Posted by floatingbridge on July 29, 2011, at 12:54:50
In reply to Re: AD's causing Tardive Dysphoria » floatingbridge, posted by kizzie2 on July 29, 2011, at 11:14:15
Hi Kizzie, I'm just a person going through my own process, so this is subjective observation plus listening to (many) *experts* of varying true expertise, and reading articles over my ability to truly comprehend. However, I am happy to listen and discuss :-)
The chronic underdosing has come into my awareness in a number of avenues.
First, over the past 12 years of my psychiatric treatment
(psychiatric sounds so dire and serious, but I guess that is exactly an accurate enough term) I have not wanted to take medication. So I have not taken it as prescribed by self-withdrawing, cutting my dose w/o telling my treating physician. Most recently I was very underdosed in Xanax which, however one feels about a maintenance dose of a benzodiazepine, it's a reality for me that cannot be presently
wished away or grunted and sweated through. I think *some*
folks do not do well introducing medication into their system and then continually cutting back. In my case, fear of medication led me to constantly skimp, therefore putting myself unknowingly in an crisis of being underdosed. My new, so far very intelligent, well-read, non-pharma related
pdoc has finally gotten me to see this. It is the flip side of compliance. I was non-compliant by trying to underdose myself thereby undercutting any medical help and thrusting
myself into intermittent crisis.Secondly, and perhaps critical to all of this, I was underdosed
by my two ex-providers in whom I relied on for care. In
regards to Xanax, they threw the conversion charts away, they absolutely told me to my face that they did not follow any conversion charts regarding benzodiazepines. I was given three weeks at 10mg of Valium per day to withdraw from a ten year maintaince of 1.5mg of Xanax. They also began to say that since I am sensitive (fibromyalgia) I could not take
medication period. So that is really underdosing IMHO. In addition, it was concluded that since I have chronic PTSD (yes, it's true) that somehow that also indicated I needed
therapy and that also meant *no drug* could help me. So the long, TMI version of how one patient came to be under medicated. I have a great role to play in all this, so I hope
this isn't pure complaining and blaming.Underdosing can also be considered as a less than stellar practioner insisting someone stick with the basic ssri when it is not working and a patient is *begging* for relief. After years. I am not suggesting here someone trudge through the
polypharmacy I have in the past few years. It's just reasonable to consider other classes of agents in a sane fashion.I dunno. Why are you interested in this, may I ask? Do you
have treatment dissatisfactions? Back to your own concerns about underdsoing by keeping a low dose, I think it's very reasonable not to overmedicate. I have been and seen others to pushed passed any possible therapeutic window in the rush to ramp folks up to a preset dose. Like when I said Lyrica was causing me some trouble I didn't like, guess what? My doctor said jeez, let's titrate you up fast and had me double within the week. That's only the last time that happened to me. I had to get off that ASAP btw.BTW, when I reposted that aricle, it was so full of editing errors and repetitions, I was embarrassed. It's practically unintelligible. All I can say is that I apologize. I was trying to convert an attachment from the researcher through various devices, and finally had to break down and buy adobe PDF converter. But that doesn't mean I knew how to use it right away :-/
The topic of chronic ssri usage as being harmful *for only (only)* a select minority of patients is meaningful to me because I had come across the article *after* I had been off of any snri/ssri agent for three months and felt a bone deep relief. I thoughts, yeah, I'm nuts. My doc said, yeah, your nuts. But it was true. I said, I am still depressed and anxious but thank god something inside, a constant clockwork agitation without ever being able to touch the real dysphoria was like a sign of life. The use of dysphoria has been my own for the past few years. It did not come on board with that article. That article and the researcher generously sending it along was personal serendipity.
Hey, so are you new here? I apologize for not knowing you.
Very best.
fb
>Hi - just re-read your reply adn saw the bit about risks of 'chronic underdosing'. Would you mind telling me a bit more of what you know about this.
>
> Im guessing that is the one of the things i am risking by trying to keep my dose low ...
>
> Thanks for all your input. There is very little discussion like this in Uk.
poster:floatingbridge
thread:991795
URL: http://www.dr-bob.org/babble/20110728/msgs/992263.html