{"id":424,"date":"2012-05-20T20:14:30","date_gmt":"2012-05-20T20:14:30","guid":{"rendered":"http:\/\/harpa.blogg.is\/2012-05-20\/mattur-lyfleysunnar\/"},"modified":"2013-11-21T09:19:31","modified_gmt":"2013-11-21T09:19:31","slug":"mattur-lyfleysunnar","status":"publish","type":"post","link":"https:\/\/harpahreins.com\/blogg\/2012\/05\/20\/mattur-lyfleysunnar\/","title":{"rendered":"M\u00e1ttur lyfleysunnar"},"content":{"rendered":"

\"Lyfleysa\"Sem stendur er \u00e9g a\u00f0 lesa m\u00e9r til um ranns\u00f3knir \u00e1 virkni \u00feunglyndislyfja, kannski \u00f6llu heldur gagnr\u00fdni \u00e1 sl\u00edkar ranns\u00f3knir. M\u00e9r var bent \u00e1 b\u00f3k Irving Kirsch<\/a> The Emperor’s New Drugs: Exploding the Antidepressant Myth<\/em>, sem kom \u00fat 2009, og innslag \u00ed 60 Minutes fr\u00e1 \u00fev\u00ed n\u00fana \u00ed febr\u00faar \u00fear sem tala\u00f0 er vi\u00f0 Kirsch o.fl.\u00a0\u00c9g hl\u00f3\u00f0 strax\u00a0ni\u00f0ur b\u00f3kinni en vegna einmuna\u00a0ve\u00f0urbl\u00ed\u00f0u undanfari\u00f0 hef \u00e9g ekki bori\u00f0 vi\u00f0 a\u00f0 lesa b\u00f3k \u00ed t\u00f6lvu. Hins vegar er \u00e9g b\u00fain a\u00f0 horfa \u00e1 \u00fe\u00e1ttinn, skanna umr\u00e6\u00f0u um hann og nokkra umr\u00e6\u00f0u um sta\u00f0h\u00e6fingar Kirsch. Sj\u00e1lfsagt blogga \u00e9g um b\u00f3kina \u00feegar \u00e9g er b\u00fain a\u00f0 lesa hana.<\/p>\n

Eftir \u00fev\u00ed sem \u00e9g les m\u00e9r meira til ver\u00f0ur m\u00e9r lj\u00f3sara hve \u00feunglyndislyfjagj\u00f6f stendur \u00e1 \u00f3traustum grunni. Kenningar um a\u00f0 \u00feunglyndi stafi af bo\u00f0efnarugli \u00ed heila eru hugmyndasm\u00ed\u00f0<\/strong> en hafa aldrei veri\u00f0 “v\u00edsindalega sanna\u00f0ar” me\u00f0 neins konar m\u00e6lingum. Og svo vir\u00f0ist sem<\/strong> v\u00edsindalegu ranns\u00f3knarni\u00f0urst\u00f6\u00f0urnar sem eiga a\u00f0 s\u00fdna fram \u00e1 verkan einstakra \u00feunglyndislyfja s\u00e9u a\u00f0allega j\u00e1kv\u00e6tt \u00farval \u00far ranns\u00f3knafj\u00f6ld<\/strong>; \u00feegar grannt er sko\u00f0a\u00f0 s\u00fdna\u00a0margar ranns\u00f3knir litla sem enga verkun en \u00feeim ni\u00f0urst\u00f6\u00f0um er hins vegar ekki flagga\u00f0. Til a\u00f0 auka enn \u00e1 vaxandi tortryggni m\u00edna\u00a0eru svo uppl\u00fdsingar sem s\u00fdna hvernig skilgreiningar\/m\u00e6likvar\u00f0i \u00feunglyndis og uppfynding lyfja<\/strong> sem byggja \u00e1 akk\u00farat \u00feessum skilgreiningum e\u00f0a m\u00e6likv\u00f6r\u00f0um haldast \u00ed hendur<\/strong>; h\u00e6nan og eggi\u00f0 eru upp fundin \u00e1 sama t\u00edma. (F\u00ednt yfirlit yfir \u00feetta er kafli Joanna Moncrieff<\/a>\u00a0 The Myth of the Antidepressant: An Historical Analysis \u00ed De-Medicalizing Misery. Psychiatry, Psychology and the Human Condition<\/em>, \u00fatg. 2011. \u00de\u00e1 b\u00f3k m\u00e1, eins og b\u00f3k Kirsch, au\u00f0veldlega hla\u00f0a fr\u00edtt ni\u00f0ur af vefnum.)<\/p>\n

\u00c9g horf\u00f0i sem sagt \u00e1 60 Minutes \u00fe\u00e1ttinn me\u00f0 vi\u00f0talinu vi\u00f0 Irvin Kirsch<\/a> en eiginlega finnst m\u00e9r \u00fe\u00f3 \u00fe\u00e6gilegra a\u00f0 lesa lungann \u00far handriti \u00fe\u00e1ttarins<\/a>. Kirsch heldur \u00fev\u00ed eindregi\u00f0 fram a\u00f0 virkni \u00feunglyndislyfja m\u00e6list s\u00e1ral\u00edti\u00f0 meiri en virkni lyfleysu (hveitipilla)<\/strong>. Hann hefur fjalla\u00f0 um \u00feetta efni fr\u00e1 \u00fev\u00ed \u00e1 t\u00edunda \u00e1ratug s\u00ed\u00f0ustu aldar og au\u00f0vita\u00f0 hloti\u00f0 \u00f3v\u00e6gna gagnr\u00fdni. Meginr\u00f6k hans eru a\u00f0 m\u00e1ttur lyfleysu s\u00e9 almennt mj\u00f6g mikill til b\u00f3ta hvers konar krankleik en svi\u00f0slj\u00f3si\u00f0 beinist \u00fe\u00f3 mest a\u00f0 ranns\u00f3knarni\u00f0urst\u00f6\u00f0um hans \u00e1 \u00feunglyndislyfjaranns\u00f3knum. Helstar eru \u00fe\u00e6r a\u00f0 \u00ed v\u00e6gu e\u00f0a me\u00f0al\u00feungu \u00feunglyndi s\u00fdni \u00feunglyndislyf engu meiri j\u00e1kv\u00e6\u00f0a virkni en lyfleysa, \u00ed dj\u00fapu \u00feunglyndi m\u00e6list \u00f6rl\u00edtill munur \u00feunglyndislyfjum \u00ed hag.<\/p>\n

Irving Kirsch n\u00fdtti s\u00e9r amr\u00edsk uppl\u00fdsingal\u00f6g og f\u00e9kk afhentar ALLAR ranns\u00f3knir sem lyfjafyrirt\u00e6ki h\u00f6f\u00f0u l\u00e1ti\u00f0 gera \u00e1 virkni nokkurra \u00feunglyndislyfja. Einungis \u00fe\u00e6r ranns\u00f3knir sem s\u00fdndu fram \u00e1 meiri virkni lyfsins sem veri\u00f0 var a\u00f0 pr\u00f3fa en lyfleysu voru birtar. \u00c9g blogga betur um \u00feetta \u00feegar \u00e9g hef lesi\u00f0 b\u00f3k Kirsch en bendi \u00e1 a\u00f0 a\u00f0rir hafa fundi\u00f0 sama \u00fat, sj\u00e1 t.d. grein Ericks H. Turner, Roberts Rosenthal o.fl., Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy<\/a>\u00a0 sem birtist \u00ed New England Journal of Medicine<\/em> snemma \u00e1rs 2008. M\u00e9r finnst svol\u00edti\u00f0 uggvekjandi a\u00f0 sj\u00e1 ni\u00f0urst\u00f6\u00f0urnar um \u00feunglyndislyfi\u00f0 sem \u00e9g et, Mirtazap\u00edn (M\u00edron), sj\u00e1 mynd 3 \u00ed greininni. Birtar greinar og ranns\u00f3knir s\u00fdna umtalsvert betri verkan lyfsins en kemur fram \u00feegar allar ranns\u00f3knarni\u00f0urst\u00f6\u00f0ur sem Bandar\u00edska lyfjaeftirliti\u00f0 hefur fengi\u00f0 um\u00a0gagnsemi \u00feessa lyfs eru sko\u00f0a\u00f0ar, munurinn er raunar mj\u00f6g mikill.\u00a0<\/p>\n

\u00c9g tek fram a\u00f0 \u00e9g kann l\u00edti\u00f0 \u00ed t\u00f6lfr\u00e6\u00f0i og get \u00fev\u00ed ekki sta\u00f0i\u00f0 \u00ed t\u00f6lfr\u00e6\u00f0ilegum deilum um \u00feetta efni en m\u00e9r s\u00fdndist \u00e1 \u00feeirri fr\u00e6\u00f0ilegu umr\u00e6\u00f0u sem \u00e9g sko\u00f0a\u00f0i um ranns\u00f3kn Turner, Rosentahl o.fl. og sko\u00f0anir Kirsch a\u00f0 menn v\u00e6ru yfirleitt\u00a0a\u00f0 hnotb\u00edtast um sm\u00e1atri\u00f0i. Raunar eru Turner og Rosentahl \u00f3samm\u00e1la Kirsch \u00ed t\u00falkun \u00fe\u00f3tt ni\u00f0urst\u00f6\u00f0ur \u00feeirra um muninn mikla \u00e1 birtum lyfjafr\u00e6\u00f0iranns\u00f3knum og \u00f6llum ranns\u00f3knum s\u00e9u n\u00e1nast samhlj\u00f3\u00f0a \u00fev\u00ed \u00feeir telja a\u00f0 \u00feunglyndislyf s\u00fdni nokkurn markt\u00e6kan kl\u00edn\u00edskan mun umfram lyfleysu. (Sj\u00e1 Efficacy of antidepressants<\/a> \u00ed British Medical Journal<\/em> apr\u00edl 2008.<\/p>\n

M\u00e1lefnalegustu r\u00f6kin gegn Kirsch finnast m\u00e9r vera \u00feau a\u00f0 sk\u00fdringin \u00e1 \u00fev\u00ed a\u00f0 enginn markt\u00e6kur munur m\u00e6list \u00e1 virkni algengra \u00feunglyndislyfja og lyfleysu gegn v\u00e6gu og me\u00f0aldj\u00fapu \u00feunglyndi \u00ed \u00f6llum kl\u00edn\u00edskum ranns\u00f3knum\u00a0s\u00e9 s\u00fa a\u00f0 \u00ed h\u00f3pi \u00feeirra sem pr\u00f3fu\u00f0u v\u00e6ru l\u00edklega einhverjir sem v\u00e6ru ekkert haldnir \u00feunglyndi heldur bara eitthva\u00f0 domm af \u00f6\u00f0rum ors\u00f6kum. Ef \u00fe\u00e1tttakandi er alls ekki haldinn \u00feeirri bo\u00f0efnavillu sem \u00e1 a\u00f0 lei\u00f0r\u00e9tta \u00fe\u00e1 lei\u00f0r\u00e9ttist n\u00e1tt\u00farlega ekki neitt me\u00f0 s\u00e9rhanna\u00f0a lyfinu og \u00fe.a.l. m\u00e6list enginn \u00e1rangur. \u00dea\u00f0 a\u00f0 \u00feunglyndislyf s\u00fdni\u00a0nokku\u00f0 betri verkun\u00a0en lyfleysa vi\u00f0 dj\u00fapu\/alvarlegu \u00feunglyndi s\u00fdni a\u00f0 \u00feunglyndislyfi\u00f0 virkar. Til a\u00f0 tr\u00faa \u00feessum r\u00f6kum \u00fearf au\u00f0vita\u00f0 a\u00f0 gefa s\u00e9r a\u00f0 \u00feunglyndi stafi af einhvers konar \u00f3jafnv\u00e6gi \u00ed bo\u00f0efnaskiptum \u00ed heila og a\u00f0 \u00ed ranns\u00f3knarh\u00f3pa \u00ed kl\u00edn\u00edskum ranns\u00f3knum\u00a0\u00e1 ge\u00f0lyfjum hafi\u00a0ekki veri\u00f0 n\u00f3gu vel vali\u00f0.<\/p>\n

M\u00f3tr\u00f6k Kirsch o.fl. eru a\u00f0 lyfleysa virki almennt og yfirleitt miklu verr \u00e1 miki\u00f0 veika \u00feunglyndissj\u00faklinga en \u00fe\u00e1 sem eru haldnir v\u00e6gu e\u00f0a me\u00f0aldj\u00fapu \u00feunglyndi, sem er svo sem ekkert \u00f3tr\u00falegt mi\u00f0a\u00f0 vi\u00f0 hve ma\u00f0ur ver\u00f0ur yfirm\u00e1ta vonlaus \u00e1 allt eftir endurteknar dj\u00fapar \u00feunglyndisd\u00fdfur.<\/p>\n

En … \u00feetta er byrjunin \u00e1 vangaveltum um hversu lengi \u00fea\u00f0 hefur veri\u00f0 vel vita\u00f0 a\u00f0 \u00feunglyndislyf skila litlum sem engum bata umfram obl\u00e1tur (hveitipillur\/lyfleysu), hvort borgi sig yfirleitt a\u00f0 eta \u00feunglyndislyf og p\u00e6lingum um hven\u00e6r ge\u00f0l\u00e6knum hef\u00f0i m\u00e1tt vera lj\u00f3st a\u00f0 kenningar um bo\u00f0efnarugl \u00ed heila sem ors\u00f6k \u00feunglyndis standast ekki …<\/p>\n","protected":false},"excerpt":{"rendered":"

Sem stendur er \u00e9g a\u00f0 lesa m\u00e9r til um ranns\u00f3knir \u00e1 virkni \u00feunglyndislyfja, kannski \u00f6llu heldur gagnr\u00fdni \u00e1 sl\u00edkar ranns\u00f3knir. M\u00e9r var bent \u00e1 b\u00f3k Irving Kirsch The Emperor’s New Drugs: Exploding the Antidepressant Myth, …<\/span> Read More …<\/span><\/a><\/span><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[11],"tags":[],"class_list":["post-424","post","type-post","status-publish","format-standard","hentry","category-gedlyf"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/424","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/comments?post=424"}],"version-history":[{"count":1,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/424\/revisions"}],"predecessor-version":[{"id":661,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/424\/revisions\/661"}],"wp:attachment":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/media?parent=424"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/categories?post=424"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/tags?post=424"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}