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Kramer: Reasons for subtherapeutic Responses.

Posted by colin wallace on April 1, 2002, at 5:38:59

Dr. Kramer,

Throughout the course of my prolonged episode of major depression, I have experienced severe akathesia/overstimulation on standard therapeutic doses of SSRI's, or a significant decrease in efficacy/cognitive function at standard doses of tricyclics, or the 'newer' anidepressants.
Currently, I take (200mg) Sam-e, which has helped tremendously, and 12.5mg Zoloft (I was prescribed 25mg for ease of administration, but find that dose to cause a 'happy stupor', in which I am clumsy, forgetful and intellectually stunted).This same effect will manifest with or without Sam-e, which I began taking relatively recently.I have to say that I now feel better than I have in years, due to this low dose med regimen.
My question is firstly, that although I feel an undoubted benefit from such a small dose ssri, is this really enough to keep a severe depression in check- or should I grit my teeth and endure the 'happy stupor' at the nominally minimum effective dose of 25mg.I value my mental clarity and require it for my employment.
Secondly, does an antidepressant response to tiny doses suggest an enzyme deficiency/renal-hepatic impairment, or could it be construed as a bonus, ie. less of a likelihood to experience any adverse effects caused at standard doses.
Any opinions much appreciated.

Colin.


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poster:colin wallace thread:101241
URL: http://www.dr-bob.org/babble/20020327/msgs/101241.html