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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 Meltingpot on August 26, 2015, at 10:02:45
Back in my 20s Antidepressants worked great, very quickly on the smalllest, starting dose.
When I hit 35 (after being off antidepressants for 3 years) my depression and agitation came back worse. I spent two years trying lots of antidepressants at starting doses, experienced excrutiating anxiety, nausea, apathy, increased suicidal thoughts. I felt like I was poisoning myself by taking them. Zyprexa got me through those two years. After two years of trying, the psychiatrist put me straight onto 40mg of Seroxat, no starting dose. Within four days I felt well, no sickness, no anxiety, no nausea.
I sometimes wonder if a lot of people give up on antidepressants simply because they feel so bad on the starting doses when if they had gone straight on a high dose they would have felt relief and continued to take them.
Denise
Posted by SLS on August 26, 2015, at 15:04:46
In reply to I sometimes wonder, posted by Meltingpot on August 26, 2015, at 10:02:45
> I sometimes wonder if a lot of people give up on antidepressants simply because they feel so bad on the starting doses when if they had gone straight on a high dose they would have felt relief and continued to take them.
One problem is that doctors don't inform the patient about the possible physical and mental side effects psychotropics can produce. They don't describe what startup side effects are, and how long drugs can take to work. Most of all, they don't follow the patients closely enough. They really should see a patient once a week at the beginning of treatment. If nothing else, the doctor can screen for the emergence of suicidality.
- Scott
Posted by Zyprexa on August 26, 2015, at 20:40:49
In reply to I sometimes wonder, posted by Meltingpot on August 26, 2015, at 10:02:45
I felt relife right away on the starting dose of SSRIs. It just got better as the dose went up. Oddly though I didn't get any relife from prozac. Celexa was the first one that worked. Now I take sertraline. High doses of SSRIs always worked best. Except when I went on a really high dose of celexa. 80mg. 60mg worked real well though.
Posted by phidippus on August 26, 2015, at 23:23:19
In reply to I sometimes wonder, posted by Meltingpot on August 26, 2015, at 10:02:45
> I sometimes wonder if a lot of people give up on antidepressants simply because they feel so bad on the starting doses when if they had gone straight on a high dose they would have felt relief and continued to take them.
Starting on a high dose increases the risk of side effects, which is why people start on a low dose.
Your experience is an exception to the rule.
Eric
Posted by Lamdage22 on August 27, 2015, at 10:34:38
In reply to Re: I sometimes wonder » Meltingpot, posted by SLS on August 26, 2015, at 15:04:46
> > I sometimes wonder if a lot of people give up on antidepressants simply because they feel so bad on the starting doses when if they had gone straight on a high dose they would have felt relief and continued to take them.
>
> One problem is that doctors don't inform the patient about the possible physical and mental side effects psychotropics can produce. They don't describe what startup side effects are, and how long drugs can take to work. Most of all, they don't follow the patients closely enough. They really should see a patient once a week at the beginning of treatment. If nothing else, the doctor can screen for the emergence of suicidality.
>
>
> - ScottI second that. Not every patient knows what psychosis is. I didnt. So i didnt know i had it.
Plus, i wasnt screened for psychosis either.
So many things went wrong and i cant change it.
Posted by SLS on August 27, 2015, at 14:46:47
In reply to Re: I sometimes wonder » Meltingpot, posted by phidippus on August 26, 2015, at 23:23:19
> > I sometimes wonder if a lot of people give up on antidepressants simply because they feel so bad on the starting doses when if they had gone straight on a high dose they would have felt relief and continued to take them.
>
> Starting on a high dose increases the risk of side effects, which is why people start on a low dose.
>
> Your experience is an exception to the rule.
>
> EricIt is conceivable that Denise's prior exposures to medication left her less reactive to subsequent exposures, both in terms of therapeutic response and side effects. This has been my personal experience, and I doubt that I am unique in this regard.
- Scott
Posted by Horse on August 27, 2015, at 16:49:23
In reply to Re: I sometimes wonder » Meltingpot, posted by SLS on August 26, 2015, at 15:04:46
> > I sometimes wonder if a lot of people give up on antidepressants simply because they feel so bad on the starting doses when if they had gone straight on a high dose they would have felt relief and continued to take them.
>
> One problem is that doctors don't inform the patient about the possible physical and mental side effects psychotropics can produce. They don't describe what startup side effects are, and how long drugs can take to work. Most of all, they don't follow the patients closely enough. They really should see a patient once a week at the beginning of treatment. If nothing else, the doctor can screen for the emergence of suicidality.
>
>
> - ScottI agree. No real knock at doctors, but I am awestruck by the ignorance of some psychs about the effects, whether they be start up or discontinuation. Or, perhaps, they don't want to influence a patient's reactions... in some cases.
At least my doc screens me and sees me frequently. He's a bit of an exception in my experience.
I'm soooo very glad my docs have started low, esp before my bipolar dx. Some of those ad's felt like hits of acid. Although meltingpot, you bring up an interesting point for thought imo.
Posted by Christ_empowered on August 28, 2015, at 12:22:47
In reply to Re: I sometimes wonder » phidippus, posted by SLS on August 27, 2015, at 14:46:47
I dunno...I think it depends, of course. When I started on the normal 20mgs starting dose of Prozac, I didn't much like it. When I started on a full 150mgs Tofranil, I didn't have any serious problems, except for typical TCA stuff that would have hit eventually.
"Start low, go slow" is often good advice, but I don't think doing otherwise is always a bad idea.
Posted by Horse on August 28, 2015, at 14:02:10
In reply to Re: I sometimes wonder, posted by Christ_empowered on August 28, 2015, at 12:22:47
Or ramp up faster? I'd prefer that right now.
This is the end of the thread.
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