双语医学阅读:抑郁症疗法或改变

2010-07-07

  New Depression Findings Could Alter Treatments   新的研究结果可能改变抑郁症的治疗方法   The results of two new studies may signal a substantial shift in the way psychiatrists and researchers think about treatment f

  New Depression Findings Could Alter Treatments

  新的研究结果可能改变抑郁症的治疗方法

  The results of two new studies may signal a substantial shift in the way psychiatrists and researchers think about treatment for severely depressed patients.

  两项研究结果将可能从根本上改变精神病医生和研究人员在重症抑郁症患者的治疗方法上的思路。

  In one, government researchers found that an injection of a powerful anesthetic drug dissolved feelings of despair in a small group of severely depressed patients in a matter of hours, and that the effect lasted for up to a week in some participants.

  第一项是政府的研究人员发现,给小部分重症抑郁症患者注射强效麻醉剂可以在大约1小时内缓解他们的绝望情绪;对于某些患者,这种效果甚至可以持续一个礼拜。

  Doctors cautioned that the study was very small, and that the drug, ketamine, is a tightly controlled substance sometimes used as a club drug that can cause hallucinations, confusion and dangerous reactions, especially when ingested in unknown doses.

  医生警告说这是一项小范围的实验,所使用的麻醉剂克他命是一种受到严格监控的药物。这种药物有时候在一些俱乐部里用作迷幻药,它能够使人产生幻觉,意识模糊甚至产生其他非常危险的反应,尤其是在吸入剂量不当的情况下。

  In the other, psychiatrists in New York found evidence that antidepressant drugs significantly increased the risk that some children and adolescents would attempt or commit suicide. Doctors have debated this risk for years, but the authors of the study were skeptical of it, and their report may sway others.

  另外一项是纽约的精神病医生发现抗抑郁药物明显增加了儿童和青少年采取自杀行为的风险。医生们就这一风险辩论了数年,但研究报告的作者对是否有必要继续辩论表示怀疑,他们的报告会改变一些人的立场。

  Both studies are being published in The Archives of General Psychiatry.

  两项研究报告都在《普通精神医学纪要》中出版。

  In the first study, Dr. Carlos A. Zarate of the National Institute of Mental Health led a team of researchers who treated 18 chronically depressed men and women with the anesthetic ketamine.

  在第一项研究中,美国国家心理健康研究所卡洛斯·A·扎拉博士领导的研究人员们用麻醉剂克他命治疗了18例慢性抑郁症男女患者。

  Five participants recovered from depression in the first day and were still significantly improved a week later. Most patients also received a placebo treatment during the study, an injection of saline solution, and showed no improvement.

  5例患者在接受治疗的第一天就有所恢复,并在一周以后明显改善。大多数患者在研究过程在中同时还接受了安慰剂治疗,即一种盐溶剂注射剂,但没有什么效果。

  Dr. Zarate said experimenting with novel approaches was crucial because the current crop of antidepressant drugs worked slowly and weakly, if at all, for millions of patients.

  扎拉博士说,新的治疗方法的实验至关重要,因为现行的抗抑郁剂药物对数百万的患者来讲,即便有效,其效果也很慢,作用也很小。

  Ketamine affects the brain in a way entirely different from drugs like Prozac, and it has shown some antidepressant effects in animal studies. It had not been tried for depression in humans.

  克他命对大脑的影响与其他药物像普罗萨克(氟苯氧苯胺)完全不同。克他命在动物实验中已经表现出了抗抑郁效果,在目前还没有用于人类抑郁症的治疗。

  “What the study tells us is that we can break this sound barrier, in effect, and get an almost immediate response that we cannot get with other drugs,”Dr. Zarate said.

  “通过研究,我们知道我们可以在治疗上打破局限,将其用于人类抑郁症的治疗,同时我们迅速得出结论:我们没有别的更好的药物可用。”

  Ketamine is not approved for depression, and it has a checkered past in psychiatric research. The drug often induces hallucinations, like whispering voices and light trails, and researchers used it in the 1990's to induce psychotic reactions in people with schizophrenia-an experiment widely criticized as unethical.

  克他命没有获得允许用于治疗抑郁症,在精神病研究方面过去一直充满变数。该药物通常会导致出现幻觉,像听到低低的声音或看见灯光的痕迹。研究人员在20世纪90年代曾使用克他命诱导精神分裂症患者的精神反应,但这一实验却遭到广泛的批判,被认为是违背了职业道德。

  Dr. Zarate said that neither doctors nor patients should use it for depression outside of carefully controlled research settings and that the results of the current trial should be considered suggestive.“This drug should be seen as a tool for understanding what mechanisms might be involved in rapid relief,”and not as a treatment, Dr. Zarate said.

  扎拉博士认为,无论是病人还是医生都绝对不可以在没有进行严格的医学实验的前提下使用克他命治疗抑郁症,本次的实验结果只能作为参考。扎拉博士表示:“该药物应该被看作是一种工具,帮助我们了解何种药物可以快速起效,”但不能作为一种治疗方法。

  The study of suicide risk, led by Dr. Mark Olfson of Columbia University and the New York State Psychiatric Institute, was based on an analysis of Medicaid records of more than 4,400 people who were hospitalized for depression in 1999 and 2000.

  自杀危机的研究是由哥伦比亚大学的马克·奥佛森博士和纽约州立精神病研究所牵头,依据1999年2000年因抑郁症住院的4400多人的医疗记录进行分析。

  The researchers found no link between the antidepressant drugs and suicidal behavior in depressed patients 19 or older. But children and adolescents in the study who were taking antidepressants were about 50 percent more likely than those not on the drugs to try to kill themselves. And they were about 15 times as likely as those not on the medications to complete the act, although the number of suicides was too small to draw definitive conclusions, the authors cautioned.

  研究人员发现抗抑郁剂和自杀行为在19岁或更大年龄的患者身上二者没有联系。但是服用抗抑郁剂的儿童和青少年比未服用看抑郁剂的儿童和青少年尝试采取自杀行为的比例要高50%.报告的作者警告说,尽管自杀的人数很少,还不足以得出最终的结论,但他们实施和完成自杀行为是未服用药物的儿童和青少年的15倍。

  In addition, there could be differences between the two groups that the Medicaid records didn't reveal:the children who received the drugs may have been more severely ill, skewing the results, they said.

  除此之外,他们说,还有一些区别医学记录并没有揭示:接受药物治疗的儿童可能已经病情十分严重了,这也使得研究结果有所偏离。

  In 2004, the Food and Drug Administration required strong warnings on the labels of antidepressant drugs alerting parents and doctors of a possible suicide risk in some children. Since then many psychiatrists have been skeptical of the suicide link.

  在2004年,国家食品药品监督管理局要求在康抑郁剂商标上郑重提醒父母和医生防止一些儿童因此产生的自杀危机。从那时开始,许多精神病医师就开始怀疑抗抑郁剂与自杀是否存在联系。

  “I was surprised by what we found,”Dr. Olfson said.“I set out thinking we'd find that the drugs”significantly reduced suicide risk.

  奥弗森博士说:“我们的研究结果让我很吃惊。我开始琢磨我们得找到明显降低自杀风险的药物。”

  The findings may prompt researchers to look at which children are most at risk, rather than continuing to debate whether the risk exists, he said.

  他指出,研究结果将促使研究人员去研究那些儿童面临的自杀风险最大,而不是没完没了的辩论这种风险是否存在。(外语教育网 王郅译)

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