Posted by Kath on July 13, 2000, at 21:08:15
In reply to Re: Good Heavens! » Kath, posted by Sunnely on July 13, 2000, at 20:10:03
Thanks so much Sunnely, I'll print that off too for future reference.
Take care, Kath> >
> > Wow - I'll have to print this off and read it VERY SLOWLY!!! Thanks very much. It'll take some slow concentration to get it absorbed. How in the heck do they know which med to give people. Is this why sometimes people have to try so many?
> >
> > Thanks alot. Kath
>
> =====================
>
> My pleasure.
>
> No hard-and-fast rules to follow regarding the choice of antidepressant. Doctors usually follow certain guidelines such as the following (mnemonic "STEPS"):
>
> 1) SAFETY - e.g., in overdose, drug-drug interactions.
>
> 2) TOLERABILITY - acute and late-emergent side effects.
>
> 3) EFFICACY - overall effectiveness, onset of action, maintenance treatment and prophylactic treatment.
>
> 4) PAYMENT - cost-effectiveness. Should be the least criterion. However, for those people who pay their own meds, this ranks up there.
>
> 5. SIMPLICITY - ease of use, need for titration (gradual increase in dose), divided daily dose, and blood level monitoring.
>
> Others:
>
> 1) Past response to a medication indicates future response (well, not always). So doctor may ask you what antidepressant worked for you in the past.
>
> 2) Family history of response to a medication is also a good indicator of possible response (not always). So doctor may ask you who among your close relatives have taken and responded to a certain antidepressant.
>
> 3) Doctors will almost always avoid a medication that you have experienced intolerable or serious side effects from past use.
>
> Unfortunately, there is no laboratory or diagnostic test in existence, yet (this may change in future with the applicatioin of human genome to medicines) to determine who among the depressed patients will respond to a particular medication. Sad to say, we are still in the era of "trial and error" when it comes to prescribing antidepressants (and other psychotropics) and yes, this is why sometimes people have to try so many meds before arriving at the right one(s).
poster:Kath
thread:40124
URL: http://www.dr-bob.org/babble/20000708/msgs/40363.html