Posted by bleauberry on May 19, 2011, at 17:09:36
In reply to Prozac 10mg better than Prozac 20mg?, posted by Agomelatinehope on May 18, 2011, at 4:29:18
How can it be possible? Because there is no one size fits all. I almost laugh when I look at the directions on a bottle saying how many milligrams are supposedly therapeutic and what a target dose is. Nobody could possibly know. Sure they can make generalizations based on studies of populations, but that in no way is going to be accurate for each person.
How about someone doing well with 1mg Lexapro. How about 1 drop of lexapro (1/10th mg)? How about 20mg prozac once a week? How about 5mg Nortriptyline? There are real live people who have found these doses to be their best.
How do we explain it? We can't. We can't even explain where the symptoms came from, what the meds actually do, why they work when they do or why they don't when they don't.
Don't worry about it. I know it's interesting to think about and ponder. All that really matters is that you are feeling better. The actual dose that accomplishes that is not important.
My best dose of prozac was 20mg. But that was after several years of 10mg being the best. Then there was Nortriptyline...5mg. Even the smallest capsule was too much and felt bad, so I had to make half capsules and that was good. Milnacipran....best dose was not even as high as the starting dose.
My doctor uses "supposedly" subtherapeutic doses frequently and has more success that way than by following the crowd.
It's all one massive reality experiment anyway. Go with what works and be happy it works. The dose could be substantially higher than a maximum recommended dose, or it could be substantially lower than a common starting dose, or anywhere in the middle. Each person has to find their own best dose. I cringe when a clinician starts a patient at a supposed starting dose and has a target dose already in mind when in fact no one has a clue what is going to happen with that particular person.
What if your doctor had said to go to 40mg to deal with the anxiety, refusing to think that it was a direct effect of prozac? And maybe things got worse and the doc had you stop it and try something else? You never would have discovered all you needed to do was REDUCE the dose. Duhh.
poster:bleauberry
thread:985607
URL: http://www.dr-bob.org/babble/20110515/msgs/985730.html