抗抑郁药是如何发挥作用的？ - Neil R. Jeyasingam：英语精读讲义

In the 1950s, the discovery of two new drugs

20世纪50年代，两种新药的发现

sparked what would become a multi-billion dollar market for antidepressants. 表達脈絡

催生了如今价值数十亿美元的抗抑郁药市场。

Neither drug was intended to treat depression at all. 短語搭配

这两种药物最初都不是为了治疗抑郁症而研发的。

In fact, at the time,

事实上，在当时，

many doctors and scientists believed

许多医生和科学家认为

psychotherapy was the only approach to treating depression.

心理治疗是治疗抑郁症的唯一方法。

The decades-long journey of discovery that followed

随后长达数十年的探索之旅

revolutionized our understanding of depression

彻底改变了我们对抑郁症的认识，

and raised questions we hadn't considered before. 短語搭配

并提出了我们以前从未考虑过的问题。

One of those first two antidepressant drugs was iproniazid,

最早的两种抗抑郁药之一是异烟肼 (iproniazid)，

which was intended to treat tuberculosis. 語法

最初用于治疗结核病。

In a 1952 trial,

在1952年的一项试验中，

it not only treated tuberculosis, 語法

它不仅治疗了结核病，

it also improved the moods of patients

还改善了患者的情绪，

who had previously been diagnosed with depression.

这些患者以前曾被诊断出患有抑郁症。

In 1956, a Swiss clinician observed a similar effect

1956年，一位瑞士临床医生观察到了类似的效果，

when running a trial for imipramine, 語法

当时他在进行丙咪嗪 (imipramine) 的试验，

a drug for allergic reactions.

这是一种治疗过敏反应的药物。

Both drugs affected a class of neurotransmitters called monoamines. 用詞

这两种药物都影响了一类叫做单胺 (monoamines) 的神经递质。

The discovery of these antidepressant drugs gave rise to the chemical imbalance theory, 短語搭配

这些抗抑郁药的发现催生了化学失衡理论，

the idea that depression is caused by 語法

即抑郁症是由

having insufficient monoamines in the brain's synapses.

大脑突触中单胺不足引起的。

Iproniazid, imipramine, and other drugs like them

异烟肼、丙咪嗪以及类似的其他药物

were thought to restore that balance by increasing the availability 語法

被认为能通过增加大脑中

of monoamines in the brain.

单胺的可用性来恢复这种平衡。

These drugs targeted several different monoamines,

这些药物靶向几种不同的单胺，

each of which acted on a wide range of receptors in the brain. 短語搭配

每种单胺都作用于大脑中广泛的受体。

This often meant a lot of side effects, 表達脈絡

这通常意味着许多副作用，

including headaches, grogginess,

包括头痛、昏昏沉沉，

and cognitive impairments, 用詞

以及认知障碍，

including difficulty with memory, thinking, and judgment.

包括记忆力、思维和判断力困难。

Hoping to make the drugs more targeted and reduce side effects, 語法

为了让药物更有针对性并减少副作用，

scientists began studying existing antidepressants

科学家开始研究现有的抗抑郁药，

to figure out which specific monoamines were most associated 短語搭配

试图找出哪些特定的单胺

with improvements in depression.

与抑郁症的改善最相关。

In the 1970s,

在20世纪70年代，

several different researchers converged on an answer. 短語搭配

几位不同的研究人员得出了相同的结论。

The most effective antidepressants all seemed to act 語氣意圖

最有效的抗抑郁药似乎都作用于

on one monoamine called serotonin.

一种叫做血清素 (serotonin) 的单胺。

This discovery led to the production of fluoxetine,

这一发现导致了氟西汀 (fluoxetine)

or Prozac, in 1988.

即百优解 (Prozac) 在1988年的问世。

It was the first of a new class of drugs

它是第一种新型药物，

called selective serotonin reuptake inhibitors, 用詞

叫做选择性血清素再摄取抑制剂，

or SSRIs,

简称 SSRI，

which block the reabsorption of serotonin, 語法

它们可以阻止血清素的重吸收，

leaving more available in the brain. 語法

从而在大脑中留下更多可用的血清素。

Prozac worked well and had fewer side effects 語法

百优解效果很好，并且副作用更少，

than older, less targeted antidepressants.

相比于老一代、针对性较弱的抗抑郁药。

The makers of Prozac also worked to market the drug 表達脈絡

百优解的制造商还在推广该药物时，

by raising awareness of the dangers of depression

努力提高公众和医学界

to both the public and the medical community.

对抑郁症危险的认识。

More people came to see depression as a disease 短語搭配

越来越多的人开始将抑郁症视为一种疾病，

caused by mechanisms beyond an individual's control, 短語搭配

由个人无法控制的机制引起，

which reduced the culture of blame and stigmatization 用詞

这减少了围绕抑郁症的

surrounding depression,

责备和污名化文化，

and more people sought help.

寻求帮助的人也变得更多了。

In the 1990s,

在20世纪90年代，

the number of people being treated for depression skyrocketed. 用詞

接受抑郁症治疗的人数激增。

Psychotherapy and other treatments fell by the wayside, 習語

心理治疗和其他疗法被冷落一旁，

and most people were treated solely with antidepressant drugs.

大多数人仅接受抗抑郁药治疗。

Since then, we've developed a more nuanced view 用詞

从那以后，我们发展出了更加细致的观点，

of how to treat depression and of what causes it.

关于如何治疗抑郁症以及它的成因。

Not everyone with depression responds to SSRIs like Prozac. 語法

并非每个抑郁症患者都对像百优解这样的 SSRI 有反应。

Some respond better to drugs that act on other neurotransmitters,

有些人对作用于其他神经递质的药物反应更好，

or don't respond to medication at all.

或者对药物根本没有反应。

For many, a combination of psychotherapy and antidepressant drugs

对许多人来说，心理治疗和抗抑郁药的结合

is more effective than either alone. 語法

比单独使用任何一种都更有效。

We're also not sure why antidepressants work 語法

我们也不确定为什么抗抑郁药

the way they do.

会以那种方式起作用。

They change monoamine levels

它们会改变单胺水平，

within a few hours of taking the medication, 表達脈絡

就在服药后几个小时内，

but patients usually don't feel the benefit until weeks later.

但患者通常要到几周后才能感觉到疗效。

And after they stop taking antidepressants,

在停止服用抗抑郁药后，

some patients never experience depression again, 表達脈絡

一些患者再也没有经历过抑郁症，

while others relapse.

而另一些患者则会复发。

We now recognize that we don't know what causes depression 表達脈絡

我们现在认识到，我们并不知道抑郁症的成因，

or why antidepressants work.

也不知道抗抑郁药为什么有效。

The chemical imbalance theory is at best an incomplete explanation. 語氣意圖

化学失衡理论充其量只是一个不完整的解释。

It can't be a coincidence 表達脈絡

几乎所有的抗抑郁药都恰好作用于血清素，

that almost all the antidepressants happen to act on serotonin,

这不可能是巧合，

but that doesn't mean serotonin deficiency

但这并不意味着缺乏血清素

is the cause of depression.

就是抑郁症的原因。

If that sounds odd, 表達脈絡

如果这听起来很奇怪，

consider a more straightforward example.

考虑一个更直接的例子。

Steroid creams can treat rashes caused by poison ivy.

类固醇药膏可以治疗由毒藤引起的皮疹。

The fact that they work doesn't mean steroid deficiency 語法

它们有效的事实并不意味着类固醇缺乏

was the cause of the rash.

是皮疹的原因。

We still have a ways to go in terms of understanding this disease. 短語搭配

在理解这种疾病方面，我们还有很长的路要走。

Fortunately, in the meantime, 表達脈絡

幸运的是，与此同时，

we have effective tools to treat it.

我们有有效的工具来治疗它。

Depression affects almost 10% of adults in the United States. 用詞

在美国，抑郁症影响着将近 10% 的成年人。

Learn more about symptoms, treatments,

了解更多关于症状、治疗的信息，

and how to help a struggling friend with this video.

以及如何通过本视频帮助挣扎中的朋友。