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789
医生,我吃那么多药都没效,真想干脆一次全吞下去,睡着别再醒来算了。”一名70多岁妇人长年久病,吃药吃到烦,向精神科医生哭诉。诸如此类久病厌药的个案,医生需不断给病人心理建设,防止他们轻率做傻事。
年近8旬的陈老太太,光是治筋骨酸痛、眼睛酸涩及慢性支气管炎等病的药物,就摆满床头柜,从早到晚药不离口,经常哀叹。
因久病厌药而到精神科求诊的长辈越来越多,当中以中风、失能或罹癌的老人居多。他说,这名老太太看诊边掉泪说,有高血压及糖尿病,每周还要洗肾3天,经常睡不着,药吃很多,但还是没好,不仅自己难过还拖累家人,很想一次把药全吞了,睡着后干脆别醒来。说着说着,老泪纵横。
医生说,约6成1老人看完诊会拿3到5种药,失能老人有8成会开5种以上的药物,3成8开10种以上药。说老人吃的药比米饭还多,虽是玩笑话,但不难看出长辈长期服药的身心负担。
长者多数不只一种疾病,服用多种药物,但会到久病“厌”药,应该还是与忧郁症有关。年纪大的人因为病痛多,加上心理、社会因素,忧郁症比率较高,病痛与忧郁又形成恶性循环。但多数忧郁老人不会到精神科就医,是更值得关怀的一群。
有些忧郁症老人“逛”医院,吃了这家的药觉得没效,又换别家,事实上,可能是忧郁症产生的头痛、食欲不振等症状,却因没有到精神科就诊,对症下药,怎么吃药也吃不好。
有些医院会在门诊协助病人整合药物,避免重复用药,目前健保云端药历也让医师可查出是否有重复开药的情况。同时提醒民众,家中老人如果常有“吃这么多药不如去死”抱怨,家人应多关怀、情况严重时应陪同到精神科就诊。
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