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Re: how to know if i reach/maintain therapeutic le

Posted by Jost on September 24, 2006, at 11:13:14

In reply to Re: how to know if i reach/maintain therapeutic le » iforgotmypassword, posted by SLS on September 24, 2006, at 7:45:40

Also: the discussions of blood testing and TDM confuse (or discuss in a rather overly co-mingles way) two (and even three) issues:

1. therapeutic levels

2. harmful levels

3. compliance issues

Leaving out compliance issues, though, it's one thing to say that you believe that above a certain level of drug may cause harmful effects (which is more true of lithium, in the discussions than tricyclics, although I don't know enough about TCA to know if it applies there, too).

It's an entirely different thing to say that there'a level that should (or does) cause a therapeutic effect. Clearly, you aren't getting a therapeutic effect-- so no matter what your blood level, that level doesn't correlate with one.

I assume that your pdoc is afraid of some harmful reaction, and that this is the reason for not giving you a higher dose.

Has s/he mentioned what specifically the problem/s might be? Because then possibly you could take more, at a slow upward titration, with more careful monitoring for the SE.

Jost


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