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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Phillipa on June 29, 2005, at 23:02:17
After reading some of the posts today it sounds like if you don't get side effects from a drug you should keep going higher until you do. So if I can take 100mg of luvox and not feel anything should I go higher. After having low PB when raising the luvox I got scared and lowered the dose. But now I found out the cuff at the health club was broken. I had gone back down to 25mg like the pdoc Rx'd. In the past I had gone up to 250mg. I did fall asleep a couple of nights on the low dose but maybe I was tired. There's a lot going on right now. What would you do? Take a low dose or raise it until you feel side effects. Thanks Phillipa
Posted by FredPotter on June 29, 2005, at 23:20:39
In reply to No Side Effects Means Take A Higher Dose?, posted by Phillipa on June 29, 2005, at 23:02:17
Dear Phillipa please don't try this with Paracetamol. In other words no it can't be true that you have to have side effects for the drug to work
Fred
Posted by Cecilia on June 30, 2005, at 1:58:04
In reply to No Side Effects Means Take A Higher Dose?, posted by Phillipa on June 29, 2005, at 23:02:17
I don`t think side effects have anything to do with benefits. Some people are lucky enough to get benefits with minimal side effects (they`re usually not writing in to Psychobabble); others like me usually get terrible side effects and no benefits. I think with psych drugs you should start at the lowest possible dose and gradually increase until A) you get benefits or B) you get intolerable side effects. Cecilia
Posted by linkadge on June 30, 2005, at 6:26:51
In reply to Re: No Side Effects Means Take A Higher Dose?, posted by Cecilia on June 30, 2005, at 1:58:04
Yeah, I agree thats nonsense. Take a dose that you think works. If not try a higher dose. If that doesn't work try something else. Don't go on side effects.
Linkadge
Posted by med_empowered on June 30, 2005, at 15:25:00
In reply to Re: No Side Effects Means Take A Higher Dose?, posted by linkadge on June 30, 2005, at 6:26:51
With some drugs, dosing until side-effects appeared used to be the way dose titration was done. Take the old-school anti-psychotics; in the outpatient setting, the idea was actually to DELIBERATELY induce pseudo-Parkinson's in the patient; the dose at which "moderate" signs of pseudo-Parkison's appeared (noticeable tremor, locomotor retardation, etc.) was the dose at which the drug became "bio-available" and therefore effective. Of course, now we know this was mean-spirited foolishness--these patients probably could've done just fine on extremely low-dose meds w/ a minimum of side-effects. I've had a few doctors say that they dose certain mood-stabilizers (especially Depakote, for some reason) until side-effects become unbearable. Now, since Depakote can cause pancreatitis, hormonal weirdness, and can make you stupid as hell, I run from these docs. Sooo..my take on it: try to stay in the low- to mid-range of therapeutic doses, since this usually minimizes problems. If needed, go up a bit, or until you reach the generally accepted max of whatever drug you're on (some docs ignore these, and will do stuff like put people on 90mgs of Remeron when 45is the usual max--that to me is ridiculous and means the doc is just playing around with meds). Side effects, for me at least, are often a reason to *stop*, because I think treatment for emotional/mental issues should be as painless as possible. Good luck!
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