体不适、虚弱、精神错乱、出汗、心率失常、攻击行为等。

别识抗抑郁药戒断反应的重要性

认识抗抑郁药的戒断反应在抑郁症治疗中有其重要意义，这种重要性在于：

1.尽管大多数戒断反应较轻，持续时间较短，但仍有少数是严重的，或存在时间长，给病人带来心的痛苦和不适。如果我们能充分认识到抗抑郁药的戒断反应，及时发现并采取措施减少或控制戒断反应，就会减少或消除患者的痛苦。

2.由于抗抑郁药戒断反应不能认识会导致不合适的治疗。比如将抗抑郁药戒断反应误诊为疾病的复燃，从而导致抗抑郁药不必要的从新使用。

下面两点可以用来区别抗抑郁药抗抑郁药的戒断反应与抑郁症复燃：

1.抗抑郁药的戒断反应常常在突然停服抗抑郁药几天内出现(或在减量中出现，但较少见)且持续时间较短，在1天--3周内消失;相反，抑郁症复燃在停用抗抑郁药后周内出现是不常见的，复燃症状倾向于慢性迁延。

2.抗抑郁药的戒断反应常在重新服用抗抑郁药治疗24小时内控制;相反，抑郁症复燃控制则慢的多。另外，还有许多抗抑郁药的戒断反应是躯体不适，也可能导致为明确原因而去做大量的实验室检查，以至浪费金钱，加重经济负担。因此，认清抗抑郁药的戒断反应，能减少不必要的治疗和不必要的费用。

3.抗抑郁药的戒断反应使患者不愿服药，而连医生都缺乏对这种隐藏的不愿服药的原因缺乏认识，可能导致医生作出加大剂量或换用另一种抗抑郁药的错误决定。

采取的对策

为了减少抗抑郁药的戒断反应发生的可能性，英国药品集推荐：抗抑郁药在连续使用8周或更长时间时不应突然停药，应在4周左右逐渐减量。

现在研究认为：抗抑郁药在1周或2周减量能使戒断反应减少到比较少。

当刚停用抗抑郁药或还在治疗时出现其他不能解释的躯体或心理症状，我们应考虑戒断反应的存在。当然，只有几天的抗抑郁药使用后停药，不需要考虑戒断反应。

许多抗抑郁药的戒断反应较轻，此时不必使用抗抑郁药物，仅给予心理上的支持及对症处理(如短时失眠治疗等)即可。少数戒断反应较严重，需要给予抗抑郁药治疗，在重新服用抗抑郁药治疗后将很快控制。

关于抑郁症，抑郁情绪你还想了解更多吗?下面广州抑郁症医院 广州治疗抑郁症，广州附医华南医院医生给大家推荐一篇国外的文献阅读，希望您对抑郁症有更多的了解。

Many studies link fibromyalgiaand depression. In fact, people with fibromyalgia are up to three times more likely to have depression at the time of their diagnosis than someone without fibromyalgia.

Some researchers feel that depression leads to changes in brain chemistry. Others look at abnormalities of the sympathetic nervous system -- the part of the nervous system that determines how you handle stress and emergencies. These abnormalities, they contend, may lead to the release of substances that cause more sensitivity to pain. The result is fibromyalgiawith its chronic pain and feelings of depression.

Learning more about the connection between fibromyalgia and depression can help you seek appropriate medical treatment from your doctor. That includes asking your doctor about antidepressants.

By following an appropriate fibromyalgia treatment plan and getting the support of family and friends, you can take control of your fibromyalgia. You can also get control over your symptoms of depression and improve your quality of life.

What Is Depression?

Sadness is a normal reaction to loss, life's struggles, or an injured self-esteem. Depression surpasses sadness and becomes a problem that affects your whole life. People who are depressed commonly experience:

loss of pleasure in enjoyable activities

weight loss or gain

low energy

feelings of guilt

a sense of worthlessness

thoughts about death

These thoughts, physical changes, and feelings interfere with daily life.

Depression that lasts for weeks at a time may be characterized as major or clinical depression. There are other types of depression. Common types include chronic depression -- known as dysthymia, bipolar depression, and seasonal depression or seasonal affective disorder (SAD).

What Is the Link Between Fibromyalgia and Depression?

The stress from fibromyalgia's pain and fatigue can cause anxiety and social isolation. The chronic deep muscle and tender point pain can result in less activity. That causes you to become more withdrawn and can also lead to depression. It is also possible that anxiety and depression are part of fibromyalgia, just like the pain.

Depression and fibromyalgia can greatly interfere with the way you manage your activities at home or at work. So it is important to openly discuss any symptoms of depression you have with your doctors.

Do People With Fibromyalgia Know They're Depressed?

Some people with fibromyalgia and chronic pain may be aware they are depressed. Others may not be sure they are depressed. Nevertheless, they know something is wrong.

The signs of depression with chronic pain may include:

decreased energy

difficulty concentrating or making decisions

feelings of hopelessness, guilt, or irritability

loss of interest in nearly all activities

persistent sad or anxious mood

uncontrollable tearfulness

In severe cases, depression with chronic pain can lead to thoughts of death or suicide.

Does Stress Increase Depression With Fibromyalgia?

The stress of living with chronic pain and relentless fatigue can put a person into "overload." That can result in overwhelming feelings of nervousness and anxiety. What isn't clear is whether a stressful life brings about the fibromyalgia or if having fibromyalgia leads to stress.

No matter which comes first, stress adds to problems of anger, distractibility, and irritability. Most patients feel worsening of pain and fatigue when they have more stress. Sometimes, severe stress occurs just before the disease starts.

Is Depression Common With Chronic Pain Conditions?

Feelings of depression are common with all types of chronic pain, including headache, back and neck pain, hip pain, shoulder pain, and the pain of fibromyalgia. For example, the prevalence of major depression in people with chronic low back pain is about three times greater than in the general population.

By the same token, having a depressive disorder also increases the risk of developing chronic pain. Patients who are depressed have greater pain. They describe greater hindrance from pain and display more pain behaviors than pain patients who are not depressed.

People with chronic pain such as fibromyalgia often become depressed and isolated. As a result, they spend more time away from other people, even people they love, such as family and friends. Instead of focusing on their personal lives or the lives of their loved ones, they become increasingly focused on their pain and suffering, which is very real. Adding to the frustration are the repeated appointments with health care providers to try to find relief and the resulting costs.

What Happens When Fibromyalgia Goes Untreated?

If you avoid treating fibromyalgia, you may descend into a spiral. The chronic pain and fatiguelimits your physical activities and exercise. That, in turn, weakens your body. You may begin to feel isolated, fearful, suspicious, lonely, and afraid, which can strain relationships.

As time goes on and your symptoms continue, you may have trouble keeping your job. Doing so can be especially difficult if you have many absences or errors because of your symptoms such as fatigue, concentration problems, and pain. If your income is lost, you will have more stress. The longer your chronic pain and other symptoms continue without relief, the more likely you will be to experience stress-related symptoms.

Are There Ways to Ease Depression With Fibromyalgia?

It's important to understand that fibromyalgia is more than the deep muscle pain and tender points you feel. It encompasses everything about you -- your feelings, emotions, and attitude; the way you respond to stress; and the way you communicate with others.

The good news is, though, that while there is no cure, the fibromyalgia pain and symptoms of depression can be successfully treated.

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广州抑制症状明显的病人像一架到处生了锈的机器，尽管任何部件都没有坏，可整个机器运转不灵。 然后，广州附医华南抑郁症还要唠叨一句，抑郁症如果一直自己调节都没有好转，建议是及时到医院检查治疗，抑郁症危害多多百度一下你就知道。

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