Posted by SLS on June 1, 2015, at 14:20:31
In reply to Re: Latuda. Need advices please! » SLS, posted by ihatedrugs1 on June 1, 2015, at 13:13:17
> I'm feeling a little better each day; hopefully, it'll continue.
If the trajectory of your illness is towards improvement right now, I don't see the rush in adding another agent. If you plateau or question the rate of improvement, the easy answer is to increase the Effexor if you can tolerate it. Raise the dosage gradually if you need to. Very few people with your level of depression respond to 150 mg/day. 300 mg/day is more common. The drug company now recognizes the maximum effective dosage as being 375 mg/day. This is quite a bit more than the original 225 mg once suggested.
As you say, it can be a waiting game. I experienced only one long-term remission from depression. I was 27 years old, and managed to squeeze in 6 months of euthymia before the drug treatment triggered a severe mania. The drugs were withdrawn, and, unfortunately, never restarted once I relapsed into depression. It is important to know, though, that the process of improvement of depression took months, not weeks. I was patient, though, because the trend was clearly towards improvement. With many of these antidepressant drug treatments, it is not the acute effect of the drug on the brain that actualizes the improvement. Otherwise, an improvement would be instantaneous. It is the changes that the brain makes to itself in response to being challenged by exposure to these drugs that produces the improvement.
It is excruciatingly hard to be patient when you are in so much pain. It is like having your hand being held over a flame. Your natural reaction is to do anything you can to pull your hand out immediately. Change dosages, change drugs, change diagnoses, change doctors, change to herbs or dietary supplements, change to magnetic or electrical stimulation, change spiritual beliefs, change jobs, etc. Anything! Just make it stop!
For me, I find it difficult to keep my hands out of the cookie jar. If a low dose of drug works a little, then a large dose ought to work a lot. Obviously, this is a mistake in thinking. What about time? If a little time works a little, then more time ought to work a lot. This, too, can be a mistake in thinking. The reality seen in each type of treatment will differ in the balance between dosage and time. This is why a doctor's education and clinical experience is so valuable. Still, there is a very real need to make educated guesses and experiment using trial-and-error. Unfortunately, that's about the best that the average psychiatrist can do when so little is known about the illnesses and mode of action of successful treatments. The future holds the promise of more precision in diagnosis and making treatment decisions.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1079315
URL: http://www.dr-bob.org/babble/20150520/msgs/1079370.html