Posted by Brainbeard on December 26, 2009, at 5:31:50
In reply to Re: sertraline and nort., posted by RocketMan on December 25, 2009, at 15:14:14
> > Also re sertraline, I've read (maybe here) that a 8mg dose produces 50% reuptake of serotonin. Anyone know about this?
>
> That sounds like a very sub-therapeutic dose in my books. I would not take anything you read here, or any internet site, as the gospel. I would suggest a minimum starting dose of 25mg and titrate up as need be.
>
> Rocket
>
>Principally agree with Rocket. What's the worth of 50% SRI? It may well have no therapeutic effect at all. But what are numbers worth anyway? I know of a research that showed that just 10mg of clomipramine (brand name Anafranil) already causes 80% occpancy of serotonin receptors, which is an occupancy similar to therapeutic doses of the SSRIs. Still, I know from my own experience that 10mg of clomipramine is NOT comparable to a therapeutic dose of an SSRI. Details do matter, and often we don't even know the details. And when 'we' (read: some obscure scientist) do, p-docs and the like are not interested in them.
Concerning sertraline: I know of a friend of mine who suffered from akathesia while combining bupropion (brand name Wellbutrin) and sertraline. She lowered her sertraline to 25 and even 12.5mg, but the akathesia persisted and only went away when she quit sertraline completely. So even a 12.5mg dose may have some effect.
8mg, on the other hand, seems like a borderline dose - a bit like kissing a Tylenol pill and hoping it will help your headache.Don't get me wrong - there ARE medications with which even very low doses may be therapeutic.
Prozac (fluoxetine) is a prime example; in the initial trials, a minimum effective dose couldn't be established since ALL doses, no matter how low, were effective. 5mg or even 2.5mg of Prozac a day can be an effective agent against dysthymia for some people. But the reason is that fluoxetine is a potent 5HT2C-antagonist, effective as such even in small doses.
So it all boils down to what a drug does and if it does that or anything else at lower doses.
poster:Brainbeard
thread:930705
URL: http://www.dr-bob.org/babble/20091217/msgs/930929.html