{"id":22329,"date":"2025-12-22T16:15:53","date_gmt":"2025-12-22T15:15:53","guid":{"rendered":"https:\/\/sygeplejevidenskab.dk\/?p=22329"},"modified":"2025-12-22T16:15:53","modified_gmt":"2025-12-22T15:15:53","slug":"nedtrapning-af-antidepressiv-medicin-er-kompleks-og-indebaerer-risiko-for-betydelige-ophoerssymptomer","status":"publish","type":"post","link":"https:\/\/sygeplejevidenskab.dk\/index.php\/2025\/12\/22\/nedtrapning-af-antidepressiv-medicin-er-kompleks-og-indebaerer-risiko-for-betydelige-ophoerssymptomer\/","title":{"rendered":"Nedtrapning af antidepressiv medicin er kompleks og indeb\u00e6rer risiko for betydelige oph\u00f8rssymptomer"},"content":{"rendered":"

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Marte Ustrup, Casper Westergaard,<\/span> Helene Speyer. Nedtrapning af antidepressiv medicin, statusartikel . Ugeskr. L\u00e6ger 2025;187:V01250040.<\/span> doi: 10.61409\/V01250040<\/a><\/p>\n

Download Resume som pdf<\/a><\/p>\n

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Af Maj Siercke, ph.d., sygeplejerske, chefredakt\u00f8r og stifter af Journal for Sygeplejevidenskab & Sygeplejevidenskab.dk<\/em> maj@sygeplejevidenskab.dk<\/a><\/p>\n

Introduktion
\n<\/span><\/strong>Forbruget af antidepressiv medicin i Danmark er stigende, og mange patienter er i langvarig behandling uden tydelig plan for afslutning. Kliniske retningslinjer beskriver prim\u00e6rt opstart og vedligeholdelse, mens viden om sikker ned- og udtrapning er begr\u00e6nset. Artiklen pr\u00e6senterer centrale principper fra <\/span>Maudsley Deprescribing Guidelines<\/a> med fokus p\u00e5 langsom, individualiseret og hyper-bolsk nedtrapning af antidepressiva.<\/p>\n

<\/span>\u200b<\/span>Metode
\n<\/span><\/strong>Der er tale om en narrativ statusartikel, som sammenfatter eksisterende forskning, internationale kliniske vejledninger og brugerdrevne erfaringer med nedtrapning af antidepressiva. Artiklen inddrager b\u00e5de neurobiologiske studier, kohortestudier, metaanalyser og patientrapporter samt de nye Maudsley Deprescribing Guidelines.<\/span><\/p>\n

\u200b<\/span>Resultater
\n<\/span><\/strong>Oph\u00f8rssymptomer ses hos en betydelig andel af patienter, der nedtrapper antidepressiva, og kan v\u00e6re hyppigere, mere alvorlige og mere langvarige, end tidligere antaget. Symptomerne kan v\u00e6re vanskelige at skelne fra tilbagefald, men adskiller sig ofte ved debut t\u00e6t p\u00e5 dosisreduktion, somatisk pr\u00e6g og hurtig bedring ved dosis\u00f8gning. Maudsley Deprescribing Guidelines foresl\u00e5r en risikoscore baseret p\u00e5 behandlingsvarighed, pr\u00e6parat, dosis og individuelle faktorer samt en hyperbolsk nedtrapningskurve med stadig mindre dosisreduktioner mod slutningen.<\/span><\/p>\n

\u200b<\/span>Diskussion
\n<\/span><\/strong>Neurobiologisk forklares oph\u00f8rssymptomer ved, at l\u00e6gemidlet fjernes hurtigere, end hjernens neuroadaptation kan f\u00f8lge med, hvilket forstyrrer en ny hom\u00f8ostatisk ligev\u00e6gt. En line\u00e6r nedtrapning med lige store dosisreduktioner ser ud til at give relativt st\u00f8rst forstyrrelse ved lave doser, hvor sm\u00e5 \u00e6ndringer i koncentration giver stor \u00e6ndring i receptorm\u00e6tning, hvilket taler for hyperbolsk nedtrapning. Evidensen for specifikke taperingsstrategier er dog fortsat begr\u00e6nset og baseret p\u00e5 teoretisk rationale, mindre studier og klinisk erfaring.<\/span><\/p>\n

\u200b<\/span>Konklusion
\n<\/span><\/strong>Nedtrapning af antidepressiva er kompleks og indeb\u00e6rer risiko for betydelige oph\u00f8rssymptomer, som kan forveksles med tilbagefald. Langsom, fleksibel og hyperbolsk nedtrapning med t\u00e6t monitorering kan potentielt reducere risikoen for sv\u00e6re forl\u00f8b, men der mangler randomiserede studier, der direkte sammenligner strategier.<\/span><\/p>\n

\u200b<\/span>Implikationer for praksis
\n<\/span><\/strong>Sundhedsprofessionelle b\u00f8r v\u00e6re opm\u00e6rksomme p\u00e5 oph\u00f8rssymptomer, deres karakteristika og betydningen af langsom, individualiseret nedtrapning. I klinisk praksis anbefales grundig forberedende samtale, risikovurdering, plan for h\u00e5ndtering af tilbagefald og selvmordsrisiko samt praktiske l\u00f8sninger til meget sm\u00e5 doser, fx dr\u00e5ber, opl\u00f8sninger eller taperingstrips, tilpasset patientens behov. <\/span><\/p>\n

L\u00e6s mere i bogen: <\/span>Noget I b\u00f8r vide om udtrapning af psykofarmaka<\/a><\/p>\n

 <\/p>\n

 <\/p>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Marte Ustrup, Casper Westergaard, Helene Speyer. Nedtrapning af antidepressiv medicin, statusartikel . Ugeskr. L\u00e6ger 2025;187:V01250040. doi: 10.61409\/V01250040 Download Resume som 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