Nyob rau hauv nws memoir Skywriting, NBC-TV xov xwm Jane Pauley qhia tawm tias nws muaj kev puas siab puas ntsws bipolar. Tus mob tau tshwm sim, nws hais tias, thaum nws tau muab tshuaj rau ib rooj plaub ntawm khaus. Qhov kev tshwm sim no tsom ntsoov rau txoj kev sib raug zoo ntawm kev yuam kev thiab kev ntxhov siab.
Pauley sau hais tias, nyob hauv ib feem ntawm nws phau ntawv tshaj tawm hauv lub Yim Hli 20, 2004, Cov Neeg, uas nws tau ntsib hypomania tom qab thawj zaug kev tswj kev yuam kev rau nws cov khaus thiab kev nyuaj siab nrog tus thib ob.
Kev nyuaj siab yog loj txaus tias qhov tshuaj tiv thaiv qis dua tus kws kho mob tau muab tshuaj rau nws, thiab nws rov qab ua rau lub xeev sib xyaw kom sib haum thiab ceev ceev. Nws tus kws kho mob piav qhia, nws hais tias, tias tus kab mob antidepressant "unmasked tsis tau-ua ntej-txhawj xeeb txog kev puas siab puas ntsws bipolar kev nyuaj siab." Tab sis qhov tseeb, kev xav thaum lub voj voos tau pib ua ntej qhov no - nrog rau kev kho. Nws tau pw hauv tsev kho mob thaum lub sij hawm thiab tau nyob rau ntawm lithium.
Cov Steroids yog dab tsi?
Raws li PDR Cov Tshuaj Kho Mob, lub ntsiab lus "steroid" siv rau "tsev neeg coob ntawm tshuaj lom neeg, uas muaj ntau cov tshuaj hormones, cov khoom pov thawj, thiab cov tshuaj." Nws tseem yog ib qho "generic designation rau cov tshooj lus sib ze rau cov qauv siv rau cov kev ua yuam kev, xws li sterols, bile acids, cardiac glycosides, androgens, estrogens, corticosteroids, thiab precursors ntawm cov vitamins D" (2000). Nws yeej tsis tsim nyog paub txog txhua yam ntawm cov neeg no - tab sis obviously, lub cev chemistry thiab cov sawv cev ntawm, tswj los ntawm, los yog txuam nrog cov tshuaj yeeb nkab no los siav.
Nws muaj kev ruaj ntseg hais tias tsis muaj dab tsi tshwm sim hauv lub cev tsis muaj kev koom tes ntawm ib cov steroid. Yog li, nws yuav tsum tsis txhob xav tsis thoob tias kev tswj kev yuam tshuaj yuav ua rau muaj kev phiv, uas "steroid psychosis" yog ib qho ua tiav. "Steroid psychosis - los yog ntau yam tsim nyog, kev puas siab ntsws los ntawm kev puas siab puas ntsws - muaj xws li psychosis, lub siab xav tsis meej (piv txwv, kev nyuab siab, kev xav, los yog ob qho tib si), thiab kev ua txhaum" (Cortlandt Letters, December 2001).
Anabolic steroids, siv los ntawm cov cim ncaws pob kom tsim cov leeg nqaij thiab ntau ntau kom txog thaum muaj ntau yam kev phom sij tshwm sim uas feem ntau cov tshuaj no raug txwv, muaj peev xwm tsim kev puas tsuaj. Cov corticosteroids, uas yuav tsum tau muab cov tshuaj kho mob rau Jane Pauley lub khaus, tau pom tau tias ua rau muaj kev puas siab puas ntsws hauv kev tshawb fawb. Cov neeg sau phau ntawv qhia txog 1972 los ntawm Boston Collaborative Drug Monitoring Program uas cov neeg mob uas tau siv ntau hom tshuaj Prednisone (corticosteroid), txij li qis tshaj mus rau qhov siab tshaj muaj ntau dua qhov tshwm sim ntawm kev puas siab puas ntsws xws li: psychosis, mania, thiab kev nyuaj siab. Daim ntawv tseem hais ntxiv tias thaum lub sij hawm tus txiv neej yog qhov lus teb rau qhov kev siv tshuaj yuam kev, kev nyuaj siab feem ntau tshwm sim los ntawm kev tshem tawm tsis ua haujlwm.
Qee cov kev paub kho mob nkeeg thiab lawv cov kev siv
Qee lub npe ntawm cov npe corticosteroids muaj xws li:
- Cortisone thiab Hydrocortisone
- Flonase® (fluticasone propionate nas)
- Lanacort® (hydrocortisone topical)
- Prednisone
- Nasonex® (mometasone nas)
Thiab ntau lwm tus neeg nws yuav dhau ntawm qhov uas muaj nyob hauv tsab xov xwm no los sim ua npe rau feem ntau ntawm lawv.
Corticosteroids yog siv los kho cov kev mob ntau yam xws li:
- Hawb pob
- Emphysema
- Crohn tus kab mob
- Bursitis
- Tendinitis
- Hlab plab
- Khaus
- Kab tom
- Lub ntswg ua xua
- Eczema
- Psoriasis
DHEA
Cov lag luam tom khw los ntawm lwm yam tshuaj steroid, DHEA, tau muaj hluav taws los ntawm ntau tus neeg hauv kev kho mob - ib tug kws tshawb fawb hu ua "cov roj nplhaib ntawm 90s." Lub npe ntawm Markowitz, Carson, thiab Jackson (1999), "... (DHEA) yog ib co kab mob nyob rau hauv tib neeg lub cev thiab pom muaj ntau yam kev ua haujlwm ntawm ntau yam tshuaj. Nws txoj kev txhawb nqa tsis ntev los no thiab muaj raws li cov nyiaj pab tshaj tawm rau pej xeem huab hwm coj tau siv ntau yam.
Me ntsis yog paub txog cov teeb meem tshwm sim ntawm DHEA thaum noj rau ntawm ib qho kev mob nyhav lossis mob ntev. Peb tau tshaj tawm ib cov ntaub ntawv ntawm mania hauv ib tug txiv neej laus tuaj yeem nkag mus rau peb lub chaw kho mob uas tsis muaj keeb kwm yav dhau los ntawm tus kheej los yog tsev neeg keeb kwm ntawm kev puas siab puas ntsws uas tshwm sim los ntawm kev siv rau DHEA nyuam qhuav siv. Tus neeg mob tau siv DHEA siv 6 lub hlis ua ntej nkag tau thiab tau siv 200-300 mg / hnub thaum lub sij hawm ntawm kev nthuav lus. "Hmoov tsis, ntau lub tuam txhab tau hais tias DHEA yog ib qho" txuj ci tseem ceeb "kev siv yeeb tshuaj los yog ib tug ciav tus hluas. .
Raws li cov kws kho kev puas siab puas ntsws Dr. Henry Lahmeyer, ib leeg siv tsis yuam kev ua rau muaj kev puas siab puas ntsws los cuam tshuam rau txhua yam kev puas hlwb; tiam sis, nws yog lub sij hawm ntev thiab muaj kev tswj hwm ntawm kev kho mob uas muaj kev puas siab ntsws los ntawm kev puas hlwb. Nyob rau hauv Pauley cov ntaub ntawv, nws tau noj tshuaj qis rau tsib lub hlis ua ntej pib qhov pib voj voog pib.
Tshawb nrhiav txog kev kho mob thiab cov ntaub ntawv ntawm kev puas siab puas ntsws muaj ntau cov ntaub ntawv tshawb fawb, xws li cov neeg tau hais ua ntej, uas qhia tias kev siv steroid yuav ua rau muaj kev puas siab puas ntsws los ntawm kev puas siab puas ntsws. Thiab thaum kev tshawb fawb tseem tsis tau qhia qhov tseeb ntawm cov rooj plaub no, qee cov kev tshawb nrhiav tau pib teeb ci rau lo lus nug no. Wood thiab al (2004) qhia tias kev tshawb fawb nrog cov nas tsuag, muaj kev nyuab siab heev, thiab kev tswj hwm ntawm kev nyuaj siab corticosterone, ua rau lub cev hloov hauv lub koom haum ntawm neurons hauv hippocampus, yog ib feem ntawm lub hlwb. Cov kev hloov no yog nrog kev coj tus cwj pwm hloov.
Tam sim no tsis muaj kev tshawb fawb uas qhia tau tias steroids yuav ua rau lub hlwb tsis ntev los yog mob. Ingram thiab Hageman (2003) sau tseg, "Muaj ntau cov ntawv xov xwm piav qhia txog cov kev mob tshwm sim ntawm kev mob puas hlwb nrog kev siv corticosteroid Thaum lub tswv yim tsis paub meej, qhov tshuaj tiv thaiv feem ntau yog kho dua nrog kev txo qis los sis kev txiav tawm ntawm qhov corticosteroid. ua li cas, kev kho mob yuav siv tshuaj tua kab mob. " Cov kev tshawb fawb ntawm Wood et al (2004) kuj qhia tau hais tias qee qhov kev hloov hauv hippocampus tuaj yeem tiv thaiv tau "kev siv tshuaj tua kab mob antidepressant thiab anticonvulsant." Cov neeg soj ntsuam no tau tshawb txog kev siv cov lithium hauv txoj haujlwm no thiab pom tias kev kho mob mus ntev nrog lithium tuaj yeem pov hwm lub hippocampus thiab. Kev txuas ntxiv ntawm txoj kab kev tshawb fawb hauv lub neej yav tom ntej no muaj cov lus cog tseg rau kev nkag siab zoo dua cov teebmeem ntawm kev mob hlwb thiab cov tswv yim ntawm kev siv tshuaj ntawm kev kho mob ntawm kev puas siab puas ntsws bipolar.
> Cov chaw
> Lub rooj sab laj Cortlandt. Cov neeg mob bipolar puas muaj kev pheej hmoo siab dua nrog kev sib kis?
> Ingram, DG, &. Hagemann, TM (2003). Cov kev kho mob Promethazine kev kho mob siab ntsws ntawm tus me nyuam. Lub Annals ntawm Pharmacotherapy. Dec 01: 37: 1036-1039.
> Markowitz, JS, Carson, WH, & Jackson, CW Ua tau > dihydroepiandrosterone > -thiab mania. Txheeb Lawm Psychology, 45, 241-242.
> PDR Kho Mob Txhais Lus. Baltimore, Maryland: Lippincott Williams & Williams. 2000.
> Perry, Paul, > Ph.D >, BCPP, & Brian C. Lund, Pharm.D. "Steroid-Induced Mental Disturbances." (Revised Revised 2004).
> Ntoo, GE, Hluas, LT, Reagan, LP, Chen, B., & McEwen, BS "Kev nyuaj siab qauv tsim qauv hauv hippocampus: Kev tiv thaiv los ntawm lithium kho." Sibtham ntawm National Academy of Science hauv tebchaws United States of American. Mar 04: 101: 3973-3978.