{"id":450,"date":"2012-10-09T21:15:02","date_gmt":"2012-10-09T21:15:02","guid":{"rendered":"http:\/\/harpa.blogg.is\/2012-10-09\/afstada-evropskra-gedlaekna-til-thunglyndislyfja\/"},"modified":"2013-11-21T09:08:39","modified_gmt":"2013-11-21T09:08:39","slug":"afstada-evropskra-gedlaekna-til-thunglyndislyfja","status":"publish","type":"post","link":"https:\/\/harpahreins.com\/blogg\/2012\/10\/09\/afstada-evropskra-gedlaekna-til-thunglyndislyfja\/","title":{"rendered":"Afsta\u00f0a evr\u00f3pskra ge\u00f0l\u00e6kna til \u00feunglyndislyfja"},"content":{"rendered":"

\u00cd yfirl\u00fdsingu Evr\u00f3psku ge\u00f0l\u00e6knasamtakanna um gagnsemi \u00feunglyndislyfja vi\u00f0 einp\u00f3la \u00feunglyndi (Position statement of the European Psychiatric Association (EPA) on the value of antidepressants in the treatment of unipolar depression<\/a>) sem birtist \u00e1 netinu seint \u00ed n\u00f3vember 2011 og \u00ed prenta\u00f0ri \u00fatg\u00e1fu \u00ed jan\u00faar 2012 er tekin eindregin afsta\u00f0a me\u00f0 \u00feunglyndislyfjagj\u00f6f umfram a\u00f0ra kosti. \u00deetta er langt plagg en l\u00edklega gefur \u00fea\u00f0 \u00feokkalega mynd af m\u00e1lflutningnum a\u00f0 telja upp heiti undirkafla. (Af \u00fev\u00ed yfirl\u00fdsingin er skrifu\u00f0 \u00e1 \u201eevr\u00f3pskri emb\u00e6ttismannaensku\u201c er or\u00f0alag stirt og kl\u00fa\u00f0urslegt og s\u00e9r \u00feess merki \u00ed \u00fe\u00fd\u00f0ingunni.) Plaggi\u00f0 skiptist svona \u00ed undirkafla:<\/font><\/p>\n

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

1. Kynning<\/font>
\n2. Bakgrunnur: Algengi og aflei\u00f0ingar einp\u00f3la \u00feunglyndis \u00ed Evr\u00f3pu og helsti vandi vi\u00f0 a\u00f0 greina og me\u00f0h\u00f6ndla \u00fea\u00f0<\/font>
\n3. Fl\u00f3knar orsakir og birtingarmyndir \u00feunglyndis og hvernig \u00fea\u00f0 tengist einstaklingsbundinni sv\u00f6run [vi\u00f0 l\u00e6knisme\u00f0fer\u00f0] og einnig fl\u00f3kinni og einstaklingsmi\u00f0a\u00f0ri\u00a0me\u00f0fer\u00f0 vi\u00f0 \u00feunglyndi<\/font>
\n4. Gagn \u00feunglyndislyfja er vel sanna\u00f0 og \u00feau eru almennt \u00f6rugg og \u00feolast vel<\/font>
\n5. Gagn \u00feunglyndislyfja skiptir m\u00e1li \u00ed l\u00e6knisfr\u00e6\u00f0ilegri me\u00f0fer\u00f0<\/font>
\n6. Vitnisbur\u00f0ur um vi\u00f0b\u00f3tarme\u00f0fer\u00f0 me\u00f0 \u00feunglyndislyfjum samkv\u00e6mt fl\u00f3kinni me\u00f0fer\u00f0ar\u00farr\u00e6\u00f0a\u00e1\u00e6tlun<\/font>
\n7. \u00deunglyndislyf virka almennt til b\u00f3ta gegn sj\u00e1lfsv\u00edgs\u00e1formum en undir \u00e1kve\u00f0num kringumst\u00e6\u00f0um geta \u00feau haft neikv\u00e6\u00f0 \u00e1hrif<\/font>
\n8. Einstaklingsmi\u00f0a\u00f0ar l\u00e6knisfr\u00e6\u00f0ilegar \u00e1kvar\u00f0anir \u00ed me\u00f0fer\u00f0 \u00feunglyndis<\/font>
\n9.\u00a0Ni\u00f0urst\u00f6\u00f0ur<\/font><\/p>\n

\"Lyfja\u00e1r\u00f3\u00f0urAlmennt m\u00e1 segja a\u00f0 \u00feunglyndislyfjagj\u00f6f s\u00e9 hampa\u00f0 mj\u00f6g \u00ed \u00feessari yfirl\u00fdsingu. Langt m\u00e1l fer \u00ed a\u00f0 bera brig\u00f0ur \u00e1 ni\u00f0urst\u00f6\u00f0ur Kirsch o.fl. um lyfleysu\u00e1hrif \u00ed \u00feunglyndislyfjapr\u00f3funum en einnig er bent \u00e1 a\u00f0 s\u00e1lfr\u00e6\u00f0ime\u00f0fer\u00f0 hv\u00edli \u00e1 \u00f3traustum grunni, t.d. s\u00e9u engar tv\u00edblindar ranns\u00f3knir til \u00e1 gagnsemi HAM (hugr\u00e6nnar atferlisme\u00f0fer\u00f0ar). Hvernig h\u00f6fundar yfirl\u00fdsingarinnar hugsa s\u00e9r a\u00f0 h\u00e6gt s\u00e9 a\u00f0 framkv\u00e6ma sl\u00edka ranns\u00f3kn er ekki \u00fatsk\u00fdrt. \u00deunglyndislyf eiga \u00e1vallt vi\u00f0, hvort sem \u00feunglyndi er v\u00e6gt e\u00f0a alvarlegt, og \u00fe\u00e6r \u00fatgefnu kl\u00edn\u00edsku lei\u00f0beiningar \u00ed Evr\u00f3pu sem segja anna\u00f0 eru einfaldlega rangar. G\u00e6ta beri \u00feess a\u00f0 gefa ekki of litla skammta af \u00feunglyndislyfjum.<\/font><\/p>\n

Auk \u00feunglyndislyfjagjafar eru h\u00f6fundar\u00a0\u00e1kaflega hlynntir \u00fev\u00ed a\u00f0\u00a0notu\u00f0 s\u00e9u \u00f6nnur ge\u00f0lyf me\u00f0fram, til a\u00f0 auka l\u00e6knandi \u00e1hrif. M\u00e6lt er me\u00f0 \u201era\u00f0me\u00f0fer\u00f0\u201c (sequential therapy), \u00fe.e. a\u00f0 pr\u00f3fa n\u00fd og n\u00fd \u00feunglyndislyf ef fyrsta lyf virkar ekki, og samsettri [lyfja]me\u00f0fer\u00f0. Samsetta lyfjame\u00f0fer\u00f0in er t.d. a\u00f0 gefa tv\u00f6 \u00feunglyndislyf \u00far \u00f3l\u00edkum lyfjaflokkum saman (sem d\u00e6mi er nefnt SSRI-lyf og M\u00edron) og a\u00f0 gefa sefandi ge\u00f0lyf sem einkum eru notu\u00f0 vi\u00f0 ge\u00f0klofa, l\u00edt\u00edum (einkum nota\u00f0 vi\u00f0 ge\u00f0hvarfas\u00fdki) e\u00f0a skjaldkirtilshorm\u00f3n samfara \u00feunglyndislyfi. \u00d6nnur samsett me\u00f0fer\u00f0 er t.d. a\u00f0 veita s\u00e1lfr\u00e6\u00f0ime\u00f0fer\u00f0 me\u00f0, nota lj\u00f3same\u00f0fer\u00f0, rafl\u00e6kningar e\u00f0a a\u00f0ra me\u00f0fer\u00f0 sem \u00f6rvar heilann.<\/font><\/p>\n

R\u00f6kin fyrir a\u00f0 skipa lyfjame\u00f0fer\u00f0 h\u00e6stan sess \u00ed me\u00f0fer\u00f0 \u00feunglyndis eru a\u00f0 kl\u00edn\u00edsk reynsla s\u00fdni a\u00f0 \u00feetta virki. Kl\u00edn\u00edsk reynsla er hins vegar ekki s\u00e9rstaklega skilgreind og raunar teki\u00f0 fram a\u00f0 h\u00fan s\u00e9 ekki m\u00e6lanleg \u00ed ranns\u00f3knum.<\/font><\/p>\n

\u00dea\u00f0 er mj\u00f6g athyglisvert a\u00f0 sko\u00f0a tengsl h\u00f6funda yfirl\u00fdsingarinnar vi\u00f0 lyfjafyrirt\u00e6ki<\/a>. A\u00f0alh\u00f6fundurinn, Hans-J\u00fcrgen M\u00f6ller,\u00a0vir\u00f0ist hafa \u00feegi\u00f0 grei\u00f0slur fr\u00e1 og gegnt \u00fdmsum st\u00f6\u00f0um fyrir \u00f6ll \u00feau lyfjafyrirt\u00e6ki sem manni detta \u00ed hug \u00ed flj\u00f3tu brag\u00f0i og framlei\u00f0a ge\u00f0lyf. Hinir h\u00f6fundarnir hafa \u00feegi\u00f0 allt fr\u00e1 fer\u00f0a- og uppihaldsstyrkjum fr\u00e1 svolei\u00f0is fyrirt\u00e6kjum upp \u00ed a\u00f0 vera n\u00e6stum eins \u00e1 hatti me\u00f0 \u00feeim og M\u00f6ller. \u00de\u00f3tt teki\u00f0 s\u00e9 fram a\u00f0 lyfjafyrirt\u00e6ki hafi ekki styrkt ger\u00f0 \u00feessarar yfirl\u00fdsingar er \u00f3m\u00f6gulegt a\u00f0 halda a\u00f0 h\u00fan s\u00e9 skrifu\u00f0 af hlutleysi \u00feegar hagsmunatengslin eru sko\u00f0u\u00f0. Ekki kemur fram \u00e1 hve l\u00f6ngu t\u00edmabili bitlingarnir voru \u00feegnir.<\/font><\/p>\n

\u00c9g veit ekki hvort Ge\u00f0l\u00e6knaf\u00e9lag \u00cdslands er a\u00f0ili a\u00f0 Evr\u00f3psku ge\u00f0l\u00e6knasamt\u00f6kunum en Hans-J\u00fcrgen M\u00f6ller var s\u00e9rstaklega augl\u00fdstur fyrirlesari \u00e1 V\u00edsinda\u00feingi Ge\u00f0l\u00e6knaf\u00e9lags \u00cdslands 23. og 24. apr\u00edl 2010. Hann flutti \u00fear erindi um st\u00f6\u00f0u og framt\u00ed\u00f0 ge\u00f0l\u00e6kninga.<\/font>
\n\u00a0<\/p>\n

\u00cd n\u00e6stu f\u00e6rslu sko\u00f0a \u00e9g kl\u00edn\u00edskar lei\u00f0beiningar ge\u00f0svi\u00f0s Landsp\u00edtalans um me\u00f0fer\u00f0 \u00feunglyndis og kv\u00ed\u00f0a, sem ekki er fari\u00f0 eftir \u00e1 ge\u00f0svi\u00f0i Landsp\u00edtalans, og t\u00e6pi \u00e1 mismunandi sj\u00f3narmi\u00f0um \u00ed lyfjagj\u00f6f vi\u00f0 \u00feunglyndi \u00ed \u00f6rf\u00e1um \u00edslenskum greinum.<\/font>
\n\u00a0
\n\u00a0
\n\u00a0
\n\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"

\u00cd yfirl\u00fdsingu Evr\u00f3psku ge\u00f0l\u00e6knasamtakanna um gagnsemi \u00feunglyndislyfja vi\u00f0 einp\u00f3la \u00feunglyndi (Position statement of the European Psychiatric Association (EPA) on the value of antidepressants in the treatment of unipolar depression) sem birtist \u00e1 netinu seint \u00ed …<\/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-450","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\/450","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=450"}],"version-history":[{"count":1,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/450\/revisions"}],"predecessor-version":[{"id":635,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/450\/revisions\/635"}],"wp:attachment":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/media?parent=450"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/categories?post=450"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/tags?post=450"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}