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Re: Started Effexor XR - nightmare! advice needed

Posted by sowhysosad on July 16, 2009, at 6:00:52

In reply to Re: Started Effexor XR - nightmare! advice needed, posted by bleauberry on July 15, 2009, at 19:23:28

> I strongly despise the common strategy of choosing preconceived dosing strategies. The patient's reactions should be the guiding factor, without any preconceived notion of where things are going, starting with the lowest possible dose. The side effects and the emotions are the steering wheel, not a pen and paper and not clinical studies on cherrypicked samples that are not representative of you and me and of which the results are so intricately flawed it could write an entire book.

I heartily agree. I recently asked my junior pdoc to prescribe fluoxetine liquid so I could start at 10mg and titrate when ready.

He sounded completely baffled by this and protested that they never start anyone on less than 20mg! No wonder a lot of people quit before getting any potential benefit because of intolerable startup effects.


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