Saturday, 3 April 2010

Therapeutic Doses

Antidepressants often get a bad press. Whether it is newspapers claiming that doctors dish them out like sweets or patients who claim that they don't work. I have been on antidepressants almost continuously for almost 12 years and I am absolutely certain that without them I wouldn't be here writing this today.

I wouldn't claim to have been on every antidepressant that there is but I have taken a fair selection of them over the years. Some seem to have made a difference, one or two don't seem to have worked, and one made me have hallucinations and feel very ill indeed.

At the moment I am taking two different antidepressants. I'm on the highest doses of both of them. One is taken in the morning and is the one that I have now been on for about a year. The dose has been increased twice; initially when I was in hospital the first time, and the second time was on my last appointment with my psychiatrist. The one that I take at night was prescribed when I had my first appointment with my psychiatrist. It's main purpose is to aid me in getting to sleep and staying that way; it's secondary purpose is as an additional drug to help with my mood.

The problem with antidepressants is that it can take quite a while for them to start to improve your mood. It is probable that many of those people who say that antidepressants don't work, haven't given them a chance. They are not like other drugs which allow you to see a difference almost immediately. Many antidepressants have to be started at low dosages and then increased over a period of time until a therapeutic dose is reached.

At long last it seems that things may be improving for me. The night-time antidepressant is now able to knock me out at night and I seem to be able to sleep the night through (apart from calls of nature). And the combination of the two antidepressants appears to be helping to lift me out of the long depression that I have been in.

It seems that the therapeutic doses of these two drugs have been built up in my body and I can hope for some respite from the darkness that my life seemed to have become. Mind you, I still don't feel full of the joys of Spring, but things don't seem quite so hopeless as they did just a few days ago.

I'm having another therapeutic dose today too. A therapeutic dose of films to watch on television thanks to it being a bank holiday weekend. the weather may not be wonderful, but at least I have something to help to pass the time.


Anonymous said...

Iknow many people for whom anti-depressants were a miracle yet in my case they very nearly killed me. When I was first prescribed them a decade ago, the doc was very hasty and didn't think to ask about my 'highs'. Partly it was my fault also since i failed to mention them (very common for bipolar types who initially tend only to seek help when they're depressed).I think/hope that doctors have a little more insight these days and these potent drugs are not dealt out with such rash frequency.
The night-time one, i think you're referring to I took for a while in conjunction with an anti-psychotic and a mood stabiliser. The tricyclics are also used in 'sub-therapeutic' doses for nerve pain (which was why I was prescribed it on top of the psych drugs). Funny you should mention the 'calls of nature' since it's also commonly used for restricting the bladder muscles (my mum takes it for such) and I found it a real relief NOT to be waking up for that very reason every night!!
Glad you've found something that works.
Take care.

Anonymous said...

I've never really understood the "need to build up a therapeutic dose" argument, at least as far as the serotonin-enhancing antidepressants go. From what I have read about them there isn't any biochemical or neurological reason why they shouldn't work immediately.

rielouise said...

A counter balance: anti-depressants save my life. I don't think I'd be here now.