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Why do low doses of some drugs mess you up worse than higher ones?


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With both Saphris and Abilify, I was horribly anxious, depressed, and angry. Also had really bad akathesia. Yet when the doses were upped, I did fine. Why is this? I would have thought if a low dose was bad then a higher one would be hell, but it actually made it better.

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No, I guess I should have clarified. I get worse than my usual unmedicated self when on low doses, but when they're raised I'm fine.

Oh wait I see what you mean. Maybe so.

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I do a lot of thinking when I walk to college, to and from everyday. And I was actually thinking about this the other day, now I'm quite a medically minded person but I just couldn't figure out why/how this happens.

My example is always the Seroquel low dose= Sedative/antihistamine I don't understand why a dose 10 times higher doesn't do the same job?

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No, I guess I should have clarified. I get worse than my usual unmedicated self when on low doses, but when they're raised I'm fine.

I know what you meant. And I still say that a drug not at the therapeutic dose could cause undesirable side effects.

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My technical understanding is very limited but I do know that antipsychotics effect multiple neurotransmitters and the effect on each is dose dependent at least to some extent. Seroquel, for example, is thought to effect histimine mostly at lower doses, but have a much bigger impact on dopamine at higher doses. Sedation is common at low doses, more activation is common at higher ones. I'd guess that Abilify also effects different neurotransmitters differently at different doses since many comment on activation at low doses that diminishes with higher ones.

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That all makes sense. It is sort of strange, although I'm just now taking a basic chemistry class in college and so I barely understand chemicals and medications at all. Thanks for all the insight and stuff ;)

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Yes, the answer is that effects are dose-dependent, meaning that certain effects that happen at low doses may not happen at all at higher ones and/or the higher dose effects are additive to the lower dose effects, leading to a different clinical outcome.

It's a pretty simple concept, really. Take for example, a half pound apple hitting you on the head, that's going to have a totally different effect than say, a 50 pound apple hitting you on the head, even though the first .5 lbs is still there....

Maybe this is a poor analogy.

Anna

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