SSRI Information 部分內容個人翻譯2 - 副作用
來源：
SSRI Information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。
Side effects
副作用
Negative side effects, also known as 「adverse drug events」 or simply 「adverse events」, are most likely to occur when:
負面作用，也被稱之為「不良藥物事件」或者更簡單點「不良事件」在以下情況更有可能發生：
starting a drug;
開始服藥階段；
the drug dosage is increased or lowered:
藥物劑量增加或者減少時；
switching from one drug to another;
從一種藥物轉換到另外一種藥物；
a new drug or drugs is/are added to current prescriptions;
處方中加入了新的藥物（單複數的藥物）；
or a drug is discontinued.
或者停用了藥物。
Psychological adverse reactions are frequently misdiagnosed as spontaneous psychiatric symptoms, even though warning labels now make reference to certain psychiatric events. For example, long-term use of SSRI antidepressants often leads to mood changes that get labelled 「bipolar disorder」. Despite the clear evidence
provided in books like Anatomy of an Epidemic by Robert Whitaker, it is not yet well recognized by doctors or patients that this problem and others are iatrogenic
(treatment-induced).
即便現在對於提及某些精神疾病事件的標籤時有諸多警告，心理不良反應也經常被誤診為自發性精神癥狀。舉個例子，長期服用SSRI類抗抑鬱葯通常會導致的情緒變化被稱為「雙相情感障礙」。儘管羅伯特·惠特克著作的《Anatomy of an Epidemic》等書中提供了明確的證據，但醫生或患者還沒有很好地認識到這一問題和其他疾病是醫源性(治療誘導的)。
（譯者註：抗抑鬱葯有轉躁率，請謹慎客觀看待觀點）
Unfortunately, many psychiatrists mistake adverse reactions for inherent disorders which have been 「unmasked」. The premise of unmasking is that whatever symptom
has appeared after starting or stopping the drug would have happened anyway and the drug merely uncovered a pre-existing problem. Believing in the concept of
「unmasking」 is one way that doctors rationalize the fact that patients are harmed by the drugs. Physicians who are not too alert and not too ethical convince
themselves that the damage that happens when drugs are given has nothing to do with the drugs. Responsible physicians understand that when people take drugs and
their physical and emotional wellbeing deteriorates, the first suspect to be ruled out should always be their prescription medication(s).
不幸的是，許多精神科醫生將不良反應錯誤的歸咎於「未查明」的內分泌紊亂。滿足未查明的前提是這類癥狀會在服藥和斷葯後的任何時間任何方式都可能出現而服用藥物只是引發了一個早已存在的問題。相信「未查明」的概念是一種醫生合理解釋病人被藥物所傷害事實的方式。那些不夠警覺也不太道德的醫生們相信藥物造成的傷害與藥物無關。負責任的醫生應該明白，當患者服用藥物後出現身體和情緒健康惡化情況的時候，他們所開的處方葯應該是第一個需要被排除的嫌疑。
The stories on this site include many where young people have been casually given prescriptions for antidepressants, for situational conditions such as loss of a
loved one, bullying by classmates, or anxiety about school or relationships. Too often, the treatment intended to cushion the impact of unhappy life experiences
results in suicide, homicide, alcoholism, or drug addiction. It is axiomatic that had the families known of the risks, they would tried to have prevented their
loved one from taking the drug. But families do not know, because they are not told.If they ever realize that the antidepressant was the problem, it happens only
after serious damage has been done, which in too many cases is death.
在這個網站上收集了很多年輕人因為失去愛人，被同學欺負，或對學校或人際關係的焦慮等情況而被隨意開出了處方葯的例子。通常情況下，這種治療是為了預防因為不愉快的生活經歷而導致的自殺、殺人、酗酒或吸毒。毫無疑問的是如果家人知道這些風險的話他們會試圖阻止他們在乎的人服用這種藥物。但家人往往並未被告知相關風險。而當他們意識到抗抑鬱藥物的問題嚴重性時，事情往往
已經達到了嚴重傷害甚至很多情況下是死亡。
Withdrawal – the worst 「side effect」
撤葯 — 最糟糕的「副作用」
Withdrawal, especially abrupt withdrawal, from any antidepressant medications can cause severe psychiatric and/or physical problems. Every individual is slightly
different, but it is important to withdraw slowly from these drugs, sometimes over a period of a year or more, and ideally under the supervision of a qualified and
experienced specialist. In many jurisdictions, doctors who have the knowledge and the will to assist their patients to withdraw, are hard to find. Withdrawal is
often more severe than the original symptoms or problems for which the antidepressant prescription was given.
任何抗抑鬱藥物的撤葯特別是突然撤葯會導致嚴重的身體或者精神問題。雖然個體情況略有不同，但是在一年或者更長的時間裡，最好在一位合格有經驗的專家監督下緩慢撤葯是很重要的。在很多情況下你很難找到有知識和有意識幫助患者撤葯的醫生。不合理撤葯後的戒斷癥狀往往比最初的癥狀或者問題更為嚴重。
Withdrawal can cause a wide range of symptoms, from headaches, brain 「zaps」, insomnia, lethargy or fatigue, to feeling anger, irritation or even extreme, uncontrollable rage, and countless others.
撤葯可能導致一系列如頭痛、大腦短路（ZAPS）、失眠、嗜睡、疲勞、易怒甚至是極端失控的憤怒等等癥狀。
The following Prescription Drug Side Effects research papers deal with dependence and withdrawal:
以下是http://RxISK.org關於藥物依賴和副作用的研究：
1、Dependence and Withdrawal
1、依賴性以及副作用
2、Halting Antidepressants
2、抗抑鬱藥物的撤葯。
3、Medicine Induced Stress Syndromes
3、藥物誘導應激綜合征
Click here to view these and other Prescription Drug Side Effects research papers.
點擊鏈接：
https://wp.rxisk.org/research-papers/查看以上以及其他http://RxISK.org的研究
Common adverse effects of antidepressants
抗抑鬱藥物常見副作用
Common side effects of antidepressant use include: nausea, dry mouth, headaches, diarrhea, nervousness, agitation or restlessness, bruxism (teeth grinding), reduced sexual desire, difficulty reaching orgasm, impulsivity, akathisia (unbearable internal restlessness or agitation), irritability, hostility, fetal abnormalities (when taken by pregnant mothers), loss of empathy, loss of motivation, loss of libido and impaired sexual response (erectile dysfunction in men, and loss of orgasm in both sexes), rash, increased sweating, weight gain, drowsiness and insomnia.
服用抗抑鬱藥物常見的副作用包括：噁心、口乾、頭痛、腹瀉、緊張、焦慮或不安,磨牙症(磨牙),性慾降低,難以達到性高潮,衝動,靜坐不能(難以忍受的內部不安或焦慮)、易怒、充滿敵意,胎兒異常(孕婦服用),失去同情心,失去動力,失去性慾和性反應受損(男性勃起功能障礙,損失兩性的性高潮),皮疹,出汗增加,體重增加,嗜睡和失眠。
Sleep disturbance, including insomnia and parasomnias are listed in most literature, but the degree to which these effects are debilitating is easy to miss for those
who have not experienced it. SSRIs can disrupt sleep for those taking the drug, and in withdrawal. Sleep disruption can last for months after the meds have been
discontinued, even for people who ean off them gradually.
睡眠障礙，包括失眠和睡眠一場在很多文獻中都有列出，但這類影響很容易被沒有相關經歷的人所忽略。SSRIs類藥物會以副作用的方式影響服用者的睡眠。睡眠障礙可能會因藥物戒斷持續數月，類似情況甚至包括漸進撤葯的人也可能會出現。
Certain effects, such as hair thinning and loss of bone density, occur when the medications are taken long-term.
而某些類似頭髮變細以及骨質密度降低的情況是在長期服用藥物後發生的。
Many of the minor common side effects of antidepressants are clearly highlighted in manufacturers』 literature. Some, such as weight gain, are often presented as 「
weight gain or loss」, a description that leaves the misleading impression that both effects are equally likely.
許多常見副作用在藥物說明書里都已經明確標示。有些副作用，例如體重增加，通常會被描述為「體重增加或者減少」，這種描述會給人一種兩個方向概率相近的誤導印象。
Sexual dysfunction affects most people who take SSRI antidepressants. A few people experience a manic reaction to these drugs and experience hyper-sexuality
instead. Manufacturer information is sometimes buried, or misleading. For example, for Paxil a table is presented with footnotes where effects experienced by
subjects in a 6-week trial are compared to placebo. It shows that 2% of subjects suffer this effect while no subjects in the placebo group did. Of course, healthy
young subjects might not admit to loss of interest in sex, and perhaps they did not notice within 6 weeks. For most people who take SSRIs for a significant length
of time, sexual side effects are guaranteed. If people realized this, they might not be so quick to demand a prescription.
大部分服用SSRIs類藥物的人會出現性功能障礙。小部分人卻會因為藥物導致狂躁而產生性慾過勝（hyper-sexuality）。藥物製造商在這方面的信息經常被埋沒或者誤導。比如在帕羅西汀的說明書中有一個為期6周受試者與安慰劑比較的相關試驗，結果顯示有2%的藥物受試者產生了相關影響而安慰劑組一個都沒有。當然健壯的年輕受試者可能不會承認對性興趣的喪失，也可能是他們在6周時間裡並沒有注意到。但對於大多數患者來說，性功能障礙幾乎是必然出現的。如果患者意識到了這點風險，他們也許就不會那麼急著要求開處方葯了。
Some side effects, such as craving for alcohol, are simply not acknowledged. Many people who take SSRIs become alcohol abusers. Among SSRI stories are thousands
in which the combined effects of an antidepressant and alcohol bring out in people the worst effects of both. People do things while under the combined influence
that they would never normally do. When Dr Healy blogged about Anne-Marie, a woman of unusual insight who eventually figured out that her SSRI was the cause of her alcoholism, Prescription Drug Side Effects received a flood of comments from people who suddenly recognized that their alcohol problem started soon after their SSRI prescription. (See Out of My Mind. Driven to Drink and comments)
一些諸如嗜酒類的副作用目前還未被承認。許多服用SSRIs藥物的人都染上了酒癮。在我們的網站故事中數以千計的人在混合服用酒精和抗抑鬱藥物出現了對人最壞的影響。人們會在這兩者的共同影響下作一些平時他們絕不會碰的事。如Healy博士在博客上提到的Anne-Marie，一位最終發現SSRI是她酗酒原因的不尋常女士，http://RxISK.org收到了大量突然意識到他們的酒癮問題是在他們被開出SSRI處方後不久才出現的人的評論。
Other side effects
其他副作用
Side effects which are less common, but not rare, include: an increase in violent thoughts and impulses, suicidal ideation, mania, loss of judgment, strange or
terrifying dreams, reduced inhibition, craving for alcohol, a tendency to indulge in reckless behavior, thought disturbance or full-blown psychosis, and increased
propensity to drug and alcohol addiction.
這類副作用談不上常見，但也並不罕見，包括：暴力和衝動思想的增加，自殺意念，狂躁，喪失判斷力，奇怪或可怕的夢，壓抑，對酒精的渴望，沉溺於魯莽行為，思想障礙或精神病，以及增加毒品和酒精成癮的傾向。
Psychotropic drugs, including SSRIs, when taken for a long time, predispose people to other addictions. This is particularly true with children who are started on these drugs at a young age and become bipolar in adolescence as a consequence. Although pharmaceutical companies have denied it for years, SSRIs and other psychotropic drugs create dependency. When people get hooked on street drugs, we call it addiction and disapprove. When people get hooked on drugs prescribed by their doctors, and suffer terrible symptoms when they try to stop taking them, it is interpreted as evidence that they have a chronic illness. Their withdrawal symptoms are mischaracterized as 「relapse」 and proof that they need the drug to stay well.
精神類藥物，包括SSRIs,在長時間服用後容易使人產生依賴性。這對於那些在孩童時期就開始一直服藥的人來說尤為嚴重，以至於在青少年時期就很可能會導致誘發雙相障礙。儘管這些年製藥公司一直否認，但SSRIs和抗抑鬱藥物的確導致依賴。當人們沉迷於街頭毒品時，我們稱之為上癮並且排斥。但當人們對藥物產生了依賴，並且在他們試圖停葯時發生了惡化情況時，這就被解釋為他們有慢性疾病的證據。他們的戒斷癥狀被誤診為複發，以此來證明他們需要服藥來保持狀態。
Most alarming of all, antidepressants can cause depression and suicidality. Despite having been forced to issue black box warnings in the USA, several manufacturers
fudge this one. For example, the Celexa, June, 2012 monograph cautions that:
這之中最令人震驚的是，抗抑鬱藥物反而可能導致抑鬱和自殺。在美國對此發出黑盒警告之後，仍然有部分製造商試圖掩蓋警告事實。例如西酞普蘭，在2012年6月的注意事項與警告里寫到：
「Depression is associated with an increased risk of suicidal thoughts, self-harm and suicide (suicide-related events). This risk persists until significant remission occurs. As improvement may not occur during the first few weeks or more of treatment, patients should be closely monitored until such improvement occurs. It is general clinical experience that the risk of suicide may increase in the early stages of recovery.」
"抑鬱與自殺念頭、自殘和相關事件的風險增加有關。這種風險一直存在，直到出現癥狀緩解。由於在最初幾周或更長的治療期間可能不會出現明顯改善，因此應密切監測患者直到癥狀改善。一般的臨床經驗表明，自殺的風險可能會在恢復的早期階段增加。"
In other words, Lundbeck is implying that Celexa makes people feel better, but until this positive effect kicks in, their depression may cause suicidality. According to their spin, it is not the drug but depression that is the problem. However, there is unequivocal evidence [1] that SSRI drugs can cause people who were never depressed and never had a suicidal thought, to become suicidal after taking these medications. People need to understand this, especially parents whose teenagers are among the many thousands whose GPs are offering them SSRIs to help them deal with boyfriend or exam problems.
換句話說，Lundbeck公司意思是西酞普蘭會讓人變好，但在這種積極效果生效之前，抑鬱也可以導致服藥者自殺。根據他們的說法，這是抑鬱症而不是藥物造成的問題。然而，有明確的證據[1]表明SSRI類藥物可以導致從未抑鬱從未有過自殺念頭的人在服用這些藥物後產生自殺念頭。人們需要了解這一點，特別是成千上萬被誘導到用SSRIs來幫助青少年度過戀愛或者類似問題的父母。
Similarly, SSRIs cause people to become violent. Studies show that the SSRI & SNRI antidepressants are among the worst drugs for causing violence (see Trends and
Data).
同樣SSRIs也會使人變得更有暴力傾向。研究表明，SSRI和SNRI類抗抑鬱葯是導致暴力的最嚴重的藥物之一(見趨勢和數據)。
Long-term use of antidepressants causes permanent changes to people』s mood and reactions. Suicide and violence are the most alarming side effects, however small the percent of affected persons may be. However, depression and bi-polar, which are more common, are the most offensive side effects. People take these drugs in the belief and hope that the medication will make them feel better, only to have their long term mental health undermined by this decision. It seems that, despite books like Anatomy of an Epidemic few physicians are aware of this. Robert Whitaker pointed this out in his 2010 book, and more recently Danish internist Peter Gotzsche bluntly stated:
長期服用抗抑鬱藥物會使人的情緒和反應發生永久性變化。無論受影響的概率有多小，自殺和暴力都是最令人擔憂的副作用。然而在抑鬱和雙相障礙的案例中，最常見的還是攻擊性很強的副作用。人們相信堅持服用藥物能讓他們感覺更好，只是因為他們的長期心理預期收到了這個決定的影響。Robert Whitaker在他的2010年的書中指出了這一點，最近，丹麥專家Peter Gotzsche直言不諱地說:
「Bipolar illness rose 35-fold in 20 years in the United States. It』s not only the loose criteria (for diagnosis) that cause this disaster; both SSRIs and ADHD
drugs cause bipolar illness…WHO studies have shown that patients fare much better in areas of the world where psychotropic drugs are little used…People may get
terrible symptoms when they try to stop (taking the drugs), both symptoms that resemble the disease and may others that they have never experienced before.」[2]
「在美國20年的時間裡，躁鬱症的發病率上升了35倍。造成這場災難的不僅僅是寬鬆的診斷標準，SSRIs和ADHD藥物也是病因...世界衛生組織的研究已經顯示患者在更少應用精神藥物的地區表現更好...當患者試圖停葯時可能會出現可怕的戒斷癥狀，這些從未經歷過的癥狀都與疾病類似」[2]
[1] Emergence of antidepressant induced suicidality, David Healy, Primary Care Psychiatry, 2000 6:23–28 ? LibraPharm Limited
[2] Deadly Medicines and Organized Crime, Psychiatry, the Drug Industry』s Paradise, Dr Peter Gotzsche, Radclofee Publishing, 2013, P196, P199
（譯者註：以下為相關趨勢和數據，和我國無關暫不作翻譯）
Trends and data
In 2011, the American National Department of Health and Human Services found that eleven percent of Americans aged 12 years and over were taking antidepressant
medication. They found that more than 60% of Americans taking antidepressant medication had been taking it for 2 years or longer, with 14% having taken the
medication for 10 years or more. The most astounding finding was that between the time periods 1988–1994 and 2005–2008 – that is, within less than 10 years – the
rate of antidepressant use in the United States among all age groups increased nearly 400%.
In the E.U., antidepressant use has also experienced huge growth since the turn of the century.
In 1955, in the USA, approximately one in 13,000 people was diagnosed with bipolar disorder, and those who were diagnosed had a 50% chance of recovering without
relapse. In 1985, researchers found that in Switzerland, the incidence of bipolar disorder had significantly increased since the introduction of antidepressants.
More recently, a meta-analysis of 35 studies involving randomized control trials found that 12.5 % of subjects treated with antidepressants experienced some form of
mania. In 2013, the American National Institute of Mental Health warns that: 「Bipolar disorder affects approximately 5.7 million American adults, or about 2.6
percent of the U.S. population age 18 and older in a given year.」
Note: Specific reference sources are not listed here. Please contact us if you would like to know the source of any of the information cited above.
PLOS 2010 study on drugs and biolence
On December 15, 2010, PLoS Medicine released a study which showed that, in regard to prescription medications associated with reports of violence towards others, the
FDA had received the most reports of violence from the SSRI & SNRI antidepressants (except for Chantix, the smoking cessation drug.) The study listed Prozac as the
number 2 drug for violence, and Paxil as number 3.
Antidepressants have been recognized as potential inducers of mania and psychosis since their introduction in the 1950s. Klein and Fink (1) described psychosis as
an adverse effect of the older tricyclic antidepressant imipramine. Since the introduction of Prozac in December, 1987, there has been a massive increase in the
number of people taking antidepressants. Preda and Bowers 2 reported that over 200,000 people a year in the U.S. enter a hospital with antidepressant-associated
mania and/or psychosis. The subsequent harm from this prescribing can be seen in these 5000+ stories.
According to an August, 2013 New York Times article, 「fully 1 in 5 Americans take at least one psychiatric medication.」
An absence of controlled scientific evidence
In the Journal of American Physicians and Surgeons, Volume 14, Number 1, Spring 2009, there is a journal article by Joel M. Kauffman, Ph.D., which is titled:
Selective Serotonin Reuptake Inhibitor (SSRI) Drugs: More Risk Than Benefits?」 In reference to Apache2 Ubuntu Default Page: It works, Dr. Kaufmann made the following statement:
「Since no clinical trial involving multiple homicides is ever likely to be run, no firmer evidence is likely to be found. Dr. David Healy noted that much of the
evidence for suicide and murder came from the efforts of journalists and lawyers.
To read the full article go to the Links page on this site (click the button at the bottom of this page).
A public health problem of epidemic proportions
There is a grave concern among advocates that adverse reactions are greatly underestimated by the public, the medical profession, and the regulatory authorities.
Each of these stories in our list can be interpreted as an adverse reaction and in most cases we have highlighted the portion of the article that refers to evidence
of bizarre behavioral change consistent with drug reaction. In some stories causation is acknowledged and the juxtaposition of these stories with those where it goes
unrecognized as well as the repetition of themes and circumstances is chilling. If indeed medications played a significant role in all these tragedies, then this is
a public health problem of epidemic proportions on a global scale.
1 Klein DF, Fink M. Psychiatric Reaction Patterns to Imipramine. Am Journal Psychiatry 1962; 119: 432-438.
2 Preda and Bowers. Antidepressant-Associated Mania and Psychosis Resulting in Psychiatric Admissions. Journal of Clinical Psychiatry 2001: 62: 30-333 National
Institute of Mental Health: Health Magazine 2010.
4Thomas J. Moore, Joseph Glenmullen, Curt D. Furberg. Prescription Drugs Associated With Reports of Violence Toward Others. PLoS Medicine: December 15, 2010.
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