Posted by AMB on March 21, 2013, at 11:23:41
In reply to Re: MAOIs lower maintenance dose?, posted by SLS on March 19, 2013, at 6:54:38
> > I don't see much talked about the MAOIs being "different" insofar there is this concept of a high dose until full remission and a lower maintenance dose treatment in the long run. I'm pretty sure I've read it somewhere more than once but I don't know if some studies actually exist to back this strategy up. Has someone successfully lowered the dose after remission without returning symptoms and less efficacy?
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> If by remission, you mean being symptom free for a period of a year or more, then it might be possible. However, if by remission, you mean the initial response that reduces symptoms, I would say that it is unlikely. Sometimes, one can benefit from taking a slightly higher dosage to first establish MAO inhibition and then cut-back to maintain it. I doubt this would represent more than a 20% difference in dosage, though.
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> In my experience with Nardil and Parnate, I need the same dosage to maintain a response as it takes to establish it. However, I have not experienced a stable remission in 25 years, so I am really describing a partial response rather than sustained remission.
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> I have not personally seen any evidence of the phenomenon described in the package label of Nardil. I don't see that people who need 60 - 90 mg/day to respond go on to maintain the response at 15 - 30 mg/day as soon as the response emerges.
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> - Scott
When I was taking parnate I heard this. It appealed to me since I was having nasty side effects with the higher dosage (I had been taking up to 90mg). When I asked my doctor about this he acknowledged that sometimes its possible raise the dose for a response, stay there for a little while until stable, and then return to the previous lower dose for maintenance (for me that was raised to 90mg and lowered to 60mg). But he did say that there was no set dosage for maintenance. From his experience at least for Parnate, 30mg or below was too low for much effect at all and more likely to cause a relapse. But he did feel that you could play with the dosing a little bit, just not that dramatically.
poster:AMB
thread:1040528
URL: http://www.dr-bob.org/babble/20130308/msgs/1040813.html