Posted by SLS on August 29, 2004, at 10:35:50
In reply to Re: Blood levels for desipramine?, posted by Ame Sans Vie on August 29, 2004, at 8:50:10
Hi Michael.
Since there is no efficacy window with desipramine as there is with nortriptyline, it is probably easiest just to continue titrating clinically to 300mg if you are tolerating the drug side effects. Roughly speaking, as listed in the PDR, 200mg is for outpatients and 300mg is for more severe inpatients. You can use blood levels as a guide to make sure you are not way underdosed or overdosed, but as Larry suggested, there is really no upper bounds established as a maximum beyond which there is no further therapeutic value. I am not you (in case you haven't noticed), but I don't glean maximum benefit (which isn't much) until I reach 300mg. I would just go for it. You'll reach a conclusion to your trial that much quicker. I would give 200mg no more than 3 weeks before moving up. After an additional 3 weeks, if you feel no improvement and have no intentions of augmenting with lithium, you can make the decision to terminate the trial. If you do respond at the 6 week mark, and are not convinced you need the full 300mg, you can try dropping back. You'll find out very quickly.
Just a suggestion. It is somewhat aggressive.
- Scott
poster:SLS
thread:383581
URL: http://www.dr-bob.org/babble/20040825/msgs/383621.html