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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by vanvog on April 10, 2013, at 18:43:12
Recently I came across some posts in the archive by people who have been on high doses of Parnate >100 mg/day but complained about diminishing returns of going higher. Still improvements on doses above 100 mg but not enough to justify the additional ... what?
Was it mainly financial concerns, side effects or toxicity risk which made you give up the high-dose strategy? Maybe it was something else?
Posted by jono_in_adelaide on April 10, 2013, at 20:57:21
In reply to PARNATE high-dose strategy and diminishing returns, posted by vanvog on April 10, 2013, at 18:43:12
Law of diminishing returns - it applies to most drugs to some degree, depending on their dose/response curve
For example, 2 Tylenol gives a certain degree of pain relief, doubling the dose to 4 tablets doesnt double the pain relief
This doesnt mean that in certain cases, it isnt worth pushing the dose to high levels if needed, you just need to keep in mind that it isnt as simple as "increase dose by 20%, increase response by 50%", you might increaase it more or less than that depending on the drug
Posted by vanvog on April 11, 2013, at 22:04:26
In reply to Re: PARNATE high-dose strategy and diminishing returns, posted by jono_in_adelaide on April 10, 2013, at 20:57:21
I'm familiar with the concept of diminishing returns, I would however like to know what made those people who pursued a high-dose strategy stop upping the dose. Let's say I get a 10% (or 5%) improvement on my symptom(s) by pushing the dose another 20mg further, I would do it if cost is no concern and the side-effects don't get worse by doing so.
Posted by Tyrannosaur on April 12, 2013, at 1:15:18
In reply to Re: PARNATE high-dose strategy and diminishing returns, posted by vanvog on April 11, 2013, at 22:04:26
> I'm familiar with the concept of diminishing returns, I would however like to know what made those people who pursued a high-dose strategy stop upping the dose. Let's say I get a 10% (or 5%) improvement on my symptom(s) by pushing the dose another 20mg further, I would do it if cost is no concern and the side-effects don't get worse by doing so.
Perhaps those people accidentally read this;
"Tranylcypromine
- >1 mg/kg associated with toxicity
- 170 mg has caused a fatality"http://curriculum.toxicology.wikispaces.net/Monoamine+oxidase+inhibitors+%28Detail%29
"More than 1 mg/kg is likely to be a significant poisoning"
Pursuing symptom relief from very high doses might produce the opposite effect. But people have done it before, although would being on very high doses of TCP long-term be a viable option?
Just be careful and be well.
Posted by Mosiba2009 on May 22, 2013, at 18:17:28
In reply to Re: PARNATE high-dose - Vanvog, posted by Tyrannosaur on April 12, 2013, at 1:15:18
Those are great links, very informative.
I think it's really easy to muck around with changing the dosage, especially increasing it without consulting with our doctor-well, I guess we get desperate to see a response-that it's easy to forget just how dangerous these meds can be, if we're not careful. Thank you so much!
> http://books.google.se/books?id=KDOeIldGWxQC&pg=PT293&lpg=PT293&dq=phenelzine+2mg/kg&source=bl&ots=QIl0P-M3zx&sig=ZCXArz6NZUr1SgA9kDPF0w6egWs&hl=en&sa=X&ei=oaFnUaK9H4mG4AT054GQDA&redir_esc=y
>
> "Tranylcypromine
> - >1 mg/kg associated with toxicity
> - 170 mg has caused a fatality"
>
> http://curriculum.toxicology.wikispaces.net/Monoamine+oxidase+inhibitors+%28Detail%29
>
> "More than 1 mg/kg is likely to be a significant poisoning"
>
> Pursuing symptom relief from very high doses might produce the opposite effect. But people have done it before, although would being on very high doses of TCP long-term be a viable option?
>
> Just be careful and be well.
>
>
This is the end of the thread.
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