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2015-01-09 15:26:46|  分类: 健康保健 |  标签: |举报 |字号 订阅

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Before discussing natural products to use for stress, anxiety, and insomnia, it is important to mention that often people suffering from these conditions also suffer from depression, and vice-versa. This often reflects low levels of brain serotonin, an important neurotransmitter (a chemical messenger responsible for transmitting information from one nerve cell to another). Serotonin has been referred to as the brain’s own mood-elevating and tranquilizing drug. There is a lot of support for this sentiment. Because the manufacture of serotonin in the brain is dependent upon how much tryptophan is delivered to the brain, in experimental studies researchers can remove tryptophan from the subject’s diet and observe the effect it has. The results from these sorts of studies have contributed greatly to our understanding of just how vital proper levels of serotonin are to a positive human experience. Table 7.1 contrasts the different effects of optimal vs. low serotonin levels.


The lower the level of serotonin, the more severe the consequences. For example, low levels of serotonin are linked to depression with the lowest levels being observed in people who have committed or attempted suicide.


2. Antidepressant drugs


In the treatment of depression conventional medicine primarily focuses on increasing the effects of serotonin. Once serotonin is manufactured in the brain it is stored in nerve cells waiting for release. Once released, the serotonin carries a chemical message by binding to receptor sites on the neighboring nerve cell. Almost as soon as the serotonin is released enzymes are at work that will either break down the serotonin or work to uptake the serotonin back into the brain cells. Either event terminates the serotonin effect. It is at this point that various drugs typically work, either inhibiting the reuptake of serotonin or preventing its breakdown. Most popular drugs of this type are referred to as SSRIs, short for Selective Serotonin Reuptake Inhibitors (see chart below). As a result of inhibiting serotonin reuptake, there is more serotonin hanging around capable of binding to receptor sites and transmitting the serotonin effect.

在治疗抑郁症中,传统医学主要集中在增加血清素的影响方面。一旦大脑中血清素生产,它存储在神经细胞等待释放。一旦释放,血清素传递绑定到相邻的神经细胞受体部位的化学信息。几乎只要血清素被释放,酶就在工作,它要么分解血清素或操作血清素返回脑细胞。或者事件终止血清素的作用。在这一点上,各种药物通常起作用,抑制血清素的再摄取或防止其分解。最流行的这类药物被称为SSRIs,简称为选择性5 -羟色胺再摄取抑制剂(见下图)。由于抑制5 -羟色胺再摄取,有更多的血清素悬挂在能够绑定到受体部位的周围并和传输5 -羟色胺的效果。

The effectiveness of antidepressant drugs has been the subject of several reviews. The results indicate that they have not been shown to work any better than placebo in cases of mild to moderate depression (the most common reason for prescription medication), and claims that antidepressants are more effective in more severe conditions have little evidence to support them. In fact, the research indicates that SSRIs and other antidepressant drugs might actually increase the likelihood of suicides in adults and children.


An additional alarming finding is that 25% of patients taking antidepressants do not even have depression or a diagnosable psychiatric problem.  So the bottom line is that millions of people are using antidepressants for a problem they do not have, and for the people who have a diagnosable condition, these medications do not work in most cases anyway and may cause significant side effects. As one group of researcher concluded, “Given doubt about their benefits and concern about their risks, current recommendations for prescribing antidepressants should be reconsidered.” This statement is a clear mandate to consider using natural medicine as a way to deal with the causes of these mood disorders.

另外一个令人震惊的发现是,有25%的患者服用抗抑郁药物甚至没有抑郁或可诊断的精神问题。 所以底线是,对于没有这方面问题的人,数以百万计的正在使用抗抑郁药的人;而对于那些有可诊断状态的人,这些药物在大多数情况下不起作用,并可能会导致重大的副作用。作为一组研究者总结道,鉴于怀疑他们的好处和风险的担忧,目前建议对于处方抗抑郁药应该重新考虑。这句话是一个明确的授权考虑使用天然药物来处理这些情绪障碍的原因。


While antidepressant drugs are at best only marginally successful in alleviating depression, they do produce many side effects. Approximately 20% of patients experience nausea; 20% headaches; 15% anxiety and nervousness; 14% insomnia; 12% drowsiness; 12% diarrhea; 9.5% dry mouth; 9% loss of appetite; 8% sweating and tremors; and 3% rashes. SSRIs also definitely inhibit sexual function. In studies where sexual side effects were thoroughly evaluated, 43% of men and women taking SSRIs reported loss of libido or diminished sexual response. There is also a significant risk for weight gain and the development of type 2 diabetes.

虽然抗抑郁药物是在最好的情况下仅略微成功缓解抑郁,它们产生许多副作用。大约有20%的患者恶心;20%的头痛;15%的焦虑和紧张, 14%的失眠;12%的嗜睡; 12%的腹泻;9.5%的口干; 9%的食欲不振;8%的出汗和震动;3%的皮疹。SSRI也肯定会抑制性功能。在性副作用的研究中做了彻底的评估,服用SSRI43%的男性和女性报告无性欲或性反应减弱。还有一个重要的风险是体重增加和2型糖尿病的发展。

3. Alternatives to SSRIs


There are effective alternatives to antidepressant drugs. For example, there are a number of lifestyle and dietary factors that lead to reduced serotonin levels. Chief among these factors are cigarette smoking, alcohol abuse, a high sugar intake, too much protein, blood sugar disturbances (hypoglycemia and diabetes), and various nutrient deficiencies. All of these factors have one thing in common – they lower serotonin levels by impairing the conversion of tryptophan to serotonin. A health-promoting lifestyle and diet go a long way towards restoring optimal serotonin levels and relieving depression. But, in the interim, natural agents like 5-HTP, S-adenosylmethionine (SAMe), or lavender extract can provide the boost in mood needed to help make important changes in diet and lifestyle easier to accomplish. Both natural agents are discussed below and a program for weaning off of SSRIs is given on page 84.

现在有有效的抗抑郁药物的替代品。例如,有许多导致血清素水平降低的生活方式和饮食因素。其中最主要的因素是吸烟、酗酒、高糖摄入、过多的蛋白质、血糖紊乱(低血糖和糖尿病)和各种营养素缺乏症。所有这些因素都有一个共同点 他们通过削弱色氨酸转化为5-羟色胺降低了5-羟色胺水平。一个促进健康的生活方式和饮食对恢复最佳的血清素水平和缓解抑郁症大有帮助。但是,在此期间,天然药剂像5-HTP、山姆医(SAMe)或者薰衣草提取物可以提供所需的提振情绪以帮助做出重要改变饮食和生活方式更容易实现。以下讨论天然药剂和替代SSRI的计划。

4. 5-hyDroxytryPtoPhan (5-htP)


5-HTP is the direct building block for serotonin. It exerts significant advantages over L-tryptophan. While only 3% of an oral dose of L-tryptophan is converted to serotonin, more than 70% of an oral dose of 5-HTP is converted to serotonin. In addition to increasing serotonin levels, 5-HTP causes an increase in endorphin levels. Numerous double-blind studies have shown that 5-HTP is equal to SSRIs and tricyclic antidepressants in terms of effectiveness, but is less expensive, better tolerated, and associated with fewer and much milder side effects.

5-HTP5-羟色胺的直接构建块。它和左旋色氨酸相比有显著的优势。在只有3%的口服剂量的左旋色氨酸转化为5 -羟色胺的同时,超过70%的口服剂量的5-HTP转化为5-羟色胺。除了增加5-羟色胺的水平,5- HTP也是导致内啡肽水平增加的原因。无数双盲研究表明,在5-HTP等效于SSRIs和三环类抗抑郁药物的有效性,但更便宜,更好的耐受性,并和较少的和更温和的副作用有关。

In many studies of depression, researchers use a rating scale called the Hamilton Depression Scale (HDS). The HDS score is determined by having

the test subject complete a series of questions in which he or she rates the severity of symptoms on a numerical basis, as follows:


1 – present but mild 存在,但轻微

2 – moderate 中等程度的

3 – severe 严重的

4 – very severe 非常严重


Symptoms assessed by the HDS include depression, feelings of guilt, insomnia, gastrointestinal symptoms, and other bodily symptoms of depression (e.g., headaches, muscle aches, heart palpitations), and anxiety. The HDS is popular in research because it provides a good assessment of the overall symptoms of depression. Table 7.3 shows the results of a study comparing 5-HTP to tryptophan and a placebo.



Table 1. – Hamilton Depression Scale from a comparative study of 5-HTP, Tryptophan, and Placebo

表1.   5-HTP、色氨酸和安慰剂的汉密尔顿抑郁量表的比较研究









Beginning of the study研究开始




End of the study (30 days) 研究结束(30天)





In another study, 5-HTP was compared with the SSRI fluvoxamine (Luvox). Fluvoxamine is used primarily in the United States as a treatment for obsessive compulsive disorder (OCD), an anxiety disorder characterized by obsessions and compulsions affecting an estimated 5 million Americans. Fluvoxamine exerts antidepressant activity comparable to (if not better than) other SSRIs like Prozac, Zoloft, and Paxil. In the study, subjects received either 5-HTP (100 mg) or fluvoxamine (50 mg) three times daily for six weeks. The assessment methods used to judge effectiveness included the HSD, the self-assessment depression scale (SADS), and physicians’ assessments (Clinical Global Impression). As indicated in Table 7.4, the percentage decrease in depression was slightly better in the 5-HTP group (60.7% vs. 56.1%). The 5-HTP was quicker-acting than the fluvoxamine, and a higher percentage of patients responded to 5-HTP than to fluvoxamine.



Table 2 – Improvement in Specific Depression Symptoms

表 2.  特定的抑郁症状的改善







Depressed mood








Physical Symptoms





The advantages of 5-HTP over fluvoxamine were really evident when looking at the subcategories of the HDS: depressed mood, anxiety, physical symptoms, and insomnia, as shown in Table 7.4. However, perhaps more important than simply relieving insomnia is 5-HTP’s ability to improve the quality of sleep. By contrast, antidepressant drugs greatly disrupt sleep processes.

当从HDS的子分类(抑郁情绪、焦虑、身体症状、失眠,如表7.4所示)看时,5-HTP相对在氟伏沙明的优势很明显。然而,或许比简单缓解失眠更重要的是 5-HTP提高睡眠质量的能力。相比之下,抗抑郁药物大大干扰睡眠的过程。


The bottom line is that 5-HTP is equal to or better than standard antidepressant drugs, and the side effects are much less severe. In addition, many people prefer to use a natural substance like 5-HTP rather than synthetic drugs.



In the study comparing 5-HTP with fluvoxamine, here is how the physicians described the differences among the two groups: “Whereas the two treatment groups did not differ significantly in the number of patients experiencing side effects, the interaction between the degree of severity of the side effects and the type of medication was highly significant: fluvoxamine predominantly produced moderate to severe side effects, and 5-HTP produced primarily mild forms of side effects. Fourteen (38.9%) of the patients receiving 5-HTP reported side effects compared with 18 patients (54.5%) in the fluvoxamine group. The most common side effects with 5-HTP were nausea, heartburn, and gastrointestinal problems (flatulence, feelings of fullness, and rumbling sensations). These side effects were rated as being very mild to mild. In contrast, most of the side effects experienced in the fluvoxamine group were of moderate to severe intensity. The only subject to drop out of the 5-HTP group did so after five weeks, while four subjects in the fluvoxamine group dropped out after only two weeks. On the basis of studies on weight loss, the longer 5-HTP is used (e.g., after 4–6 weeks of use), the less the problem with mild nausea.” 

该研究比较了5-HTP和氟伏沙明,以下就是医生描述了两组之间的差异:“这两个治疗组中出现副作用的患者数量、副作用的严重程度和药物的类型之间的相互作用没有显著差异是非常重要的:氟伏沙明主要产生中度到重度的副作用,而5-HTP主要产生温和形式的副作用。14(38.9%)接受5-HTP的患者报告有副作用,而氟伏沙明组的患者有18(54.5%)。服用5-HTP最常见的副作用是恶心、胃灼热、肠胃问题(肠胃气胀、饱腹感和隆隆的感觉)。这些副作用被认为是非常温和的。相比之下,氟伏沙明组经受的大多数的副作用是中度至重度的强度。5-HTP组在五周后仅有一个受试者退出,而四氟伏沙明组的受试者仅两周后有4个受试者退出。基于减肥的研究,时间越长5-HTP(如使用4 - 6周后),轻度恶心的问题就越少。


 (编译自《压力、焦虑和失眠》,作者 Michael T. Murray, N.D

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