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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Jasmineneroli on September 29, 2004, at 23:14:14
Hey all:
I went to my Pdoc today expecting to have him add Wellbutrin to my mix (Klonopin+Celexa), due to sexual side effects from Celexa. He told me this was his plan at our last visit.However, since I'm getting jaw-clenching and headaches from Celexa as well (which Wellbutrin will not address), he decided that I should lower my Celexa dose to try to eliminate all SE's.
This sounds sensible, and preferable, in terms of having to take fewer drugs. BUT I only take 10mg of Celexa now (the usual dose is 20-40mg). Pdoc says I should try 5mg. Can this be therapeutic at such a low dose???? Anyone take such a low dose (comparatively) of any SSRI or TCA or MAOI, and have success???
I'm worried that I'll get my GAD incessant thoughts again. I've been feeling good (apart from the SE's) for several months now.
Thanks,
Jas
Posted by tabitha on September 30, 2004, at 0:42:54
In reply to Can a ridiculously low dose be therapeutic?, posted by Jasmineneroli on September 29, 2004, at 23:14:14
I took 5mg celexa for a couple years and did fine on that amount. Recently I upped it to 10mg, but I start getting more side effects at that dose. There's definitely a difference for me between those 2 levels. The only way to find out your minimum effective dose is to experiment.
Did you ask your pdoc if he treats other people at that dose? He might know more. Personally I think the standard dosages of SSRIs are too high.
Posted by linkadge on September 30, 2004, at 7:22:56
In reply to Re: Can a ridiculously low dose be therapeutic?, posted by tabitha on September 30, 2004, at 0:42:54
These drugs are *powerful* and yes a sub "theraputic dose* will still boost your serotonin.
When I was taking lithium, 5mg of celexa was the difference between depression or no depression.
Linkadge
Posted by Ritch on September 30, 2004, at 13:43:10
In reply to Can a ridiculously low dose be therapeutic?, posted by Jasmineneroli on September 29, 2004, at 23:14:14
I'm bipolar and tiny doses of SSRI's (including Effexor and Cymbalta in there too) control my GAD symptoms fairly well, but if I increase the dose then I actually become *more* agitated and panicky. About a .5mg - 1.0mg (yes point 5) equivalent of Celexa works fairly well for me (with any of the serotonin reuptake inhibitors). I read something here (I think) about certain people have a genetic difference with regard to receptor densities of a certain subtype that makes them extra sensitive to SSRi's. Don't know which one.
Posted by pablo1 on September 30, 2004, at 18:51:34
In reply to Re: Can a ridiculously low dose be therapeutic?, posted by Ritch on September 30, 2004, at 13:43:10
Yes, I also agree recommended doses are too high & have read about tiny doses being effective. I was on 37.5mg (1/4 std dose) and I felt it strongly and resented doubling that dose after a week. I will admit the effect of 75mg did wear off after a few weeks as I got used to it but enough of the side effects remained for me to decide to quit.
I've got three of those 75mg effexor's left and that would last three weeks if I took 1/16th of a dose (9.4mg). I've tried 1/8th dose at 37.5 & still felt it quite obviously. I think I'll try that since I did like the antianxiety effect of it just not the daytime sleepiness followed by awaking in sweat repeatedly through the night.
Posted by zero on October 1, 2004, at 0:51:12
In reply to Can a ridiculously low dose be therapeutic?, posted by Jasmineneroli on September 29, 2004, at 23:14:14
I'm Bipolar II w. lots of anxiety.
Standard doses of SSRI's (and most other AD's) make me extremely anxious/irritable/racing thoughts/"I'm going insane" feelings/hypomanic.
My best AD experience has been w. 1.25mg. of Paxil (my previous pdoc called this a "pediatric" dose - he didn't believe me that it had any effect). This very low dose helped greatly w. my Social Phobia and Panic symptoms.
z
Posted by Jasmineneroli on October 1, 2004, at 22:59:05
In reply to Re: Can a ridiculously low dose be therapeutic?, posted by zero on October 1, 2004, at 0:51:12
I really appreciate you taking time to share your experiences!
My Pdoc said he hadn't had anyone on such a low does to Celexa personally, but was aware of good responses to such amounts. He made a statement that reminds me why I respect him - "we are all different, different things work for different people".
I've been on other serotonergic drugs in the past (including Celexa a few years ago, when my GP told me that 10mg was too low to be therapeutic and put me up to 20mg!). I always react with side effects right away, early in the titrating up process..then at the "normal" dose, I have strong or extreme side effects. Celexa 20mg eventually made me depressed and suicidal. So I'm really glad to have the very low dose level affirmed!!!
I agree with those who think that SSRI's are generally prescribed in too large amounts. It's not necessary to isolate one neurotransmitter, without regard for balance. I think for me, in the past, I had negative results when serotonin levels were unbalanced without an SRRI and then again with it!!!
So far, on lowering the dose to 5mg, I felt an increase in anxiety first day - nothing unmanageable. Day 3 and I'm feeling alright, with less jaw-clenching. Hope to be getting orgasms again soon!!!!!!
Thanks again all.
Regards,
Jas
This is the end of the thread.
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