The results of two new studies may signal a substantial shift in the way psychiatrists and researchers think about treatment for severely depressed patients.

兩項(xiàng)研究結(jié)果將可能從根本上改變精神病醫(yī)生和研究人員在重癥抑郁癥患者的治療方法上的思路。

In one, government researchers found that an injection of a powerful anesthetic drug dissolved feelings of despair in a small group of severely depressed patients in a matter of hours, and that the effect lasted for up to a week in some participants.

第一項(xiàng)是政府的研究人員發(fā)現(xiàn)，給小部分重癥抑郁癥患者注射強(qiáng)效麻醉劑可以在大約1小時(shí)內(nèi)緩解他們的絕望情緒；對(duì)于某些患者，這種效果甚至可以持續(xù)一個(gè)禮拜。

Doctors cautioned that the study was very small, and that the drug, ketamine, is a tightly controlled substance sometimes used as a club drug that can cause hallucinations, confusion and dangerous reactions, especially when ingested in unknown doses.

醫(yī)生警告說(shuō)這是一項(xiàng)小范圍的實(shí)驗(yàn)，所使用的麻醉劑克他命是一種受到嚴(yán)格監(jiān)控的藥物。這種藥物有時(shí)候在一些俱樂(lè)部里用作迷幻藥，它能夠使人產(chǎn)生幻覺(jué)，意識(shí)模糊甚至產(chǎn)生其他非常危險(xiǎn)的反應(yīng)，尤其是在吸入劑量不當(dāng)?shù)那闆r下。

In the other, psychiatrists in New York found evidence that antidepressant drugs significantly increased the risk that some children and adolescents would attempt or commit suicide. Doctors have debated this risk for years, but the authors of the study were skeptical of it, and their report may sway others.

另外一項(xiàng)是紐約的精神病醫(yī)生發(fā)現(xiàn)抗抑郁藥物明顯增加了兒童和青少年采取自殺行為的風(fēng)險(xiǎn)。醫(yī)生們就這一風(fēng)險(xiǎn)辯論了數(shù)年，但研究報(bào)告的作者對(duì)是否有必要繼續(xù)辯論表示懷疑，他們的報(bào)告會(huì)改變一些人的立場(chǎng)。

Both studies are being published in The Archives of General Psychiatry.

兩項(xiàng)研究報(bào)告都在《普通精神醫(yī)學(xué)紀(jì)要》中出版。

In the first study, Dr. Carlos A. Zarate of the National Institute of Mental Health led a team of researchers who treated 18 chronically depressed men and women with the anesthetic ketamine.

在第一項(xiàng)研究中，美國(guó)國(guó)家心理健康研究所卡洛斯·A·扎拉博士領(lǐng)導(dǎo)的研究人員們用麻醉劑克他命治療了18例慢性抑郁癥男女患者。

Five participants recovered from depression in the first day and were still significantly improved a week later. Most patients also received a placebo treatment during the study, an injection of saline solution, and showed no improvement.

5例患者在接受治療的第一天就有所恢復(fù)，并在一周以后明顯改善。大多數(shù)患者在研究過(guò)程在中同時(shí)還接受了安慰劑治療，即一種鹽溶劑注射劑，但沒(méi)有什么效果。

Dr. Zarate said experimenting with novel approaches was crucial because the current crop of antidepressant drugs worked slowly and weakly, if at all, for millions of patients.

扎拉博士說(shuō)，新的治療方法的實(shí)驗(yàn)至關(guān)重要，因?yàn)楝F(xiàn)行的抗抑郁劑藥物對(duì)數(shù)百萬(wàn)的患者來(lái)講，即便有效，其效果也很慢，作用也很小。

Ketamine affects the brain in a way entirely different from drugs like Prozac, and it has shown some antidepressant effects in animal studies. It had not been tried for depression in humans.

克他命對(duì)大腦的影響與其他藥物像普羅薩克（氟苯氧苯胺）完全不同。克他命在動(dòng)物實(shí)驗(yàn)中已經(jīng)表現(xiàn)出了抗抑郁效果，在目前還沒(méi)有用于人類抑郁癥的治療。

“What the study tells us is that we can break this sound barrier, in effect, and get an almost immediate response that we cannot get with other drugs,”Dr. Zarate said.

“通過(guò)研究，我們知道我們可以在治療上打破局限，將其用于人類抑郁癥的治療，同時(shí)我們迅速得出結(jié)論：我們沒(méi)有別的更好的藥物可用。”

Ketamine is not approved for depression, and it has a checkered past in psychiatric research. The drug often induces hallucinations, like whispering voices and light trails, and researchers used it in the 1990's to induce psychotic reactions in people with schizophrenia-an experiment widely criticized as unethical.

克他命沒(méi)有獲得允許用于治療抑郁癥，在精神病研究方面過(guò)去一直充滿變數(shù)。該藥物通常會(huì)導(dǎo)致出現(xiàn)幻覺(jué)，像聽(tīng)到低低的聲音或看見(jiàn)燈光的痕跡。研究人員在20世紀(jì)90年代曾使用克他命誘導(dǎo)精神分裂癥患者的精神反應(yīng)，但這一實(shí)驗(yàn)卻遭到廣泛的批判，被認(rèn)為是違背了職業(yè)道德。

Dr. Zarate said that neither doctors nor patients should use it for depression outside of carefully controlled research settings and that the results of the current trial should be considered suggestive.“This drug should be seen as a tool for understanding what mechanisms might be involved in rapid relief,”and not as a treatment, Dr. Zarate said.

扎拉博士認(rèn)為，無(wú)論是病人還是醫(yī)生都絕對(duì)不可以在沒(méi)有進(jìn)行嚴(yán)格的醫(yī)學(xué)實(shí)驗(yàn)的前提下使用克他命治療抑郁癥，本次的實(shí)驗(yàn)結(jié)果只能作為參考。扎拉博士表示：“該藥物應(yīng)該被看作是一種工具，幫助我們了解何種藥物可以快速起效，”但不能作為一種治療方法。

The study of suicide risk, led by Dr. Mark Olfson of Columbia University and the New York State Psychiatric Institute, was based on an analysis of Medicaid records of more than 4,400 people who were hospitalized for depression in 1999 and 2000.

自殺危機(jī)的研究是由哥倫比亞大學(xué)的馬克·奧佛森博士和紐約州立精神病研究所牽頭，依據(jù)1999年2000年因抑郁癥住院的4400多人的醫(yī)療記錄進(jìn)行分析。

The researchers found no link between the antidepressant drugs and suicidal behavior in depressed patients 19 or older. But children and adolescents in the study who were taking antidepressants were about 50 percent more likely than those not on the drugs to try to kill themselves. And they were about 15 times as likely as those not on the medications to complete the act, although the number of suicides was too small to draw definitive conclusions, the authors cautioned.

研究人員發(fā)現(xiàn)抗抑郁劑和自殺行為在19歲或更大年齡的患者身上二者沒(méi)有聯(lián)系。但是服用抗抑郁劑的兒童和青少年比未服用看抑郁劑的兒童和青少年嘗試采取自殺行為的比例要高50%.報(bào)告的作者警告說(shuō)，盡管自殺的人數(shù)很少，還不足以得出最終的結(jié)論，但他們實(shí)施和完成自殺行為是未服用藥物的兒童和青少年的15倍。

In addition, there could be differences between the two groups that the Medicaid records didn't reveal：the children who received the drugs may have been more severely ill, skewing the results, they said.

除此之外，他們說(shuō)，還有一些區(qū)別醫(yī)學(xué)記錄并沒(méi)有揭示：接受藥物治療的兒童可能已經(jīng)病情十分嚴(yán)重了，這也使得研究結(jié)果有所偏離。

In 2004, the Food and Drug Administration required strong warnings on the labels of antidepressant drugs alerting parents and doctors of a possible suicide risk in some children. Since then many psychiatrists have been skeptical of the suicide link.

在2004年，國(guó)家食品藥品監(jiān)督管理局要求在康抑郁劑商標(biāo)上鄭重提醒父母和醫(yī)生防止一些兒童因此產(chǎn)生的自殺危機(jī)。從那時(shí)開(kāi)始，許多精神病醫(yī)師就開(kāi)始懷疑抗抑郁劑與自殺是否存在聯(lián)系。

“I was surprised by what we found,”Dr. Olfson said.“I set out thinking we'd find that the drugs”significantly reduced suicide risk.

奧弗森博士說(shuō)：“我們的研究結(jié)果讓我很吃驚。我開(kāi)始琢磨我們得找到明顯降低自殺風(fēng)險(xiǎn)的藥物。”

The findings may prompt researchers to look at which children are most at risk, rather than continuing to debate whether the risk exists, he said.

他指出，研究結(jié)果將促使研究人員去研究那些兒童面臨的自殺風(fēng)險(xiǎn)最大，而不是沒(méi)完沒(méi)了的辯論這種風(fēng)險(xiǎn)是否存在。