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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Janelle on July 12, 2001, at 16:16:39
Thanks so much for clarifying - that's what I thought you meant - that 2 weeks on a med should be "sufficient" (my word here!) for some sign of improvement or worsening. I could tell that Celexa was starting to help after a couple of weeks, but plateaued after that, and also had ongoing foggy and heavy headedness. Tried taking it at night - no better. I'm now feeling like Effexor is not lifing me and may even be increasing my anxiety, obessive thoughts - as I went down on Celexa and up on Effexor I felt worse and when I was up to "full" dose of Effexor was the WORST day - had to call the doctor - she had me back it down to half till next appointment.
So, I guess by TWO weeks, a person should have some kind of sign, one way or the other, if a med is starting to work or is having adverse (bad) effects???? Thanks.
Posted by stjames on July 12, 2001, at 17:00:02
In reply to PELLMELL, others: more on med trial length:, posted by Janelle on July 12, 2001, at 16:16:39
> So, I guess by TWO weeks, a person should have some kind of sign, one way or the other, if a med is starting to work or is having adverse (bad) effects???? Thanks.
james here....I don not agree. 4 weeks min. I never could tell by 2 weeks.
James
Posted by pellmell on July 12, 2001, at 17:47:51
In reply to Re: PELLMELL, others: more on med trial length:, posted by stjames on July 12, 2001, at 17:00:02
> james here....
>
> I don not agree. 4 weeks min. I never could tell by 2 weeks.I'll agree with you. You should wait at least four weeks before you decide if the drug is having a theraputic effect.
But if the side-effects of a drug are still significantly interfering with your life after 14 days, do you still think it's worth sticking it out?
-pm
Posted by Janelle on July 12, 2001, at 19:34:03
In reply to PELLMELL, others: more on med trial length:, posted by Janelle on July 12, 2001, at 16:16:39
Hi Pellmell, you know sOOOOOOOOO much and are so good at expressing it. Anyway, somewhere above, you referred to "monoaminergenic" (not sure I got the spelling, but I'm sure you know what I'm referring to!) but what does this mean (in plain English if possible!). I can't figure it out. Mono refers to one, so does this mean meds that work on one amino acid? Hmmmm ... hope you (or someone else who knows) come back here to read and can explain. THANKS!
Posted by Janelle on July 12, 2001, at 19:36:46
In reply to Re: PELLMELL, others: more on med trial length:, posted by stjames on July 12, 2001, at 17:00:02
James, thanks for your feedback. I needed 3 weeks at 40 mg Celexa to realize that basically LITTLE to nothing was happening.
Not as sure with Effexor as I might have titrated up too fast, will ask doc, but I do feel it is working against me.
Posted by pellmell on July 12, 2001, at 20:34:17
In reply to PELLMELL: U genius! What's monoaminerginic mean?, posted by Janelle on July 12, 2001, at 19:34:03
Janelle,
Hey, thanks for the compliment. :)
I've been reading _Essential Psychopharmacology_ by Stephen M. Stahl, an *excellent* psychopharm textbook (thank you Penn State University library system!) and I guess I just wanted to show off. Heh.
You're on the right track with your prefix sleuthing. Monoamines are molecules derived from one amino acid. You might recognize a few of them: serotonin (5HT), norepiniphrine (NE), and dopamine (DA). There're lots of others. The suffix -ergic means "activated or produced by," but in psychopharmacology it seems to be used more generally, meaning something more like "having a lot to do with." So monoaminergic means something like "something that has an effect on/produces monoamines." A monoaminergic neuron is a neuron that produces monoamines. A serotonergic neuron is a type of monoaminergic neuron that produces serotonin.
In one of my last posts I sort of misused the word you asked about when I said "If that were all it took, monoaminergic drugs would take effect very quickly..." I probably should've said something like "if that were the case, antidepressants would take effect very quickly," because some monoaminergic drugs (notably stimulants like Ritalin, which work on dopamine systems) *do* work right away.
Hope that clears it up for you.
-pm
Posted by Janelle on July 12, 2001, at 21:09:31
In reply to Re: PELLMELL: U genius! What's monoaminerginic mean? » Janelle, posted by pellmell on July 12, 2001, at 20:34:17
Pellmell,
WOW - thanks! Yes, what you wrote does clarify the matter (and I'm glad this board is archived so I can refer back to it, since I bet I'll need to).
I don't know how to do a thread within a thread, so I hope this gets out there and you see it!
Lucky you to be able to read, concentrate and understand a book like _Essential Psychopharmacology_ by Stephen M. Stahl.
In my current state, I can't read more than "junky" light magazines and do crossword puzzles (sometimes).
Now that I know what Monoamines are, I also finaly know what MAOI's really are! Heh! I never quite understood them versus SSRI's except that the two must NOT be mixed (taken together).
And I also was confused by what you said about how in one of your last posts wherein you sort of "misused" the monoaminergenic when you said "If that were all it took, monoaminergic drugs would take effect very quickly..." I understand it now, when you substituted "if that were the case, antidepressants would take effect very quickly," because some monoaminergic drugs (notably stimulants like Ritalin, which work on dopamine systems) *do* work right away. THANKS!
-Janelle
Posted by Janelle on July 12, 2001, at 21:12:21
In reply to Re: PELLMELL: U genius! What's monoaminerginic mean?, posted by Janelle on July 12, 2001, at 21:09:31
I'm not good with this thread within a thread thing - I can't seem to do it, and forgot to change the heading of my post to you right above here! Please read that. Thanks! And thanks for all your helpful info.
Posted by stjames on July 12, 2001, at 21:51:02
In reply to Re: PELLMELL, others: more on med trial length: » stjames, posted by pellmell on July 12, 2001, at 17:47:51
> But if the side-effects of a drug are still significantly interfering with your life after 14 days, do you still think it's worth sticking it out?
>
> -pmJames here....
It depends. Many side effects go away when the AD kicks in. Everyone has their limit, so how much is too much, side effect wise, is personal. Many AD's knock you out till they kick in.
The real question one needs to ask early on is not "is it working ?" but "can I tolerate this long enough to see if it works ?"
Dosing is so important, a short trial does not give you time to try higher doses. If the dose is not right, it does not matter how long a trial you give an AD.James
Posted by Jackster on July 13, 2001, at 18:04:25
In reply to Re: PELLMELL, others: more on med trial length:, posted by stjames on July 12, 2001, at 21:51:02
>
> James here....
>
> It depends. Many side effects go away when the AD kicks in. Everyone has their limit, so how much is too much, side effect wise, is personal. Many AD's knock you out till they kick in.
>
> The real question one needs to ask early on is not "is it working ?" but "can I tolerate this long enough to see if it works ?"
> Dosing is so important, a short trial does not give you time to try higher doses. If the dose is not right, it does not matter how long a trial you give an AD.
>
> James
I have been taking Zoloft for the last 2 months - just gone up to 75mg for the last 2 weeks with no effect. I know it should be working by now, but with Zoloft they don't give you a dosage that works - they just say between 50 - 200mg. So now I don't know whether it's not working because I'm not taking a high enough dose, or because it just isn't right for me. BTW, each time I titrate up, it's hell with anxiety. Any thoughts?Jackie
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