Psycho-Babble Medication | about biological treatments | Framed
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Re: "Slow Build" = fewer side effects PERMANENTLY???

Posted by jamie on December 15, 1999, at 3:12:04

In reply to "Slow Build" = fewer side effects PERMANENTLY???, posted by David Mirtzer on December 15, 1999, at 0:15:03

> So many times, including in this month's comments on Celexa, I have seen it said that starting low on an AD and building dosage gradually will minimize side effects. Does this mean that side effect "X" may stay around permanently, or at least a longer period of time, if maintenance dosage is reached fast instead of gradually? Or does it simply mean that the early weeks on the med will be harder to handle and discouraging with the quicker build?
> Put another way: If I'm willing to put up with a more "brutal" first month in terms of side effects by building dosage quickly, am I creating some sort of risk in terms of the *longer-term* side effect profile? Or, worse yet, am I jeopardizing the ultimate effectiveness of the drug?

David, the slow build method doesn't have any relation to longterm effectiveness or longterm side effects. Too many people quit their medicine prematurely due to side effects. Slow build lets the body adjust. The goal is to keep the patient on the medicine long enough. There may still be side effects longterm with a slow build, but they won't be as harsh and intolerable as they were early in treatment. So if you can bear the side effects of higher doses early, go for it. If the drug is going to work, you'll get there a little quicker.

One interesting research study abstract I came across showed how patients were given the ultimate goal dose of tricyclics right from the get go, compared to other patients titrated up gradually in standard fashion. After 72 hours, the patients started immediately on the full dose were nearly completely cured of depression. This study put into question the theory of antidepressant lag time, but didn't offer any more details. It was interesting to see their patients got well so fast when started at the highest dose immediately. So if you can take the side effects, more power to ya. jamie




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