Posted by med_empowered on June 3, 2005, at 2:25:58
In reply to Re: When Did People Discover Low Doses of AD's Work?, posted by 4WD on June 2, 2005, at 22:30:02
Dosing psychiatric drugs is tricky, and it seems as if shrinks have historically acted by first using mega-doses or one-size-fits all doses, and then coming to their senses and using a med sensibly later on. Take Thorazine for instance. In the US in particular, docs went crazy with it--people were being prescribed 1500, 2000mgs a day! With Haldol, 20mgs used to be a standard dose. Now, when old drugs are used, they're used in lower doses. The excessive dosing of old school anti-psychotics is one reason the new ones look so appealing; compared to the mega-doses of hardcore old drugs, smallish doses of the new ones are pretty harmless. When you adjust the dosage, though, there are fewer differences in side-effects; 4-8mgs/day of Haldol, for instance, compares pretty well with Risperdal over the long haul. With antidepressants, particularly the new one, one of the big selling points, as another responder pointed out, was that a doc could start someone off on an effective dose and then work up or add on as needed. Plus, the doses were pretty standardized. While a patient on Tofranil might take anywhere from 100mgs a day to 200+ outpatient, and up to 600 in patient (I would *hate* to be that patient, though), Prozac started at 20 and usually capped out at 60-80. Docs are still kinda crazy with the ADs though. Like, when I started Zoloft, my doc started at 100mgs, then upped it to 150mgs a few days later. It worked, but it was kinda heavy-handed.
poster:med_empowered
thread:506072
URL: http://www.dr-bob.org/babble/20050601/msgs/507214.html