SSRI Information 部分內容個人翻譯1 - 概述

SSRI Information

來源：https://ssristories.org/ssris/#Antidepressants_explained

申明：感謝 @JetLuo 的引導。個人認可藥物治療的作用也正在服藥，此翻譯為個人練習。僅作為個人對於一個並不完善的系統內反對意見方的認知學習。不接受商業和非商業授權轉載，不保證準確性以及可靠性，不作為診斷或者治療參考。長坑緩填，看看就好，原文侵刪。知乎這編輯器什麼破玩意。

個人翻譯-第一部份

「If it can be solved by $5,000 or a new boyfriend, it』s not depression.」

「如果一個問題用5000美元或者一個男朋友就能解決，那它就不是抑鬱症了。」

Antidepressants explained 抗抑鬱藥物簡介

Selective serotonin-reuptake inhibitors, or SSRIs, and serotonin and noradrenaline-reuptake inhibitors, or SNRIs, arethe most commonly prescribed antidepressants. Dr. David Healy notes that the terms SSRI and SNRI are marketing terms,and not scientific or clinical.These drugs are not useful for treating serious depression,[1] and they definitely do not solve the problems of everyday living that cause people to be sad and worried. In the fifth edition of his book Psychiatric Drugs Explained, he starts his chapter on antidepressants as follows: 選擇性5—羥色胺再攝取抑製劑(SSRIs)、五羥色胺和去甲腎上腺素再攝取抑製劑(SNRIs)是臨床上最常見的抗抑鬱葯。David Healy博士指出類似SSRI和SNRI的稱謂是市場營銷術語而非科學或者臨床術語。這類藥物對於嚴重的抑鬱症未必有效，[1]但它們肯定不能解決日常生活中讓人們感到悲傷和焦慮的問題。在第五版《精神病藥物》中，他在抗抑鬱藥物的章節開始寫了如下內容：

[1] Pyschiatric Drugs Explained, Fifth Edition, Churchill Livingston, 2009, p 51.

David Healy (psychiatrist)WIKI：https://en.wikipedia.org/wiki/David_Healy_(psychiatrist)

Dr. Healy goes on to explain that antidepressants are little use for people who have psychological symptoms in the absence of physical symptoms such as: loss of energy, loss of interest, poor concentration, altered sleep patterns, altered appetite, plus other physical symptoms. He notes that antidepressants 「are not anti-psychological problem pills」.

Healy博士繼續解釋到，抗抑鬱藥物對於有明顯心理癥狀而非軀體化癥狀（例如：失去生活能量，失去樂趣，社交貧乏，睡眠模式改變，食慾改變，以及其它的軀體化癥狀）的人來說收效甚微。他指出抗抑鬱藥物「不是治療心理問題的藥物」。

In other words, too many people are taking these drugs for different underlying conditions, some of which they are not useful for treating. Expectations of consumers and physicians increase the demand for the drugs, and perceptions of their benefit are shaped by other factors than true efficacy. For example, minor 「depression」 often goes away in a matter of months, and if a person is taking an antidepressant, they may feel better for reasons that have nothing to do with the medication. Similarly, other factors in treatment may cause an improvement in mood and outlook, while a person is taking an antidepressant. In these cases they may believe that the drug caused them to feel better when in reality a sugar pill would have worked just as well.

但另一方面，太多的人在探討這類藥物在某些未必適合這類藥物處理領域裡的作用。消費者和醫生的治療期望增加了藥物的需求，比起藥物的真正功效他們的利益傾向更多受到了其它因素影響。舉個例子，輕微的「抑鬱」通常會在幾個月後就自行消失，但如果人們同時在服用抗抑鬱藥物，那他們也許會因為藥理以外的原因而好轉。同理，一個正在服用抗抑鬱藥物的人也可能會因為治療中的其它因素導致情緒和預期的改善。在這些情況下，他們可能會相信是藥物讓他們變好了，而實際上，吃糖也能起到同樣的作用。

個人翻譯—第二部分

How do SSRIS and other antidepressants work?

SSRIS和其他類型抗抑鬱葯是如何起效的?

Whole books, for example The Emperor』s New Drugs by Irving Kirsch, have been written about the lack of effectiveness of these medications. However, these medications definitely do something. Reading thousands of stories about these drugs, it becomes clear that they have effects, which may not be what non-users imagine. People who take them report feeling different, and clinicians like Healy insist that they can sometimes be very useful, especially if taken for short duration. 「This is because of their anxiolytic properties, which can be energizing, or may simply blunt the experience of of difficult emotions,」 says Healy. 「These are not 「happy pills」. Whatever happiness is, it does not come from behind the counter of your local pharmacy.」

例如 Irving Kirsch著作的《The Emperor』s New Drugs》這類整本書都是關於這些藥物缺乏有效性的文章。然而，這類藥物的確有所作為。在了解成千上萬關於類似藥物的故事之後，這類作用變得更加明了，這並不是什麼非親歷者想像出來的。收到他們報告的人會對此感覺完全不同，而像Healy這樣的臨床醫生堅持認為這類藥物有時有用特別是在短期服用時是非常有用的。「這是因為它們的抗焦慮特性，既可能使人充滿活力，也可能只是單純的弱化（鈍化）人的負面情緒體驗，」Healy說到。「它們並不是開心丸。而無論幸福是什麼，它都不會源自你當地藥店的櫃檯」

Many people who take these drugs report feeling 「detached」. They lose their ability to empathize, their inhibitions and their judgement. Sometimes, they lose their natural fear of death. In short, their emotions are blunted. They do not make people happy. SSRI antidepressant pills free them from the restrictions imposed by feelings for others, of conscience, and self-control. Peoples』 natural instincts that would normally make them feel horror at the idea of driving into oncoming traffic, jumping off a cliff, stabbing someone, stealing, hitting or shooting can be diminished by these medications. While it might be a good thing to reduce exam-related panic, when this same effect overrides reluctance to die because of unpleasant life events, it is not so positive.

許多服用這類藥物的人報告上有「detached」（譯者註：超然，無所謂，看淡一切。譯者適應期也有）的感覺。他們失去了類似同情、壓抑和評價的情緒能力。有些時候，他們失去了對死亡本能的恐懼。簡而言之，他們的情緒反應變遲鈍了。他們也並沒有讓人快樂。SSRI類抗抑鬱藥物將他們從他人感受，道德約束以及自我約束中解放了出來。這類藥物可能減少對於類似逆車道開車，跳崖，砍人，偷窺，槍擊等這類危險行為身而為人本能的恐懼。雖然減少與考試有關的恐懼可能是件好事，但當這個效果應用於「不甘用死來面對不愉快的生活事件」的情況時，它就未必那麼正面了。

quote:「Antidepressants have so many dangerous and unpleasant side effects that doctors should be very careful in prescribing them」, according to Dr. Derelie Mangin, the current David Braley and Nancy Gordon Chair in Family Medicine at McMaster University . 「Patients need to be better informed so that they do not develop unrealistic expectations about what pills can do to help them. Many people who take antidepressants would be much better served by a program of routine, vigorous exercise.」

引用：「鑒於抗抑鬱藥物有如此多危險和令人不快的副作用，醫生面對開藥的問題時應該非常謹慎」，根據David Braley博士和Nancy Gordon在McMaster大學的家庭醫學部所做的研究顯示「病人需要被告知更多的信息，這樣他們至少不會對藥物產生不切實際的期望。許多服用抗抑鬱葯的人會通過定期、有力的身體運動來改善情況。」

（譯者註：2018年2月14續更）

個人翻譯—第三部分

Most common antidepressants

最常見的抗抑鬱藥物

There are two main categories of antidepressant: the SSRIs and SNRIs, of which Prozac (fluoxetine) was the first,

approved for use in the USA in 1987, and the older Tricyclic drugs, (e.g. imipramine). Common antidepressants are

listed below with their chemical name first and their brand names second. Brand names are often country specific.

最常見的抗抑鬱藥物主要有兩大類：SSRIs(譯者註：選擇性5—羥色胺再攝取抑製劑）以及SNRIs（譯者註：五羥色胺和去甲腎上腺

素再攝取抑製劑)，其中常見的百憂解（氟西汀)是第一種，在1987年被批准用於美國。另外還有較老的三環類藥物（比如丙咪嗪）

。下面列出了常見的抗抑鬱葯其化學名稱和品牌名稱。品牌名稱往往因為國家不同有所差異。

The links on the chemical names take the reader to Prescription Drug Side Effects where reported side effects, patient naratives, and other information is provided. You might also want to check out a particular antidepressant in the sex, suicide, and violence zones on Prescription Drug Side Effects, where the reported side effects for each are described.

化學名稱上的鏈接將會把讀者引導至RxISK.org，那裡有相關藥物副作用報道以及病人描述和其他信息。你可能還想在RxISK.org上查找針對性、自殺和暴力區域特定的抗抑鬱藥物。

一、SSRI and SNRI Antidepressants

SSRI和SNRI類藥物

（譯者註：因知乎編輯器限制以及本人學藝不精，表格無法原格式複製。在此聲明：前列為藥物化學名稱，後列為品牌名稱，品牌名稱不做翻譯，很多國產品牌是沒有列出的）

Bupropion（安非他酮）— Wellbutrin, Budeprion, Prexaton, Elontril, Aplenzin

Citalopram（西酞普蘭）— Celexa, Akarin, Celapram, Celius, Ciazil, Cipramil, Cipram, Cimal, Citabax, Ciprapine,

Citalec, Citol, Dalsan, Cilift, Recital, Emocal, Sepram, Seropram, Citox, Cital

Desvenlafaxine（去甲文拉法辛） — Pristiq

Duloxetine（度洛西汀）— Cymbalta, Ariclaim, Xeristar, Yentreve, Duzela, Dulane

Escitalopram（依他普侖）— Lexapro, Cipralex, Seroplex, Esertia

Fluvoxamine（氟伏沙明）— Luvox, Fevarin, Faverin, Dumyrox, Favoxil, Movox, Floxyfral

Paroxetine

（帕羅西汀）— Paxil, Seroxat, Sereupin, Aropax, Deroxat, Divarius, Rexetin, Xetanor, Paroxat,

Loxamine, Deparoc

Sertraline（舍曲林）— Zoloft, Lustral, Serlain, Asentra, Tresleen

Venlafaxine（文拉法辛）— Effexor

Vortioxetine（沃替西汀）— Brintellix

二、Other Antidepressants

其他抗抑鬱藥物

Mirtazapine（米氮平）— Remeron, Soltab

Trazodone（曲唑酮）— Desyrel, Oleptro, Beneficat, Deprax, Desirel or Desyrel, Molipaxin, Thombran, Trazorel,

Trialodine, Trittico, Mesyrel

Tricyclics（三環抗抑鬱葯）— Amitriptyline, Anafranil (clomipramine), (Amoxapine, Desipramine (Norpramin),

Dosulepin, Doxepin, Imipramine (Tofranil) Nortriptyline (Pamelor), Protriptyline (Vivactil), Trimipramine

(Surmontil)

三、 Other Antidepressant/ Anxiety/ Tranquilizer medications

其他抗抑鬱/抗焦慮/鎮靜類藥物

Benzodiazepines（苯二氮平類藥物）— Ativan (lorazepam) aka Lorenin, Lorsilan, Temesta, Tavor, Lorabenz; Atarax (hydroxyzine, hydroxyzine hydrochloride) aka Vistaril; Dalmane (flurazepam) aka Dalmadorm; Dormex (brotizolam) aka Lendormin, Noctilan, Sintonal; Halcion (triazolam); Klonapin (clonezepam) aka Rivotril, Iktorivil, Paxam; Lectopam (bromazepam) aka Bromam, Lexotanil, Lexotan, Librium (chlordiazepoxide) aka Elenium, Libritabs, Nobrium (medazepam); Risolid; ProSom (estazolam); Restoril (temazepam); Tranxene (clorazepate) aka Tranxilium; Valium (diazepam) aka Antenex, Apaurin, Apzepam, Apozepam, Hexalid, Pax, Stesolid, Stedon, Vival, Valaxona; Versed (midazolam); Xanax (alprazolam) aka Helex, Xanor, Onax, Alprox, Restyl, Tafil, Paxal, Serax (oxazepam)

Neuroleptics（安定劑、鬆弛劑）— Abilify (aripiprazole), Chlorpromazine (Thorazine), Depixol aka Fluanxol (flupentixol or flupenthixol), Fanapt aka Fanapta aka Zomaril (iloperidone), Modecate (fluphenazine), Geodon (ziprasidone), Haloperidol (Haldol), Invega (paliperidone), Latuda (lurasidone), Fentazin, Trialvil (perphenazine), Risperdal (risperidone), Seroquel (quetiapine), Zyprexa (olanzapine)

Other（其他類型）— BuSpar (buspirone), Equanil aka Meprin aka Miltown (meprobamate), Zopiclone (cyclopyrrolone) aka Imovane Zimovane

推薦閱讀：