{"id":485,"date":"2013-02-08T19:54:56","date_gmt":"2013-02-08T19:54:56","guid":{"rendered":"http:\/\/harpa.blogg.is\/2013-02-08\/geldingarlyf-andvokulyf-sjalfsvigshvatalyf\/"},"modified":"2013-11-19T09:58:16","modified_gmt":"2013-11-19T09:58:16","slug":"geldingarlyf-andvokulyf-sjalfsvigshvatalyf","status":"publish","type":"post","link":"https:\/\/harpahreins.com\/blogg\/2013\/02\/08\/geldingarlyf-andvokulyf-sjalfsvigshvatalyf\/","title":{"rendered":"Geldingarlyf, andv\u00f6kulyf, sj\u00e1lfsv\u00edgshvatalyf …"},"content":{"rendered":"

\u00c9g var a\u00f0 lesa greinina Relabeling the Medications We Call Antidepressants<\/a> eftir David Healy og David Antonuccio (birtist \u00ed Scientifica<\/i> 2012). A\u00f0 v\u00edsu vissi \u00e9g fyrir flest \u00fea\u00f0 sem \u00feeir fjalla um en d\u00e1ist a\u00f0 stuttu og skipulegu yfirliti og m\u00e6li eindregi\u00f0 me\u00f0 \u00feessari grein hafi menn \u00e1huga \u00e1 \u00fev\u00ed hvort \u00feunglyndislyf virki vi\u00f0 \u00feunglyndi og hvernig \u00feau virka sannanlega \u00e1 \u00fdmsan annan \u00f3heppilegan m\u00e1ta. Greinarnar sem \u00feeir v\u00edsa \u00ed eru flestar a\u00f0gengilegar \u00ed landsa\u00f0gangi (gegnum hvar.is<\/a>).<\/font><\/p>\n

\"SpurningHealy og Antonuccio\u00a0draga upp nokkrar\u00a0m\u00e6listikur og m\u00e1ta algeng \u00feunglyndislyf vi\u00f0 \u00fe\u00e6r. <\/font><\/p>\n

Fyrsta m\u00e6listikan er: \u00deunglyndislyf \u00e6tti a\u00f0 s\u00fdna markt\u00e6kt meiri verkun en lyfleysa. \u00deeir gera grein fyrir fr\u00e6gustu ranns\u00f3knum \u00e1 \u00feessu og rekja ni\u00f0urst\u00f6\u00f0ur \u00feeirra sem eru \u00ed stuttu m\u00e1li sagt a\u00f0 bati af \u00feunglyndislyfjum umfram lyfleysu m\u00e6list s\u00e1ral\u00edtill og n\u00e6r eing\u00f6ngu \u00ed h\u00f3pi sj\u00faklinga sem teljast f\u00e1rveikir af \u00feunglyndi. Raunar er \u00feessi litli munur sem m\u00e6list l\u00edka h\u00e1lfger\u00f0 blekking \u00fev\u00ed yfirleitt leyfist sj\u00e1lfsv\u00edgskand\u00edd\u00f6tum ekki a\u00f0 taka \u00fe\u00e1tt \u00ed lyfjaranns\u00f3knum lyfjafyrirt\u00e6kja og \u00ed m\u00f6rgum ranns\u00f3knum er byrja\u00f0 \u00e1 a\u00f0 gefa \u00f6llum lyfleysu \u00ed tv\u00e6r vikur og \u00feeir reknir \u00far ranns\u00f3kninni sem byrjar a\u00f0 batna af lyfleysunni (\u201ewash-out period\u201c er \u00feetta kalla\u00f0 og dregur au\u00f0vita\u00f0 \u00far m\u00f6guleikanum \u00e1 a\u00f0 lyfleysa ein og s\u00e9r sv\u00ednvirki \u00e1 \u00fe\u00e1tttakendur). <\/font><\/p>\n

\u00deeir gera l\u00edka grein fyrir h\u00f6rmulegum ni\u00f0urst\u00f6\u00f0um sem fengust \u00ed risast\u00f3rri ranns\u00f3kn sem sn\u00e9rist um \u00e1rangur af \u00feunglyndislyfjum \u00ed raunheimi en ekki st\u00fdr\u00f0um t\u00edmabundnum lyfjaranns\u00f3knum, \u00fe.e. STAR*D ranns\u00f3kninni. \u00cd henni voru pr\u00f3fa\u00f0ar \u00fdmsar samsetningar sem \u00e1ttu a\u00f0 n\u00fdtast \u00feunglyndissj\u00faklingum, s.s. fleiri \u00feunglyndislyf en eitt samt\u00edmis, sto\u00f0lyf \u00far \u00f6\u00f0rum lyfjaflokkum e\u00f0a hugr\u00e6n atferlisme\u00f0fer\u00f0 sem sto\u00f0. Sj\u00faklingunum var fylgt eftir \u00ed \u00e1r og \u00ed lj\u00f3s kom a\u00f0 3% batna\u00f0i a\u00f0 r\u00e1\u00f0i (108 \u00feunglyndissj\u00faklingum af 4.041); hinir \u00fdmist h\u00e6ttu \u00fe\u00e1ttt\u00f6ku \u00ed ranns\u00f3kninni e\u00f0a n\u00e1\u00f0u einungis mj\u00f6g t\u00edmabundnum bata og veiktust aftur. \u00dea\u00f0 sem er kannski a\u00f0allega athyglisvert \u00ed sambandi vi\u00f0 ni\u00f0urst\u00f6\u00f0ur STAR*D k\u00f6nnunarinnar er a\u00f0 \u00ed fyrstu birtu ni\u00f0urst\u00f6\u00f0um, \u00fe.e. \u00e1 vegum \u00feeirra sem ger\u00f0u ranns\u00f3knina, var \u00fev\u00ed haldi\u00f0 fram a\u00f0 67% \u00fe\u00e1tttakenda hef\u00f0i batna\u00f0 \u00feunglyndi\u00f0 me\u00f0 \u00feessum a\u00f0fer\u00f0um …<\/font><\/p>\n

\u00deunglyndislyf eru vegin og l\u00e9ttv\u00e6g fundin \u00ed \u00f6\u00f0ru \u00fev\u00ed mati sem Healy og Antonuccio nota. Sumar ni\u00f0urst\u00f6\u00f0urnar eru au\u00f0vita\u00f0 vel\u00feekktar, s.s. aukin sj\u00e1lfsv\u00edgsh\u00e6tta ungs f\u00f3lks sem gefi\u00f0 er \u00feunglyndislyf (\u00feess vegna er svartur a\u00f0v\u00f6runarmi\u00f0i \u00e1 \u00feessum lyfjum \u00ed Bandar\u00edkjunum, \u00e9g veit ekki hvort svo er h\u00e9r \u00e1 landi) e\u00f0a s\u00fa mj\u00f6g algenga og vel\u00feekkta aukaverkun flestra algengustu \u00feunglyndislyfjanna a\u00f0 draga \u00far e\u00f0a drepa kynhv\u00f6t f\u00f3lks.<\/font><\/p>\n

M\u00e9r \u00fe\u00f3tti athyglisvert a\u00f0 lesa samantekt \u00feeirra um ranns\u00f3knir sem benda til \u00feess a\u00f0 \u00ed sumum tilvikum auki \u00feunglyndislyf l\u00edkurnar \u00e1 vi\u00f0varandi \u00feunglyndi. Um \u00feetta haf\u00f0i \u00e9g lesi\u00f0 svol\u00edti\u00f0 \u00e1\u00f0ur, t.d. flestar greinarnar sem \u00feeir v\u00edsa \u00ed, en var ekki b\u00fain a\u00f0 l\u00e6ra hugtaki\u00f0 \u201etardive dysphoria\u201c sem m\u00e6tti kalla s\u00ed\u00f0komna vanl\u00ed\u00f0an\/\u00f3eir\u00f0 \u00e1 \u00edslensku (hugtaki\u00f0 er b\u00fai\u00f0 til me\u00f0 hli\u00f0sj\u00f3n af vel\u00feekkta hugtakinu\u00a0\u201etardive dyskinesia\u201c, s\u00ed\u00f0komin hreyfitruflun sem fylgir st\u00f6ku sinnum t\u00f6ku sefandi lyfja og l\u00fdsir s\u00e9r \u00ed k\u00e6kjum og kippum\u00a0 … \u00ed rauninni er s\u00ed\u00f0komin s\u00fat miklu betri \u00fe\u00fd\u00f0ing \u00e1 tardive dysphoria en \u00fev\u00ed mi\u00f0ur skilja of f\u00e1ir gamla or\u00f0i\u00f0 s\u00fat). \u00deeir sem telja a\u00f0 \u00feunglyndislyf valdi s\u00ed\u00f0kominni vanl\u00ed\u00f0an, jafnvel kr\u00f3n\u00edsku \u00feunglyndi, byggja \u00e1 \u00fev\u00ed a\u00f0 bo\u00f0efnakerfi heilans bregst flj\u00f3tt vi\u00f0 inngripum (sem s\u00e9st vel \u00ed tilraunum \u00e1 d\u00fdrum) og g\u00e6ti t.d. brug\u00f0ist vi\u00f0 ser\u00f3t\u00f3n\u00edn-aukandi lyfi me\u00f0 \u00fev\u00ed a\u00f0 draga saman ser\u00f3t\u00f3n\u00edn-framlei\u00f0slu, \u00feau vi\u00f0br\u00f6g\u00f0 endist lengi, s\u00e9u jafnvel \u00f3afturkr\u00e6f. Ein greinin um \u00feetta, sem v\u00edsa\u00f0 er \u00ed \u00far Relabeling the Medications We Call Antidepressants, var n\u00fd fyrir m\u00e9r, Tardive dysphoria: The role of long term antidepressant use in-inducing chronic depression?<\/a> sem birtist \u00ed Medical Hypotheses<\/i> \u00ed j\u00fan\u00ed 2011. Eftirtektarver\u00f0ast vi\u00f0 \u00fe\u00e1 grein \u00fe\u00f3tti m\u00e9r a\u00f0 m\u00e1lflutningurinn er \u00ed vi\u00f0tengingarh\u00e6tti … \u00f3l\u00edkt greinafj\u00f6ld um gagnsemi \u00feessa e\u00f0a hins \u00feunglyndislyfsins \ud83d\ude09<\/font><\/p>\n

Ni\u00f0urst\u00f6\u00f0ur Healy og Antonuccio eru, eins og v\u00e6nta m\u00e1, a\u00f0 svok\u00f6llu\u00f0 \u00feunglyndislyf s\u00fdni n\u00e6sta l\u00edtinn v\u00edsindalega m\u00e6ldan \u00e1rangur \u00ed l\u00e6kningu \u00e1 \u00feunglyndi en s\u00fdni \u00e1 hinn b\u00f3ginn margs konar a\u00f0ra verkan m\u00e6tavel\u00a0\u00ed s\u00f6mu v\u00edsindalegu ranns\u00f3knunum. \u00deess vegna myndu \u00fdmis \u00f6nnur heiti \u00feessara lyfja vera mun meir l\u00fdsandi og meira \u00ed samr\u00e6mi vi\u00f0 v\u00edsindalega m\u00e6lda verkun \u00feeirra, s.s. geldingarlyf (antiaphrodisiac medications – fryg\u00f0arhamlandi lyf er eiginlega vonlaus samsetning \u00e1 \u00edslensku, finnst m\u00e9r, \u00fe\u00f3tt \u00fea\u00f0 v\u00e6ri n\u00e1kv\u00e6mari \u00fe\u00fd\u00f0ing); andv\u00f6kuhvetjandi lyf; kv\u00ed\u00f0aaukandi lyf o.s.fr. En \u00feeir vi\u00f0urkenna f\u00faslega a\u00f0 svolei\u00f0is heiti sem tengjast betur v\u00edsindalega m\u00e6ldri algengustu og \u00f6flugustu\u00a0verkun lyfjanna v\u00e6ru ekki s\u00e9rlega marka\u00f0sv\u00e6n.<\/font><\/p>\n

\u00cd greininni nefna \u00feeir f\u00e9lagar a\u00f0 \u201eantidepressant\u201c (and-\u00feunglyndis lyf) s\u00e9 mj\u00f6g villandi heiti yfir \u00feessi lyf og velta fyrir s\u00e9r hvort \u00fea\u00f0 skipti ekki m\u00e1li\u00a0\u00feegar sj\u00faklingar\u00a0eru uppl\u00fdstir um verkunarm\u00e1tt \u00feeirra. \u00c9g staldra\u00f0i a\u00f0eins vi\u00f0 \u00feetta, hafandi eti\u00f0 hinar og \u00feessar \u00feunglyndislyfjasortirnar \u00ed meir en \u00e1ratug og oftar en ekki veri\u00f0 \u00e1 m\u00f6rgum lyfjum \u00ed senn, af allra handa tagi. \u00de\u00e6r uppl\u00fdsingar sem Healy og Antonuccio birta \u00ed greininni eru flestar alls ekkert n\u00fdjar af n\u00e1linni, \u00f6murlega l\u00edtill \u00e1rangur \u00feunglyndislyfja borinn saman vi\u00f0 lyfleysu hefur t.d. veri\u00f0 \u00e1 almannavitor\u00f0i fr\u00e1 \u00fev\u00ed 2008. \u00c9g skil ekki hvernig s\u00fa sta\u00f0reynd getur hafa fari\u00f0 fram hj\u00e1 nokkrum \u00feeim ge\u00f0l\u00e6kni sem s\u00fdnir l\u00e1gmarkslit \u00e1 a\u00f0 fylgjast me\u00f0 \u00ed sinni fr\u00e6\u00f0igrein. \u00c1 hinn b\u00f3ginn haf\u00f0i \u00e9g, sj\u00faklingurinn, aldrei heyrt \u00e1 \u00feetta minnst fyrr en \u00e9g f\u00f3r a\u00f0 lesa m\u00e9r sj\u00e1lf til um \u00feunglyndislyf, \u00e1 \u00fatm\u00e1nu\u00f0um li\u00f0ins \u00e1rs. Hversu uppl\u00fdsta \u00e1kv\u00f6r\u00f0un getur sj\u00faklingur teki\u00f0 \u00feegar hann er ekki uppl\u00fdstur um a\u00f0alatri\u00f0i \u00ed l\u00e6knisme\u00f0fer\u00f0?<\/font>
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\u00c9g var a\u00f0 lesa greinina Relabeling the Medications We Call Antidepressants eftir David Healy og David Antonuccio (birtist \u00ed Scientifica 2012). A\u00f0 v\u00edsu vissi \u00e9g fyrir flest \u00fea\u00f0 sem \u00feeir fjalla um en d\u00e1ist a\u00f0 …<\/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-485","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\/485","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=485"}],"version-history":[{"count":1,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/485\/revisions"}],"predecessor-version":[{"id":600,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/485\/revisions\/600"}],"wp:attachment":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/media?parent=485"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/categories?post=485"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/tags?post=485"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}