Posted by Elizabeth on July 19, 2001, at 10:57:16
In reply to Re: Mirtazapine (Remeron), posted by JohnL on July 18, 2001, at 17:48:55
> This is exactly why I do not subscribe to the popular practice of "giving it more time". In my experience, if there isn't some kind of hint of a good reaction in the first week or two, at least a hint, then I am quite willing to trash it and move on.
I generally like that technique, at least for most drugs (more on that in a minute). One thing I'd add is that for antidepressants in general, you should give them two weeks at a dose that could reasonably be expected to work.
> There is a perfect drug for everyone, but we'll never find it if we're forced to stay with something that isn't working out, or stay with something hoping it will work a month or two later.
This theory (that there's a "perfect drug for everyone") I don't buy so much!
> When a medicine is right, you'll know it without a doubt in a short amount of time.
This technique does produce false positives at times, though perhaps not false negatives so much. (I'm thinking of when I started taking Nardil and it seemed to work miracles but stopped working after less than a year and made things *worse* in the long run.)
I think that Buspar, for example (the subject of a couple of current threads), is a drug that takes longer to work even than most other antidepressants, and for which the recommended therapeutic dose range is too low. It has a reputation for being ineffective, but I wonder if that might not change if people started taking higher doses and giving it a longer time to work. That's an exceptional case, though; most of the time, I think you're right that
One other exception I can think of is Effexor. I say this because it has such a wide range of possibly effective doses; some people will notice improvement after 2 weeks on 75 mg, but others need 400 mg.
I'll be interested to find out whether the "JohnL Method" proves successful in my current trial (desipramine, which I've been taking for about 2 1/2 weeks -- though only about 7-10 days within the normal therapeutic dose range -- and which seems to be doing something already). Having tried so many exotic things, I would find it terribly ironic if the "right drug" for me proved to be a tricyclic!
-elizabeth
poster:Elizabeth
thread:10400
URL: http://www.dr-bob.org/babble/20010714/msgs/70844.html