![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 12 to 36 of 36. Go back in thread:
Posted by linkadge on March 16, 2010, at 16:37:41
In reply to Re: SSRI - better response with less frequent dosing?, posted by Brainbeard on March 16, 2010, at 16:23:32
All I know is that if I take the same dose of the same med day in day out, I almost routienly get worse.
When I mix things up a bit now and again (adjust the dose) add / subtract a med I do better.
Linadge
Posted by bleauberry on March 16, 2010, at 17:20:08
In reply to SSRI - better response with less frequent dosing?, posted by linkadge on March 15, 2010, at 11:03:10
Well, in the world of herbs many experts recommend pulsing doses or taking short holidays in order to keep the substance's effectiveness strong. I don't see why meds are any different.
I actually feel best on most ADs in the first couple days of starting, and then for a couple days after stopping. But if taken continually, not very good. So pulsing doses would make sense.
The problem with regular dosing is that it will cause significant changes in the brain and body. Proponents of ADs for depression will say that is a good thing, that is what we want to happen. But there is no way for us to know what changes are going to occur or whether they will be in our favor or not, until after the fact.
I personally see no problem with taking meds as-needed. It is completely dependent upon how the individual person feels on that med, the med's behavior on their physiology, and such. I am certainly not at all recommending anyone stop taking regular doses. That's not it. What I am saying is that if someone can tweek a med to help them feel better by managing doses in a manner that is different than the norm, then cool.
Me for example, I hate ssris, but if I had no choice except one of them, I know how they behave with me. Getting on feels good, getting off feels good, staying on feels bad. I do not want my brain to down regulate from constant serotonin overload. I want it to keep responding to waves of serotonin. It won't do that if I keep taking it. I'll instead go numb.
I do not believe however that this is a strategy for any newcomer to meds to be messing with. They should do what their doctor says, assuming it is a very good doctor. It is later in the game, when someone has been on a ton of meds and still having problems, and they have a lot of experience, that novel strategies are warranted. My opinion. Of course, that includes a lot of us.
Posted by Frustratedmama on March 16, 2010, at 17:52:01
In reply to Re: SSRI - better response with less frequent dosing?, posted by bleauberry on March 16, 2010, at 17:20:08
Just a thought.....what do you all think would happen if one were to alternate two similar preferred meds every other day (let's say that one responds to zoloft and prozac and every other day took the opposite one) would this work? Just wondering.....Haven't tried it but it sure would be nice to avoid this poop out stuff that keeps happening to the majority of us here.
Posted by conundrum on March 16, 2010, at 22:42:33
In reply to Re: SSRI - better response with less frequent dosing?, posted by bleauberry on March 16, 2010, at 17:20:08
How bout D-amphetamine? It boosts serotonin, noradrenaline, and dopamine and only lasts for part of the day. Doesn't give your mind as much time to downregulate. Also you can take some days off it.
Posted by manic666 on March 17, 2010, at 4:43:00
In reply to Re: SSRI - better response with less frequent dosing? » bleauberry, posted by conundrum on March 16, 2010, at 22:42:33
playing god with your meds, if new to them is crazy/// its like saying i may as well take the hole months worth in one go an then i dont need any for a month///how stupid is that //now look at your own question if new on meds.???????????????
Posted by Brainbeard on March 17, 2010, at 5:27:20
In reply to SSRI - better response with less frequent dosing?, posted by linkadge on March 15, 2010, at 11:03:10
I'd like to add to Linkadge's original contribution that daily dosing schedules are based on practical considerations, not on what actually happens in the brain. The half-life of a drug and its blood plasma levels aren't predictive in a simple, one-on-one manner of its effects on receptors in the brain.
An example: Geodon's (ziprasidone's) half-life is very short, about 6-8 hours, but the half-life of its binding to 5HT2A-receptors is about 20 hours. Receptor binding typically lasts much longer than a drug's half-life.
It's just that for most people, having non-circadian dosing schedules would be too difiicult and lead to non-compliance.
Posted by manic666 on March 17, 2010, at 7:36:59
In reply to Re: SSRI - better response with less frequent dosing?, posted by manic666 on March 17, 2010, at 4:43:00
yes i no what linkage is saying, im just makeing sure the newbies dont get idea,s above there station//an try something dangerous
Posted by Brainbeard on March 17, 2010, at 7:53:59
In reply to Re: SSRI - better response with less frequent dosing?, posted by manic666 on March 17, 2010, at 7:36:59
With all due respect, Manic, I wasn't replying to you.
I don't think, by the way, that unconventional dosing strategies are dangerous per se - not more dangerous than conventional dosing, except perhaps in the case of bipolar disorder.
Posted by linkadge on March 17, 2010, at 8:11:27
In reply to Re: SSRI - better response with less frequent dosing?, posted by manic666 on March 17, 2010, at 4:43:00
I don't think its "playing god with your meds". Surely, if god were involved in my medication magement, my recovery might be a little more flavorful.
Nevertheless, I think the fear of taking charge and experimenting a little is what keeps some people in a bad place.
With no patient experimentation, how can anyone know what works? I mean, as we are finding out these days, there is a stark contrast between what actually helps patients and what is purported to help in the literature.
Those who follow orders to a T, rarely make new discoveries.
Linadge
Posted by manic666 on March 17, 2010, at 9:55:57
In reply to Re: SSRI - better response with less frequent dosing?, posted by Brainbeard on March 17, 2010, at 7:53:59
of course not in the right hands,but there are plenty of people like me who are self taught to read an right an dyslexic// giveing me advice is like lighting the blue touch paper an run.????i did have a cool affect,when tappering from sertraline to citalapram somewere in the middle was a cool place//but i hit on that buy accident an could not remember the exact dose/// an that was when in remission f*** knows when im not an dont remember the year ,never mind day an month//no direspect to anyone im looking after the thick dorks like me.
Posted by bleauberry on March 17, 2010, at 17:30:16
In reply to Re: SSRI - better response with less frequent dosing?, posted by manic666 on March 17, 2010, at 9:55:57
When it comes to dermitology or urology or something like that, I would need some help from a very knowledgeable doctor.
But when it comes to psychiatry, I disagree with the view of "playing God". Nobody can do that. Only God can play God. I see it instead as being "in charge of personal health management". For that, no doctor can do that better than I can. Sorry, that's just the bare naked truth of the matter. And in fact, if you invite God into your life, He can help you be wiser and stronger in doing just that.
A note to manic in case you missed it in my previous post, there was a warning for nerbies to not try this at home.
Posted by Phillipa on March 17, 2010, at 20:28:00
In reply to Re: SSRI - better response with less frequent dosing?, posted by Brainbeard on March 17, 2010, at 7:53:59
Now that makes perfect sense as the worst thing a bipolar can do is skip a med. Conventional is fine. Docs suggest it a lot at least mine has. Phillipa
Posted by Dr. Bob on March 17, 2010, at 20:41:19
In reply to Re: SSRI - better response with less frequent dosing?, posted by manic666 on March 17, 2010, at 4:43:00
> how stupid is that
Would anyone like to try to show manic how he might interpret things more charitably or otherwise encourage him to rephrase or apologize? You may have the power to help him avoid being blocked again.
Bob
Posted by manic666 on March 18, 2010, at 5:01:35
In reply to Re: SSRI - better response with less frequent dosing?, posted by manic666 on March 17, 2010, at 4:43:00
playing god with your meds, if new to them is crazy/// its like saying i may as well take the hole months worth in one go an then i dont need any for a month///how stupid is that //now look at your own question if new on meds.??//////////// Right bob i asume you read this post yourself//it says how stuid is that,///not how stupid are you.//i am refering to nobody just makeing a statment of fact.an apoiligy from you would go down well //but thats not going to happen/// i try to take your dieing forum from the brink of collaspe with some meaty debates hurting no one, an posting on soicial just to keep it alive..//for a stupid statment you made its plain you want me out and an easy life until babble dies.///tell you what bob i quit //you keep your poster that screw every newbie that enters babble, an goes sraight out the door. i dont want newbies being told by people that clearly belong in a mental hospital what to do,//people liked my straight talk it a refreshing change for the suck up aproach//whatch it die again like it did in my 5 week ban RIP
Posted by Brainbeard on March 18, 2010, at 5:49:38
In reply to SCREW babble leave this thead for all to see RIP, posted by manic666 on March 18, 2010, at 5:01:35
That's all folks!
The beating heart of Psychobabble has left. ;)
Posted by Justherself54 on March 18, 2010, at 9:34:42
In reply to Re: SCREW babble leave this thead for all to see RIP, posted by Brainbeard on March 18, 2010, at 5:49:38
That was unkind.
Posted by Dr. Bob on March 18, 2010, at 9:52:54
In reply to Re: SCREW babble leave this thead for all to see RIP » Brainbeard, posted by Justherself54 on March 18, 2010, at 9:34:42
> i try to take your dieing forum from the brink of collaspe with some meaty debates ... for a stupid statment you made its plain you want me out
manic, I appreciate the energy you bring to Psycho-Babble. I don't think incivility is necessary to keep it from collapsing. I don't want you out, I just want you to be civil.
Let's keep follow-ups civil, too, thanks,
Bob
Posted by Brainbeard on March 18, 2010, at 10:09:51
In reply to Re: SCREW babble leave this thead for all to see RIP » Brainbeard, posted by Justherself54 on March 18, 2010, at 9:34:42
> That was unkind.
I don't think so - it was an ironic reply to a narcissistic overstatement. In fact, Manic thanked me for it, missing the irony. I really don't have anything against Manic and wish him all the best, wether he stays with us or not. It was just his stating that this board would collapse without him that was begging for a tongue in cheek reaction.
Posted by Justherself54 on March 18, 2010, at 16:35:42
In reply to Re: SCREW babble etc.- The Rightful Place Of Irony, posted by Brainbeard on March 18, 2010, at 10:09:51
There's a fine line between irony and sarcasm. To further state that Manic thanked you, missing the so-called irony, is again, in my opinion, unkind.
This is what can be so frustrating to me regarding babble. If one is clever with words, one can often circumvent the PBC's or PBS's.
A good many of us are not quick-witted and clever with the written word..but we all deserve respect.
Posted by Dr. Bob on March 18, 2010, at 18:45:18
In reply to Re: SCREW babble etc.- The Rightful Place Of Irony » Brainbeard, posted by Justherself54 on March 18, 2010, at 16:35:42
> a narcissistic overstatement.
>
> Brainbeard> To further state that Manic thanked you, missing the so-called irony, is again, in my opinion, unkind.
>
> Justherself54Please don't post anything that could lead others to feel put down.
But please don't take this personally, either, this doesn't mean I don't like you or think you're bad people, and I'm sorry if this hurts you.
More information about posting policies and tips on alternative ways to express oneself, including a link to a nice post by Dinah on I-statements, are in the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above posts, should of course themselves be civil.
Is anyone going to try to help manic avoid being blocked again?
Thanks,
Bob
Posted by manic666 on March 19, 2010, at 4:11:48
In reply to Re: please be civil » Brainbeard » Justherself54, posted by Dr. Bob on March 18, 2010, at 18:45:18
You are right i did missread brain beards post, an thank for looking out for me.//brainbeard i thought you were genuine in the remark, an not takeing the piss, some think i may Do at times ,but put ONLY JOKEING at the end, you disapiont me an i genuinly trust people //you took advantage of my trust,bob not calling any one just saying it like it is.
Posted by manic666 on March 19, 2010, at 14:33:53
In reply to SSRI - better response with less frequent dosing?, posted by linkadge on March 15, 2010, at 11:03:10
ok, im sorry i got heated with the meds experiment debate, it none of my buisness what meds you take , an im sorry for over reacting i apologize
Posted by Brainbeard on March 19, 2010, at 16:34:13
In reply to justerself54 THANKS, posted by manic666 on March 19, 2010, at 4:11:48
Manic, I apologize for not telling you straight I was being ironic, and also for talking about your reaction to it on the board - especially the latter was unethical, as I realized soon after writing my post.
Posted by Dr. Bob on March 23, 2010, at 0:28:40
In reply to Another apology - irony RIP, posted by Brainbeard on March 19, 2010, at 16:34:13
Posted by Meltingpot on March 26, 2010, at 14:35:34
In reply to SSRI - better response with less frequent dosing?, posted by linkadge on March 15, 2010, at 11:03:10
Linkadge,
I can understand why you are doing what you are doing. I have found in the past that if I increase my dose of SSRI and then drop it the next day I feel a bit better the day after. Or sometimes not taking it one day can make me feel better, not great but It does give me some relief from the constant numbness, blah type feeling.
However, I've only felt the need to do this sort of thing now that the meds don't work properly. When I took Seroxat and it worked I never needed to play around with the dose or even wanted to.
Now though I feel bad on them and even worst off them, the better place is somewhere in between.
Denise
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.