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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by zuma on February 28, 2006, at 15:28:07
i'm having trouble resolving that more than 10 mgs of lexapro can be effective b/c the literature says no increased benefit was found above 10 mgs, and you know the drug company would love for that to be the case so they could sell more. do you think people can still gain benefit from above 10 mgs or is it just placebo effect?
Posted by Racer on February 28, 2006, at 17:11:15
In reply to how can more than 10 mgs lexapro work?, posted by zuma on February 28, 2006, at 15:28:07
I don't think it's placebo effect. While, for the majority of people, there may be no increased benefit for dosages above 10mg, some people will metabolise Lexapro far outside the average. Either more efficiently, or less. Those people will require a dosage outside average, thus more or less than the 10mg that the pharmaceutical company states.
That's my guess, but I bet it's not far wrong.
Posted by med_empowered on February 28, 2006, at 19:53:10
In reply to Re: how can more than 10 mgs lexapro work?, posted by Racer on February 28, 2006, at 17:11:15
its kind of like the cymbalta situation--60mgs is the standard, but people are above and below. Clinical data can speak to response in the aggregate--how a selected pool responds--but it cant quite speak to individuals. Sooo..although as standard practice its probably best to stick with best studied doses, there will be cases where using less or more will be beneficial. Also..some people take other drugs (ex: depakote) that will reduce blood levels of many antidepressants. For these people, you'll need to boost the dose just to get an effect similar to standard dosing.
Posted by Phillipa on February 28, 2006, at 20:44:17
In reply to Re: how can more than 10 mgs lexapro work?, posted by med_empowered on February 28, 2006, at 19:53:10
Wrong again. I always thought 20mg of lexapro was the standard. Oh well. You learn something new everyday. Fondly, Phillipa
Posted by ed_uk on March 3, 2006, at 17:06:16
In reply to how can more than 10 mgs lexapro work?, posted by zuma on February 28, 2006, at 15:28:07
>i'm having trouble resolving that more than 10 mgs of lexapro can be effective b/c the literature says no increased benefit was found above 10 mgs, and you know the drug company would love for that to be the case so they could sell more. do you think people can still gain benefit from above 10 mgs or is it just placebo effect?
Several reasons.....
1. Dosage recommendations are usually based on short trials eg. 4-6 weeks. Doses > 10mg are unlikely to be more effective in the short term, but may be more effective for some patients in the long term.
2. Clinical trials do not determine which dose will be most effective for a given individual, they only tell us which dose is likely to be best for most people ie. not everyone.
Ed
This is the end of the thread.
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