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Re: Micro-doses?

Posted by JD on April 14, 1999, at 12:58:17

In reply to Micro-doses?, posted by Steve on April 13, 1999, at 21:29:14


Doctors really should start being more aware of this (and stop chalking it up to placebo-loving and/or hysterical patients!) Beyond my personal experience of exactly the same kinds of things you mention, there exist some reliable medical reports of people who can only tolerate, say, much less than 1mg of Prozac, but who go on to have quite good results. (I actually used an eye-dropper for the liquid stuff for a while, personally.) Especially for patients with a history of panic attacks, I know of some doctors who INSIST on beginning with 25% of a"normal" SSRI dose and only adjusting it on an as-needed basis. Interestingly, I also had just the kind of micro-dose response to DHEA you mentioned... unsympathetic doctors can think such reactions are nuts but they're can be very frustrating and are usually very much for real.

To make a long story short, a good doctor should absolutely consider smaller dosages across the board in your case. Your previous manic reaction to a standard Paxil dose is a potential area of concern in any further use of SSRIs (there's lots more out there!), but the main issue may be that ALL of your dosages for these meds have been too high from the get-go. If you don't have such a doctor already, you might invest your time in finding one who knows pharmacotherapy well enough to do more than prescribe the standard dosages listed in the Physicians Desk Reference. (No offense to psychiatrists, but it's surprising how many of them are out there who prescribe meds on a less than fully-informed and fully patient-oriented basis!)

Chin up and good luck! - JD

> Does anyone know anything about microdoses helping
> when normal ones don't. I have baffled many doctors with
> my fatigue in response to 20 mgs paxil or .25 mg xanax,
> akathisia from 20 mg Prozac, dystonic reactions in response
> to 1 mg haldol and 5 mg zyprexa, which were given in response
> to a manic episode precipitated by 20 mg paxil. Not to mention
> that 2.5 mgs of DHEA made me extremely restless for days.
> Does anyone know of any success treating cases like this with
> miniscule doses?




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