【全浸阅读】再见抑郁...药
【全浸阅读】再见抑郁...药
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内容导读
➤1.-本周推荐Articles
1. Frontcover-Welcome to Britaly
2. Business-What next for Meta?
3. Science & Technology-Venus's Lips
4. Culture-Medicis 2.0
5. People-The man who said no
➤2.-Leaders-Drugs & Depression-见原文部分
➤3.-延伸阅读Extensive
【全浸阅读】Drug & Depression
全浸阅读=TotalImmerseDynamic eReading=TIDE
➤Leader-
Drugs and depression
Set patients free
Most people on antidepressants don’t need them. Time to wean them off
-antidepressants
-wean off
Thedoctortriedtoweanheroffsleepingpills.医生设法使她逐渐停止服用安眠药片。
P1
Almost 35 years ago American drug regulators approved Prozac, the first in a series of blockbuster antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Prozac and its cousins were lauded by patients and doctors as miracle drugs. They lifted low moods quickly and seemed to have no drawbacks. Divorce, bereavement, problems at work—a daily pill was there to help with that, and anything else which made you sad. Many people have stayed on these drugs for life. In Western countries today between one person in seven and one in ten takes antidepressants.
-the first in a series of blockbuster(megahit/smash hit)
-Prozac and its cousins
-were lauded by...(praised,glorify/extol)
-lifted low moods quickly
-seemed to have no drawbacks
-bereavement-sorrow/pain over the death of loved one
-a daily pill was there to help with that, and anything else which...
-stayed on...for life...
P1....antidepressants....SSRIs...
P2.
The shine of SSRIs has worn off. A growing number of studies show that they are less effective than thought. Drug companies often publish the results of clinical trials selectively, withholding those in which the drugs turn out not to work well. 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 (real) placebo effect in only 15% of patients.
-has worn off
-less effective than thought
-publish the results...selectively, withholding those in which...
-turn out not to work well
-had a substantial benefit beyond a (real)placebo effect
P2. ...the SSRIS...has worn off...
P3.
Clinical guidelines have been revised accordingly in recent years. No longer are drugs the recommended first line of treatment for less severe cases of depression. For these, self-help guidance, behavioural therapy and recommendations for things like exercise and sleep are preferable. For work burnout, a sick note for time off may suffice. The drugs are to be reserved only for more severe depression, where they can be truly lifesaving.
-cliniclal guidelines
-have been revised accordingly
-the recommended first line of treatment
-self-help guidance
-behavioral therapy
-are preferable
-work burnout
-a sick note for time off
-suffice(be enough)
-to be reserved only for ...
-truly life-saving
P3...guidelines...have been revised...
P4.
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. The side-effects are often lifelimiting and, as people age, become life-threatening. They can include sexual dysfunction (which sufferers describe as “genital anaesthesia”), lethargy, emotional numbness, increased risk of birth defects when the pills are taken during pregnancy, and, in older people, strokes, falls, seizures, heart problems and bleeding after surgery. This is a threat to healthcare systems as longterm users age.
-are already on them
-refilling prescriptions
-should be helped to get off the drugs
-side-effects
-life-limiting
-life-threatening
-sex dysfunction
-genital anaesthesia
-lethargy(listless)
-emotional numbness
-birth defects
-when the pills are taken during pregnance, and , in...
-seizures(a sudden violent attack of illness)
-bleeding after surgery
P4...the problems...
P5.
Doctors rarely talk to patients about stopping the drugs because they fear this could lead to a return of depressive symptoms. But for many people it may be fine to stop. Even among longterm users with several past episodes of depression, a recent trial in Britain showed that 44% of patients could stop taking pills safely. For milder cases, the success rate is probably higher still.
-rarely talk to...about stopping because...they fear this could lead to
-a return of
-depressive symptoms
-with several past episodes of depressions
-could stop taking pills safely
P5. for some...it may be fine to stop...
P6.
Several things are needed for change to happen. Doctors need guidelines on how to deprescribe the drugs. Healthcare insurers and providers, such as Britain’s various national health services, should start paying for delivery techniques that help those who wish to give up the drugs but who need to do so gradually in order to avoid severe withdrawal effects. These include liquid formulations, tapering strips which contain pills with progressively smaller drug concentrations, and the services of pharmacies which prepare bespoke doses. In the Netherlands, 70% of people using tapering strips have managed to quit successfully.
-are needed for change to happen
-guidelines on how to
-deprescribe the drugs
-start paying for
-delivery techniques that help...
-who wish to give up...but who need to do so gradually in order to avoid
-severe withdrawal effects
-liquid formulations
-tapering strips
-bespoke doses
P6. ...things are needed for change to happen...
P7.
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. Add to that the misery of the millions whose lives have been robbed of common joys by nearuseless prescriptions, and the case for change is unanswerable.
-all this could cost more than
-the cost of side-effects will soon pile up
-add to that the misery of...
-whose lives have been robbed of common joys
-by near-useless prescriptions
-the case for change is unanswerable
P7. though cost more...must make the change happen...
闻王昌龄左迁龙标遥有此寄
李白
杨花落尽子规啼，闻道龙标过五溪。 我寄愁心与明月，随君直到夜郎西。
机翻中文仅供参考
药物和抑郁症
让患者自由
大多数服用抗抑郁药的人不需要它们。是时候戒掉它们了 大约 35 年前，美国药品监管机构批准了百忧解，这是一系列重磅炸弹抗抑郁药中的第一个，称为选择性血清素再摄取抑制剂 (SSRI)。百忧解和它的表亲被患者和医生称赞为神药。他们很快解除了低落的情绪，似乎没有任何缺点。离婚、丧亲之痛、工作中的问题——每天都有一颗药丸可以解决这些问题，以及其他任何让你难过的事情。许多人终生服用这些药物。在今天的西方国家，七分之一到十分之一的人服用抗抑郁药。
SSRIs 的光芒已经消退。越来越多的研究表明，它们没有想象中那么有效。制药公司经常选择性地公布临床试验结果，隐瞒那些药物效果不佳的结果。当独立科学家对 1979 年至 2016 年间提交给美国药品监管机构的所有试验结果进行审查时，发现抗抑郁药仅在 15% 的患者中具有超越（真正）安慰剂效应的实质性益处。
临床指南已相应修订最近几年。对于不太严重的抑郁症病例，药物不再是推荐的一线治疗方法。对于这些，自助指导、行为治疗和运动和睡眠等方面的建议是可取的。对于工作倦怠，请假病假就足够了。这些药物只能用于更严重的抑郁症，在那里它们可以真正挽救生命。
问题是许多不需要抗抑郁药的人已经在服用它们，重新填写几年甚至几十年前写的处方。应该帮助他们戒毒。副作用通常会限制生命，并且随着人们年龄的增长，会危及生命。它们可能包括性功能障碍（患者将其称为“生殖器麻醉”）、嗜睡、情绪麻木、怀孕期间服用避孕药时出生缺陷的风险增加，以及老年人中风、跌倒、癫痫发作、心脏问题和出血手术后。随着长期使用者年龄的增长，这对医疗保健系统构成威胁。
医生很少与患者谈论停止用药，因为他们担心这可能导致抑郁症状复发。但对许多人来说，停下来可能很好。即使在过去有几次抑郁症的长期服用者中，最近在英国进行的一项试验表明，44% 的患者可以安全地停止服药。对于较轻的情况，成功率可能会更高。
要发生变化，需要做一些事情。医生需要关于如何开药的指南。医疗保险公司和提供者，例如英国的各种国家医疗服务机构，应该开始为那些希望放弃药物但需要逐渐放弃药物以避免严重戒断影响的人提供帮助。这些包括液体制剂、含有药物浓度逐渐降低的药丸的锥形条，以及准备定制剂量的药房服务。在荷兰，70% 使用锥形条的人已成功戒烟。
这一切都可能比今天重新填写处方花费更多。但是有这么多人服用药物，副作用的成本很快就会堆积起来。再加上数百万人的痛苦，他们的生活被几乎无用的药方剥夺了共同的快乐，改变的理由是无法回答的。
More reading》》》
