抗憂鬱藥是如何發揮作用的？ - Neil R. Jeyasingam：英語精讀講義

In the 1950s, the discovery of two new drugs

20世紀50年代，兩種新藥的發現

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

催生了如今價值數十億美元的抗憂鬱症藥物市場。

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

這兩種藥物最初都不是為了治療憂鬱症而研發的。

In fact, at the time,

事實上，在當時，

many doctors and scientists believed

許多醫生和科學家認為

psychotherapy was the only approach to treating depression.

心理治療是治療憂鬱症的唯一方法。

The decades-long journey of discovery that followed

隨後長達數十年的探索之旅

revolutionized our understanding of depression

徹底改變了我們對憂鬱症的認識，

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

並提出了我們以前從未考慮過的問題。

One of those first two antidepressant drugs was iproniazid,

最早的兩種抗憂鬱症藥物之一是異煙肼 (iproniazid)，

which was intended to treat tuberculosis. 文法

最初用於治療結核病。

In a 1952 trial,

在1952年的一項試驗中，

it not only treated tuberculosis, 文法

它不僅治療了結核病，

it also improved the moods of patients

還改善了患者的情緒，

who had previously been diagnosed with depression.

這些患者以前曾被診斷出患有憂鬱症。

In 1956, a Swiss clinician observed a similar effect

1956年，一位瑞士臨床醫生觀察到了類似的效果，

when running a trial for imipramine, 文法

當時他在進行丙咪嗪 (imipramine) 的試驗，

a drug for allergic reactions.

這是一種治療過敏反應的藥物。

Both drugs affected a class of neurotransmitters called monoamines. 用詞

這兩種藥物都影響了一類叫做單胺 (monoamines) 的神經傳導物質。

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

這些抗憂鬱症藥物的發現催生了化學失衡理論，

the idea that depression is caused by 文法

即憂鬱症是由

having insufficient monoamines in the brain's synapses.

大腦突觸中單胺不足引起的。

Iproniazid, imipramine, and other drugs like them

異煙肼、丙咪嗪以及類似的其他藥物

were thought to restore that balance by increasing the availability 文法

被認為能透過增加大腦中

of monoamines in the brain.

單胺的可用性來恢復這種平衡。

These drugs targeted several different monoamines,

這些藥物靶向幾種不同的單胺，

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

每種單胺都作用於大腦中廣泛的受體。

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

這通常意味著許多副作用，

including headaches, grogginess,

包括頭痛、昏昏沉沉，

and cognitive impairments, 用詞

以及認知障礙，

including difficulty with memory, thinking, and judgment.

包括記憶力、思維和判斷力困難。

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

為了讓藥物更有針對性並減少副作用，

scientists began studying existing antidepressants

科學家開始研究現有的抗憂鬱症藥物，

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

試圖找出哪些特定的單胺

with improvements in depression.

與憂鬱症的改善最相關。

In the 1970s,

在20世紀70年代，

several different researchers converged on an answer. 片語搭配

幾位不同的研究人員得出了相同的結論。

The most effective antidepressants all seemed to act 語氣意圖

最有效的抗憂鬱症藥物似乎都作用於

on one monoamine called serotonin.

一種叫做血清素 (serotonin) 的單胺。

This discovery led to the production of fluoxetine,

這一發現導致了氟西汀 (fluoxetine)

or Prozac, in 1988.

即百憂解 (Prozac) 在1988年的問世。

It was the first of a new class of drugs

它是第一種新型藥物，

called selective serotonin reuptake inhibitors, 用詞

叫做選擇性血清素再攝取抑制劑，

or SSRIs,

簡稱 SSRI，

which block the reabsorption of serotonin, 文法

它們可以阻止血清素的重吸收，

leaving more available in the brain. 文法

從而在大腦中留下更多可用的血清素。

Prozac worked well and had fewer side effects 文法

百憂解效果很好，並且副作用更少，

than older, less targeted antidepressants.

相比於老一代、針對性較弱的抗憂鬱症藥物。

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

百憂解的製造商還在推廣該藥物時，

by raising awareness of the dangers of depression

努力提高公眾和醫學界

to both the public and the medical community.

對憂鬱症危險的認識。

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

越來越多的人開始將憂鬱症視為一種疾病，

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

由個人無法控制的機制引起，

which reduced the culture of blame and stigmatization 用詞

這減少了圍繞憂鬱症的

surrounding depression,

責備和污名化文化，

and more people sought help.

尋求幫助的人也變得更多了。

In the 1990s,

在20世紀90年代，

the number of people being treated for depression skyrocketed. 用詞

接受憂鬱症治療的人數激增。

Psychotherapy and other treatments fell by the wayside, 慣用語

心理治療和其他療法被冷落一旁，

and most people were treated solely with antidepressant drugs.

大多數人僅接受抗憂鬱症藥物治療。

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

從那以後，我們發展出了更加細緻的觀點，

of how to treat depression and of what causes it.

關於如何治療憂鬱症以及它的成因。

Not everyone with depression responds to SSRIs like Prozac. 文法

並非每個憂鬱症患者都對像百憂解這樣的 SSRI 有反應。

Some respond better to drugs that act on other neurotransmitters,

有些人對作用於其他神經傳導物質的藥物反應更好，

or don't respond to medication at all.

或者對藥物根本沒有反應。

For many, a combination of psychotherapy and antidepressant drugs

對許多人來說，心理治療和抗憂鬱症藥物的結合

is more effective than either alone. 文法

比單獨使用任何一種都更有效。

We're also not sure why antidepressants work 文法

我們也不確定為什麼抗憂鬱症藥物

the way they do.

會以那種方式起作用。

They change monoamine levels

它們會改變單胺濃度，

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

就在服藥後幾個小時內，

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

但患者通常要到幾週後才能感覺到療效。

And after they stop taking antidepressants,

在停止服用抗憂鬱症藥物後，

some patients never experience depression again, 表達脈絡

一些患者再也沒有經歷過憂鬱症，

while others relapse.

而另一些患者則會復發。

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

我們現在認識到，我們並不知道憂鬱症的成因，

or why antidepressants work.

也不知道抗憂鬱症藥物為什麼有效。

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

化學失衡理論充其量只是一個不完整的解釋。

It can't be a coincidence 表達脈絡

幾乎所有的抗憂鬱症藥物都恰好作用於血清素，

that almost all the antidepressants happen to act on serotonin,

這不可能是巧合，

but that doesn't mean serotonin deficiency

但這並不意味著缺乏血清素

is the cause of depression.

就是憂鬱症的原因。

If that sounds odd, 表達脈絡

如果這聽起來很奇怪，

consider a more straightforward example.

考慮一個更直接的例子。

Steroid creams can treat rashes caused by poison ivy.

類固醇藥膏可以治療由毒藤引起的皮疹。

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

它們有效的事實並不意味著類固醇缺乏

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. 片語搭配

在理解這種疾病方面，我們還有很長的路要走。

Fortunately, in the meantime, 表達脈絡

幸運的是，與此同時，

we have effective tools to treat it.

我們有有效的工具來治療它。

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

在美國，憂鬱症影響著將近 10% 的成年人。

Learn more about symptoms, treatments,

了解更多關於症狀、治療的資訊，

and how to help a struggling friend with this video.

以及如何透過本影片幫助掙扎中的朋友。