A new class of drug that could prevent depression and PTSD | Rebecca Brachman

譯者: Thomas Tam 審譯者: SF Huang

So the first antidepressants were made from, of all things,

抗憂鬱藥的誕生

是由第二次世界大戰所留下的 火箭燃料所製成。

rocket fuel, left over after World War II.

Which is fitting, seeing as today, one in five soldiers develop depression,

相符的，就像今天 有五分之一軍人罹患了憂鬱症，

or post-traumatic stress disorder or both.

或創傷後壓力症候群或兩者皆得。

But it's not just soldiers that are at high risk for these diseases.

但，不只有軍人是高危險的族群，

It's firefighters, ER doctors, cancer patients, aid workers, refugees --

消防員、急診醫生、癌症患者、 援助工作者和難民等 ––

anyone exposed to trauma or major life stress.

任何暴露於精神創傷 或重大生活壓力下的人都可能罹患。

And yet, despite how commonplace these disorders are,

然而，儘管這些疾病很普遍，

our current treatments, if they work at all,

我們目前所有的治療方法， 如果它們真的有效的話，

only suppress symptoms.

只能抑制症狀。

In 1798, when Edward Jenner discovered the first vaccine --

1798 年，愛德華．詹納 發現了首支疫苗 ––

it happened to be for smallpox --

碰巧是用於天花上 ––

he didn't just discover a prophylactic for a disease,

他發現的不僅是一種疾病的預防用藥，

but a whole new way of thinking:

還是一種全新的思維方式：

that medicine could prevent disease.

藥物可以預防疾病。

However, for over 200 years,

然而，200 多年來，

this prevention was not believed to extend to psychiatric diseases.

人們卻不認為這種預防藥物 可擴展運用到精神疾病。

Until 2014, when my colleague and I accidentally discovered

直到 2014 年， 當我和同事偶然發現

the first drugs that might prevent depression and PTSD.

第一批可能預防憂鬱症 和創傷後壓力症的藥物。

We discovered the drugs in mice,

藥物是從老鼠試驗中發現，

and we're currently studying whether they work in humans.

目前正研究是否適用於人類。

And these preventative psychopharmaceuticals

而這些預防性的精神藥物

are not antidepressants.

不是抗憂鬱藥。

They are a whole new class of drug.

它們是一類全新的藥物。

And they work by increasing stress resilience,

其效用是增強人們的耐壓復原力，

so let's call them resilience enhancers.

所以我們稱之為復原力增強劑。

So think back to a stressful time that you've since recovered from.

回想一下你處於緊張狀態 恢復過來的時刻。

Maybe a breakup or an exam, you missed a flight.

也許由分手、考試 或是你錯過班機所引起。

Stress resilience is the active biological process

耐壓復原力是我們承受壓力後，

that allows us to bounce back after stress.

能夠具韌性反彈的生物過程。

Similar to if you have a cold and your immune system fights it off.

類似於如果我們感冒了， 免疫系統會對抗一樣。

And insufficient resilience

當面對嚴重的壓力

in the face of a significant enough stressor,

卻無法具足夠的韌性回彈時，

can result in a psychiatric disorder, such as depression.

能導致精神疾病，如憂鬱症。

In fact, most cases of major depressive disorder

事實上多數主要的憂鬱症，

are initially triggered by stress.

是由壓力所引發的。

And from what we've seen so far in mice,

目前從老鼠身上看到的情況是，

resilience enhancers can protect against purely biological stressors,

復原力增強劑可防止 單純的生物性壓力，

like stress hormones,

像壓力荷爾蒙

and social and psychological stressors, like bullying and isolation.

以及社會和心理壓力， 如欺凌與孤立。

So here is an example where we gave mice

以下的例子是我們給老鼠

three weeks of high levels of stress hormones.

三週高劑量的壓力荷爾蒙。

So, in other words, a biological stressor without a psychological component.

換句話說，沒有參雜 心理因素的生物壓力。

And this causes depressive behavior.

這同樣導致憂鬱行為。

And if we give three weeks of antidepressant treatment beforehand,

如果我們預先給予三週的抗憂鬱治療，

it has no beneficial effects.

並沒有任何助益。

But a single dose of a resilience enhancer given a week before

但在一週前給予單劑量的 復原力增強劑，

completely prevents the depressive behavior.

就能完全預防憂鬱的行為。

Even after three weeks of stress.

即使經過三週的壓力後。

This is the first time a drug has ever been shown

這是藥物第一次出現能夠預防

壓力形成負面影響的效果。

to prevent the negative effects of stress.

Depression and PTSD are chronic, often lifelong, clinical diseases.

憂鬱症和創傷後壓力症候群， 通常是種慢性、終生的疾病。

They also increase the risk of substance abuse, homelessness,

患者還會增強濫用藥物、無家可歸、

heart disease, Alzheimer's, suicide.

心臟病、老年癡呆和自殺等風險。

The global cost of depression alone is over three trillion dollars per year.

光憂鬱症的費用 每年全球就超過 3 兆美元。

But now, imagine a scenario where we know someone is predictively

但現在想像一下，我們預知某人將會

at high risk for exposure to extreme stress.

處於極端壓力的高風險下。

Say, a red cross volunteer going into an earthquake zone.

比如，一名紅十字志工進入震災區。

In addition to the typhoid vaccine,

在她前往災區前，除了傷寒疫苗，

we could give her a pill or an injection of a resilience enhancer

我們可以給她一顆藥丸

或注射復原力增強疫苗。

before she leaves.

So when she is held at gunpoint by looters or worse,

當她被搶劫者持槍恐嚇 或遇到更糟的情況時，

she would at least be protected against developing depression or PTSD

至少可以防止在事後患上憂鬱症

或創傷後壓力症候群。

after the fact.

It won't prevent her from experiencing the stress,

復原力增強劑不能阻止 她經歷這種壓力，

but it will allow her to recover from it.

但會讓她從中恢復過來。

And that's what's revolutionary here.

這就是革命性的所在。

By increasing resiliency,

通過提高對壓力的彈性，

we can dramatically reduce her susceptibility to depression and PTSD,

我們可以大大降低她憂鬱症 和創傷後壓力症的發病機率，

possibly saving her from losing her job, her home, her family or even her life.

可能挽回她失去工作、家庭、 家人，甚至是她的生命。

After Jenner discovered the smallpox vaccine,

詹納發現天花疫苗後，

a lot of other vaccines rapidly followed.

許多其他疫苗迅速接連地問世。

But it was over 150 years

但過了 150 多年，

before a tuberculosis vaccine was widely available.

結核病疫苗才被廣泛、普及地使用。

Why?

為什麼呢？

In part because society believed

部分原因是社會相信

that tuberculosis made people more sensitive and creative and empathetic.

結核病使人們更敏感、 富創造性和同理心。

And that it was caused by constitution and not biology.

它是由體質，而非生物學所引發的。

And similar things are still said today about depression.

現今對憂鬱症仍然有著類似的想法。

And just as Jenner's discovery opened the door

正如詹納的發現

為之後的疫苗開啟了大門；

for all of the vaccines that followed after,

the drugs we've discovered open the possibility of a whole new field:

而我們發現的藥物， 可能開啟了一個全新領域：

preventative psychopharmacology.

預防性精神藥理學。

But whether that's 15 years away,

但結果是否要等 15 年，

or 150 years away,

或 150 年，

depends not just on the science,

不僅僅取決於科學，

but on what we as a society choose to do with it.

而是我們這個社會 選擇要如何看待處理 。

Thank you.

謝謝。

(Applause)

（掌聲）