{"id":425,"date":"2012-05-25T16:08:48","date_gmt":"2012-05-25T16:08:48","guid":{"rendered":"http:\/\/harpa.blogg.is\/2012-05-25\/nyju-lyfin-keisarans\/"},"modified":"2013-11-21T09:19:17","modified_gmt":"2013-11-21T09:19:17","slug":"nyju-lyfin-keisarans","status":"publish","type":"post","link":"https:\/\/harpahreins.com\/blogg\/2012\/05\/25\/nyju-lyfin-keisarans\/","title":{"rendered":"N\u00fdju lyfin keisarans"},"content":{"rendered":"

\u00c9g er n\u00e6stum b\u00fain a\u00f0 lesa The Emperor’s New Drugs<\/em> eftir Irving Kirsch og finnst m\u00e1lflutningur hans vel r\u00f6kstuddur og sannf\u00e6randi. \u00c9g get heldur ekki s\u00e9\u00f0 a\u00f0 \u00fea\u00f0 hafi gengi\u00f0 vel a\u00f0 hrekja \u00feann m\u00e1lflutning; einna helst reyna menn a\u00f0 stagla fram og aftur um hvort m\u00e6list sannanlega 16% b\u00f3t miki\u00f0 \u00feunglyndra af \u00feunglyndislyfjum og hvort megi kjafta \u00fea\u00f0 hlutfall upp me\u00f0 n\u00fdjum m\u00e6lingart\u00e6kjum.\u00a0En meira a\u00f0 segja h\u00f6r\u00f0ustu andst\u00e6\u00f0ingar Kirsch vir\u00f0ast n\u00faor\u00f0i\u00f0 sam\u00feykkja a\u00f0 batann sem l\u00edti\u00f0 e\u00f0a \u00ed me\u00f0allagi \u00feunglyndir hlj\u00f3ta af lyfjum megi a\u00f0 mestu skrifa \u00e1 lyfleysu\u00e1hrif.<\/p>\n

\"Lyfleysu\u00e1hrif\"Fyrstu ni\u00f0urst\u00f6\u00f0ur Kirsch o.fl. eftir a\u00f0 hafa sko\u00f0a\u00f0 38 kl\u00edn\u00edskar ranns\u00f3knir \u00e1 virkni \u00fdmiss konar \u00feunglyndislyfja \u00e1 meir en 3000 \u00feunglyndissj\u00faklinga (u.\u00fe.b. 40% af \u00feeim ranns\u00f3knarni\u00f0urst\u00f6\u00f0um voru aldrei birtar heldur daga\u00f0i uppi hj\u00e1 Bandar\u00edsku matv\u00e6la- og lyfjaeftirlitstofnuninni) voru a\u00f0 \u00feunglyndislyf s\u00fdndu b\u00f3t umfram lyfleysu \u00ed um 25% tilvika. Eftir \u00fev\u00ed sem hann sko\u00f0a\u00f0i fleiri og n\u00fdrri ranns\u00f3knir l\u00e6kka\u00f0i s\u00fa tala. Enginn munur m\u00e6ldist milli \u00fdmissa lyfja, \u00fe.e. ekkert eitt lyf virka\u00f0i betur en \u00f6nnur \u00ed \u00feessum ranns\u00f3knum. \u00de\u00f3tt sj\u00faklingum h\u00f6ldnum v\u00e6gu e\u00f0a me\u00f0al\u00feungu \u00feunglyndi batna\u00f0i talsvert \u00ed \u00feessum ranns\u00f3knum var enginn munur \u00e1 bata \u00feeirra sem batna\u00f0i af lyfleysu og \u00feeirra sem batna\u00f0i af virku lyfi. Eini raunverulegi munurinn sem m\u00e6ldist \u00e1 lyfleysu og virku lyfi var \u00ed h\u00f3pi \u00feeirra sem greindir voru me\u00f0 alvarlegt \u00feunglyndi.<\/p>\n

R\u00e9tt er a\u00f0 taka fram a\u00f0 \u00feeim sem batnar helst af lyfjum eru \u00feeir sem eru haldnir v\u00e6gu e\u00f0a me\u00f0al\u00feungu \u00feunglyndi. \u00cd \u00feeirra tilvikum m\u00e6list samt enginn munur \u00e1 bata hvort sem \u00feeir eta lyfleysu e\u00f0a\u00a0 \u00feunglyndislyf. \u00c1hrifin eru \u00feau s\u00f6mu, \u00fe.e. jafn j\u00e1kv\u00e6\u00f0. En sj\u00faklingum h\u00f6ldnum sl\u00e6mu \u00feunglyndi batnar s\u00ed\u00f0ur. Munurinn sem m\u00e6list \u00e1 virku lyfi og lyfleysu er ekki til marks um a\u00f0 \u00feeim sj\u00faklingum n\u00fdtist lyf betur en hinum minna veiku heldur sk\u00fdrist af \u00fev\u00ed a\u00f0 lyfleysa virkar s\u00ed\u00f0ur \u00e1 illa haldna \u00feunglyndissj\u00faklinga en \u00e1 hina. Af hverju \u00fea\u00f0 stafar er s\u00ed\u00f0an \u00f3v\u00edst.<\/p>\n

Kirsch setur fram tilg\u00e1tur um af hverju lyfleysa virkar s\u00ed\u00f0ur en \u00feunglyndislyf \u00e1 \u00fe\u00e1 sem eru miki\u00f0 \u00feunglyndir, \u00fev\u00ed\u00a0s\u00ed\u00f0ur eftir \u00fev\u00ed sem sj\u00faklingarnir eru veikari. B\u00e1\u00f0ar tilg\u00e1turnar gera r\u00e1\u00f0 fyrir a\u00f0 svolei\u00f0is \u00fe\u00e1tttakendur \u00ed lyfjaranns\u00f3kn beri kennsl \u00e1 lyf og lyfleysu og tv\u00edblindni ranns\u00f3knanna s\u00e9 \u00fev\u00ed hj\u00f3m eitt. Annars vegar er l\u00edklegt a\u00f0 \u00feessir miki\u00f0 veiku sj\u00faklingar hafi haft vi\u00f0varandi \u00feunglyndi lengi og hafi pr\u00f3fa\u00f0 \u00fdmis lyf \u00e1\u00f0ur en \u00feeir t\u00f3ku \u00fe\u00e1tt \u00ed ranns\u00f3kninni. \u00deeim s\u00e9u \u00fev\u00ed vel kunnar algengar aukaverkanir af \u00feunglyndislyfjum og geti \u00feannig \u00feekkt hvort \u00feeir eti lyfleysu e\u00f0a lyf me\u00f0an \u00e1 lyfjaranns\u00f3kn stendur. \u00deeir geri s\u00e9r engar vonir um a\u00f0 lyfleysa virki og af \u00fev\u00ed \u00feeir \u00feekkja muninn skapist einhvers konar afleidd lyfleysu\u00e1hrif af vissunni, bygg\u00f0ri \u00e1 reynslu, um a\u00f0 \u00feeir \u00feiggi n\u00fdtt virkt \u00feunglyndislyf. Hin tilg\u00e1tan er s\u00fa a\u00f0 vegna \u00feess hve veikir \u00feessir sj\u00faklingar eru f\u00e1i \u00feeir h\u00e6rri skammta af lyfinu sem veri\u00f0 er a\u00f0 pr\u00f3fa. Ekkert bendir til \u00feess a\u00f0 h\u00e6rri skammtar skili betri \u00e1rangri en \u00fev\u00ed h\u00e6rri sem lyfjaskammturinn er \u00fev\u00ed meiri e\u00f0a algengari eru aukaverkanir af lyfinu. H\u00e6rri skammtur => meiri aukaverkanir => au\u00f0veldara fyrir\u00a0\u00fe\u00e1tttakanda \u00ed ranns\u00f3kn a\u00f0 \u00feekkja hvort hann tekur virkt lyf e\u00f0a lyfleysu => v\u00e6gi hreinna lyfleysu\u00e1hrifa minnkar.<\/p>\n

Svo er spurningin: Hversu mikill var batinn sem m\u00e6ldist af lyfjum? Bandar\u00edska matv\u00e6la- og lyfjaeftirliti\u00f0 (FDA) notar Hamilton ge\u00f0l\u00e6g\u00f0arskalann (HRDS) til a\u00f0 meta \u00feunglyndi og \u00fea\u00f0 var gert \u00ed \u00f6llum \u00feeim lyfjaranns\u00f3knum sem skila\u00f0 var inn til FDA og Kirsch sko\u00f0a\u00f0i. L\u00e6knar meta sj\u00faklinga eftir \u00feessum skala sem n\u00e6r fr\u00e1 1 upp \u00ed 51. T.d. er gefi\u00f0 1 stig ef sj\u00faklingi finnst l\u00edfi\u00f0 ekki \u00feess vir\u00f0i a\u00f0 lifa \u00fev\u00ed, 4 stig ef sj\u00faklingur hefur gert alvarlega tilraun til sj\u00e1lfsv\u00edgs, 2 batastig m\u00e1 f\u00e1 fyrir a\u00f0 sofa \u00fat n\u00f3ttina \u00ed sta\u00f0 \u00e1rv\u00f6ku o.s.fr. Kl\u00edn\u00edskt markt\u00e6kur bati af \u00feunglyndislyfjum m\u00e6ldist a\u00f0 me\u00f0altali t\u00e6p 2 batastig \u00e1 Hamilton-kvar\u00f0anum, sem er l\u00edtill munur. Bresk heilbrig\u00f0isyfirv\u00f6ld (NICE, \u00fe.e.\u00a0National Institute for Health and Clinical Excellence – Kl\u00edn\u00edskar lei\u00f0beiningar Landsp\u00edtalans fyrir \u00feunglyndi og kv\u00ed\u00f0a<\/a> eru bygg\u00f0ar \u00e1 samsvarandi lei\u00f0beiningum NICE) tekur einungis 3 stig e\u00f0a meira gild sem kl\u00edn\u00edskt markt\u00e6kan bata.<\/p>\n

Lyfjafyrirt\u00e6ki hafa brug\u00f0ist vi\u00f0 \u00feessum l\u00e9legu ni\u00f0urst\u00f6\u00f0um me\u00f0 \u00fev\u00ed a\u00f0 birta einungis j\u00e1kv\u00e6\u00f0ar ranns\u00f3knarni\u00f0urst\u00f6\u00f0ur, hampa \u00feeim og margbirta \u00fe\u00e6r j\u00e1kv\u00e6\u00f0ustu. Neikv\u00e6\u00f0u lyfjaranns\u00f3knarni\u00f0urst\u00f6\u00f0urnar l\u00edta ekki dagsins lj\u00f3s svolei\u00f0is a\u00f0 ge\u00f0l\u00e6knar og a\u00f0rir l\u00e6knar sj\u00e1 \u00fe\u00e6r ekki. Raunar m\u00e1 lyfjafyrirt\u00e6ki l\u00e1ta gera eins margar ranns\u00f3knir og \u00fea\u00f0 vill og dugir a\u00f0 s\u00fdna fram \u00e1 kl\u00edn\u00edskt markt\u00e6kan mun \u00ed tveimur ranns\u00f3knum af \u00f3t\u00f6lulegum fj\u00f6lda. \u00cd m\u00ednum augum er \u00fea\u00f0 svipa\u00f0 og ef \u00e9g m\u00e6tti kasta fimm teningum fimmt\u00edu sinnum e\u00f0a oftar og \u00feegar \u00e9g fengi loksins s\u00f6mu t\u00f6lu \u00e1 \u00f6llum teningum yr\u00f0i \u00fea\u00f0 eina kast teki\u00f0 gilt sem Yatz\u00ed en horft framhj\u00e1 hinum atrennunum.<\/p>\n

Gagnr\u00fdni \u00e1 m\u00e1lflutning Kirsch<\/strong><\/p>\n

Enginn hefur bori\u00f0 brig\u00f0ur \u00e1 t\u00f6lfr\u00e6\u00f0i\u00farvinnslu Kirsch og \u00fe.a.l. ekki hraki\u00f0 \u00fe\u00e1 fullyr\u00f0ingu a\u00f0\u00a0almennt og yfirleitt\u00a0s\u00fdnist ekkert gagn af \u00feunglyndislyfjum umfram gagn af lyfleysu. Svo vir\u00f0ist sem andst\u00e6\u00f0ingar Kirsch einbeiti s\u00e9r a\u00f0 \u00feessum u.\u00fe.b. 16% mj\u00f6g \u00feunglyndra sem vir\u00f0ast f\u00e1 einhverja b\u00f3t af \u00feunglyndislyfjum umfram m\u00e6lanleg lyfleysu\u00e1hrif. Markmi\u00f0 \u00feeirra er fyrst og fremst a\u00f0 hrekja tilg\u00e1tur Kirsch um a\u00f0 sk\u00fdringin \u00e1 batanum s\u00e9 einfaldlega s\u00fa a\u00f0 lyfleysa virki verr \u00e1 \u00feessa sj\u00faklinga en a\u00f0ra. Til \u00feess a\u00f0 hrekja tilg\u00e1tur hans setja \u00feeir fram a\u00f0rar tilg\u00e1tur og reyna jafnvel a\u00f0 meta lyfjaranns\u00f3knargagnagrunninn upp \u00e1 n\u00fdtt. D\u00e6mi um \u00feetta er n\u00fdleg grein Michael E. Thase o.fl. Assessing the \u2018true\u2019 effect of active antidepressant therapy v. placebo in major depressive disorder: use of a mixture model<\/a>\u00a0 \u00ed\u00a0 British Journal of Psyciatry<\/em> desember 2011 \u00fear sem \u00e1kv. m\u00e6lingarm\u00f3del var nota\u00f0 til a\u00f0 meta upp \u00e1 n\u00fdtt fimm lyfjaranns\u00f3knir \u00e1 escitalopram (Cipralex). S\u00fa ni\u00f0ursta\u00f0a f\u00e9kkst a\u00f0 20-25% mj\u00f6g \u00feunglyndra sj\u00faklinga fengju kl\u00edn\u00edskt markt\u00e6ka b\u00f3t af lyfinu. Gagnr\u00fdni \u00e1 \u00feessa grein felst svo einkum \u00ed gagnr\u00fdni \u00e1 m\u00e6lingarm\u00f3deli\u00f0 …<\/p>\n

\u00cd annarri grein eftir Michael E. Thase, sem hefur a\u00f0 eigin s\u00f6gn teki\u00f0 \u00fe\u00e1tt \u00ed \u00f6llum \u00feunglyndislyfjaranns\u00f3knum lyfjafyrirt\u00e6kja fr\u00e1 d\u00f6gum Prozac \u00e1 n\u00edunda \u00e1ratug s\u00ed\u00f0ustu aldar, vi\u00f0urkennir hann a\u00f0 t\u00f6lfr\u00e6\u00f0ilegar ni\u00f0urst\u00f6\u00f0ur Kirsch ver\u00f0i ekki hraktar, sj\u00e1 The Small Specific Effects of Antidepressants in Clinical Trials: What Do They Mean to Psychiatrists?<\/a> \u00ed Current Psychiatry Reports<\/em> desember 2011.\u00a0Greinin\u00a0vir\u00f0ist fyrst og fremst v\u00f6rn fyrir ge\u00f0l\u00e6kna (afskaplega l\u00e9leg v\u00f6rn finnst m\u00e9r, sem betur fer reynir Thase ekki a\u00f0 verja \u00feunglyndislyfjaranns\u00f3knirnar sem hann t\u00f3k sj\u00e1lfur \u00fe\u00e1tt \u00ed a\u00f0 gera og hvernig lyfjafyrirt\u00e6ki hafa hagr\u00e6tt ni\u00f0urst\u00f6\u00f0um \u00feeirra me\u00f0 s\u00e9rst\u00f6ku \u00farvali birtra ni\u00f0ursta\u00f0na). Ni\u00f0ursta\u00f0a hans er a\u00f0 af \u00fev\u00ed \u00feunglyndislyf geti hugsanlega n\u00fdst einhverjum litlum sj\u00faklingah\u00f3pi s\u00e9 stundum r\u00e9tt a\u00f0 \u00e1v\u00edsa \u00feeim, ofbo\u00f0slega aukningu \u00ed \u00feunglyndislyfjareseptum megi skrifa \u00e1 heimilisl\u00e6kna fyrst og fremst og\u00a0\u00ed takt vi\u00f0 t\u00edskuna klikkir hann \u00fat me\u00f0 a\u00f0 gott s\u00e9 a\u00f0 beitt s\u00e9 samt\u00edmis s\u00e1lfr\u00e6\u00f0ime\u00f0fer\u00f0 og lyfjame\u00f0fer\u00f0 vi\u00f0 dj\u00fapu \u00feunglyndi. Me\u00f0fer\u00f0in sem ge\u00f0l\u00e6knar veita s\u00e9 mikilv\u00e6gari en lyfin \u00feegar komi\u00f0 er\u00a0\u00fat \u00ed l\u00edfi\u00f0 sj\u00e1lft, \u00fe.e. \u00fat fyrir ramma tilb\u00fainna ranns\u00f3knara\u00f0st\u00e6\u00f0na, segir Thase. Hann vir\u00f0ist \u00fe\u00f3 gera \u00fev\u00ed sk\u00f3na a\u00f0 me\u00f0fer\u00f0 hj\u00e1 ge\u00f0l\u00e6kni feli \u00e1vallt \u00ed s\u00e9r lyfjame\u00f0fer\u00f0 \u00feegar miki\u00f0 veikir \u00feunglyndissj\u00faklingar eiga \u00ed hlut.<\/p>\n

Eftir 60 Minutes \u00fe\u00e1ttinn um Kirsch og N\u00fdju lyfin keisarans<\/a> \u00ed febr\u00faar sl. sendu Bandar\u00edsku ge\u00f0l\u00e6knasamt\u00f6kin (APA) fr\u00e1 s\u00e9r tilkynningu<\/a> \u00fear sem sko\u00f0anir Kirsch eru ford\u00e6mdar, hann saka\u00f0ur um a\u00f0 kynda undir h\u00e6ttulegar hugmyndir o.fl. En \u00ed tilkynningu APA eru engin r\u00f6k fyrir sta\u00f0h\u00e6fingum samtakanna. Raunar minnir \u00feessi tilkynning mig mj\u00f6g \u00e1 \u201eEn hva\u00f0 n\u00fdju f\u00f6tin keisarans eru gl\u00e6sileg og sitja vel og hva\u00f0 sl\u00f3\u00f0inn er st\u00f3rkostlegur” \u00ed s\u00f6gunni fr\u00e6gu \ud83d\ude09<\/p>\n

Um mi\u00f0jan mars 2012 kom tilkynning fr\u00e1 stj\u00f3rnarformanni Bandar\u00edsku ge\u00f0l\u00e6knasamtakanna, John M. Oldham, \u00fear sem hann segir a\u00f0 CBS, sj\u00f3nvarpsst\u00f6\u00f0in sem ger\u00f0i 60 Minutes \u00fe\u00e1ttinn um ni\u00f0urst\u00f6\u00f0ur Kirsch, hafi meina\u00f0 s\u00e9r\u00a0 a\u00f0 koma fram \u00ed \u00fe\u00e6ttinum.\u00a0(Sj\u00e1 Antidepressants and the Placebo Effect, Revisited <\/a>\u00ed Psychiatric News<\/em> 16. mars 2012.) Oldham segist hafa sent CBS br\u00e9f og be\u00f0i\u00f0 um a\u00f0 \u00fea\u00f0 v\u00e6ri birt \u00e1 heimas\u00ed\u00f0u \u00fe\u00e1ttarins en ekki var\u00f0 or\u00f0i\u00f0 vi\u00f0 \u00feeirri \u00f3sk. \u00cd br\u00e9finu segist hann hafa lagt \u00e1herslu \u00e1 a\u00f0 m\u00f6rgum sj\u00faklingum farnist vel \u00e1\u00a0\u00feunglyndislyfjum undir handlei\u00f0slu s\u00edns heimilisl\u00e6knis e\u00f0a s\u00e9rfr\u00e6\u00f0il\u00e6knis og \u00fe\u00e1tturinn g\u00e6ti hvatt \u00fe\u00e1 til a\u00f0 h\u00e6tta lyfjat\u00f6ku, jafnvel h\u00e6tta \u00ed vi\u00f0t\u00f6lum hj\u00e1 s\u00ednum l\u00e6kni, sem g\u00e6ti haft alvarlegar aflei\u00f0ingar \u00ed f\u00f6r me\u00f0 s\u00e9r. Oldham tekur undir me\u00f0 Michael Thase (sj\u00e1 kr\u00e6kju \u00ed greinar hans h\u00e9r a\u00f0 ofan) um a\u00f0 me\u00f0fer\u00f0 ge\u00f0l\u00e6kna s\u00e9 a\u00f0alatri\u00f0i en lyfin aukaatri\u00f0i. En \u00feess utan s\u00e9 sanna\u00f0 m\u00e1l a\u00f0 \u00feunglyndislyf skipti meginm\u00e1li \u00ed me\u00f0h\u00f6ndlun alvarlegs \u00feunglyndis, af \u00feeim hlj\u00f3ti f\u00f3lk oft t\u00edmabundinn bata, \u00feau komi \u00ed veg fyrir endurtekin veikindi og \u00feau bjargi mannsl\u00edfum.<\/p>\n

Andsv\u00f6r Kirsch vi\u00f0 tilkynningu Bandar\u00edsku ge\u00f0l\u00e6knasamtakanna m\u00e1 sj\u00e1 h\u00e9r<\/a>.<\/p>\n

Eigin ni\u00f0ursta\u00f0a<\/strong><\/p>\n

\"N\u00fdjuTja … eftir a\u00f0 hafa lesi\u00f0 megni\u00f0 af N\u00fdju lyfjunum keisarans<\/em> (The Emperor’s New Drugs<\/em>), horft \u00e1 60 Minutes innslagi\u00f0 um m\u00e1lflutning Kirsch og sko\u00f0a\u00f0 gagnr\u00fdni \u00feeirra sem \u00e6tla m\u00e1 a\u00f0 vert s\u00e9 a\u00f0 taka mark \u00e1\u00a0hallast \u00e9g \u00f3neitanlega a\u00f0\u00a0\u00fev\u00ed sem\u00a0Kirsch heldur fram. \u00c9g get ekki anna\u00f0 s\u00e9\u00f0 a\u00f0 n\u00fdju lyfin keisarans geri \u00e1l\u00edka\u00a0gagn og skj\u00f3li\u00f0 sem n\u00fdju f\u00f6tin keisarans veittu: Sums\u00e9 ekkert.<\/p>\n

Til vara m\u00e1 hugga sig vi\u00f0 a\u00f0 lyfleysu\u00e1hrifin framkalla bata hj\u00e1 mj\u00f6g m\u00f6rgum sem eta \u00feunglyndislyf og til frekari vara a\u00f0 e.t.v. virki \u00feunglyndislyf eitthva\u00f0 \u00e1 alvarlegt \u00feunglyndi. \u00dev\u00ed mi\u00f0ur eru \u00feessar varaskeifur til l\u00edtils gagns fyrir mig ef \u00e9g sko\u00f0a eigin reynslu af miklu lyfja\u00e1ti s\u00ed\u00f0asta \u00e1ratuginn: \u00c9g get ekki s\u00e9\u00f0 a\u00f0 nokkurt gagn hafi veri\u00f0 \u00ed \u00feeim lyfjum nema e.t.v. einu \u00feeirra sem h\u00e6tti a\u00f0 virka eftir 3-4 m\u00e1nu\u00f0i og hefur sannanlega ekki virka\u00f0 s\u00ed\u00f0an … hafi \u00fea\u00f0 \u00fe\u00e1 yfirh\u00f6fu\u00f0 virka\u00f0 \u00e1 s\u00ednum t\u00edma. Aukaverkanir af lyfjat\u00f6ku hafa oft veri\u00f0 sl\u00e6mar og eftir \u00e1 s\u00e9\u00f0 stundum r\u00fdrt l\u00edfsg\u00e6\u00f0i m\u00edn verulega.<\/p>\n

Loks er \u00e9g samm\u00e1la Thase og Oldham um a\u00f0 me\u00f0fer\u00f0 hj\u00e1 ge\u00f0l\u00e6kni feli \u00ed s\u00e9r \u00f3tal\u00a0margt anna\u00f0 en\u00a0lyf og geti veri\u00f0 mj\u00f6g til b\u00f3ta fyrir sj\u00faklinginn.<\/p>\n","protected":false},"excerpt":{"rendered":"

\u00c9g er n\u00e6stum b\u00fain a\u00f0 lesa The Emperor’s New Drugs eftir Irving Kirsch og finnst m\u00e1lflutningur hans vel r\u00f6kstuddur og sannf\u00e6randi. \u00c9g get heldur ekki s\u00e9\u00f0 a\u00f0 \u00fea\u00f0 hafi gengi\u00f0 vel a\u00f0 hrekja \u00feann m\u00e1lflutning; …<\/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-425","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\/425","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=425"}],"version-history":[{"count":1,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/425\/revisions"}],"predecessor-version":[{"id":660,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/425\/revisions\/660"}],"wp:attachment":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/media?parent=425"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/categories?post=425"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/tags?post=425"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}