Posted by bleauberry on August 5, 2008, at 18:32:25
In reply to How long till switch??, posted by MattSanz on August 5, 2008, at 1:20:27
If you want to be able to say you followed the STARD protocol for maximum odds, then somehow you gotta make it another 18 days.
Other things to ponder though: A couple studies looked into the topic of delayed response. The general findings were: Early hints of improvement = higher likelihood of robust improvment given more time; lack of hints of improvement = low likelihood of robust response, or a longer than usual delayed response. It doesn't mean someone's fate is definately determined by the first week or two, but that the odds one way or other are.
I do not see someone getting remarkably well after getting worse in 5 1/2 weeks. Why? Because I've never seen it happen, that's all there is to that story. If on the other hand you were feeling the same as you started or neutral, that's a world different than feeling worse. Feeling worse at 5 1/2 weeks is what they call deterioration in clinical studies and is what gets participants removed from continuing the trial.
You are your own best boss. Only you can decide. I am just throwing some different points of views out there to ponder. If there is credence to recent topics about balanced norepinephrine and serotonin, then another route would be to keep zoloft, maybe at a lower dose, and add nortriptyline or desipramine.
Actually, a Ritalin test would be cool. If you could just get a prescription for one day supply of Ritalin to see what it does for your mood (2.5mg-5mg once to thrice per the day), that would be a good hint. Forget the anxiety, jitteriness, etc, if it happens. Just look at the mood part. If Ritalin improves mood on top of Zoloft, then you automatically know you need something in the noradrenergic arena in your treatment. It's called the methylphenidate challenge test. It's so easy, cheap and fast to do, I'm surprised it isn't better known and used all the time. It doesn't guarantee anything, but it is a tool that can increase your odds of success in going a particular direction versus another.
Worst case scenario: Hang on for 18 more days and then make a decision.
poster:bleauberry
thread:844251
URL: http://www.dr-bob.org/babble/20080805/msgs/844401.html