精神的重要

今天門診遇到一位病人。目前身體狀況不錯，也沒有明顯精神症狀的感覺。她提到之前為了胸悶、胸痛、肩頸痠 痛、失眠、手麻的問題，困擾了5年之久。

主訴及病史:
CAME ALONE, SHE COMPLAINED OF PALPITATION, CHESTTIGHTNESS AND PAIN, INSOMNIA ALSO NECK TIGHTNESS AND   NUMBNESS OF EXTREMITIES MANAGED AT OPD OF INT MEDICINE OPD  OF MANY HOSPITAL INCLUDING 市南醫 郭婦產 AND OUR OPD BUT NO SIGNIFICANT  FINDING SINCE 5 YEARS AGO. SHE ADMITTED  THESE SYMPTOMS DEVELOPED FROM PREVIOUS PERCIPITATING FAMILY STRESS--- HUSBAND'S EXTRAMARITAL EVENT  WITH DEPRESSED AND  ANXIOUS MOOD R/O POST PARTUM BUT INSOMNIA AND MOOD SX  RESOLVE 4 YEARS LATER AFTER THE STRESS BUT SOMATIC SYMPTOMS PERSISTED WITH LESS INTENSITY. SHE WAS REFERRED BY OUR  NEUROLOGIST HERE YESTERDAY.           
                                           
在精神科門診後，吃了下列二藥。
lextan 
dogmatyl                                             
病症大為的改善，也讓身為復健科醫療人員的我，多了一份了解，復健和精神是非常相關聯的。彼此之間的合作是非常之重要。

Lextan:

衛生署許可適應症：焦慮狀態（急性緊張和焦慮狀態，人際間接觸困難，激越躁動，失眠， 焦慮，激昂性抑鬱反應）
作用：鎮靜、安眠、治療緊張性疼痛頭痛、顫抖、焦慮緊張
副作用：疲勞、嗜睡、肌肉衰弱、情感麻 木、警覺性降低、混亂、頭痛、暈眩、步態不穩、複視…等

Dogmatyl

衛生署許可適應症：精神病狀態、消化性潰瘍
作用：穩定精神狀況
副作用：嗜睡，發抖、坐不穩、不自 主運動、說話困難，口乾、便祕、排尿困難，體重增加，月經不規則…..等