{"id":449,"date":"2012-10-08T17:40:06","date_gmt":"2012-10-08T17:40:06","guid":{"rendered":"http:\/\/harpa.blogg.is\/2012-10-08\/virka-thunglyndislyf-til-skada\/"},"modified":"2013-11-21T09:08:49","modified_gmt":"2013-11-21T09:08:49","slug":"virka-thunglyndislyf-til-skada","status":"publish","type":"post","link":"https:\/\/harpahreins.com\/blogg\/2012\/10\/08\/virka-thunglyndislyf-til-skada\/","title":{"rendered":"Virka \u00feunglyndislyf til ska\u00f0a?"},"content":{"rendered":"

\"Primum\u00c1 s\u00ed\u00f0ustu \u00e1rum hafa heyrst \u00e6 h\u00e1v\u00e6rari raddir um a\u00f0 \u00feunglyndislyf geti beinl\u00ednis valdi\u00f0 \u00fev\u00ed a\u00f0 \u00feunglyndi versni. \u00dea\u00f0 er \u00fataf fyrir sig n\u00f3gu sl\u00e6mt a\u00f0 heyra af \u00fev\u00ed a\u00f0 v\u00edsindalegur grunnur undir \u00feessi lyf s\u00e9 \u00fev\u00ed mi\u00f0ur \u00ed algerum molum og a\u00f0 l\u00edklega virki \u00feau s\u00e1ral\u00edti\u00f0 betur en hveitipillur \u00e1 \u00feunglyndi (sbr. s\u00ed\u00f0ustu tv\u00e6r f\u00e6rslur); verra er ef lyfin gera sj\u00fakd\u00f3minn \u00feungb\u00e6rari.<\/font><\/p>\n

Aukaverkanir \u00feunglyndislyfja \u00e6tti a\u00f0 vera \u00f3\u00fearft a\u00f0 rekja, \u00fea\u00f0 eru \u00fea\u00f0 margir sem kannast m\u00e6tavel vi\u00f0 svolei\u00f0is aukaverkanir. Aukaverkanir eru mismunandi eftir lyfjategundum og einstaklingsbundi\u00f0 hve miki\u00f0 f\u00f3lk finnur fyrir \u00feeim. Algengar aukaverkanir af \u00feeim flestum er kyndeyf\u00f0 og \u201ea\u00f0 finnast ma\u00f0ur vera flatur\u201c, \u00fe.e. a\u00f0 tilfinningar dofni mj\u00f6g.\u00a0Af l\u00edfsh\u00e6ttulegum aukaverkunum m\u00e1 nefna aukna h\u00e6ttu \u00e1 sj\u00e1lfsv\u00edgi, einkum \u00ed upphafi me\u00f0fer\u00f0ar. \u00deegar beitt er fj\u00f6llyfjagj\u00f6f, eins og oftast t\u00ed\u00f0kast s\u00e9 sj\u00faklingur \u00e1litinn \u00feunglyndur a\u00f0 r\u00e1\u00f0i, getur samspil \u00feunglyndislyfja og annarra lyfja haft l\u00edfsh\u00e6ttu \u00ed f\u00f6r me\u00f0 s\u00e9r. (Sj\u00e1 t.d. greinarnar Lyfjaspurningin: Of miki\u00f0 ser\u00f3t\u00f3n\u00edn \u00ed heilanum?<\/a> og Lyfjaspurningin. Geta milliverkanir lyfja leitt til lengingar \u00e1 QT-bili?<\/a> \u00ed L\u00e6knabla\u00f0inu <\/i>2010 og 2012.)<\/font>
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Giovanni A. Fava hefur skrifa\u00f0 margar greinar um \u00feann ska\u00f0a sem \u00feunglyndislyf kunna a\u00f0 valda, einkum \u00feann a\u00f0 \u00feau kunni a\u00f0 gera \u00feunglyndi\u00f0 verra. \u00cd grein hans og Emanuela Offidania sem birtist \u00ed \u00e1g\u00fast 2011<\/a> segir a\u00f0 \u00fe\u00f3tt \u00feunglyndislyf s\u00fdni g\u00f3\u00f0a verkun \u00e1 \u00feunglyndiskast [Fava veltir ekki fyrir s\u00e9r hvort s\u00fa g\u00f3\u00f0a verkun s\u00e9 lyfleysu\u00e1hrif] virki \u00feau s\u00ed\u00f0ur vi\u00f0 endurtekinni dj\u00fapri ge\u00f0l\u00e6g\u00f0 e\u00f0a sem fyrirbyggjandi a\u00f0ger\u00f0 gegn \u00fev\u00ed a\u00f0 sj\u00faklingi versni aftur. Menn h\u00e9ldu \u00e1\u00f0ur a\u00f0 sj\u00faklingar sem t\u00e6kju \u00feunglyndislyf t\u00edmabundi\u00f0 (h\u00e6ttu t\u00f6ku \u00feess innan h\u00e1lfs \u00e1rs) bi\u00f0u l\u00edtinn ska\u00f0a af en \u00ed ranns\u00f3kn sem Helga Gar\u00f0arsd\u00f3ttir o.fl. hafi birt 2009<\/a> s\u00fdni sig a\u00f0 enginn munur er \u00e1 \u00feeim \u00fea\u00f0 ger\u00f0u og \u00feeim sem t\u00f3ku \u00feunglyndislyf helmingi lengur: Sama h\u00e6tta er \u00e1 a\u00f0 veikjast aftur. L\u00edkurnar \u00e1 a\u00f0 veikjast aftur h\u00e6kka svo um 23% taki f\u00f3lk \u00feunglyndislyf \u00ed meir en \u00e1r skv. \u00feeirri ranns\u00f3kn.<\/font><\/p>\n

Fava telur a\u00f0 \u00feegar \u00feunglyndislyfjum er \u00e1v\u00edsa\u00f0 \u00ed meir en h\u00e1lft \u00e1r (6-9 m\u00e1nu\u00f0i) hverfi kl\u00edn\u00edsk verkun lyfsins vegna \u00feess a\u00f0 bo\u00f0efnakerfi heilans hefur \u00fe\u00e1 l\u00e6rt a\u00f0 vinna gegn \u00feeim. Auk \u00feess s\u00e9 h\u00e6tta \u00e1 a\u00f0 v\u00e6gt \u00feunglyndi breytist \u00ed illv\u00edgt me\u00f0fer\u00f0ar\u00feoli\u00f0 \u00feunglyndi s\u00e9u lyfin tekin lengi. \u00deegar \u00feunglyndislyfjagj\u00f6f er h\u00e6tt eftir svo langan t\u00edma geta fr\u00e1hvarfseinkenni og vi\u00f0br\u00f6g\u00f0in sem lyfin kveiktu \u00ed bo\u00f0efnakerfi heilans hrint af sta\u00f0 n\u00fdju \u00feunglyndiskasti. \u00dev\u00ed meir sem lyfjaskammtar s\u00e9u h\u00e6kka\u00f0ir og \u00fev\u00ed oftar sem skipt er um \u00feunglyndislyf \u00fev\u00ed meiri eru l\u00edkurnar \u00e1 a\u00f0 sj\u00fakd\u00f3murinn versni.<\/font>
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\u00cd tveimur n\u00fdlegum greinum, sem \u00fer\u00f3unars\u00e1lfr\u00e6\u00f0ingurinn Paul W. Andrews er a\u00f0alh\u00f6fundur a\u00f0 er annars vegar r\u00e6kilega \u00fatsk\u00fdrt hva\u00f0a \u00e1hrif \u00feunglyndislyf hafa \u00e1 heilann og hvernig \u00feau \u00e1hrif geti veri\u00f0 til \u00fdmiss ska\u00f0a, jafnvel valdi\u00f0 \u00f3afturkr\u00e6fum ska\u00f0a (sj\u00e1 Primum Non Nocere: An Evolutionary Analysis of Whether Antidepressants Do More Harm than Good<\/a>) og hins vegar s\u00fdnt fram \u00e1 me\u00f0 safnranns\u00f3kn (meta-analysis) a\u00f0 \u00feunglyndislyf tefja bata og kunna a\u00f0 \u00fdta undir endurtekin \u00feunglyndisk\u00f6st. (Sj\u00e1 Blue Again: Perturbational Effects of Antidepressants Suggest Monoaminergic Homeostasis in Major Depression<\/a>).\u00a0B\u00e1\u00f0ar \u00feessar greinar eru mj\u00f6g langar og \u00e1 k\u00f6flum ansi \u00feungur texti fyrir f\u00f3lk eins og mig sem hefur takmarka\u00f0a \u00feekkingu \u00e1 efnafr\u00e6\u00f0i og t\u00f6lfr\u00e6\u00f0i. (Auk \u00feess er \u00e9g \u00f3samm\u00e1la \u00fer\u00f3unarfr\u00e6\u00f0ilegu sk\u00fdringunni \u00e1 \u00feunglyndi sem Andrews hampar.) En \u00ed \u00feeim er ger\u00f0 mj\u00f6g r\u00e6kileg grein fyrir efninu og v\u00edsa\u00f0 \u00ed fj\u00f6lda heimilda sem koma a\u00f0 gagni vilji menn kynna s\u00e9r ska\u00f0leg \u00e1hrif \u00feunglyndislyfja \u00e1 heilann e\u00f0a ranns\u00f3knir sem s\u00fdna a\u00f0 \u00feunglyndislyf geti \u00fdtt undir \u00fea\u00f0 a\u00f0 sj\u00faklingi elnar s\u00f3ttin.<\/font><\/p>\n

\u00cd s\u00ed\u00f0arnefndu grein Andrews o.fl., Blue Again: Perturbational Effects of Antidepressants Suggest Monoaminergic Homeostasis in Major Depression<\/a>, segir a\u00f0 \u201em\u00f3tst\u00f6\u00f0u\u00feol\u201c (oppositional tolerance) myndist \u00feegar \u00feunglyndislyf raska taugabo\u00f0efnakerfi heilans. \u00deegar lyfjat\u00f6kunni er h\u00e6tt kemst taugabo\u00f0efnakerfi\u00f0 ekki sj\u00e1lfkrafa \u00ed jafnv\u00e6gi. \u00dev\u00ed meiri \u00e1hrif sem \u00feunglyndislyf hafa \u00e1 taugabo\u00f0efni \u00fev\u00ed har\u00f0ari ver\u00f0a r\u00f6ng vi\u00f0br\u00f6g\u00f0 taugabo\u00f0efniskerfisins \u00feegar \u00e1hrifa lyfjanna g\u00e6tir ekki lengur. \u00deessi sannindi s\u00e9u samt engan veginn v\u00edsbending um a\u00f0 eitthva\u00f0 hafi \u00ed upphafi veri\u00f0 bogi\u00f0 vi\u00f0 taugabo\u00f0efnakerfi \u00ed heilum \u00feunglyndra. Ef \u00e1 hinn b\u00f3ginn skyldi vera eitthva\u00f0 til \u00ed bo\u00f0aefna-\u00f3jafnv\u00e6giskenningunni v\u00e6ri l\u00edka h\u00e6gt a\u00f0 sk\u00fdra hva\u00f0 \u00feunglyndislyf virka takmarka\u00f0 me\u00f0 \u00feessu m\u00f3tst\u00f6\u00f0u\u00feoli, bo\u00f0efnakerfi heilans l\u00e6rir nefnilega a\u00f0 vinna gegn lyfjunum. (Hvernig \u00fea\u00f0 gerist er \u00edtarlega sk\u00fdrt \u00ed hinni greininni, Primum Non Nocere …<\/a>)<\/font><\/p>\n

Andrews og f\u00e9lagar f\u00f3ru yfir fj\u00f6lda ranns\u00f3kna \u00e1 \u00fev\u00ed \u00ed hve miklum m\u00e6li f\u00f3lk veikist aftur \u00feegar \u00fea\u00f0 h\u00e6ttir \u00e1 \u00feunglyndislyfi bori\u00f0 saman vi\u00f0 f\u00f3lk sem h\u00e6ttir \u00e1 lyfleysu. \u00deeir vitna \u00ed margar ranns\u00f3knir sem \u00feeir telja s\u00fdna a\u00f0 \u00feunglyndissj\u00faklingum sem ekki taka lyf batnar miklu hra\u00f0ar en \u00feeim sem taka \u00feunglyndislyf. Me\u00f0allengd dj\u00faprar ge\u00f0l\u00e6g\u00f0ar er 12-13 vikur taki sj\u00faklingur ekki \u00feunglyndislyf, skv. \u00feessum ranns\u00f3knum (sem eru ekki n\u00fdjar af n\u00e1linni enda l\u00edklega erfitt n\u00fa a\u00f0 finna \u00feunglyndissj\u00faklinga sem ekki er \u00e1v\u00edsa\u00f0 lyfjum). \u00deunglyndislyf byrji ekki a\u00f0 virka fyrr en eftir nokkrar vikur og yfirleitt eru sj\u00faklingar l\u00e1tnir taka \u00feau m\u00e1nu\u00f0um saman. \u00deetta bendi til \u00feess a\u00f0 \u00feunglyndislyfjamer\u00f0fer\u00f0 tefji fyrir sj\u00e1lfkrafa bata \u00ed \u00feunglyndiskasti. (Pasternak o.fl., sem margir v\u00edsa til, dr\u00f3gu \u00fe\u00e1 \u00e1lyktun af sinni ranns\u00f3kn<\/a> a\u00f0 me\u00f0allengd dj\u00faprar ge\u00f0l\u00e6g\u00f0ar v\u00e6ri 23 vikur ef sj\u00faklingar t\u00e6kju \u00feunglyndislyf.)<\/font><\/p>\n

\u00deeir nefna a\u00f0 \u00feunglyndissj\u00faklingum s\u00e9 \u00ed s\u00edvaxandi m\u00e6li \u00e1v\u00edsa\u00f0 \u00fdmiss konar \u00f6\u00f0rum ge\u00f0lyfjum me\u00f0 \u00feunglyndislyfjum til a\u00f0 auka \u00e1hrif \u00feeirra. A\u00f0 mati Andrews og f\u00e9laga ruglar \u00feetta bo\u00f0efnakerfi heilans enn meir sem g\u00e6ti enn auki\u00f0 h\u00e6ttuna \u00e1 bakslagi \u00feegar lyfjat\u00f6ku er h\u00e6tt.<\/font>
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\u00deeir sem hallast a\u00f0 \u00fev\u00ed a\u00f0 ni\u00f0urst\u00f6\u00f0ur ranns\u00f3kna hafi takmarka\u00f0 gildi \u00feegar kl\u00edn\u00edsk reynsla segi anna\u00f0 (eins og t.d. er marghamra\u00f0 \u00e1 \u00ed n\u00fdlegri yfirl\u00fdsingu Evr\u00f3psku ge\u00f0l\u00e6knasamtakanna um gagnsemi \u00feunglyndislyfja<\/a>) hef\u00f0u gott af \u00fev\u00ed a\u00f0 lesa grein ge\u00f0l\u00e6knisins Joanna Moncrieff, Why is it so difficult to stop psychiatric drug treatment? It may be nothing to do with the original problem<\/a> fr\u00e1 2006 \u00fev\u00ed \u00fear vitnar h\u00fan oft \u00ed s\u00edna kl\u00edn\u00edsku reynslu (auk \u00fdmissa ranns\u00f3kna). Af \u00feeirri reynslu megi draga \u00fe\u00e1 \u00e1lyktun a\u00f0 \u00fea\u00f0 s\u00e9 afar erfitt a\u00f0 h\u00e6tta \u00e1 ge\u00f0lyfjum, jafnvel \u00fe\u00f3tt ni\u00f0urtr\u00f6ppun s\u00e9 h\u00e6g. H\u00fan fjallar s\u00ed\u00f0an um \u00fdmis ge\u00f0lyf, \u00fe.\u00e1.m. \u00feunglyndislyf, og kemst a\u00f0 \u00feeirri ni\u00f0urst\u00f6\u00f0u a\u00f0 hvers kyns \u00edhlutun \u00ed taugabo\u00f0efnakerfi heilans geti haft alvarleg eftirk\u00f6st. \u00deegar sj\u00faklingur h\u00e6ttir \u00e1 lyfjum og veikist s\u00e9 \u00fea\u00f0 oftar en ekki fr\u00e1hvarfseinkenni e\u00f0a \u00f6nnur aflei\u00f0ing af lyfjagj\u00f6finni en ekki a\u00f0 sj\u00fakd\u00f3murinn brj\u00f3tist fram \u00e1 n\u00fd. \u00cd b\u00f3kinni The Myth of the Chemical Cure<\/i> fer h\u00fan miklu d\u00fdpra \u00ed efni\u00f0 og v\u00edsar til fj\u00f6lda ranns\u00f3kna en meginni\u00f0ursta\u00f0an er hin sama.<\/font>
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S\u00fa litla b\u00f3t sem \u00e9g kann a\u00f0 hafa haft af \u00feunglyndislyfjum \u00ed minni sj\u00fakd\u00f3msg\u00f6ngu eru l\u00edklega lyfleysu\u00e1hrif og \u00feau heldur l\u00e9leg. Og \u00feegar \u00e9g byrja\u00f0i a\u00f0 kynna m\u00e9r \u00feunglyndislyf fyrir sk\u00f6mmu taldi \u00e9g a\u00f0 \u00feau hef\u00f0u veri\u00f0 tilt\u00f6lulega meinlaus mi\u00f0a\u00f0 vi\u00f0 m\u00f6rg \u00f6nnur \u00feau lyf sem m\u00e9r hafa veri\u00f0 \u00e1v\u00edsa\u00f0.\u00a0 En eftir a\u00f0 hafa lesi\u00f0 m\u00e9r til og skrifa\u00f0 \u00ferj\u00e1r f\u00e6rslur um efni\u00f0 hafa n\u00fa runni\u00f0 \u00e1 mig tv\u00e6r gr\u00edmur hva\u00f0 \u00feetta var\u00f0ar. Hva\u00f0 \u00e1hrif \u00e6tli st\u00f6\u00f0ugt hringl me\u00f0 \u00feunglyndislyfjategundir hafi haft \u00ed gegnum t\u00ed\u00f0ina? Hva\u00f0 eftir anna\u00f0 var \u00e9g l\u00e1tin sn\u00f6ggh\u00e6tta \u00e1 einu \u00feunglyndislyfi, \u00fev\u00ed \u00fea\u00f0 reyndist ekki virka e\u00f0a virka\u00f0i einungis mj\u00f6g t\u00edmabundi\u00f0, og byrja \u00e1 \u00f6\u00f0ru. Og oft voru lyfjaskammtarnir talsvert h\u00e6rri en r\u00e1\u00f0lag\u00f0ir dagskammtar.<\/font><\/p>\n

Eina \u00feunglyndislyfi\u00f0 sem \u00e9g man almennilega hvernig var a\u00f0 h\u00e6tta \u00e1 var \u00fea\u00f0 fyrsta, Seroxat (SSRI-lyf). M\u00e9r var \u00e1v\u00edsa\u00f0 \u00fev\u00ed \u00feegar \u00e9g veiktist fyrst, 1998, og t\u00f3k \u00fea\u00f0 \u00ed tv\u00f6 \u00e1r. \u00de\u00e1 var \u00e9g h\u00e6tt a\u00f0 \u00feola \u00feetta lyf, f\u00e9kk hro\u00f0alega \u00f3\u00fe\u00e6gilega f\u00f3ta\u00f3eir\u00f0 sem ger\u00f0i \u00fea\u00f0 a\u00f0 verkum a\u00f0 \u00e9g \u00e1tti mj\u00f6g erfitt me\u00f0 a\u00f0 sofna. M\u00e9r lei\u00f0 illa skv. \u00fatfyllingu \u00e1 Beck’s \u00feunglyndiskvar\u00f0anum (en \u00e9g hef miklar efasemdir um gagnsemi \u00feess kvar\u00f0a n\u00fana) og var upp\u00e1lagt a\u00f0 sn\u00f6ggh\u00e6tta \u00e1 Seroxati og sn\u00f6ggbyrja \u00e1 Remeron (heitir n\u00fana M\u00edron og er ekki SSRI-lyf). Vikurnar \u00e1 eftir upplif\u00f0i \u00e9g eitthva\u00f0 sem l\u00edktist mest fyrirt\u00ed\u00f0arspennu \u00e6tta\u00f0ri \u00far helv\u00edti: \u00c9g hef\u00f0i geta\u00f0 drepi\u00f0 mann og annan! M\u00e9r finnst ekkert skr\u00edti\u00f0 \u00fe\u00f3tt \u00f3virkir alkar falli \u00feegar \u00feeir eru l\u00e1tnir sn\u00f6ggh\u00e6tta \u00e1 Seroxat, eins og \u00e9g veit nokkur d\u00e6mi um, \u00e1hrifin eru \u00feannig. Seinna meir var \u00e9g l\u00e1tin byrja aftur a\u00f0 taka Seroxat af \u00fev\u00ed M\u00edroni\u00f0 haf\u00f0i \u00fe\u00e1 aukaverkun a\u00f0 stytta t\u00ed\u00f0ahring um viku og kannski g\u00e6ti Seroxati\u00f0 slegi\u00f0 \u00e1 \u00fea\u00f0 … n\u00fa e\u00f0a fyrirt\u00ed\u00f0arspennu sem M\u00edroni\u00f0 magna\u00f0i upp … og svefnlyf l\u00f6gu\u00f0u aukaverkunina spennu og \u00f3eir\u00f0 af Seroxati … og svo h\u00e6tti M\u00edron a\u00f0 virka … og svo framvegis.<\/font><\/p>\n

Myndin s\u00fdnir Hippokrates fr\u00e1 Kos og \u00feau fr\u00e6gu or\u00f0 Primum non nocere (Umfram allt ska\u00f0a ekki) sem Hippokrates sag\u00f0i ekki. \u00cd upprunalegum ei\u00f0staf \u00feeim sem kenndur er vi\u00f0 Hippokrates og \u00fatskrifa\u00f0ir l\u00e6knanemar \u00ed Vesturl\u00f6ndum s\u00f3ru vi\u00f0 segir:\u00a0\u201e\u0394\u03b9\u03b1\u03b9\u03c4\u03ae\u03bc\u03b1\u03c3\u03af \u03c4\u03b5 \u03c7\u03c1\u03ae\u03c3\u03bf\u03bc\u03b1\u03b9 \u1f10\u03c0’ \u1f60\u03c6\u03b5\u03bb\u03b5\u03af\u1fc3 \u03ba\u03b1\u03bc\u03bd\u03cc\u03bd\u03c4\u03c9\u03bd \u03ba\u03b1\u03c4\u1f70 \u03b4\u03cd\u03bd\u03b1\u03bc\u03b9\u03bd \u03ba\u03b1\u1f76 \u03ba\u03c1\u03af\u03c3\u03b9\u03bd \u1f10\u03bc\u1f74\u03bd, \u1f10\u03c0\u1f76 \u03b4\u03b7\u03bb\u03ae\u03c3\u03b5\u03b9 \u03b4\u1f72 \u03ba\u03b1\u1f76 \u1f00\u03b4\u03b9\u03ba\u03af\u1fc3 \u03b5\u1f34\u03c1\u03be\u03b5\u03b9\u03bd.\u201c, or\u00f0r\u00e9tt: \u201e\u00c9g mun nota matar\u00e6\u00f0i [l\u00e6kningar]\u00a0til a\u00f0 a\u00f0sto\u00f0a \u00fe\u00e1 sj\u00faku eftir \u00fev\u00ed sem \u00e9g hef m\u00e1tt og d\u00f3mgreind til og einnig halda mig fr\u00e1 \u00fev\u00ed a\u00f0 ska\u00f0a heilsu og [halda mig fr\u00e1] \u00f3r\u00e9ttl\u00e6ti.\u201c\u00a0\u00cd \u00feeirri \u00fatg\u00e1fu Hippokratesarei\u00f0sins sem \u00edslenskir l\u00e6knar undirrita n\u00fa hefur \u00feetta veri\u00f0 umor\u00f0a\u00f0 \u00ed \u201ea\u00f0 beita kunn\u00e1ttu minni me\u00f0 fullri al\u00fa\u00f0 og samviskusemi.\u201c Annars sta\u00f0ar er haft eftir Hippokratesi \u201e\u1f00\u03c3\u03ba\u03ad\u03b5\u03b9\u03bd, \u03c0\u03b5\u03c1\u1f76 \u03c4\u1f70 \u03bd\u03bf\u03c5\u03c3\u03ae\u03bc\u03b1\u03c4\u03b1, \u03b4\u03cd\u03bf, \u1f60\u03c6\u03b5\u03bb\u03ad\u03b5\u03b9\u03bd, \u1f22 \u03bc\u1f74 \u03b2\u03bb\u03ac\u03c0\u03c4\u03b5\u03b9\u03bd<\/font>\u201c<\/font> e\u00f0a \u201eHva\u00f0 var\u00f0ar l\u00e6kningu\/hj\u00fakrun vi\u00f0 sj\u00fakd\u00f3mum, [\u00fearf a\u00f0 hafa] tvennt [\u00ed huga], gj\u00f6ri\u00f0 gagn, spilli\u00f0\/ska\u00f0i\u00f0 ei.\u201c<\/p>\n

Heimildir<\/font>
\n\u00a0<\/p>\n

Andrews, Paul W. o.fl. 2011. Blue Again: Perturbational Effects of Antidepressants Suggest Monoaminergic Homeostasis in Major Depression<\/a>. Frontiers in Psychology<\/i> 2. \u00e1rg.<\/font><\/p>\n

Andrews, Paul W. o.fl.\u00a0 2012. Primum Non Nocere: An Evolutionary Analysis of Whether Antidepressants Do More Harm than Good<\/a>. Frontiers in Psychology<\/i> 3. \u00e1rg.<\/font><\/p>\n

Fava, Giovanni A. og Emanuela Offidania. 2011. The mechanisms of tolerance in antidepressant action<\/a>. Progress in Neuro-Psychopharmacology and Biological Psychiatry<\/i> 35:5 , s. 1593\u20131602.<\/font><\/p>\n

Gardarsdottir, Helga o.fl. 2009. Duration of Antidepressant Drug Treatment and Its Influence on Risk of Relapse\/Recurrence: Immortal and Neglected Time Bias<\/a>. American Journal of Epidemiology<\/i> 170:3, s. 280-285.<\/font><\/p>\n

El\u00edn I. Jacobsen, Einar S. Bj\u00f6rnsson. 2010. Lyfjaspurningin: Of miki\u00f0 ser\u00f3t\u00f3n\u00edn \u00ed heilanum?<\/a> L\u00e6knabla\u00f0i\u00f0<\/i> 12. tbl. 96.\u00e1rg.<\/font><\/p>\n

El\u00edn I. Jacobsen, Einar S. Bj\u00f6rnsson. 2012,\u00a0 Lyfjaspurningin. Geta milliverkanir lyfja leitt til lengingar \u00e1 QT-bili?<\/a> L\u00e6knabla\u00f0i\u00f0 <\/i>10. tbl. 98. \u00e1rg.<\/font><\/p>\n

Herrell, Howard. 2000.\u00a0 The Hippocratic Oath: A Commentary and Translation<\/a>. Utilis.net.<\/font><\/p>\n

Middleton, Hugh og Joanna Moncrieff.\u00a0 2011. \u2018They won’t do any harm and might do some good\u2019: time to think again on the use of antidepressants?<\/a> British Journal of\u00a0 General\u00a0 Practice<\/i>. 1:61(582), s. 47\u201349. [T\u00edmariti\u00f0 h\u00e9t \u00e1\u00f0ur The Journal of the Royal College of General Practitioners<\/i>.]<\/font><\/p>\n

Moncrieff, Joanna. 2006. Why is it so difficult to stop psychiatric drug treatment? It may be nothing to do with the original problem<\/a>. Medical Hypotheses<\/i>.[Greinin hefur \u00e1tt a\u00f0 birtast \u00ed 68. \u00e1rgangi \u00feessa t\u00edmarits en \u00e9g fann einungis fyrirfram birta vefgrein \u00fear sem t\u00f6lubla\u00f0s og \u00e1rgangs er ekki geti\u00f0.]<\/font><\/p>\n

Moncrieff, Joanna og David Cohen. 2006.\u00a0 Do Antidepressants Cure or Create Abnormal Brain States?<\/a> PLOS Medicine<\/i> 3(7): e240.<\/font><\/p>\n

Moncrieff, Joanna. The Myth of the Chemical Cure<\/i>. A Critique of Psychiatric Drug Treatment<\/i>. 2008.<\/font><\/p>\n

Primum non nocere<\/a> \u00e1 Wikipedia<\/i>.<\/font><\/p>\n

Posternak o.fl. 2006. The naturalistic course of unipolar major depression in the absence of somatic therapy<\/a>. Journal of Nervous & Mental Disease<\/i> 194:5, s. 324-329.<\/font>
\nEkki er au\u00f0velt a\u00f0 finna greinina \u00ed opnum a\u00f0gangi og\u00a0 h\u00e9r er kr\u00e6kt \u00ed skanna\u00f0a \u00fatg\u00e1fu \u00e1 s\u00ed\u00f0u Robert Withaker.<\/font><\/p>\n

Stef\u00e1n B. Sigur\u00f0sson. 2006.\u00a0 \u201eHvernig hlj\u00f3mar ei\u00f0urinn sem l\u00e6knar sverja?\u201c<\/a>. V\u00edsindavefurinn<\/i> 24.3.2006.<\/font>
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\u00c1 s\u00ed\u00f0ustu \u00e1rum hafa heyrst \u00e6 h\u00e1v\u00e6rari raddir um a\u00f0 \u00feunglyndislyf geti beinl\u00ednis valdi\u00f0 \u00fev\u00ed a\u00f0 \u00feunglyndi versni. \u00dea\u00f0 er \u00fataf fyrir sig n\u00f3gu sl\u00e6mt a\u00f0 heyra af \u00fev\u00ed a\u00f0 v\u00edsindalegur grunnur undir \u00feessi lyf …<\/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-449","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\/449","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=449"}],"version-history":[{"count":1,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/449\/revisions"}],"predecessor-version":[{"id":636,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/449\/revisions\/636"}],"wp:attachment":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/media?parent=449"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/categories?post=449"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/tags?post=449"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}