The 10-day ordeal, 12 young boys and their soccer coach

10天的煎熬，12個小男孩和他們的足球教練。

found alive in a flooded cave in Thailand.

在泰國的一個被水淹沒的山洞裡被發現活體。

Narrator: Remember when that happened?

旁白：還記得那是什麼時候發生的嗎?

It was one of the most difficult

這是一個最困難的

rescue missions of all time,

救援任務的所有時間。

involving as many as 10,000 people,

牽涉到多達1萬人。

and now we know that rescuers gave the boys a drug

現在我們知道，救援人員給孩子們下了藥。

which helped the mission succeed.

這有助於特派團的成功。

That drug was ketamine.

那藥是氯胺酮。

Ketamine was first synthesized in the 1960s

氯胺酮最早是在20世紀60年代合成的

as an anesthetic, a sedative.

作為麻醉劑、鎮靜劑。

That's why it was so useful in the rescue mission.

所以它在救援任務中才會有如此大的作用。

But ketamine actually has a lot of different uses.

但其實氯胺酮有很多不同的用途。

In the '80s, it became a popular club drug,

在80年代，它成了一種流行的俱樂部藥物。

gaining nicknames like Special K and Cat Valium,

獲得特別K和貓咪安定等綽號。

and more recently, in early 2019,

而最近，在2019年初。

a form of ketamine was approved

氯胺酮的形式被準許

by the FDA as an antidepressant.

被美國食品和藥物管理局列為抗抑鬱劑。

So how does a drug that's so multipurpose actually work?

那麼，如此多用途的藥物究竟是如何發揮作用的呢？

Ketamine is what scientists call a dirty drug.

氯胺酮是科學家們所說的髒藥。

That means it doesn't just target

這意味著它不僅僅針對

one system in your brain, but dozens.

大腦中的一個系統，但幾十個。

It has a weak effect on opiate receptors

它對阿片受體的影響很微弱

in the dopamine system,

在多巴胺系統中。

which drugs like heroine and cocaine target.

海洛因和可卡因等藥物的目標。

But most importantly, ketamine manipulates

但最重要的是，氯胺酮可以操縱

a neurotransmitter called glutamate,

一種叫做穀氨酸的神經遞質。

earning it the attention of psychiatrists nationwide.

贏得了全國精神病學家的關注。

Glutamate is what many of the neurons in your brain

穀氨酸是你大腦中許多神經元的來源

use to communicate with each other,

用來互相交流。

and without it, well, your brain would essentially shut down

如果沒有它，好了，你的大腦會 基本上關閉了

like a city grid without power.

就像一個沒有電力的城市電網。

Now, at high doses, ketamine seems to block glutamate.

現在，在高劑量下，氯胺酮似乎可以阻斷穀氨酸。

That's why it's such an effective anesthetic.

這就是為什麼它是一種有效的麻醉劑。

But in low doses, like what you might find at a club

但劑量很低，就像你在俱樂部裡找到的那樣

or in a spray of the FDA-approved drug esketamine,

或在FDA準許的藥物艾司他敏的噴霧中。

it actually ramps up glutamate production,

它實際上是加劇了穀氨酸的生產。

and that comes with all kinds of side effects.

而且還伴隨著各種副作用。

It can make you hallucinate or feel as though

它可以讓你產生幻覺或感覺好像

you're losing touch with reality.

你正在失去與現實的聯繫。

And it might also help build new connections or synapses

而且它還可能幫助建立新的連接或突觸。

between neurons, electrifying new parts of that city grid.

神經元之間，為該城市電網的新部分通電。

Chadi Abdallah: When people are stressed for a long time

Chadi Abdallah:當人們長期處於緊張狀態時

or when they suffer from depression for a while,

或當他們患有一段時間的抑鬱症。

they start losing these connections,

他們開始失去這些聯繫。

and when we give them ketamine 24 hours,

而當我們給他們氯胺酮24小時。

they reverse. Now they look like more a normal brain.

他們逆轉。現在他們看起來更像一個正常的大腦。

So we believe that perhaps ketamine

所以我們認為，也許氯胺酮

is working by regenerating these connections

正在通過重新生成這些連接來工作

that are needed for normal brain functioning.

大腦正常運作所需的。

Narrator: And that could make ketamine

旁白：那會讓氯胺酮

one of the best drugs out there for treating depression.

是治療抑鬱症的最佳藥物之一。

This isn't how other antidepressants work.

這不是其他抗抑鬱藥的工作方式。

Medications like Prozac and Zoloft take weeks if not months

像百憂解和左洛復這樣的藥物需要數週甚至數月的時間。

to kick in, and they regulate serotonin,

來啟動，他們調節血清素。

another chemical in the brain,

大腦中的另一種化學物質。

which scientists have long tied to depression.

科學家們早已將其與抑鬱症聯繫在一起。

These more traditional drugs may work for some people,

這些比較傳統的藥物可能對某些人有效。

but not for everyone.

但不是每個人都適合。

In fact, as many as 4 million American adults

事實上，多達400萬的美國成年人。

have treatment-resistant depression.

患有耐治療的抑鬱症。

And for them, well, ketamine might be

而對他們來說，好吧，氯胺酮可能是

the only drug out there that can provide relief.

唯一的藥物有 可以提供緩解。

That's according to Doctor Andre Atoian.

這是安德烈-阿圖安醫生說的。

He's the founder of Ketamine Specialists,

他是氯胺酮專家的創始人。

a clinic where he administers ketamine to patients with

診所，他在那裡給患者服用氯胺酮，並在那裡

mood disorders, pain, and addiction.

情緒障礙、疼痛和成癮。

Andre Atoian: Ketamine is the agent that works when

安德烈-阿圖安。Ketamine is the agent that works when

most others have failed.

其他大多數人都失敗了。

It is something that really allows us to give patients

它是真正讓我們給患者的東西

a sort of new hope 'cause a lot of people that I treat

一種新的希望，因為很多人，我治療

have basically already tried everything,

基本上已經試過了所有的東西。

and they're in this situation

而他們在這種情況下

where nothing's really working,

在那裡，沒有什麼真正的工作。

and they're suffering, they're miserable.

他們很痛苦，他們很可憐。

Narrator: So it's hard to deny that ketamine's effect

旁白：所以很難否認氯胺酮的作用... ...

on depression sounds promising,

在抑鬱症方面，聽起來很有希望。

and, clearly, it's a useful sedative.

而且，很明顯，這是一個有用的鎮靜劑。

But here's the thing...

但事情是這樣的...

Nolan Williams: As far as effect, it's, you know,

諾蘭-威廉姆斯至於效果，這是，你知道的。

there's still a lot we don't know.

還有很多我們不知道的。

Narrator: That's Doctor Nolan Williams,

旁白：那是Nolan Williams醫生

an assistant professor of psychiatry

精神病學助理教授

at the Stanford University Medical Center.

在斯坦福大學醫學中心。

He says that because ketamine manipulates so many different

他說，因為氯胺酮能操縱許多不同的東西

receptors in the brain,

大腦中的受體。

it's been hard to nail down all of them.

很難把它們全部釘死。

So it's still unclear how it might affect different patients

所以目前還不清楚它對不同的患者會有什麼影響

both short- and long-term,

短期和長期。

and researchers still haven't figured out

而研究人員仍然沒有弄清楚

how to preserve its benefits as an antidepressant.

如何保持其作為抗抑鬱劑的優勢。

Abdallah: The challenge is how to maintain

阿卜杜拉。挑戰是如何保持

these new connections.

這些新的連接。

Is it to give ketamine repeatedly?

是要反覆給氯胺酮嗎？

We know that we cannot give it every day,

我們知道，我們不可能每天都付出。

that's like substance of abuse,

這就像濫用的物質。

because then it will harm the brain.

因為那樣會傷害大腦。

Narrator: So while FDA approval is considered

旁白：所以雖然FDA的準許被認為是

a victory for the millions of people

百姓的勝利

with treatment-resistant depression,

與治療耐藥的抑鬱症。

doctors still caution that ketamine should only be used

醫生還是提醒說，氯胺酮只能用於

as a last resort.

作為最後的手段。