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Re: Did patience pay off for your AD to work? » SS Ohdee

Posted by SLS on May 16, 2012, at 21:34:59

In reply to Re: Did patience pay off for your AD to work?, posted by SS Ohdee on May 9, 2012, at 19:43:32

> I took Lexapro when I was 15, but I didn't seem to have a concept then of how horribly depressed I really was and had no desire to be social. I didn't take anything for any other episode until last year. I've been doing the "Merry-go-Round" since.
>
> My psych told me that I really just need to choose something and stick with it, as I haven't stuck with any adjunct med for over two months. But in my defense, when one feels suicidal, isn't that the time to consider something different?

Two months is a long time to struggle with suicidal thoughts. While you are trialing different antidepressants, perhaps it makes sense to use Zyprexa, Seroquel, or Abilify to mitagate these thoughts.

Ideally, one would experience some improvement by the end of week three, regardless of how slight it may be. Sometimes, a doctor will notice a small improvement that has not been perceived by the patient. This can be a dangerous time in treatment. Someone who has suffered from a severe anergic depression will often experience an increase in mental energy before a positive effect on mood emerges. During this period of time, the increased energy allows one to think about suicide more actively, create a plan, and act on it. A patient should be instructed that this is possibility, and that weekly visits are necessary.

Some people report having to wait 6 weeks before anything positive happens. I like to give any one dosage adjustment three weeks to produce results. Consider, though, that it might take two or three weeks to reach the target dosage and allow for the drug to reach a [pharmacokinetic] equilibrium.

Patience?

Supposedly, most people who are going to respond well to an antidepressant will begin to do so by the end of week 4.

No one that I know of has a crystal ball. How does one know in advance if they are in the minority of people who respond well to an antidepressant, but only after eight weeks have passed?

These are very difficult decisions. Hopefully, your doctor can make his judgments based upon prior clinical experience in a way that neither of us can.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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