Name: 【TED】Rebecca Brachman:藥物可以預防抑鬱症和創傷後應激障礙嗎？(能否用藥物預防抑鬱症和創傷後應激障礙？|Rebecca Brachman) (【TED】Rebecca Brachman: Could a drug prevent depression and PTSD? (Could a drug prevent depression and PTSD? | Rebecca Brachman))
Uploaded: 2021-01-14T06:42:04.000Z
Duration: 18 min 24 s

基礎被動語態

and at the time this picture was taken in the late 1800s,

那個時候，每七個人之中就有一個人

We had no idea what was causing this disease.

當時沒人知道 這種疾病的病因是什麼。

it was your constitution that made you susceptible.

And it was a highly romanticized disease.

結核病當時還是 一種被高度浪漫化的疾病，

And some people actually thought it gave you heightened sensitivity

有些人甚至認為它會讓人極為敏感

we instead knew that tuberculosis was caused

by a highly contagious bacterial infection,

是由一種高傳染性的 細菌感染所引起，

of us being able to maybe develop drugs to treat it.

那就是我們可能 可以研發藥物治療結核病。

So doctors had discovered a new drug, iproniazid,

所以醫生發明了一種新藥 ──異菸鹼異丙醯肼，

that they were optimistic might cure tuberculosis,

變得更樂於社交，更充滿活力，

One medical report actually says they were "dancing in the halls."

一份醫療報告甚至稱病人們都 「在走廊上跳舞」。

this was not necessarily because they were getting better.

這並不一定是因為 他們的病情有所好轉。

Another medical report describes them as being "inappropriately happy."

另一份醫療報告說這些病人 「開心得不正常」。

And that is how the first antidepressant was discovered.

這就是第一種抗抑鬱劑的研發歷史。

So accidental discovery is not uncommon in science,

but it requires more than just a happy accident.

但是僅僅有幸運的意外是不夠的。

You have to be able to recognize it for discovery to occur.

As a neuroscientist, I'm going to talk to you a little bit

我要和大家分享我自己的親身經歷。

with whatever you want to call the opposite of dumb luck --

就讓我們稱它為有心的意外吧。

非常幸運地，自從1950 年代以來，

we've developed some other drugs and we can actually now cure tuberculosis.

我們研發了其他 可以治癒結核病的藥物。

And at least in the United States, though not necessarily in other countries,

儘管其他國家還可能存在結核病， 至少在美國

and probably most of you are not too worried about TB.

大多數人也不太擔憂患結核病。

But a lot of what was true in the early 1900s

we can say now about psychiatric disorders.

We are in the middle of an epidemic of mood disorders

我們正處於精神疾病氾濫的年代，

like depression and post-traumatic stress disorder, or PTSD.

抑鬱症和創傷後壓力疾患 就是精神疾病的兩個例子。

One in four of all adults in the United States

每四個成年人中 就有一個患有精神病，

which means that if you haven't experienced it personally

即使你或你的家人沒有精神類疾病，

it's still very likely that someone you know has,

你認識的人當中 很可能有精神病患者，

愛滋病、瘧疾、糖尿病、戰爭，

as the leading cause of disability worldwide.

成為世界上導致殘疾的首要因素。

And also, like tuberculosis in the 1950s,

在 1950 年代， 我們從一種抗組織胺藥中

意外地發現了第二種抗抑鬱的藥物。

from an antihistamine that was making people manic,

And in both the case of the tuberculosis ward and the antihistamine,

在這兩個關於 結核病和抗組織胺藥例子中，

that a drug that was designed to do one thing --

原本發明用來 治療結核病或過敏的藥物，

treat tuberculosis or suppress allergies --

could be used to do something very different --

這種改變用途的作法其實困難重重。

And this sort of repurposing is actually quite challenging.

當醫生第一次見到異菸鹼異丙醯肼 對情緒的影響時，

When doctors first saw this mood-enhancing effect of iproniazid,

they didn't really recognize what they saw.

異菸鹼異丙醯肼 是治療結核病的藥物，

from the framework of being a tuberculosis drug

以至於他們認為他們所見到的 是藥物的副作用，

as a side effect, an adverse side effect.

1954 年很多病人患有嚴重的欣快症。

a lot of these patients in 1954 are experiencing severe euphoria.

And they were worried that this might somehow interfere

所以他們建議，只有病症十分嚴重，

So they recommended that iproniazid only be used in cases of extreme TB

而且病人情緒十分穩定時， 才使用異菸鹼異丙醯肼，

and in patients that were highly emotionally stable,

這與我們今天用這種藥物來 抗抑鬱的情形正好相反。

which is of course the exact opposite of how we use it as an antidepressant.

他們太習慣從結核病的角度 來考量這種藥物，

They were so used to looking at it from the perspective of this one disease,

以至於他們不能意識到 它對其他疾病更大的作用。

they could not see the larger implications for another disease.

說句公道話，這也不是他們的錯，

And to be fair, it's not entirely their fault.

我們所有人都受功能固著影響。

Functional fixedness is a bias that affects all of us.

功能固著使我們看到一種事物時，

It's a tendency to only be able to think of an object

傾向只想到其傳統固有的 作用和功能。

in terms of its traditional use or function.

That's sort of this preconceived framework

這使得我們都很難 為事物想出新用途，

And that actually makes repurposing pretty hard for all of us,

which is, I guess, why they gave a TV show to the guy who was,

異菸鹼異丙醯肼和伊米帕明 藥效都很強，

So the effects in both the case of iproniazid and imipramine,

【TED】Rebecca Brachman:藥物可以預防抑鬱症和創傷後應激障礙嗎？(能否用藥物預防抑鬱症和創傷後應激障礙？|Rebecca Brachman) (【TED】Rebecca Brachman: Could a drug prevent depression and PTSD? (Could a drug prevent depression and PTSD? | Rebecca Brachman))

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【TED】Rebecca Brachman:藥物可以預防抑鬱症和創傷後應激障礙嗎？(能否用藥物預防抑鬱症和創傷後應激障礙？|Rebecca Brachman) (【TED】Rebecca Brachman: Could a drug prevent depression and PTSD? (Could a drug prevent depression and PTSD? | Rebecca Brachman))

weird

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chronic

mental