Posted by jannbeau on November 13, 2002, at 15:04:58
In reply to Low dose effectiveness, posted by SJMA on November 13, 2002, at 14:32:08
>Hi, SJMA,
I am not a physician and thus cannot tell you whether you need an increase in medication, but, as an informed patient and a toxicologist, I would suggest that you are on to something when you ask "why change the dose if it's doing what I need it to do?"
One tennet of pharmacology and medicinal chemistry is that one should take the lowest effective dose (or the fewest doses) of a medication in order to reduce the probability of adverse side effects, just as you suggest.
However, with psychotropic medications the definition of "effective" seems occasionally to get lost in translation. Seems the physician relies upon the patient to tell him/her- often without objective measure- whether the medication is "working." Sometimes, also, it seems that an effect of the medication (don't confuse "effect" with "efficacy" or "effectiveness") may change over time; the patient may seek a change. Often, the physician may just "think" the dose should be higher, based on his/her clinical accumen-or the lack thereof- or on the literature or, God forbid, what he/she hears from the drug rep. Then, again, the effective dose may different for different conditions. For instance,it may take more medication to treat major depression effectively than it takes to treat dysthymia (note the "may" in that last statement).
Hope you continue to do well on Effexor, at whatever dose you need to take.
Cheers,
jannbeau
I have PMDD, which makes for many a teary mood swing during two weeks every month. Additionally I have seasonal affective disorder, and actually moved to the southwest in order to escape the debilitating symptoms of lack of sun. I tried Sam-e last winter when the fatigue set in, with fair result, but this year it seemed to have lost it's efficacy. I finally broke down and asked my therapist to recommend an antidepressant, and have been taking 37.5 mg of Effexor XR daily for two weeks. My hormones have not caused me to cry, and I feel awake and energetic during the day now (two weeks ago I was drinking MAJOR caffeine just to drag myself around and barely get anything done). My question is this-if I'm feeling so much better on 37.5 mgs a day, why should I increase the dosage? It seems the likelihood of side effects increases, and I'm not really suffering from any now.
poster:jannbeau
thread:13781
URL: http://www.dr-bob.org/babble/20021108/msgs/127502.html