檳榔戒斷症候群：常常被忽略的精神科問題

The Betel Nut Withdrawal: An Often Overlooked Psychiatric Condition?

目的：吃檳榔在東南亞和南太平洋群島是很普遍的現象，但吃檳榔會導致習慣、成癮，和戒斷等問題。我們報告一個停用檳榔引起的戒斷症候群，是以往常被忽略的精神科問題。病例報告：一名五十一歲的男性病患在停止吃檳榔後出現情緒起伏、焦慮、睡眠障礙、和類似感冒症狀等戒斷症狀，這些症狀在接受低劑量的抗憂鬱／抗焦慮劑和安眠藥後緩解。結論：根據本個案報告和其他文獻報告，我們認為檳榔和其他成癮物質一樣，臨床上也可以用DSM-IV-TR來診斷檳榔的戒斷症候群和依賴，並提醒大家注意吃檳榔所潛藏的精神科問題。

Objective: The use of betel nut has been widespread in Southeast Asia and the south Pacifi c islands. Betel nut-chewing leads to habituation, addiction, and withdrawal. We report a case of a patient with betel nut withdrawal which had been an often overlooked psychiatric problem. Case Report: A 51-year-old male patient with habitual chewing of betel nuts developed withdrawal symptoms after stopping his betel nut use. Those symptoms included mood swings, anxiety, sleep disturbances, and fl u-like symptoms. His symptoms were resolved after receiving supportive pharmacological treatments with a low dose of antidepressant/anxiolytic and hypnotics. Conclusion: Our patient in this case report supported the concept of clinically identifi able betel nut withdrawal and its dependence, which can be diagnosed using criteria similar to those currently used for other substances of abuse. Based on the report in this case and those in the literature, we are calling attention to this psychiatric problem of betel use.