Ua manaʻo paha ʻoe i kahi hoʻomaha ʻē i hiki ʻole ai iā ʻoe ke noho ma kahi kūlana a wahi paha no ka manawa pōkole? Ke manaʻo nei ʻoe e neʻe a puni a hoʻoluliluli i kou mau wāwae i nā manawa a pau me kahi manaʻo hoʻomaha ʻole e puka mai ana mai loko mai? He hopena ʻaoʻao paha kēia o kahi lāʻau lapaʻau āu e lawe nei. I kēia lā e kamaʻilio mākou e pili ana i kēia maʻi (Akathisia). Mai makaʻu, he mea nui loa ka ʻike i kēia.
He aha kēia (Akathisia)? E hoʻomaopopo maʻalahi kākou.
ʻO Akathisia ka hōʻiliʻili o nā hōʻailona e pili ana i ka ʻōnaehana nerve a me ka noʻonoʻo (`(Neuropsychiatric syndrome)`). Eia kekahi, he maʻi neʻe ia. I kēia hihia, he paʻakikī loa ke noho a noho mālie paha ma muli o ka hoʻomaha nui e puka mai ana mai loko mai. Loaʻa ka huaʻōlelo "akathisia" mai ka ʻōlelo Helene mai, ʻo ia hoʻi "hiki ʻole ke noho". Loaʻa pinepine kēia ʻano i ka wā e hoʻohana ai i kekahi mau lāʻau lapaʻau, ʻoiai nā lāʻau lapaʻau `(Antipsychotic)` a i ʻole `(Neuroleptic)` i hoʻohana ʻia no nā maʻi noʻonoʻo. ʻAʻole wale ia, hiki ke pili pū kēia (akathisia) me kekahi mau kūlana olakino e like me `(Parkinson's disease)`. Manaʻo ke kanaka me (akathisia) i ka hoʻomaha nui a me ka hoʻomaha ʻole i loko. ʻO ia ke kumu e makemake nui ai lākou e neʻe mau, ʻoiai e hoʻoneʻe i ko lākou mau wāwae. Hana pinepine ʻia kēia mau neʻe ʻana ma ke ʻano like (`repetitive`). Hiki i kēia makemake hiki ʻole ke kāohi ʻia ke neʻe ke hoʻoluhi nui. Hoʻokaʻawale nā kauka i kēia ʻano (akathisia) i kekahi mau ʻano, ma muli o ka wā e hoʻomaka ai nā hōʻailona a me ka lōʻihi o ko lākou mau manawa.
- ʻO ka akathisia koʻikoʻi: Hana pinepine kēia i nā lā mua ma hope o ka hoʻomaka ʻana i kahi lāʻau lapaʻau, ʻoi aku hoʻi kahi antipsychotic, a i ʻole ke hoʻonui ʻia ka nui. ʻAʻole i ʻoi aku ma mua o ʻeono mahina ka lōʻihi.
- ʻAkathisia mau loa: Hana ʻia kēia ʻano akathisia ke mau nā hōʻailona no nā mahina ʻeono a ʻoi. Hiki ke mau no nā mahina a i ʻole nā makahiki.
- Tardive akathisia: Hana ʻia kēia ma hope o ka hoʻomaka ʻana i kekahi mau lāʻau lapaʻau, ka hoʻonui ʻana i ka nui, a i ʻole ʻekolu mahina ma hope. Hoʻopili pinepine ʻia me kahi maʻi neʻe ʻē aʻe i kapa ʻia ʻo tardive dyskinesia.
- Ka haʻalele ʻana i ka akathisia: Hiki ke hana ʻia kēia ʻano ke hoʻemi ʻia a hoʻopau loa ʻia paha ka nui o kekahi mau lāʻau lapaʻau.
Ua like anei ʻo Akathisia me ka hopohopo?
ʻAʻole, mai huikau i nā mea ʻelua. ʻElua mau kūlana like ʻole ʻo Akathisia a me ka hopohopo. He maʻi neʻe ʻo Akathisia, ʻoiai he kūlana olakino noʻonoʻo ka hopohopo. Eia nō naʻe, hiki iā lākou ke kaʻana like i kekahi mau ʻano maʻamau. No ka laʻana, ka hoʻomaha ʻole, a me ka hiki ʻole ke kāohi i nā manaʻo a me ke ʻano o kekahi. Eia nō naʻe, ʻo ka hiʻohiʻona nui o ka akathisia he makemake hiki ʻole ke kāohi e neʻe mau. He mea kākaʻikahi nā hōʻailona e pili ana i ka makaʻu a i ʻole ka hopohopo. Eia nō naʻe, he mea maʻamau no ka poʻe me ka akathisia ke manaʻo hopohopo a me ke kaumaha ma muli o kēia makemake hiki ʻole ke kāohi e neʻe.
ʻO ka mea pōʻino, ua kuhihewa pinepine ʻia ke ʻano (Akathisia) he hopohopo mau a/a i ʻole ka hoʻonāukiuki.
Pehea ka maʻamau o Akathisia?
ʻO Akathisia ka maʻi neʻe maʻamau e pili ana i ka lāʻau psychotropic, ʻoi aku hoʻi ka lāʻau antipsychotic. Ua manaʻo ʻia a hiki i ka 24% o ka poʻe me
ka schizophrenia e lawe ana i ka lāʻau no ka maʻi he akathisia. Ma kekahi noiʻi, 39% o ka poʻe e lawe ana i ka clozapine a me 45% o ka poʻe e lawe ana i nā antipsychotics hanauna mua (FGA) i loaʻa i ka akathisia.
He aha nā hōʻailona o (Akathisia)?
ʻIke pinepine ʻia nā hōʻailona Akathisia ma hope o kou hoʻomaka ʻana e lawe i kahi lāʻau antipsychotic, a i ʻole ma hope o ka hoʻonui ʻana o kāu kauka i ka nui. ʻO ka hōʻailona nui
ka manaʻo o ka hoʻomaha ʻole, a i ʻole ka haʻalulu . Manaʻo ka poʻe me akathisia i ka makemake nui e hoʻoluliluli i ko lākou kino, ʻoiai ko lākou mau wāwae, mai ko lākou mau pūhaka a i ko lākou mau kuʻekuʻe wāwae. Inā loaʻa iā ʻoe ka akathisia, hiki iā ʻoe ke hana i kēia mau mea:
- Hoʻohui mau wau i koʻu mau wāwae a laila hoʻopololei hou iā lākou.
- Ke neʻe mau nei koʻu mau wāwae i koʻu noho ʻana.
- Ke kū ʻoe, hoʻoili ʻoe i ke kaumaha mai kekahi wāwae a i kekahi.
- Ke luliluli nei au i mua a i mua i koʻu noho ʻana.
- Ke hele mau nei lākou i mua a i mua, a i ʻole e kū ana ma kahi hoʻokahi a hoʻohālike e hele ana.
I kekahi kanaka ʻē aʻe, ʻike ʻia paha kēia mau hōʻailona a me nā neʻe ʻana e like me kekahi kanaka e hoʻoluliluli mau ana a ʻaʻole hiki ke noho mālie.
Inā loaʻa iā ʻoe kēia mau hōʻailona, he mea nui e kamaʻilio me kāu kauka i ka wā hikiwawe loa. Pehea ka manaʻo o ka loaʻa ʻana o (Akathisia)?
Hoʻākāka pinepine ka poʻe me Akathisia i ka manaʻo o ka hoʻomaha ikaika o loko a me ka makemake hiki ʻole ke kaohi e neʻe. Hoʻākāka pinepine lākou i ka manaʻo hoʻomaha ʻole a me ka hiki ʻole ke hoʻomaha. Hiki iā lākou ke manaʻo i ka ʻūlū ke pono lākou e noho mālie, e like me ke kūlana. ʻO kēia hoʻomaha ʻole o loko e hoʻoulu pinepine i ka poʻe me Akathisia e ʻike i ka hopohopo a me ke kaumaha. Wahi a Akathisia lōʻihi,
Ua pili ia i ka hoʻonui ʻia o ka pilikia o ka hōʻeha ponoʻī ʻana a i ʻole ka hana pepehi kanaka. Inā loaʻa iā ʻoe nā manaʻo pepehi iā ʻoe iho a i ʻole makemake ʻoe e hōʻeha iā ʻoe iho, he mea nui e ʻimi koke i ke kōkua lapaʻau.
He aha nā kumu o Akathisia?
ʻAʻole ʻike nā kānaka ʻepekema i ke kumu pololei o ka akathisia. Akā manaʻo lākou no ka mea ke ālai nei kekahi mau lāʻau lapaʻau i nā mea loaʻa i loko o ka lolo e loaʻa ana kahi kemika i kapa ʻia ʻo dopamine. He neurotransmitter ʻo Dopamine, kahi kemika e kōkua ana i nā hana kino koʻikoʻi he nui, me kā mākou neʻe ʻana. ʻO kēia ālai ʻana ke kumu o nā neʻe ʻana i kāohi ʻole ʻia. Aia kekahi mau lāʻau lapaʻau e pili ana me ka akathisia: Ua pili pū ʻo Akathisia me kekahi mau kūlana olakino:- ʻO ka maʻi o Parkinson .
- ʻO ka maʻi/ mumū o ka lolo ('Encephalitis').
- Nā ʻeha poʻo (ʻeha lolo traumatic - TBI).
Nā lāʻau lapaʻau antipsychotic e pili ana me Akathisia
ʻO Akathisia ka maʻi neʻe maʻamau e pili ana i nā lāʻau antipsychotic. I kekahi manawa kapa ʻia e nā kauka he akathisia i hoʻoulu ʻia e ka antipsychotic. ʻO nā lāʻau antipsychotic, a i ʻole neuroleptics, e hāʻule i ʻelua mau māhele nui:- Nā lāʻau antipsychotics hanauna mua a i ʻole "maʻamau" (FGA).
- ʻO ka lua o ka hanauna a i ʻole "ʻokoʻa" `(Antipsychotics - SGA)`.
ʻO Akathisia ka mea i pili pinepine ʻia me nā lāʻau lapaʻau ma ka papa `(FGA)`, ʻoiai nā mea i ʻoi aku ka ikaika a hoʻohana ʻia i nā dosis kiʻekiʻe. ʻOi aku ka haʻahaʻa o ka pilikia me nā lāʻau `(SGA)`. Kuhikuhi nā kauka i kēia mau lāʻau `(FGA)` a me `(SGA)` no nā ʻano maʻi neuropsychiatric like ʻole. Eia kekahi laʻana:- Nā hana hoʻopilikia i ka hana ma ka dementia.
- Maʻi bipolar.
- Kaumaha.
- Nā maʻi ʻai.
- Maʻi hopohopo laulā.
- ʻAʻole hiki ke hiamoe .
- Ka maʻi hoʻokaumaha-koʻikoʻi (`Ka maʻi hoʻokaumaha-koʻikoʻi -ʻOCD `).
- Nā maʻi pilikino.
- Ka maʻi hoʻoluhi ma hope o ka trauma (PTSD).
Ka maʻi Schizoaffective . ʻO Schizophrenia a me nā maʻi pili.
Nā hiʻohiʻona o kekahi mau lāʻau FGA (me nā inoa inoa) e pili ana paha me Akathisia:- ʻO Chlorpromazine (Thorazine®)
- ʻO Fluphenazine (Prolixin®)
- ʻO Haloperidol (Haldol®)
- ʻO Loxapine (Loxitane®)
- ʻO ka lāʻau lapaʻau Prochlorperazine (Compro®, Compazine®)
ʻO kekahi o nā lāʻau lapaʻau SGA i loaʻa ka pilikia nui no Akathisia:- ʻO Paliperidone (Invega®)
- ʻO Ziprasidone (Geodon®)
Nā lāʻau antidepressant e pili ana iā Akathisia
ʻOiai ʻaʻole maʻamau e like me nā lāʻau antipsychotic, ua pili pū kekahi mau antidepressants i ka akathisia. ʻO kēia mau mea:- Nā mea hoʻopale serotonin reuptake koho (SSRIs): ʻO kēia nā lāʻau antidepressants i kuhikuhi pinepine ʻia. Nā laʻana: fluoxetine (Prozac®), paroxetine (Paxil®).
- Nā mea hoʻopaʻa monoamine oxidase (MAOIs): ʻO kēia nā mea hoʻōla mua i hoʻomohala ʻia. ʻOiai ua kūpono lākou, hoʻohana pinepine ʻia nā lāʻau lapaʻau hou a palekana me nā hopena ʻaoʻao liʻiliʻi.
- Nā lāʻau antidepressant Tricyclic (TCA): Ua kuhikuhi nā kauka i kēia mau mea ke hana ʻole nā lāʻau antidepressant ʻē aʻe. Nā laʻana: clomipramine (Anafranil®), amitriptyline (Elavil®).
Ua kuhikuhi nā kauka i nā antidepressants no nā kūlana e like me:- Kaumaha.
- Maʻi bipolar.
- Nā maʻi hopohopo.
- ʻEha mau loa.
- Ka maʻi hoʻokaumaha-koʻikoʻi (OCD).
- Nā hoʻouka kaua panic.
- Ka maʻi hoʻoluhi ma hope o ka trauma (PTSD).
Ua manaʻo ʻia aia ma waena o 10% a me 18% o ka poʻe me ka maʻi bipolar I e lawe ana i nā antidepressants e hoʻomohala i ka akathisia. Nā lāʻau lapaʻau ʻē aʻe e pili ana me Akathisia
ʻO nā lāʻau lapaʻau ʻē aʻe e pili pū ana me Akathisia:- Nā lāʻau lapaʻau no ka nausea a i ʻole ka luaʻi ʻana (antiemetics), e.g. metoclopramide.
- Nā lāʻau lapaʻau no ke koko kiʻekiʻe, e.g. `reserpine`, `methyldopa`.
- Nā mea ālai i ke kahawai kalipuna, e.g. cinnarizine, diltiazem.
- Nā lāʻau hoʻomaha.
- Lāʻau lapaʻau no ka poniuniu.
- ʻO 'Azithromycin' (kahi lāʻau antibiotic i hoʻohana nui ʻia).
- ʻO Buspirone (he lāʻau lapaʻau no ka hopohopo).
Hiki ke hana ʻia ʻo Akathisia e nā lāʻau lapaʻau ʻole e like me ka amphetamine, methamphetamine, a me ka cocaine. Pehea e ʻike ai (Akathisia)?
ʻO ka maʻamau, ʻike nā kauka iā Akathisia ma ka nānā ʻana i ke ʻano a me nā hōʻailona o ka mea maʻi ('clinical observation'). ʻAʻole pono kēia i nā hoʻāʻo koko a i ʻole nā hoʻāʻo kiʻi. ʻO ke ʻano maʻamau i hoʻohana ʻia e loiloi i ka pae o Akathisia ʻo ia ka "Barnes Akathisia-Rating Scale (BARS)". Inā manaʻo ʻoe he Akathisia kou, e nīnau kāu kauka iā ʻoe e pili ana i kāu mau hōʻailona, mōʻaukala olakino, a me nā lāʻau lapaʻau o kēia manawa. E nānā pū lākou i kāu ʻano a me kāu neʻe ʻana. ʻO ka mea pōʻino, he paʻakikī pinepine ka ʻike ʻana iā Akathisia. No ka mea, ua like kona mau hōʻailona me nā kūlana olakino noʻonoʻo ʻē aʻe, no ka laʻana:- ʻO ka noʻonoʻo ʻole.
- Mania.
- Ka maʻi hoʻolohe-hemahema/hyperactivity (ADHD).
- Kaumaha hoʻonāukiuki.
Pehea e mālama ʻia ai ʻo Akathisia?
ʻAʻohe lāʻau lapaʻau kūikawā no Akathisia i kēia manawa. Inā loaʻa kāu Akathisia i kahi lāʻau lapaʻau, e hoʻāʻo paha kāu kauka e hoʻololi iā ʻoe i kahi lāʻau lapaʻau ʻē aʻe a hōʻemi paha i ka nui o ka lāʻau lapaʻau āu e lawe nei (inā hiki). Ua hōʻike kekahi mau noiʻi e hiki i kēia mau lāʻau lapaʻau ke kōkua me Akathisia:- ʻO nā mea pale beta, no ka laʻana propranolol.
- ʻO Benzodiazepines (kahi papa o nā lāʻau lapaʻau i hoʻohana ʻia e mālama i nā kūlana e like me ka hopohopo, ka insomnia, a me nā hopu ʻana).
- ʻO ka mirtazapine haʻahaʻa haʻahaʻa (he antidepressant).
- ʻO Anticholinergics (kahi ʻano lāʻau lapaʻau i hoʻohana ʻia e mālama i nā kūlana e like me ka hānō).
- Wikamina B6.
Hiki ke pale ʻia ʻo Akathisia?
Ke hoʻāʻo nei nā kānaka ʻepekema e hoʻomaopopo piha iā Akathisia, kona mau kumu, a me nā lāʻau lapaʻau. Akā ua ʻike lākou he ʻoi aku ka nui o ka ulu ʻana o Akathisia i nā kūlana aʻe:- Inā ʻoe e lawe ana i ka lāʻau antipsychotic hanauna mua.
- Inā lawe nui ʻoe i ka lāʻau lapaʻau.
- Inā hoʻonui koke kāu kauka i ka nui o kāu lāʻau lapaʻau, a i ʻole ke koʻikoʻi.
- Inā he waena ʻoe a ʻelemakule paha.
Ma muli o kēia mau ʻoiaʻiʻo, ʻo ke ala maikaʻi loa e pale aku ai iā Akathisia, ʻo ia ke hoʻomaka ʻana o nā kauka i kēia mau lāʻau lapaʻau ma ka liʻiliʻi loa a hoʻonui mālie i ka liʻiliʻi inā pono. Ma mua o ka hoʻomaka ʻana i kekahi lāʻau lapaʻau, he mea nui e kamaʻilio me kāu kauka e pili ana i nā pilikia, nā pono, a me nā hopena ʻaoʻao. He aha ka wānana no (Akathisia)?
Inā ʻike mua ʻia ʻo Akathisia a hoʻōki ʻia ka lāʻau lapaʻau e hoʻoulu ai (inā hiki), hoʻomaikaʻi pinepine ke ʻano. Eia nō naʻe, inā ʻaʻole mālama ʻia ʻo Akathisia, hiki ke hoʻonāwaliwali loa. Nui ka poʻe me Akathisia e ʻike i ka hopohopo nui a me ke kaumaha (`dysphoria`). Loaʻa paha iā lākou nā manaʻo pepehi kanaka. Inā loaʻa iā ʻoe nā manaʻo pepehi kanaka, he mea nui e ʻimi koke i ke kōkua lapaʻau.
Āhea ʻoe e ʻike ai i ke kauka e pili ana i (Akathisia)?
Inā loaʻa iā ʻoe nā hōʻailona o Akathisia, he mea nui e kamaʻilio me kāu kauka. ʻO ka wikiwiki o ka loaʻa ʻana o ke kumu, ʻo ka wikiwiki hoʻi o ka hoʻololi ʻana i kāu lāʻau lapaʻau a hoʻomalu i ke kūlana. He hopena ʻaoʻao hoʻonāukiuki loa ʻo Akathisia i hiki ke hana ʻia e kekahi mau lāʻau lapaʻau. Inā hopohopo ʻoe e loaʻa paha iā ʻoe ʻo Akathisia ma hope o ka hoʻomaka ʻana i ka lāʻau lapaʻau no kahi maʻi noʻonoʻo a i ʻole ka maʻi neurological, mai makaʻu e nīnau i kāu kauka e pili ana i ia mea. Inā loaʻa iā ʻoe nā hōʻailona o Akathisia, e haʻi koke i kāu kauka . Nā mea nui e hoʻomanaʻo (Leka Lawe-Home)
- ʻO Akathisia kahi kūlana kahi e hiki ʻole ai ke noho ma kahi hoʻokahi a me ka pono mau e neʻe.
- Hiki ke hana ʻia kēia e kekahi mau lāʻau antipsychotic. Hiki nō hoʻi ke hana ʻia e nā antidepressants a me nā lāʻau lapaʻau ʻē aʻe.
- ʻO nā hōʻailona e komo pū ana me ka haʻalulu o nā wāwae, ka hele wāwae ʻana, a me ka hiki ʻole ke noho ma kahi hoʻokahi.
- ʻAʻole kēia he hopohopo, akā hiki iā ia ke hoʻoulu i ka hopohopo.
- Inā loaʻa iā ʻoe kēia mau hōʻailona, e hōʻoia e haʻi i kāu kauka. Hiki ke mālama ʻia kēia kūlana ma ka hoʻololi ʻana i ka nui o kāu lāʻau lapaʻau a i ʻole ke hoʻololi ʻana i kahi lāʻau lapaʻau ʻē aʻe.
- Mai ho'ōki i ka lawe ʻana i kāu lāʻau lapaʻau a hoʻololi paha i ka nui me ka ʻole o ke aʻo ʻana a kāu kauka.
- Hiki ke hoʻohuli ʻia ʻo Akathisia inā ʻike ʻia a mālama ʻia i ka wā mua.
Inā he mau nīnau hou aku kāu e pili ana i kēia, mai kānalua e kamaʻilio me kāu kauka. E noho olakino!
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