Posted by CamW. on July 30, 2002, at 17:43:55
In reply to Re: Paxil and Anxiety/Cam , posted by house on July 30, 2002, at 14:35:32
House - It is always a good idea to give an antidepressant a trial of 8 weeks, unless the is absolutely no change at 5 weeks.
Since meds for panic disorder seem to always need a longer trial to take effect, perhaps any partial response, no matter how early that response is, should be given at least an 8 week trial. Perhaps 10 weeks amy even be better.
The rationale for this comes from studies of Prozac™ (fluoxetine) in obsessive-compulsive disorder (OCD) in which this SSRI can take 26 weeks to show a 50% improvement in symptoms.
Also, it can take 8 to 10 months for Clozaril™ (clozapine) to cause any noticeable improvement in when used for tardive dyskinesia (TD).
I guess when using medication to treat mental disorders, patience can be a virtue. The problem didn't develop overnight (in a vast majority of cases), therefore I guess we shouldn't expect the medications to work that quickly. Most of the medications used in psychiatry require one or more of the body's subsystems.
Realignment of the neurotransmitter/receptor concentrations leading to a recoupling of body's stress defense system (the HPA axis) in depressive disorders is a good example of the body needing to make adjustments to itself before relief from the depression is attained. People with chronic depression may need to take antidepressants for life because they need to artificially maintain their neurotransmitters (and thus their receptors) at certain concentrations to allow their flight-or-fight system working (again, the HPA axis)
Another case where neurotransmitter adjusting is needed is the downregulation of dopamine receptors and the upregulation of endogenous dopamine output in the nucleus accumbens in controlling a drug addiction; be it due to prescription drugs, nonprescription drugs, smoking, and alcohol. I guess we could go one step further with this and say that neurotransmitter adjustment must occur in other addictions as well (eg. eating disorders, sexual disorders, and internet porn addictions, to name a few).
Just thinking out loud. - Cam
poster:CamW.
thread:114402
URL: http://www.dr-bob.org/babble/20020725/msgs/114455.html