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!
poster:med_empowered
thread:521334
URL: http://www.dr-bob.org/babble/20050627/msgs/521604.html