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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Conundrum on September 15, 2010, at 21:45:11
I posted on another board where i was beat down with star*d results that showed that a few weeks isn't enough time to know if an antidepressant will help, but it takes 6 to 8 weeks. I did not know this and my last two psychiatrists did not believe this for quite a few drugs. I hope I'm not getting short changed, but damn it can be hard to be that patient.
How long do you guys usually wait?
Posted by Phillipa on September 16, 2010, at 0:33:21
In reply to 6-8 weeks: Does everyone do this?, posted by Conundrum on September 15, 2010, at 21:45:11
Well they say 12 weeks and the only one that worked for me was about that long. Well l5 years now and no more work. About to stop trying. Just maybe stop them but something keeps me now adding the lexapro to luvox. Some you know especially I feel if not for you horrible side effects. Phillip ps I'm sorry you got it and yes very hard to be patient
Posted by europerep on September 16, 2010, at 3:37:38
In reply to Re: 6-8 weeks: Does everyone do this? » Conundrum, posted by Phillipa on September 16, 2010, at 0:33:21
yeah, in the beginning I'm always like "hmm 12 weeks that's a damn long time", but once I am on a med I usually decide to go for it (if not longer, so as to spend a sufficient amount of time on the maximum dose). to me, that feels better than quitting too early and not knowing 100% whether the med may have started working or not.
I think another member said that parnate started to work for her only after three months, but then it worked quite well. I believe that there are quite a few people who unfortunately quit a drug too early.
Posted by linkadge on September 16, 2010, at 6:38:52
In reply to 6-8 weeks: Does everyone do this?, posted by Conundrum on September 15, 2010, at 21:45:11
>I posted on another board where i was beat down >with star*d results that showed that a few weeks >isn't enough time to know if an antidepressant >will help, but it takes 6 to 8 weeks.
Well, I would like to see more than one study confirm this result. Because, if I am not mistaken, I've seen other studies suggest the converse. That is, if the drug shows zero benefit in the first 2 weeks, its likely not going to do much.
That being said, if there is any improvement, there could well be more the longer you wait.
I think the longer you wait too, the more likely the patient is to spontaniously remit.
Can you reference the section of the study which reaches this conclusion?
Linkadge
Posted by SLS on September 16, 2010, at 6:52:57
In reply to Re: 6-8 weeks: Does everyone do this?, posted by linkadge on September 16, 2010, at 6:38:52
It may be that some patients don't recognize the earliest, most subtle improvements that a treatment may produce within the first 2 weeks. Alternatively, it may take a few weeks to reach the dosage that will produce results. It is interesting, though, that the following study demonstrates a pattern of early response with a drug (fluoxetine) that is supposed to take a long time to reach kinetic equilibrium.
- Scott--------------------------------------
Am J Psychiatry 157:1423-1428, September 2000
© 2000 American Psychiatric AssociationArticle
Timing of Onset of Antidepressant Response With Fluoxetine Treatment
Andrew A. Nierenberg, M.D., Amy H. Farabaugh, M.A., Jonathan E. Alpert, M.D., Ph.D., Johanna Gordon, B.A., John J. Worthington, M.D., Jerrold F. Rosenbaum, M.D., and Maurizio Fava, M.D.
OBJECTIVE: The purpose of this study was to assess the time until onset of antidepressant response with fluoxetine treatment. METHOD: The authors evaluated 182 outpatients with major depression who had a sustained acute response to fluoxetine treatment. The outpatients received 8 weeks of treatment with 20 mg/day of fluoxetine and were assessed biweekly with the 17-item Hamilton Depression Rating Scale. The onset of response was defined as a 30% decrease in score on the Hamilton depression scale that persisted and led to a 50% decrease by week 8. The Kaplan-Meier product limit and Cox regression analysis were used to model the relationship between relevant variables and time until onset of response. RESULTS: The authors found that at weeks 2, 4, and 6, the probabilities of having an onset of response (for responders) were 55.5%, 24.7%, and 9.3%, respectively. The cumulative probabilities of onset of response at each time point were 55.5%, 80.2%, and 89.5%. Neither demographics nor clinical characteristics of depression predicted time until initial response. CONCLUSIONS: These data suggest that more than half of eventual responders to fluoxetine treatment at 8 weeks start to respond by week 2; over 75% start to respond by week 4. Conversely, the lack of onset of response at 46 weeks was associated with about a 73%88% chance that patients would not have an onset of response by 8 weeks.
Posted by weatherfreak on September 16, 2010, at 7:14:08
In reply to Re: 6-8 weeks: Does everyone do this?, posted by SLS on September 16, 2010, at 6:52:57
In regards to SSRI/SNRI's Aussie shrinks have finally conceded the fact that they work faster than the standard 4-6 week crap that the drug companies say.
I think it's a very personal thing as everyone reacts differently to every single med on the market. I personally know with most meds if it will help me after 2 weeks, but I use to appease some pdocs for 4 to shut them up.
Other meds have worked instantly like ritalin. Ropinirole (requip/repreve) was prescribed for RLS but blew my depression away after 2-3 days, totally unexpected.
So in answer to your Q, if I don't think it's working I stop taking it, but I always research it first to see what others say is a fair time to wait for an effect.
Posted by Conundrum on September 16, 2010, at 7:14:31
In reply to Re: 6-8 weeks: Does everyone do this?, posted by linkadge on September 16, 2010, at 6:38:52
http://ajp.psychiatryonline.org/cgi/content/full/164/2/201
Here is what I was reading. I don't know where to find that actual study results myself.
Posted by Zyprexa on September 17, 2010, at 14:07:38
In reply to 6-8 weeks: Does everyone do this?, posted by Conundrum on September 15, 2010, at 21:45:11
I most deffinitly don't give it 6-8 weeks. If a med is not working I usualy know in a week. Taking it longer just makes problems worse. Same for APs.
Posted by Conundrum on September 17, 2010, at 14:15:15
In reply to Re: 6-8 weeks: Does everyone do this?, posted by Zyprexa on September 17, 2010, at 14:07:38
I've seen two psychiatrists recently who said thats too long. My GP is the only one who recommends the 6-8 weeks. Based on the Star*D recommendations some people are waiting 12 weeks. A lot could happen in 12 weeks though. You could get your dog, your pickup truck, your woman, and you job back in that length of time :D I doubt they controlled for spontaneous remission.
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