外刊双语：抑郁症患者该停药了？

原文标题：
Drugs and depression
Set patients free
Most people on antidepressants don’t need them. Time to wean them off.
药物与抑郁症
让患者自由
大多数患者都不需要服用抗抑郁药。是时候停药了。

[Paragraph 1]

ALMOST 35 YEARS ago American drug regulators approved Prozac, the first in a series of blockbuster antidepressants known as selective serotonin re-uptake inhibitors (SSRIs).

大约35年前，美国药物监管机构批准了百忧解的上市。百忧解是重点抗抑郁系列药（名称为“五羟色胺再摄取抑制剂”）中的第一种。

Prozac and its cousins were lauded by patients and doctors as miracle drugs. They lifted low moods quickly and seemed to have no drawbacks.

百忧解及其同类药物被患者和医生誉为神奇之药。他们的药效快，能使低落情绪迅速消失，似乎没有缺点。

Divorce, bereavement, problems at work—a daily pill was there to help with that, and anything else which made you sad.

离婚、丧亲之痛、职场难题，及其他让你难过的事情——每天服药可以帮助你解决这些问题。

Many people have stayed on these drugs for life. In Western countries today between one person in seven and one in ten takes antidepressants.
许多人终生都需要服用这些药物。在当今的西方国家，有十分之一到七分之一的人在服用抗抑郁药。

[Paragraph 2]
The shine of SSRIs has worn off. A growing number of studies show that they are less effective than thought.
SSRIs的光环逐渐消失。越来越多的研究表明，它们的药效不如想象的那么好。

Drug companies often publish the results of clinical trials selectively, withholding those in which the drugs turn out not to work well.
制药公司经常会选择性地公布临床试验的结果，而不公布那些药物效果不佳的结果。

When the results of all trials submitted to America’s medicines regulator between 1979 and 2016 were scrutinised by independent scientists, it turned out that antidepressants had a substantial benefit beyond a placebo effect in only 15% of patients.
1979年至2016年间提交给美国药品监管机构的所有试验结果都经过了独立科学家的仔细审查，结果表明，除了有安慰效应之外，仅有15%的患者认为抗抑郁药有实际药效。

[Paragraph 3]
Clinical guidelines have been revised accordingly in recent years.
近年来，临床指南已相应修订。

No longer are drugs the recommended first line of treatment for less severe cases of depression.
对于轻度抑郁症患者，药物不再是首选治疗措施。

For these, self-help guidance, behavioural therapy and recommendations for things like exercise and sleep are preferable.
对于这些人来说，自助指导、行为治疗以及锻炼和睡眠等方面的建议更可取。

For work burnout, a sick note for time off may suffice.
对于职业倦怠问题，一张病假单就足够了。

The drugs are to be reserved only for more severe depression, where they can be truly life-saving.
这些药物只能用于重度抑郁症患者，这才算挽救生命。

[Paragraph 4]
The problem is that lots of people who do not need antidepressants are already on them, refilling prescriptions written years or even decades ago. They should be helped to get off the drugs.
问题是，许多不需要抗抑郁药的人在服药，他们一直重复按照几年甚至几十年前开的药方拿药。应该帮助他们停止服用抗抑郁药。

The side-effects are often life-limiting and, as people age, become life-threatening.
药物的副作用是折寿，随着年龄的增长，这会危及生命。

They include sexual dysfunction (which sufferers describe as “genital anaesthesia”), lethargy, emotional numbness, increased risk of birth defects when taken during pregnancy, and, in older people, strokes, falls, seizures, heart problems and bleeding after surgery.
其中包括性功能障碍（患者称之为“生殖器无感”）、无精打采、情感麻木、怀孕期间服用会增加胎儿先天性缺陷的风险，老年人会出现中风、跌倒、癫痫、心脏病和手术后大出血等问题。

This is a threat to health-care systems as long-term users age.
随着长期用药者的年龄增长，这对医疗系统构成一种威胁。

[Paragraph 5]
Doctors rarely talk to patients about stopping the drugs because they fear this could lead to a return of depressive symptoms.
医生很少与患者谈论停药的问题，因为他们担心停药可能会导致抑郁症的复发。

But for many people it may be safe to stop.
但对许多人来说，停药可能是安全的。

Even among long-term users with several past episodes of depression, a recent trial in Britain showed that 44% of patients could stop taking pills safely.
最近英国的一项试验显示，即使在那些有过几次抑郁症发作经历的长期用药者中，44%的患者可以安全停药。

For milder cases, the success rate is probably higher still.
对于轻度抑郁症患者，成功率可能更高。

[Paragraph 6]
Several things are needed for change to happen.
需要采取几项措施来改变现状。

Doctors need guidelines on how to de-prescribe the drugs.
医生需要如何取消药物处方的指导。

Health-care insurers and providers such as Britain’s various national health services should start paying for ways of delivering the drugs that help those who wish to stop taking them but who need to taper off them in order to avoid severe withdrawal effects.
医疗保险公司和英国各种国家医疗服务机构等供药方，应该开始为提供药物的方式付费。供药是为了帮助那些希望停止服用但需要逐渐减少的人，以避免严重的停药副作用。

These include liquid formulations, tapering strips which contain pills with progressively smaller drug concentrations, and the services of compounding pharmacies, which prepare bespoke doses.
其中包括液体制剂、含有药物浓度逐渐降低的锥形条减药方案，以及配制定制剂量的复合药房服务。

In the Netherlands, 70% of people using tapering strips have managed to quit successfully.
在荷兰，70%使用锥形条减药方案的人成功停药。

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All this could cost more than refilling prescriptions today. But with so many people on the drugs, the costs of side-effects will soon pile up.
所有这一切的成本可能比现在重新开药方还要高。但由于有这么多人在服用药物，副作用的成本很快就会增加。

Add to that the misery of the millions whose lives have been robbed of their common joys by useless prescriptions, and the case for change is unanswerable.
再加上数百万人的痛苦，他们因为无用的药方而失去了普通人的快乐，改变（即停药）的理由是无可争辩的。

（恭喜读完，本篇英语词汇量562左右）
原文出自：2022年10月22日《TE》Leaders版块。
精读笔记来源于：自由英语之路
本文翻译整理: Irene本文编辑校对: Irene
仅供个人英语学习交流使用。

（来自于网络）
SSRI（Selective Serotonin Reuptake Inhibitor）是一类新型的抗抑郁药品，学名是五羟色胺再摄取抑制剂，意为选择性5-羟色胺再摄取抑制剂。SSRIs（即SSRI类药物）是二十世纪80年代开发并试用于临床，常用于临床的SSRIs有6种：氟西汀、帕罗西汀、舍曲林、氟伏沙明、西酞普兰和艾司西酞普兰。这类药物选择性抑制突触前膜对5-HT的回收，对NE影响很小，几乎不影响多巴胺（DA）的回收。其中的帕罗西汀有轻度的抗胆碱能作用。

 
百忧解主要是抑制中枢神经对5-羟色胺的再吸收，用于治疗抑郁症和其伴随之焦虑，治疗强迫症及暴食症。
 
独立型科学家是指科学家独自一个人做出了自己得到科学共同体承认的主要贡献，它们的大部分论文是独立署名的。独立型科学家之所以独立，有课题方面的原因，例如理论研究比实验研究容易独立；也有个性方面的原因，有的科学家喜欢独处，独立发表自己的见解，不受别人的干扰。

荷兰研究者开发了一种名为「tapering strips」的减药方法。如果患者症状明显加重，则可以降低减量幅度，或延长减量间隔。如果患者持续存在症状，则可以先暂停减量，或加回上一个剂量；此后，其中一些患者则可以耐受更慢的减量。

【重点句子】（3 个）
Divorce, bereavement, problems at work—a daily pill was there to help with that, and anything else which made you sad.
离婚、丧亲之痛、职场难题，及其他让你难过的事情——每天服药可以帮助你解决这些问题。

For these, self-help guidance, behavioural therapy and recommendations for things like exercise and sleep are preferable.
对于这些人来说，自助指导、行为治疗以及锻炼和睡眠等方面的建议更可取。

The side-effects are often life-limiting and, as people age, become life-threatening.
药物的副作用是折寿，随着年龄的增长，这会危及生命。