Posted by bleauberry on November 30, 2010, at 19:35:35
In reply to Need help approaching pdoc, posted by merpmerp on November 29, 2010, at 17:18:07
Ask the doc..."subtherapeuthic in who's definition?" A medical journal? The pharm company? Show me a bible that says only such and such a dose will work.
Ask him, "Why does Dr C in New Hampshire have repeated success treating difficult cases with 1mg lexapro, starting at a mere drop per day (that's 1/10th mg). ???
A better option to consider....
Lower the dose to 2.5mg as your gut instincts tell you...TRUST your instincts, not a psychiatrist. Honestly, everything they do is a mere guessing experiment in which they cannot in any way predict the outcome. But lowering the dose is not the end of the story. Add to it 10mg of nortriptyline.
Keep in mind, the whole ssri strategy itself could be very wrong with you. You are already half way there to discovering whether it is or not. The final move to 2.5mg should tell you. Also keep in mind, no single ssri can compare to the magic that can happen when a tca such as nortriptyline is added. This is an old school trick that used to work very well.
Go to psychotropical.com and read all the stuff there. You will have your eyes opened to a lot of stuff that will strongly prepare you to have a solid productive dialogue with your doctor.
In the process of going from 5mg to 2.5mg, this could explode in your face if done wrong. You'll need to buy some single edged razor blades because you are going to need them to cut tiny pieces off the 5mg....4.9mg, 4.6mg, 4.5mg, 4.2mg, and so on....very gradually in tiny steps work down to 2.5mg over about a month. Do it too fast and it will almost surely go sour, in which case he will say told ya so and then you'll be stuck. Or better, ask for the liquid lex, so you can measure it as accurate as 1/10th of a milligram which is one drop.
Some things to remember...
There is no hard science in psychiatry.
Every prescription is a guess.
SSRI monotherapy is highly over-rated. (IMO)
Trust your instincts.
Make changes in very tiny steps.
poster:bleauberry
thread:971808
URL: http://www.dr-bob.org/babble/20101117/msgs/971997.html