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Offline 2013

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Dosage
« on: February 07, 2014, 11:43:02 PM »
I have a bunch of questions. Hopefully, someone will have some answers for me ! What usually determines how much medication you need? Body weight? Metabolism? Severity of symptoms?  How do you know whether you should increase your dosage? I am on lexapro  10mg. Is it harder to get off the meds and stay off them if you are at a higher dosage? 
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Re: Dosage
« Reply #1 on: February 08, 2014, 01:04:25 AM »
What usually determines how much medication you need? Body weight? Metabolism? Severity of symptoms?

Probably all of the above. Antidepressants work by initiating and sustaining the growth of new brain cells to replace those killed off by chronic stress hormone exposure. How much you need is determined by individual biology. Taking too little fails to support this process, however, taking more than needed does not produce a greater response.

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How do you know whether you should increase your dosage?


If the dose taken is not easing the anxiety, or depression sufficiently then a higher dose may be needed. You may also need to up the dose if stress levels later increase.

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Is it harder to get off the meds and stay off them if you are at a higher dosage?

Not really, though it may taking longer to wean off them. Antidepressants are not addictive, they don't create cravings, so staying off them is not usually a problem. However, both anxiety and depression are often chronic conditions which wax and wane, but don't totally resolve so you may need to take antidepressants again in the future. This is also the case with therapy.

Also be aware that there is growing evidence that antidepressants become progressively less effective every time they are stopped and restarted, requiring higher doses to achieve the previous level of control. They may also produce more severe, and sometimes different, initial side-effects. According to one study the odds of antidepressants working after each restart drops by nearly 20%. Note that this applies to all antidepressants, not just those taken previously. (interestingly, there is some evidence that taking a similarly shaped placebo the second time around may produce at least some of the full effects of the original antidepressant)

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline Gale

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Re: Dosage
« Reply #2 on: February 08, 2014, 12:32:26 PM »
Hi Ian!!!! Could you please answer a few questions for me.  I am currently taking 150 mg. of zoloft and 1 mg. of ativan some weeks it does nothing, and for a few weeks I get relief. My pdoc will not change my zoloft. The only one she added was Neurotin, which I am so scared to take. I recentlywatched a episode on DR. OZ  and  he was saying that  so mny people who are on meds should not be taking them at all. And if meds do not  work, then it is probably a physical problem.  Scared the crap out of me. You know me!!!!!!!!  So   what is a person to do???   I am stll worried about MS. PLEASE HELP!!!!!!!
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Re: Dosage
« Reply #3 on: February 08, 2014, 04:38:09 PM »
My pdoc will not change my zoloft.

There is no point taking a med that doesn't work at the prescribed dose. Either the dose is raised, or the med switched for another. Another possibility is to add a small dose of Buspar (buspirone) which will often give an extra boost to SSRIs which are nearly, but not quite working.

As for your psychiatrist, remember that your paying for the service. You're the one in charge. Unless there is a very good reason for not doing something about the Zoloft insist that it is.

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The only one she added was Neurotin, which I am so scared to take.

It might work just enough to make a difference. But, IMHO, fixing the antidepressant is a better option.

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And if meds do not  work, then it is probably a physical problem.

Anxiety disorders are physical problems. Among other things, your brain has fewer neurons in the hippocampal regions, and fewer benzodiazepine-GABA complex binding sites than normal.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

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