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抗抑郁药效果不好,为何仍如此流行?

2016-06-17 MedSci MedSci原创

一项研究对抗抑郁药的作用产生了怀疑。最新研究发现,对于儿童和青少年,几乎所有抗抑郁药物都没有作用。那么在英国,为什么抗抑郁药的使用会继续攀升呢?以前的研究表明,轻度或中度抑郁症的成人患者,应用百忧解类抗抑郁药,比如选择性5-羟色胺再摄取抑制剂(SSRIs),效果不优于安慰剂。令人困惑的是,其他的研究发现,这些药物有作用。例如,最近的一项研究发现,在重度抑郁的成人患者中,SSRIs优于安慰剂。但有理

一项研究对抗抑郁药的作用产生了怀疑。最新研究发现,对于儿童和青少年,几乎所有抗抑郁药物都没有作用。那么在英国,为什么抗抑郁药的使用会继续攀升呢?

以前的研究表明,轻度或中度抑郁症的成人患者,应用百忧解类抗抑郁药,比如选择性5-羟色胺再摄取抑制剂(SSRIs),效果不优于安慰剂。

令人困惑的是,其他的研究发现,这些药物有作用。例如,最近的一项研究发现,在重度抑郁的成人患者中,SSRIs优于安慰剂。

但有理由认为,除非研究人员没有联系制药公司,并且分析所有试验数据,否则我们可能无法相信大多数的研究。

去年葛兰素史克曾揭示关于青少年研究的完整数据,比如自杀等副作用的发生比它最初显现的高。

尽管有很多的争议,但这些药物的处方数量每年都在上升。在英国最贫困的地区,六分之一的人在使用抗抑郁剂。批评者说,虽然这些药物可以挽救那些严重抑郁症患者的生命,但是,每天悲伤的人应用的太泛滥了。如果抗抑郁剂的治疗作用有限,那么为什么它们这么受欢迎?

原因不明

给患者服用抗抑郁剂的家庭医生,可能会觉得没有什么别的东西可以给他的患者。英国指南说,访谈治疗应该是轻度抑郁症患者的首选,但是等待的时间可能超过一年,对今天痛苦挣扎的人没有太大的帮助。

并且,许多患者觉得这些药物是有帮助的。在5月份,英国议会跨党派小组药物依赖的会议上,伦敦大学学院精神病学家乔安娜指出,这很大一部分可能是安慰剂效应。

抗抑郁药的广泛使用一个因素可能是来自制造商的广泛的信念,即药物可以通过纠正大脑中的化学物质的失衡。据说提高了让人感觉良好的化学物质,5-羟色胺的水平。

这可能不是真的。虽然药物确实增加了这种化学物质,但从未被证明抑郁症是由低5-羟色胺引起。事实上,虽然理论丰富,我们仍然不知道是什么原因导致抑郁症。

抗抑郁药确实改变了我们的感觉,一些人发现服用抗抑郁及有效,但有些人则发现无效。有用的。应用者倾向应用抗抑郁剂平化他们的情绪。

但这并不意味着抗抑郁药正在纠正化学物质的失衡。毕竟,许多人发现,酒精可以帮助他们放松,并感到不那么害羞,但这并不是因为纠正在大脑中的酒精缺乏引起的。

戒断症状


“化学失衡”的神话可能鼓励一些人服用药物。但是不可掉以轻心,因为抗抑郁药有一些缺点。

不同于上世纪60年代流行的苯二氮卓类药物,已经很大程度地取代苯二氮卓类的抗抑郁药应该是非成瘾。事实上,有些人发现很难停药,试图停药可以触发戒断症状,如焦虑和失眠。

官方的说法是,这表明该人仍然是抑郁的,仍需要长期治疗。如果慢慢地减少剂量,许多人可以停药药物。

药物也可以有副作用,如性冲动的丧失和体重增加。最令人担忧的是,可触发一些人暴力或自杀的想法。最新的研究表明,所有的抗抑郁药中,文拉法辛是最易使青少年自杀。

这项最新研究的团队抱怨说,由于缺乏数据,他们无法评估其他药物对患者自杀情况的评估。

因此,只有当研究人员能够从临床试验中获得所有的数据时,才可能发现服用抗抑郁剂的风险与效益的真正平衡,但这些药物的制造商仍在拒绝临床研究者获得所有临床试验的数据。

原始出处:

If antidepressants don’t work well, why are they so popular? New Scientist. 9 June 2016

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    2016-11-03 lsndxfj
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    2016-11-14 wetgdt
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    2016-06-18 沉心多思

    好文章,值得学习

    0

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    2016-06-17 hl573567

    现在人们面对的压力太大了,因为欲望永远的不到满足,精神紧张,好多人都有抑郁症,唉!

    0

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