TEDxNewYork
Rebecca Brachman: Could a drug prevent depression and PTSD?
Rebecca Brachman: Pode un fármaco previr a depresión e o estrés postraumático?
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O camiño cara a un novo fármaco está empedrado con descubrimentos accidentais. Neste conto ben contado de como se produce a ciencia, a neurocientífica Rebecca Brachman comparte noticias dun tratamento innovador atopado de forma fortuíta que pode previr o desenvolvemento de trastornos mentais como a depresión ou o estrés postraumático. E agarda atento por un inesperado --e controvertido-- xiro.
Rebecca Brachman - Neuroscientist, writer, entrepreneur
Rebecca Brachman is a pioneer in the field of preventative psychopharmacology, developing drugs to enhance stress resilience and prevent mental illness. Full bio
Rebecca Brachman is a pioneer in the field of preventative psychopharmacology, developing drugs to enhance stress resilience and prevent mental illness. Full bio
Double-click the English transcript below to play the video.
00:13
This is a tuberculosis ward,
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Este é un pavillón de tuberculosos,
00:16
and at the time this picture was taken
in the late 1800s,
in the late 1800s,
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e cando se tomou a foto,
a finais do século XIX,
a finais do século XIX,
00:19
one in seven of all people
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unha de cada sete persoas
00:22
died from tuberculosis.
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morría de tuberculose.
00:24
We had no idea
what was causing this disease.
what was causing this disease.
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Non tiñamos nin idea de que
estaba a causar esta enfermidade.
estaba a causar esta enfermidade.
00:28
The hypothesis was actually
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A hipótese era, de feito,
00:30
it was your constitution
that made you susceptible.
that made you susceptible.
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que a nosa constitución
nos facía susceptibles.
nos facía susceptibles.
00:33
And it was a highly romanticized disease.
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E foi unha enfermidade moi idealizada.
00:36
It was also called consumption,
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Chamóuselle “tise”,
00:39
and it was the disorder of poets
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e era a doenza dos poetas,
00:42
and artists and intellectuals.
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dos artistas e dos intelectuais.
00:45
And some people actually thought
it gave you heightened sensitivity
it gave you heightened sensitivity
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E había quen pensaba que te transportaba
a unha maior sensibilidade
a unha maior sensibilidade
00:48
and conferred creative genius.
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e che outorgaba un xenio creativo.
00:52
By the 1950s,
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Durante a década dos 50,
00:54
we instead knew
that tuberculosis was caused
that tuberculosis was caused
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sóubose que a tuberculose estaba causada
00:57
by a highly contagious
bacterial infection,
bacterial infection,
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por unha infección bacteriana
moi contaxiosa,
moi contaxiosa,
01:00
which is slightly less romantic,
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o que era ben menos romántico,
01:03
but that had the upside
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pero tiña a vantaxe
01:05
of us being able to maybe
develop drugs to treat it.
develop drugs to treat it.
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de que se cadra podiamos
crear medicinas para tratala.
crear medicinas para tratala.
01:08
So doctors had discovered
a new drug, iproniazid,
a new drug, iproniazid,
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Os médicos descubriron un novo fármaco,
a iproniacida,
a iproniacida,
01:11
that they were optimistic
might cure tuberculosis,
might cure tuberculosis,
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coa que tiñan esperanzas
de curar a tuberculose;
de curar a tuberculose;
01:15
and they gave it to patients,
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así que lla deron aos pacientes,
01:16
and patients were elated.
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e os pacientes estaban eufóricos.
01:18
They were more social, more energetic.
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Estaban máis sociables, máis activos.
01:22
One medical report actually says
they were "dancing in the halls."
they were "dancing in the halls."
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Un informe médico indicaba que
eles estaban a "bailar polos corredores".
eles estaban a "bailar polos corredores".
01:27
And unfortunately,
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Por desgraza,
01:29
this was not necessarily
because they were getting better.
because they were getting better.
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isto non significaba
que estivesen mellorando.
que estivesen mellorando.
01:32
A lot of them were still dying.
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Moitos estaban morrendo.
01:35
Another medical report describes them
as being "inappropriately happy."
as being "inappropriately happy."
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Outro informe médico describiuno como
"indebidamente felices".
"indebidamente felices".
01:43
And that is how the first
antidepressant was discovered.
antidepressant was discovered.
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E así foi como se descubriu
o primeiro antidepresivo.
o primeiro antidepresivo.
01:47
So accidental discovery
is not uncommon in science,
is not uncommon in science,
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Polo tanto, os descubrimentos accidentais
non son raros na ciencia,
non son raros na ciencia,
01:52
but it requires more
than just a happy accident.
than just a happy accident.
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pero cómpre algo máis
ca un feliz accidente.
ca un feliz accidente.
01:55
You have to be able to recognize it
for discovery to occur.
for discovery to occur.
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Debes ser capaz de recoñecelo
para poder descubrilo.
para poder descubrilo.
01:59
As a neuroscientist,
I'm going to talk to you a little bit
I'm going to talk to you a little bit
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Como neurocientífica, vou falar un pouco
sobre a miña experiencia de primeira man
02:02
about my firsthand experience
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02:03
with whatever you want to call
the opposite of dumb luck --
the opposite of dumb luck --
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con como queirades chamarlle
ao contrario do puro azar,
ao contrario do puro azar,
02:06
let's call it smart luck.
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podemos chamarlle azar intelixente.
02:08
But first, a bit more background.
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Pero primeiro, un pouco máis de contexto.
02:12
Thankfully, since the 1950s,
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Afortunadamente, dende os anos 50,
02:15
we've developed some other drugs
and we can actually now cure tuberculosis.
and we can actually now cure tuberculosis.
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desenvolvemos outros fármacos
e agora podemos curar a tuberculose.
e agora podemos curar a tuberculose.
02:19
And at least in the United States,
though not necessarily in other countries,
though not necessarily in other countries,
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E polo menos nos Estados Unidos, aínda
que non necesariamente noutros países
que non necesariamente noutros países
02:22
we have closed our sanitoriums
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pechamos os nosos sanatorios
02:24
and probably most of you
are not too worried about TB.
are not too worried about TB.
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e probablemente á maioría de vós
non vos preocupe moito a tuberculose.
non vos preocupe moito a tuberculose.
02:28
But a lot of what was true
in the early 1900s
in the early 1900s
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Pero moito do que era certo
a principios do século XX.
a principios do século XX.
02:31
about infectious disease,
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sobre enfermidades infecciosas
02:33
we can say now
about psychiatric disorders.
about psychiatric disorders.
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pódese dicir agora
dos trastornos psíquicos.
dos trastornos psíquicos.
02:36
We are in the middle
of an epidemic of mood disorders
of an epidemic of mood disorders
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Estamos no medio dunha epidemia
de trastornos emocionais
de trastornos emocionais
02:39
like depression and post-traumatic
stress disorder, or PTSD.
stress disorder, or PTSD.
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coma a depresión
ou o estrés postraumático.
ou o estrés postraumático.
02:44
One in four of all adults
in the United States
in the United States
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Un de cada catro adultos nos EE. UU.
02:48
suffers from mental illness,
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sofre unha enfermidade mental,
02:50
which means that if you haven't
experienced it personally
experienced it personally
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o que significa que
se non a viviches en persoa
se non a viviches en persoa
02:53
or someone in your family hasn't,
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nin ninguén da túa familia a tivo,
02:55
it's still very likely
that someone you know has,
that someone you know has,
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é moi probable
que a teña alguén que coñezas,
que a teña alguén que coñezas,
02:58
though they may not talk about it.
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aínda que non fale dela.
03:02
Depression has actually now surpassed
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A depresión superou
03:05
HIV/AIDS, malaria, diabetes and war
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á sida, á malaria, á diabetes e á guerra
03:10
as the leading cause
of disability worldwide.
of disability worldwide.
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coma primeira causa
de discapacidade no mundo.
de discapacidade no mundo.
03:13
And also, like tuberculosis in the 1950s,
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E tamén, coma a tuberculose nos 50,
03:17
we don't know what causes it.
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non sabemos qué a provoca.
03:19
Once it's developed, it's chronic,
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Unha vez que se desenvolve, é crónica,
dura toda a vida,
03:21
lasts a lifetime,
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03:22
and there are no known cures.
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e non hai cura coñecida.
03:26
The second antidepressant we discovered,
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O segundo antidepresivo que descubrimos
03:28
also by accident, in the 1950s,
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tamén por accidente, nos anos 50,
03:31
from an antihistamine
that was making people manic,
that was making people manic,
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a partir dun antiestamínico
que estaba volvendo maníaca á xente,
que estaba volvendo maníaca á xente,
03:35
imipramine.
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foi a imipramina.
03:38
And in both the case of the tuberculosis
ward and the antihistamine,
ward and the antihistamine,
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E no caso do pavillón de tuberculosos
e mais no do antiestamínico,
e mais no do antiestamínico,
03:41
someone had to be able to recognize
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alguén se deu conta
03:43
that a drug that was designed
to do one thing --
to do one thing --
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de que o fármaco creado
para facer unha cousa,
para facer unha cousa,
03:46
treat tuberculosis
or suppress allergies --
or suppress allergies --
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--tratar a tuberculose
ou suprimir alerxias--
ou suprimir alerxias--
03:48
could be used to do
something very different --
something very different --
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podería usarse para algo moi diferente
--tratar a depresión.
03:51
treat depression.
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03:53
And this sort of repurposing
is actually quite challenging.
is actually quite challenging.
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Este tipo de redeseño
é bastante estimulante.
é bastante estimulante.
03:56
When doctors first saw
this mood-enhancing effect of iproniazid,
this mood-enhancing effect of iproniazid,
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Cando os médicos viron por primeira vez
como a iproniacida melloraba o ánimo,
como a iproniacida melloraba o ánimo,
04:00
they didn't really recognize
what they saw.
what they saw.
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non se decataron do que estaban vendo.
04:02
They were so used to thinking about it
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Estaban tan habituados a pensar
04:04
from the framework
of being a tuberculosis drug
of being a tuberculosis drug
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dende o marco de que era un fármaco
para a tuberculose
para a tuberculose
04:07
that they actually just listed it
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que se limitaron a anotalo
04:09
as a side effect, an adverse side effect.
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como un efecto secundario,
un efecto secundario negativo.
un efecto secundario negativo.
04:12
As you can see here,
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Como podedes ver aquí,
04:13
a lot of these patients in 1954
are experiencing severe euphoria.
are experiencing severe euphoria.
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moitos deses pacientes en 1954
estaban experimentando euforia extrema.
estaban experimentando euforia extrema.
04:18
And they were worried
that this might somehow interfere
that this might somehow interfere
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E eles estaban preocupados por se isto
podería interferir dalgún xeito
podería interferir dalgún xeito
04:22
with their recovering from tuberculosis.
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coa súa recuperación da tuberculose.
04:25
So they recommended that iproniazid
only be used in cases of extreme TB
only be used in cases of extreme TB
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Así que se recomendou que a iproniacida
se empregase só en tuberculoses extremas
se empregase só en tuberculoses extremas
04:31
and in patients that were
highly emotionally stable,
highly emotionally stable,
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e en pacientes que fose
moi estables emocionalmente,
moi estables emocionalmente,
04:36
which is of course the exact opposite
of how we use it as an antidepressant.
of how we use it as an antidepressant.
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que é o modo contrario
a como se emprega un antidepresivo.
a como se emprega un antidepresivo.
04:40
They were so used to looking at it
from the perspective of this one disease,
from the perspective of this one disease,
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Estaban tan habituados a velo
dende a perspectiva dunha soa doenza
dende a perspectiva dunha soa doenza
04:44
they could not see the larger implications
for another disease.
for another disease.
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que non podían ver as grandes implicacións
para outra distinta.
para outra distinta.
04:49
And to be fair,
it's not entirely their fault.
it's not entirely their fault.
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E sendo sinceros, non é só culpa súa.
04:52
Functional fixedness
is a bias that affects all of us.
is a bias that affects all of us.
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A fixación funcional é
un prexuízo que nos afecta a todos.
un prexuízo que nos afecta a todos.
04:54
It's a tendency to only
be able to think of an object
be able to think of an object
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É a tendencia de dar pensado nun obxecto
04:58
in terms of its traditional
use or function.
use or function.
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só en termos da súa función tradicional.
E o contexto mental é diferente, non si?
05:01
And mental set is another thing. Right?
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05:03
That's sort of this preconceived framework
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É con esta especie de marco preconcibido
05:05
with which we approach problems.
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con quen afrontamos os problemas.
05:07
And that actually makes repurposing
pretty hard for all of us,
pretty hard for all of us,
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E isto fainos moi complicado
facer ese redeseño,
facer ese redeseño,
05:10
which is, I guess, why they gave
a TV show to the guy who was,
a TV show to the guy who was,
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supoño que por iso lle deron
un programa de TV a un tipo
un programa de TV a un tipo
05:14
like, really great at repurposing.
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ao que se lle dá tan ben facelos.
05:16
(Laughter)
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(Risas)
05:19
So the effects in both the case
of iproniazid and imipramine,
of iproniazid and imipramine,
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Os efectos, nos dous casos,
da iproniacida e da imipramina
da iproniacida e da imipramina
05:23
they were so strong --
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foron tan fortes
que había maníacos,
ou persoas bailando polos corredores.
ou persoas bailando polos corredores.
05:24
there was mania,
or people dancing in the halls.
or people dancing in the halls.
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05:27
It's actually not that surprising
they were caught.
they were caught.
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Non é tan sorprendente que se detectasen.
05:30
But it does make you wonder
what else we've missed.
what else we've missed.
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Pero isto fai que te preguntes
qué máis pasamos por alto.
qué máis pasamos por alto.
05:35
So iproniazid and imipramine,
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A iproniacida e a imipramina,
05:37
they're more than just
a case study in repurposing.
a case study in repurposing.
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son máis que un caso de redeseño.
05:39
They have two other things in common
that are really important.
that are really important.
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Teñen en común outras dúas cousas
moi importantes.
moi importantes.
05:42
One, they have terrible side effects.
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Primeira: terribles efectos secundarios.
05:45
That includes liver toxicity,
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Entre outros, toxicidade hepática,
05:47
weight gain of over 50 pounds,
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incremento de peso de preto de 25 quilos,
05:50
suicidality.
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tendencias suicidas.
05:52
And two, they both
increase levels of serotonin,
increase levels of serotonin,
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E segundo: os dous aumentan
os niveis de serotonina,
os niveis de serotonina,
05:56
which is a chemical signal in the brain,
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que é un sinal químico no cerebro,
05:59
or a neurotransmitter.
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un neurotransmisor.
06:01
And those two things together,
right, one or the two,
right, one or the two,
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E se collemos as cousas xuntas,
--cada unha delas,
--cada unha delas,
separada non é tan importante--
06:03
may not have been that important,
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pero xuntas significaban que cumpría
desenvolver fármacos máis seguros,
desenvolver fármacos máis seguros,
06:05
but the two together meant
that we had to develop safer drugs,
that we had to develop safer drugs,
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06:09
and that serotonin seemed
like a pretty good place to start.
like a pretty good place to start.
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e que a serotonina parecía
un bo sitio para comezar.
un bo sitio para comezar.
06:13
So we developed drugs
to more specifically focus on serotonin,
to more specifically focus on serotonin,
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Por iso, desenvolvemos fármacos
que se centrasen máis na serotonina,
que se centrasen máis na serotonina,
06:17
the selective serotonin
reuptake inhibitors, so the SSRIs,
reuptake inhibitors, so the SSRIs,
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os inhibidores selectivos
de recaptación da serotonina (ISRS),
de recaptación da serotonina (ISRS),
06:21
the most famous of which is Prozac.
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o máis famoso dos cales é o Prozac.
06:24
And that was 30 years ago,
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Diso hai 30 anos,
06:26
and since then we have mostly
just worked on optimizing those drugs.
just worked on optimizing those drugs.
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e dende aquela viñémonos centrando
en mellorar eses fármacos.
en mellorar eses fármacos.
06:29
And the SSRIs, they are better
than the drugs that came before them,
than the drugs that came before them,
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E os ISRS son mellores ca os fármacos
que había antes ,
que había antes ,
06:32
but they still have a lot of side effects,
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pero aínda teñen
moitos efectos secundarios:
moitos efectos secundarios:
06:35
including weight gain, insomnia,
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suba de peso, insomnio,
06:38
suicidality --
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tendencias suicidas...
06:40
and they take a really long time to work,
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e tardan moito en facer efecto,
06:42
something like four to six weeks
in a lot of patients.
in a lot of patients.
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unhas catro ou seis semanas
en moitos pacientes.
en moitos pacientes.
E iso naqueles en que funcionan.
06:45
And that's in the patients
where they do work.
where they do work.
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Hai moitos pacientes
aos que estes fármacos non lles funcionan.
aos que estes fármacos non lles funcionan.
06:47
There are a lot of patients
where these drugs don't work.
where these drugs don't work.
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06:50
And that means now, in 2016,
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E iso significa que agora, en 2016,
06:53
we still have no cures
for any mood disorders,
for any mood disorders,
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aínda non temos cura
para ningún trastorno emocional,
para ningún trastorno emocional,
06:57
just drugs that suppress symptoms,
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só fármacos que suprimen síntomas,
06:59
which is kind of the difference between
taking a painkiller for an infection
taking a painkiller for an infection
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o que é como se para unha infección
tomamos un analxésico
tomamos un analxésico
07:03
versus an antibiotic.
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ou un antibiótico.
07:04
A painkiller will make you feel better,
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Co analxésico pódeste sentir mellor,
pero non vai facer nada
para tratar a enfermidade subxacente.
para tratar a enfermidade subxacente.
07:06
but is not going to do anything
to treat that underlying disease.
to treat that underlying disease.
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07:10
And it was this flexibility
in our thinking
in our thinking
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E grazas a esta flexibilidade
no noso pensamento
no noso pensamento
07:13
that let us recognize
that iproniazid and imipramine
that iproniazid and imipramine
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puidemos recoñecer
que a iproniacida e a imipramina
que a iproniacida e a imipramina
07:16
could be repurposed in this way,
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poderían redeseñarse dese xeito,
07:18
which led us to the serotonin hypothesis,
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o que nos levou á hipótese da serotonina,
07:20
which we then, ironically, fixated on.
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coa que, ironicamente, nos obsesionamos.
07:23
This is brain signaling, serotonin,
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Estes son sinais no cerebro, serotonina,
dun anuncio de ISRS.
07:26
from an SSRI commercial.
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07:27
In case you're not clear,
this is a dramatization.
this is a dramatization.
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Por se non está claro,
isto é unha dramatización.
isto é unha dramatización.
07:30
And in science, we try
and remove our bias, right,
and remove our bias, right,
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E na ciencia,
intentamos eliminar os prexuízos
intentamos eliminar os prexuízos
07:34
by running double-blinded experiments
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facendo estudos de dobre cego
07:37
or being statistically agnostic
as to what our results will be.
as to what our results will be.
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ou sendo estatisticamente agnósticos
sobre os resultados que podemos atopar.
sobre os resultados que podemos atopar.
07:40
But bias creeps in more insidiously
in what we choose to study
in what we choose to study
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Pero os nesgos entran raposeiramente
naquilo que decidimos estudar
naquilo que decidimos estudar
07:45
and how we choose to study it.
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e en como decidimos estudalo.
07:48
So we've focused on serotonin now
for the past 30 years,
for the past 30 years,
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E así, nos últimos 30 anos,
centrámonos na serotonina,
centrámonos na serotonina,
07:51
often to the exclusion of other things.
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excluíndo con frecuencia outros elementos.
07:54
We still have no cures,
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Seguimos sen ter cura.
07:57
and what if serotonin
isn't all there is to depression?
isn't all there is to depression?
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E se a serotonina non fose
o único factor da depresión?
o único factor da depresión?
08:00
What if it's not even the key part of it?
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E se nin sequera fose unha parte esencial?
08:02
That means no matter how much time
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Isto significa que tanto ten o tempo
08:04
or money or effort we put into it,
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os cartos ou o esforzo que lle adiquemos,
08:07
it will never lead to a cure.
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nunca nos levará a unha cura.
Nos últimos anos, os médicos descubriron
o que probablemente é
o que probablemente é
08:10
In the past few years,
doctors have discovered
doctors have discovered
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08:13
probably what is the first truly new
antidepressant since the SSRIs,
antidepressant since the SSRIs,
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o primeiro antidepresivo real dende os
inhibidores de recaptación da serotonina,
inhibidores de recaptación da serotonina,
08:18
Calypsol,
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o Calipsol,
08:19
and this drug works very quickly,
within a few hours or a day,
within a few hours or a day,
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e este fármaco funciona moi rápido,
nunhas poucas horas ou un día,
nunhas poucas horas ou un día,
08:23
and it doesn't work on serotonin.
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e non se basea en serotonina.
08:25
It works on glutamate,
which is another neurotransmitter.
which is another neurotransmitter.
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Faino no glutamato, outro neurotransmisor.
08:28
And it's also repurposed.
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E tamén tiña outra función.
08:29
It was traditionally used
as anesthesia in surgery.
as anesthesia in surgery.
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Tradicionalmente empregábase
coma anestesia en operacións.
coma anestesia en operacións.
Pero ao revés cós fármacos anteriores
08:33
But unlike those other drugs,
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08:35
which were recognized pretty quickly,
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que se identificaron bastante axiña,
08:37
it took us 20 years
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levou 20 anos darse conta
08:38
to realize that Calypsol
was an antidepressant,
was an antidepressant,
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de que o Calipsol era un antidepresivo,
08:41
despite the fact that it's actually
a better antidepressant,
a better antidepressant,
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a pesar de ser, en realidade,
un antidepresivo mellor
un antidepresivo mellor
ca a maioría dos outros fármacos.
08:44
probably, than those other drugs.
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08:45
It's actually probably because of the fact
that it's a better antidepressant
that it's a better antidepressant
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E probablemente,
por ser un antidepresivo mellor
por ser un antidepresivo mellor
08:50
that it was harder for us to recognize.
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custounos máis recoñecelo.
08:52
There was no mania to signal its effects.
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Non había loucura
que amosase os seus efectos.
que amosase os seus efectos.
08:54
So in 2013, up at Columbia University,
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En 2013, na Universidade de Columbia,
08:57
I was working with my colleague,
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estaba a traballar coa miña colega,
08:59
Dr. Christine Ann Denny,
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a dra. Christine Ann Denny,
09:01
and we were studying Calypsol
as an antidepressant in mice.
as an antidepressant in mice.
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estabamos estudando o Calipsol
como un antidepresivo en ratos.
como un antidepresivo en ratos.
09:05
And Calypsol has, like,
a really short half-life,
a really short half-life,
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O Calipsol ten unha vida media moi curta,
09:08
which means it's out of your body
within a few hours.
within a few hours.
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o que significa que permanece no corpo
só unhas poucas horas.
só unhas poucas horas.
Estábamos facendo probas piloto.
09:11
And we were just piloting.
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09:13
So we would give an injection to mice,
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Poñeriámoslle unha inxección aos ratos,
09:15
and then we'd wait a week,
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e esperariamos unha semana,
09:16
and then we'd run
another experiment to save money.
another experiment to save money.
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e despois fariamos outro experimento
para poder aforrar cartos.
para poder aforrar cartos.
09:20
And one of the experiments I was running,
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E nun dos meus experimentos
09:22
we would stress the mice,
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estresabamos aos ratos,
09:23
and we used that as a model of depression.
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e usabamos isto
como un modelo de depresión.
como un modelo de depresión.
09:26
And at first it kind of just looked
like it didn't really work at all.
like it didn't really work at all.
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Ao comezo parecía
que non funcionaba en absoluto.
que non funcionaba en absoluto.
09:29
So we could have stopped there.
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Puidemos parar nese momento.
09:31
But I have run this model
of depression for years,
of depression for years,
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Pero usei este modelo de depresión
durante moitos anos,
durante moitos anos,
09:34
and the data just looked kind of weird.
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e os resultados parecían estraños.
09:36
It didn't really look right to me.
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Parecíame que estaban mal.
09:38
So I went back,
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Volvín atrás,
09:39
and we reanalyzed it
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o e reanaliceinos
09:41
based on whether or not they had gotten
that one injection of Calypsol
that one injection of Calypsol
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baseándome en se recibiran ou non
unha inxección de Calipsol
unha inxección de Calipsol
09:44
a week beforehand.
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a semana anterior.
09:46
And it looked kind of like this.
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E eran algo coma isto.
09:48
So if you look at the far left,
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Se mirades á esquerda,
09:51
if you put a mouse in a new space,
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se poñedes un rato nun novo espazo,
09:53
this is the box, it's very exciting,
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a caixa neste caso, é moi emocionante,
09:55
a mouse will walk around and explore,
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o rato camiñará e explorará a contorna
09:58
and you can see that pink line
is actually the measure of them walking.
is actually the measure of them walking.
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e pódese ver a liña rosa,
que á a medida do que camiñan.
que á a medida do que camiñan.
10:02
And we also give it
another mouse in a pencil cup
another mouse in a pencil cup
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Tamén puxemos outro rato
nun gobelete
nun gobelete
10:05
that it can decide to interact with.
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co que podía decidir interaccionar.
10:07
This is also a dramatization,
in case that's not clear.
in case that's not clear.
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Isto tamén é unha dramatización,
por se non está claro.
por se non está claro.
10:10
And a normal mouse will explore.
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Un rato normal explorará.
10:14
It will be social.
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Será sociable.
10:16
Check out what's going on.
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Mirade o que está a pasar.
10:18
If you stress a mouse
in this depression model,
in this depression model,
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Se estresas un rato
neste modelo de depresión,
neste modelo de depresión,
10:20
which is the middle box,
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que é a caixa do medio,
10:23
they aren't social, they don't explore.
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non son sociables, non exploran.
10:25
They mostly just kind of hide
in that back corner, behind a cup.
in that back corner, behind a cup.
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Eles, sobre todo, escóndense
nesa esquina, detrás do gobelete.
nesa esquina, detrás do gobelete.
10:29
Yet the mice that had gotten
that one injection of Calypsol,
that one injection of Calypsol,
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Porén, os ratos que recibiron
a inxección de Calipsol,
a inxección de Calipsol,
10:32
here on your right,
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1200
védelo á vosa dereita,
10:34
they were exploring, they were social.
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1960
estaban explorando, eran sociables.
10:36
They looked like they
had never been stressed at all,
had never been stressed at all,
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Parecía coma se nunca antes
estiveran estresados,
estiveran estresados,
10:40
which is impossible.
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1200
o que era imposible.
10:42
So we could have just stopped there,
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Poderíamos parar aquí,
10:44
but Christine had also used
Calypsol before as anesthesia,
Calypsol before as anesthesia,
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pero Christine tamén usara antes
Calipsol como anestesia,
Calipsol como anestesia,
e había uns anos que detectara
10:49
and a few years ago she had seen
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que parecía ter algúns efectos
estraños nas células
estraños nas células
10:50
that it seemed to have
some weird effects on cells
some weird effects on cells
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e nalgún outro comportamento
10:53
and some other behavior
223
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10:54
that also seemed to last
long after the drug,
long after the drug,
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que tamén parecía manterse
moito despois de tomar o fármaco,
moito despois de tomar o fármaco,
se cadra, unhas poucas semanas.
10:57
maybe a few weeks.
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10:58
So we were like, OK,
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Así que nos dixemos,
10:59
maybe this is not completely impossible,
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ao mellor isto non é de todo imposible”,
11:02
but we were really skeptical.
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pero eramos moi escépticas.
11:03
So we did what you do in science
when you're not sure,
when you're not sure,
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E fixemos o que se fai en ciencia
cando un non está seguro:
cando un non está seguro:
11:06
and we ran it again.
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1200
intentámolo outra vez.
11:08
And I remember being in the animal room,
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Lembro de estar no cuarto dos animais,
11:11
moving mice from box to box
to test them,
to test them,
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movendo ratos dunha caixa á outra
para analizalos,
para analizalos,
11:15
and Christine was actually sitting
on the floor with the computer in her lap
on the floor with the computer in her lap
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3616
e Christine estaba sentada no chan
co ordenador no colo
co ordenador no colo
11:18
so the mice couldn't see her,
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para que os ratos non a visen,
11:20
and she was analyzing
the data in real time.
the data in real time.
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e ela estaba analizando os datos
en tempo real.
en tempo real.
11:22
And I remember us yelling,
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Recordo que berramos,
11:23
which you're not supposed to do
in an animal room where you're testing,
in an animal room where you're testing,
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3296
algo que non debes facer nunha sala
con animais que estás analizando,
con animais que estás analizando,
11:27
because it had worked.
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1576
porque funcionou.
11:28
It seemed like these mice
were protected against stress,
were protected against stress,
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Parecía coma se estes ratos
estivesen protexidos contra o estrés,
estivesen protexidos contra o estrés,
11:33
or they were inappropriately happy,
however you want to call it.
however you want to call it.
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3056
ou estaban indebidamente felices,
coma lle queirades chamar.
coma lle queirades chamar.
11:36
And we were really excited.
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2440
E estabamos moi emocionadas.
11:39
And then we were really skeptical,
because it was too good to be true.
because it was too good to be true.
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E despois eramos realmente escépticas,
porque era demasiado bo para ser certo.
porque era demasiado bo para ser certo.
11:43
So we ran it again.
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1200
Así que volvémolo probar.
11:45
And then we ran it again in a PTSD model,
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Volvemos probalo nun modelo
de estrés postraumático,
de estrés postraumático,
11:48
and we ran it again
in a physiological model,
in a physiological model,
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2416
e outra vez nun modelo fisiolóxico,
11:50
where all we did was give stress hormones.
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2216
onde só lles demos hormonas do estrés.
11:53
And we had our undergrads run it.
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Tiñamos estudantes facendo probas.
11:54
And then we had our collaborators
halfway across the world in France run it.
halfway across the world in France run it.
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E tamén os nosos colaboradores
do outro lado do mundo, en Francia.
do outro lado do mundo, en Francia.
11:59
And every time someone ran it,
they confirmed the same thing.
they confirmed the same thing.
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E cada vez que alguén facía probas
confirmábanos o mesmo.
confirmábanos o mesmo.
12:03
It seemed like
this one injection of Calypsol
this one injection of Calypsol
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Parecía que esta inxección de Calipsol
12:05
was somehow protecting
against stress for weeks.
against stress for weeks.
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dalgunha maneira protexía
do estrés durante semanas.
do estrés durante semanas.
12:09
And we only published this a year ago,
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Publicamos isto hai só un ano,
12:11
but since then other labs
have independently confirmed this effect.
have independently confirmed this effect.
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4080
pero dende aquela outros laboratorios
confirmaron este efecto independentemente.
confirmaron este efecto independentemente.
12:15
So we don't know what causes depression,
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Non sabemos qué causa a depresión,
12:18
but we do know that stress
is the initial trigger
is the initial trigger
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pero si que o estrés é a causa inicial
12:22
in 80 percent of cases,
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no 80 por cento dos casos,
e a depresión e o estrés postraumático
son doenzas distintas,
son doenzas distintas,
12:24
and depression and PTSD
are different diseases,
are different diseases,
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12:26
but this is something
they share in common.
they share in common.
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2016
pero isto é algo que comparten.
12:28
Right? It is traumatic stress
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O estrés traumático,
12:30
like active combat or natural disasters
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2896
coma un combate ou un desastre natural
12:33
or community violence or sexual assault
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ou violencia nas comunidades
ou unha agresión sexual
ou unha agresión sexual
12:36
that causes post-traumatic
stress disorder,
stress disorder,
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que causa
trastorno por estrés postraumático,
trastorno por estrés postraumático,
12:38
and not everyone that is exposed to stress
develops a mood disorder.
develops a mood disorder.
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e non todo o mundo exposto ao estrés
desenvolve un trastorno emocional.
desenvolve un trastorno emocional.
12:44
And this ability to experience
stress and be resilient
stress and be resilient
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E esta capacidade de
sentir estrés e resistilo
sentir estrés e resistilo
12:47
and bounce back and not develop
depression or PTSD
depression or PTSD
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4160
e recuperarse e non desenvolver
depresión ou estrés postraumático
depresión ou estrés postraumático
12:52
is known as stress resilience,
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coñécese como resistencia ó estrés,
12:54
and it varies between people.
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e varía de persoa a persoa.
12:56
And we have always thought of it
as just sort of this passive property.
as just sort of this passive property.
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3336
Sempre pensamos que se trataba
dun tipo de capacidade pasiva.
dun tipo de capacidade pasiva.
13:00
It's the absence of susceptibility factors
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Non hai factores de susceptibilidade
13:02
and risk factors for these disorders.
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nin factores de risco
para estes trastornos.
para estes trastornos.
13:05
But what if it were active?
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Pero e se fose unha capacidade activa?
13:08
Maybe we could enhance it,
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Se cadra, poderiamos mellorala,
13:09
sort of akin to putting on armor.
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algo así como poñer unha armadura.
13:13
We had accidentally discovered
the first resilience-enhancing drug.
the first resilience-enhancing drug.
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Descubrimos accidentalmente o primeiro
fármaco que mellora a resistencia.
fármaco que mellora a resistencia.
E como dixen, só administramos
unha pequena cantidade de fármaco
unha pequena cantidade de fármaco
13:18
And like I said, we only gave
a tiny amount of the drug,
a tiny amount of the drug,
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2776
13:21
and it lasted for weeks,
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1576
e o efecto durou semanas,
13:23
and that's not like anything
you see with antidepressants.
you see with antidepressants.
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3216
algo que non se parece en nada
ao que vemos cos antidepresivos.
ao que vemos cos antidepresivos.
13:26
But it is actually kind of similar
to what you see in immune vaccines.
to what you see in immune vaccines.
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4320
Parécese máis ao que pasa coas vacinas.
13:31
So in immune vaccines,
you'll get your shots,
you'll get your shots,
279
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2936
Coas vacinas, pos unha inxección,
13:34
and then weeks, months, years later,
280
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3376
e durante semanas, meses ou anos,
13:37
when you're actually exposed to bacteria,
281
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2336
cando te expós á bacteria
13:39
it's not the vaccine in your body
that protects you.
that protects you.
282
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2456
non é a vacina do teu corpo
quen te protexe,
quen te protexe,
13:42
It's your own immune system
283
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1376
é o teu propio sistema inmunolóxico
13:43
that's developed resistance and resilience
to this bacteria that fights it off,
to this bacteria that fights it off,
284
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4136
que desenvolveu resistencia e resiliencia
contra esta bacteria e pode combatela,
contra esta bacteria e pode combatela,
13:47
and you actually never get the infection,
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2136
e ti non colles a infección,
13:50
which is very different
from, say, our treatments. Right?
from, say, our treatments. Right?
286
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3056
o que é moi distinto
a tratar a infección, non si?
a tratar a infección, non si?
13:53
In that case, you get the infection,
you're exposed to the bacteria,
you're exposed to the bacteria,
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3816
Neste segundo caso,
colles a infección, exposte á bacteria,
colles a infección, exposte á bacteria,
13:57
you're sick, and then you take,
say, an antibiotic which cures it,
say, an antibiotic which cures it,
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enfermas, e despois
tomas un antibiótico que a cura,
tomas un antibiótico que a cura,
14:00
and those drugs are actually working
to kill the bacteria.
to kill the bacteria.
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828900
3240
e eses fármacos traballan
para eliminar a bacteria.
para eliminar a bacteria.
Nin se parece ao que comentei antes,
dos fármacos paliativos,
dos fármacos paliativos,
14:04
Or similar to as I said before,
with this palliative,
with this palliative,
290
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2496
14:07
you'll take something
that will suppress the symptoms,
that will suppress the symptoms,
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2856
tomarás algo que eliminará os síntomas,
14:10
but it won't treat
the underlying infection,
the underlying infection,
292
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2696
pero non tratará a infección subxacente,
14:12
and you'll only feel better
during the time in which you're taking it,
during the time in which you're taking it,
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3336
e tan só te atoparás mellor
mentres esteas tomando o fármaco,
mentres esteas tomando o fármaco,
14:16
which is why you have to keep taking it.
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por iso tes que seguir tomándoo.
14:18
And in depression and PTSD --
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E para a depresión
e o estrés postraumático
e o estrés postraumático
14:20
here we have your stress exposure --
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--velaquí temos a exposición ao estrés--
14:22
we only have palliative care.
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só temos tratamentos paliativos.
14:25
Antidepressants only suppress symptoms,
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Os antidepresivos só eliminan os síntomas,
14:28
and that is why you basically
have to keep taking them
have to keep taking them
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e esa é basicamente a razón pola cal
hai que seguir tomándoos
hai que seguir tomándoos
14:30
for the life of the disease,
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durante a duración da enfermidade,
14:32
which is often
the length of your own life.
the length of your own life.
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que é, con frecuencia, a da propia vida.
14:35
So we're calling our resilience-enhancing
drugs "paravaccines,"
drugs "paravaccines,"
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Por iso lles chamamos aos nosos fármacos
que melloran a resistencia “paravacinas”,
que melloran a resistencia “paravacinas”,
14:40
which means vaccine-like,
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que significa "coma unha vacina"
14:41
because it seems
like they might have the potential
like they might have the potential
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porque parece que tivesen o potencial
14:44
to protect against stress
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de protexernos contra o estrés
14:46
and prevent mice from developing
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e previr que os ratos desenvolvan
14:49
depression and post-traumatic
stress disorder.
stress disorder.
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depresión e estrés postraumático.
14:52
Also, not all antidepressants
are also paravaccines.
are also paravaccines.
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Non todos os antidepresivos
son paravacinas.
son paravacinas.
14:57
We tried Prozac as well,
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Tamén probamos co Prozac,
14:58
and that had no effect.
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e non tivo efecto ningún.
15:01
So if this were to translate into humans,
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Se isto se trasladase aos seres humanos
15:04
we might be able to protect people
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poderíamos protexer á xente
que está potencialmente en perigo
15:06
who are predictably at risk
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de trastornos provocados polo estrés
15:08
against stress-induced disorders
like depression and PTSD.
like depression and PTSD.
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coma a depresión
ou o estrés postraumático.
ou o estrés postraumático.
15:12
So that's first responders
and firefighters,
and firefighters,
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Persoas como traballadores
de primeiros auxilios e bombeiros,
de primeiros auxilios e bombeiros,
15:16
refugees, prisoners and prison guards,
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refuxiados, reclusos
e funcionarios de prisións,
e funcionarios de prisións,
15:20
soldiers, you name it.
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soldados, por citar algúns.
15:23
And to give you a sense
of the scale of these diseases,
of the scale of these diseases,
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Para darvos unha idea da magnitude
deste tipo de enfermidades,
deste tipo de enfermidades,
15:27
in 2010, the global burden of disease
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en 2010, a carga global destas doenzas
15:30
was estimated at 2.5 trillion dollars,
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estimouse en 2,5 billóns de dólares
15:35
and since they are chronic,
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e como son crónicas,
15:36
that cost is compounding
and is therefore expected to rise
and is therefore expected to rise
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o custo é acumulativo
polo que se prevé que medre
polo que se prevé que medre
15:39
up to six trillion dollars
in just the next 15 years.
in just the next 15 years.
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en seis billóns de dólares
só nos próximos 15 anos.
só nos próximos 15 anos.
15:44
As I mentioned before,
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Como mencionei antes,
15:46
repurposing can be challenging
because of our prior biases.
because of our prior biases.
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redeseñar un fármaco pode ser complexo
por causa dos nosos nesgos previos.
por causa dos nosos nesgos previos.
15:50
Calypsol has another name,
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O calipsol ten outro nome,
15:53
ketamine,
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ketamina,
15:55
which also goes by another name,
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que tamén é coñecida como
15:57
Special K,
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Special K,
15:58
which is a club drug and drug of abuse.
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unha droga de deseño e un estupefaciente.
16:02
It's still used across the world
as an anesthetic.
as an anesthetic.
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Aínda se emprega ao redor do mundo
como anestésico.
como anestésico.
16:05
It's used in children.
We use it on the battlefield.
We use it on the battlefield.
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Emprégase en nenos.
Empregámola nos campos de batalla.
Empregámola nos campos de batalla.
16:08
It's actually the drug of choice
in a lot of developing nations,
in a lot of developing nations,
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De feito é o fármaco elixido
en moitos países en desenvolvemento
en moitos países en desenvolvemento
16:11
because it doesn't affect breathing.
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porque non afecta á respiración.
16:13
It is on the World Health Organization
list of most essential medicines.
list of most essential medicines.
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Está na lista de fármacos esenciais
da Organización Mundial da Saúde.
da Organización Mundial da Saúde.
16:18
If we had discovered ketamine
as a paravaccine first,
as a paravaccine first,
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Se descubrísemos a ketamina
primeiro com unha paravacina,
primeiro com unha paravacina,
16:22
it'd be pretty easy for us to develop it,
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sería bastante doado desenvolvérmola,
16:25
but as is, we have to compete
with our functional fixedness
with our functional fixedness
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pero temos que competir
contra a fixación funcional
contra a fixación funcional
16:29
and mental set that kind of interfere.
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e os construtos mentais que interfiren.
16:33
Fortunately, it's not
the only compound we have discovered
the only compound we have discovered
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Por sorte, non é
o único composto que descubrimos
o único composto que descubrimos
16:37
that has these prophylactic,
paravaccine qualities,
paravaccine qualities,
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con esas calidades
profilácticas e paravacinais,
profilácticas e paravacinais,
16:41
but all of the other drugs
we've discovered,
we've discovered,
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pero os outros fármacos que atopamos,
ou compostos se prefiren,
son totalmente novos,
son totalmente novos,
16:44
or compounds if you will,
they're totally new,
they're totally new,
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16:46
they have to go through
the entire FDA approval process --
the entire FDA approval process --
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teñen que superar o proceso completo
de aceptación da FDA
de aceptación da FDA
16:50
if they make it before
they can ever be used in humans.
they can ever be used in humans.
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antes de poder usarse en seres humanos.
16:54
And that will be years.
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E iso vai supoñer anos.
16:55
So if we wanted something sooner,
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Se queremos algo máis axiña,
16:58
ketamine is already FDA-approved.
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a ketamina xa está aprobada pola FDA.
17:00
It's generic, it's available.
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É xenérica, está dispoñible.
17:03
We could develop it for a fraction
of the price and a fraction of the time.
of the price and a fraction of the time.
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Podería desenvolverse
pola metade de prezo e de tempo.
pola metade de prezo e de tempo.
17:08
But actually, beyond
functional fixedness and mental set,
functional fixedness and mental set,
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Pero, máis alá da fixación funcional
e o construto mental,
e o construto mental,
17:12
there's a real other challenge
to repurposing drugs,
to repurposing drugs,
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hai outro desafío para
o redeseño de fármacos:
o redeseño de fármacos:
17:16
which is policy.
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as políticas.
17:18
There are no incentives in place
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Non existen incentivos
17:20
once a drug is generic and off patent
and no longer exclusive
and no longer exclusive
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--se o fármaco é xenérico e sen patente
e non existe unha exclusividade--
e non existe unha exclusividade--
17:24
to encourage pharma companies
to develop them,
to develop them,
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que animen ás farmacéuticas
a desenvolvelos,
a desenvolvelos,
17:26
because they don't make money.
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porque non gañan cartos.
17:28
And that's not true for just ketamine.
That is true for all drugs.
That is true for all drugs.
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Isto non só é certo para a ketamina.
Éo para todos os fármacos.
Éo para todos os fármacos.
17:32
Regardless, the idea itself
is completely novel in psychiatry,
is completely novel in psychiatry,
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De todos os xeitos, a propia idea
é totalmente novidosa en psiquiatría,
é totalmente novidosa en psiquiatría,
17:38
to use drugs to prevent mental illness
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usar drogas para previr
enfermidades mentais
enfermidades mentais
17:42
as opposed to just treat it.
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no canto de tratalas.
17:44
It is possible that 20, 50,
100 years from now,
100 years from now,
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É posible que en 20, 50, ou 100 anos
17:49
we will look back now
at depression and PTSD
at depression and PTSD
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miremos a depresión
e o estrés postraumático
e o estrés postraumático
17:53
the way we look back
at tuberculosis sanitoriums
at tuberculosis sanitoriums
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como miramos hoxe
os sanatorios de tuberculosos,
os sanatorios de tuberculosos,
17:57
as a thing of the past.
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como cousas do pasado.
17:59
This could be the beginning of the end
of the mental health epidemic.
of the mental health epidemic.
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Isto podería ser o principio da fin
dunha epidemia de saúde mental.
dunha epidemia de saúde mental.
18:05
But as a great scientist once said,
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Pero como un gran científico dixo,
18:09
"Only a fool is sure of anything.
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" Só un tolo está seguro de algo,
18:12
A wise man keeps on guessing."
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o sabio segue intentando adiviñar."
[MacGyver]
18:16
Thank you, guys.
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Grazas.
18:17
(Applause)
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(Aplausos)
ABOUT THE SPEAKER
Rebecca Brachman - Neuroscientist, writer, entrepreneurRebecca Brachman is a pioneer in the field of preventative psychopharmacology, developing drugs to enhance stress resilience and prevent mental illness.
Why you should listen
Current treatments for mood disorders only suppress symptoms without addressing the underlying disease, and there are no known cures. The drugs Rebecca Brachman is developing would be the first to prevent psychiatric disorders such as post-traumatic stress disorder (PTSD) and depression.
Brachman completed her PhD at Columbia University, prior to which she was a fellow at the National Institutes of Health, where she discovered that immune cells carry a memory of psychological stress and that white blood cells can act as antidepressants and resilience-enhancers. Brachman's research has been featured in The Atlantic, WIRED and Business Insider, and her work was recently described by Dr. George Slavich on NPR as a "moonshot project that is very much needed in the mental health arena."
In addition to conducting ongoing research at Columbia, Brachman is an NYCEDC Entrepreneurship Lab Fellow and cofounder of Paravax -- a biotech startup developing vaccine-like prophylactic drugs ("paravaccines") -- along with her scientific collaborator, Christine Ann Denny. She is also working on a non-profit venture to repurpose existing generic drugs for use as prophylactics, and previously served as the Interim Program Director for Outreach at the Zuckerman Institute at Columbia University.
Brachman is also a playwright and screenwriter. She holds Bachelor's degrees in both neuroscience and creative wWriting, and she is currently working on a tech-focused writing project with her long-time writing partner, Sean Calder ("Grimm," "Damages," "ER"). She served as the director of NeuWrite, a national network of science-writing groups that fosters ongoing collaboration between scientists, writers and artists, and she has been featured as a storyteller at The Story Collider.
(Photo: Kenneth Willardt)
Rebecca Brachman | Speaker | TED.com