Posted by bleauberry on July 18, 2009, at 12:26:16
In reply to Re: complex med situation after poop out SLS » ben, posted by SLS on July 18, 2009, at 10:56:10
> > Hi Scott
> >
> > Why low dose Effexor to the TCA?
> >
> > regards
> >
> > ben
>
>
> The only reason I mentioned it is because it was one of Bleauberry's suggestions. It seems his doctor uses this sort of strategy. I really don't see how it would work, but you never know. If you have never tried Effexor before, you will, of course, want to start at a low dosage and move up slowly.
>
> From what I can gather, the minimum dosage of Effexor that people respond to when used alone is 150mg. I don't consider giving Effexor a full trial until one goes up to 300mg. If I ever return to Effexor, it will be at 300mg in combination with 150mg of nortriptyline.
>
>
> - ScottScott is generally correct. I must clarify for perspective that my doctor's patient population is a little more defined than the average psychiatrist or doctor patient population. These people are ill with known diseases such as Lyme, Lyme-like, or yeast overgrowth, they have histories of psychiatric meds, and they are more prone to negative reactions and side effects than most people. That's why the low doses work for them. They are sensitive to the negatives, but also sensitive to the postives, so the whole dosing spectrum is lower.
I agree with SLS completely. Get the TCA back up where it was. Get effexor to where it feels good, where ever that is. SLS is generally correct in shooting for a high dose, but as can be seen at askapatient.com, there are plenty of people who find that just 37.5mg or 75mg is an excellent therapeutic dose for them. Everyone is different and everyone needs to be treated different. My opinion.
It's the other meds you are taking that I have a problem with. I agree with SLS the lithium should stay at some low dose probably forever. Outside of TCA + Effexor, I think the removal of other variable meds is a good thing unless you know for sure they are doing you significant goodness.
poster:bleauberry
thread:907071
URL: http://www.dr-bob.org/babble/20090709/msgs/907340.html