超三分之一的美国人因服用药物增加了患抑郁症几率

More than a third of American adults are taking prescription drugs, including hormones for contraception, blood pressure medications and medicines for heartburn, that carry a potential risk of depression, according to a study published in the Journal of the American Medical Association.

据一篇刊登在《美国医学协会杂志》上的报告指出，三分之一的美国人因为服用如避孕药、降血压和抗酸剂等处方药增加了患抑郁症的几率。

The study found that people who took multiple drugs associated with a possible increased risk of depression were also more likely to be depressed, but researchers couldn’t distinguish whether the medications were the cause. It’s possible people already had a medical history of depression prior to taking the drugs, or the medical conditions they were being treated for could have contributed to their depression.

研究发现，那些服用可能增加抑郁风险的多种药物的人群更容易抑郁，但研究人员无法区分它是否是由药物引起。有可能是这些人在服用这些药物前已经有抑郁病史，也有可能是由他们所服用的药物引起。

The work is part of a provocative and growing body of research that documents how polypharmacy — the use of multiple prescription drugs at the same time — has risen in the United States. The number of Americans taking at least five prescription drugs at the same time rose sharply between 1999 and 2012, and the elderly are particularly at risk for dangerous interactions between drugs.

这项研究是一个具有争议性的、不断增长的研究机构的一部分，该机构记录了美国的多重用药(同时使用多种处方药)是如何不断增长的。从1999年到2012年，同时服用至少五种处方药的美国人数量急剧增加，在不同药物之间产生的危险互动中，老年人的风险尤其高。

The study examined drugs that list possible adverse side effects including depression and suicide, but that does not mean the link was always well-characterized — or that people should stop taking a drug that could be helping them. Painkillers and antidepressants were listed, which could be related to underlying reasons for the depression.

这项研究检查了可能会导致抑郁和自杀等副作用的药物，但这并不意味着两者之间一定是有联系的——或者人们应该停止服用这些能帮助他们的药物。止痛药和抗抑郁药物也在名单之中，它们可能与抑郁症的潜在原因有关。

Dima Qato, an assistant professor at the University of Illinois at Chicago College of Pharmacy who led the study, said that while there has been attention to social factors that increase risk for depression, there is often little attention to the role of medications.

该文的第一作者、芝加哥伊利诺伊大学的一名助理教授迪马·卡托说，人们已经关注了抑郁症风险不断增加的社会因素，但对药物的作用却少有关注。

“We know polypharmacy is growing, we know it is not always promoting good health and longevity in patients, and we know a lot of drugs have certain adverse effects — and one of them is depression and suicidal symptoms,” Qato said. “As a pharmacist, when a patient comes in and reports depressive symptoms, I just think it’s really important to think about what other medications they are on.”

他说:“我们知道，多重用药正在不断增加，我们知道它并非一定可以让病人得到健康和长寿，我们也知道很多药物都有一定的副作用——其中之一就是抑郁和自杀症状。作为一名药剂师，当病人出现抑郁症状时，我要想，要了解一下病人同时还在服用什么药物是非常重要的。”

The study analyzed a detailed survey of thousands of American adults taken every two years between 2005 and 2014, in which people opened their medicine cabinets and showed researchers all the prescription drugs they had taken in the last month. They were also assessed for depression.

该研究自2005年至2014年间每两年对数千名美国成年人进行了调查。调查中，人们打开药箱，向研究人员展示他们上个月服用的所有处方药，并且对他们进行了抑郁评估。

Over the decade, Qato and colleagues found that 37 percent of U.S. adults, on average, took medications associated with a side effect of depression.

过去十年来，卡托和他的同事们发现，平均37%的美国成年人服用的药物中其副作用之一是抑郁症。

The team also found that the number of people taking at least three medications that carried a potential side effect of depression increased over the survey time period, from 6.9 percent in the 2005-2006 survey to 9.5 percent in 2013-2014. The rate of depression tripled in people taking at least three medications with a possible side effect, compared to people taking no drugs with that side effect.

研究小组还发现，在调查期间，服用至少带有三种潜在抑郁症副作用药物的人数有所增加，从2005-2006年调查的6.9%上升至2013-2014年的9.5%。与服用没有这些副作用的药物的人相比，服用至少三种药物的人患抑郁症的几率增加了两倍。

Michael Steinman, a professor of medicine at the University of California at San Francisco, pointed out that for many drugs, the risk of depression as a side effect is not well understood and may even be controversial. Studies have shown mixed evidence, for example, about a link between commonly taken high blood pressure drugs called beta blockers and depression.But even if doctors don’t have definitive proof that a particular drug is causing a depression, the study is a reminder that physicians should consider the role of medications — particularly for patients on multiple medications associated with increased risk of an adverse side effect, which the study shows are commonly used.

加州大学旧金山分校的医学教授迈克尔.斯坦曼指出，对于许多药物来说，抑郁症作为副作用的风险尚未得到充分理解，甚至可能存在争议。例如，研究表明，常见的高血压药物——β-受体阻滞药和抑郁症之间存在联系。但即使医生没有明确的证据证明某种特定的药物会导致抑郁,这项研究仍提醒我们,医生应该考虑药物的作用——特别是对于服用研究中显示的常见的多种药物的患者，这些药物会增加副作用的风险。

“It should up the ante about having the conversation about whether a medication is really helpful,” Steinman said. “A lot of times, people stay on medications for a long time. It’s easier to continue than to stop them. It’s a reminder to always be thinking: does this person really need this medication?”

斯坦曼说：“我们应该就药物是否真的有用展开讨论。很多时候，人们长期依赖于药物。要停止服用其实是比较难的。这就提醒我们要时刻思考:这个人真的需要这种药物吗?”

Qato said that pharmacists stick labels on pill bottles, warning that drugs increase the risk of drowsiness, that people should take food or not drink alcohol with a certain medication, but that many patients — and doctors — may be unaware of the depression risks of certain prescription drugs.

卡托说，药剂师在药瓶上贴上标签，警告说药物会增加嗜睡的风险，人们应随餐服药，或者吃某种药物时不能喝酒，但是很多病人——包括医生——可能都没意识到一些处方药的抑郁风险。

“Even if the same doctor is prescribing drugs, the fact is that it’s really difficult — there’s no software that tells a doctor, ’your patient is on three drugs that predispose them or are associated potentially with depression or suicidal symptoms,’” Qato said.

“即使是同一位医生在开药，事实是这真的很困难——没有软件能告诉医生，‘你的病人正在服用三种药物，这些药物会使他们提前死亡，或者可能会与抑郁或自杀症状有关，’”卡托称。