Posted by SLS on August 17, 2013, at 4:56:23
In reply to starting up a new med????, posted by Roslynn on August 14, 2013, at 10:04:16
With a drug like Effexor, people sometimes experience brief "blip" improvement. It can happen as soon as the third day of starting treatment and last a few days. However, just because this improvement disappears does not mean that it won't return later. It can take three weeks or longer at a higher dosage to receive the "true" antidepressant response. So, the question becomes, how do you know? You don't. You have no better choice than to keep taking Effexor to find out. Some people need 300 mg/day. Some can only tolerate 150 mg/day. Because biological tests are not yet ready for deployment in the field, there is nothing a doctor can do except rely on his clinical experience with previous patients in order to reach decisions. I would say that your blip improvements are a good sign (at least according to my doctors at the NIMH, NIH), and that it is worth continuing your trial of Effexor.
I would love to see you hit the bullseye. If it turns out that Effexor is only partially effective, some people find that adding Wellbutrin, nortriptyline, Remeron, or even lithium as adjuncts is a better choice than simply switching to another drug. For me, I found it necessary to build a regime around a core treatment of a combination of MAOI and TCA. To that, I added several mood stabilizers and augmentors. It is not an ideal answer, but, so far, it is the best we have come up with. I look forward to the arrival of "deep TMS" to trigger a more robust improvement. The first 100 machines are due to be deployed in the US by the Brainsway company in Israel very soon. This new H-coil device was approved by the FDA in January. It can penetrate to more than twice the depth in the brain as the Neurostar machine. Supposedly, it can induce a current directly into important limbic structures rather than rely on a secondary effect.
I don't know why I wrote so much. Perhaps it was to impart to you a feeling of hopefullness that there are treatments that you may not have tried yet and that have a genuine chance of improving the quality of your life. I have had a pretty rough time recently with negative outlook towards my treatment. I guess I needed some positive reinforcement.
- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1048986
URL: http://www.dr-bob.org/babble/20130730/msgs/1049203.html