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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Roslynn on December 21, 2008, at 19:39:51
Hi everyone,
Is it a good sign or a bad sign if a med works well the first 5 days or so, then not as much?
Is it a sign that it will eventually work? Or does it just mean nothing?Thanks for any help!
Roslynn
Posted by Phillipa on December 21, 2008, at 20:13:13
In reply to if a med worked the first 5 days then not so much?, posted by Roslynn on December 21, 2008, at 19:39:51
I feel it depends on what the med was or is. Phillipa
Posted by desolationrower on December 21, 2008, at 21:11:01
In reply to if a med worked the first 5 days then not so much?, posted by Roslynn on December 21, 2008, at 19:39:51
Well, its often a sign of placebo response. Some drugs it is normal, a benzo might require a dosage increase as you move toward a stable dosage.
-d/r
Posted by Orangecat on December 22, 2008, at 2:50:37
In reply to if a med worked the first 5 days then not so much?, posted by Roslynn on December 21, 2008, at 19:39:51
Usually meds take a bit of time to ramp up before you get an effect from them. I'm wondering if it could be that you are highly sensitive to the med, and that now it is building up in your body, it does not 'feel' as effective. Check with your pdoc regarding dosage.
Posted by SLS on December 22, 2008, at 7:02:30
In reply to if a med worked the first 5 days then not so much?, posted by Roslynn on December 21, 2008, at 19:39:51
In my estimation:
> Is it a good sign or a bad sign if a med works well the first 5 days or so, then not as much?
It depends on the drug. It is a personal hypothesis of mine that many people experience what many call a "blip" improvement in the first week that lasts for a few days and then disappears.
> Is it a sign that it will eventually work?
I believe the blip response indicates an increased likelihood of responding to the treatment that produced it.
> Or does it just mean nothing?
Something means something. Something doesn't mean nothing. Anything you do or don't experience as the result of the exposure to specific drugs and drug combinations potentially yields information that can be used to help guide future treatment choices.
- Scott>
> Thanks for any help!
>
> Roslynn
Posted by bleauberry on December 22, 2008, at 16:55:04
In reply to if a med worked the first 5 days then not so much?, posted by Roslynn on December 21, 2008, at 19:39:51
It depends on what the drug is. Fast acting ones, such as the benzos or stimulants, can work in hours to a few days. Antidepressants take weeks to see improvement, if it is to happen, and then months to see even more improvements gradually take hold.
I cannot cite the exact studies because I didn't bookmark them, but at pubmed I saw at least 3 different studies that looked at this very topic. In general what they found was that when people had some sort of rapid response, whether it quickly faded or not, was highly indicative of a later response and remission. The lack of a rapid response was highly indicative of a poor response later and a poor prognosis for remission.
These studies pointed out that they did not guarantee a rapid response equals good later response, or that lack of rapid response equals poor later response, but rather the odds of one or the other are magnified greatly depending on the initial response, usually seen within the first week.
If you are handling the side effects ok, the best thing to do is to mark a date on your calendar about 2 months from now and just go about life as best you can until then. That date is your time to reflect and see where you are. Until then, just take the daily dose like a vitamin and go through your day. Do not expect changes to happen in ways you can notice day to day. They will probably creep up on you slowly to where you can see them really well looking backwards, but not so much while they are happening.
At least you know that statistically the odds are in your favor.
Posted by Roslynn on December 22, 2008, at 17:25:42
In reply to if a med worked the first 5 days then not so much?, posted by Roslynn on December 21, 2008, at 19:39:51
Thank you all for your helpful and thoughtful responses.
I am hoping, I am hoping, this means I will respond to the drug in four to six weeks or so.
Let's all hang in there as we wait for the sun to shine a bit brighter each day.
Roslynn
Posted by linkadge on December 22, 2008, at 18:18:45
In reply to Re: if a med worked the first 5 days then not so much?, posted by Roslynn on December 22, 2008, at 17:25:42
Early drug effects are *not necessaarily* placebo effects. Some of these meds can supress REM sleep immediately and REM supression can produce fast acting antidepressant effects.
Monoamine reuptake inhibitors can also produce immediate behavioral effects (after all, the monoamine increase happens immediately). I don't necessarily equate this to the full clinical responce, but there is no doubt an acute effect for me (that ususally subsides over a few days for me at least).
I remember first taking celexa I had visual halluciations that caused me to giggle uncontrollably for the first few hours.
Linkadge
Posted by Phillipa on December 22, 2008, at 19:22:14
In reply to Re: if a med worked the first 5 days then not so much?, posted by linkadge on December 22, 2008, at 18:18:45
Did it work? Phillipa
This is the end of the thread.
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