Posted by ed_uk on May 4, 2006, at 14:22:21
In reply to Re: Is lithium any good? » ed_uk, posted by Don_Bristol on May 4, 2006, at 10:44:09
Hi Don
>Parnate does *not* seem to be the trade name in the UK
Parnate *was* the trade name in the UK. Currently, it is only available as a generic from Goldshield.
>I was told that the max is 30mg....
Your doc is wrong! Tranylcypromine *never* had a maximum dose in the UK.
Your pdoc can check two reference sources......
1. The BNF, which states:
Initially 10 mg twice daily not later than 3 p.m., increasing the second daily dose to 20 mg after 1 week if necessary; doses above 30 mg daily under close supervision only; usual maintenance dose 10 mg daily
The bit about the usual maintenance dose being 10mg should be removed. The idea that patients can be treated effectively with very low maintenance doses of ADs has long since been discarded by psychiatrists. It is now believed that patients should be maintained on the same dose which was originally effective in producing remission eg. 20mg three times a day or whatever......
2. The manufacturers official data sheet (also called the SPC). You pdoc should have access to the compendium of data sheets, where s/he can look up tranylcypromine. The official data sheet states:
A dosage of three tablets a day should only be exceeded with caution.
IMO, this is not an intelligent statement. Clearly, MAOIs need to be treated with due respect. Tranylcypromine does not, however, suddenly become dangerous when the daily dose exceeds 30mg.
Regards
Ed
poster:ed_uk
thread:637942
URL: http://www.dr-bob.org/babble/20060504/msgs/639992.html