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Are meds supposed to work in 2 weeks?


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I have the luxury of seeing my pdoc about every 2 weeks and it seems like we try something new every 2 weeks.  Tried some lithium.. didnt work after 2 weeks, so tried depakote, didnt work after 2 weeks, so now I'm trying lamictal.

Before this it was trying some APs and some SSRIs.  I'm just wondering if this is the right way to go about things- are you really supposed to feel some effects in only 2 weeks?? I find it kind of pointless because I start out at some dose definitely below theraputic dose.. try that for 2 weeks, and when it does nothing, pdoc is like- well lets try this instead.

Wouldn't it make more sense to, if after 2 weeks it didnt work, to maybe double- or increase in some way the dosage, to see if that would help.. at least get to the theraputic dosages, and then after 5-6 weeks or so of not working- then try something else??

I didnt go to school for psychiatry so I honestly have no idea.. but it just seems like I am trying drug after drug without even staying on them long enough to even see if there is a difference.

Or maybe I'm wrong, meds do work in 2 weeks, and I've just been med-resistant so far?

Any thoughts? Thanks!  (and sorry if this is in the wrong forum..)

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I agree with you...it seems very wacko to me. Some people do feel good effects on some meds fairly soon, others take longer. How in the world you could tell for sure after such a short time is beyond me. For example, with Lamictal some people will feel it at 25 or 50 mgs. With me, it took getting to 125 before I felt any AD effect.

Did he give you a starter pack of Lamictal?

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I agree with you...it seems very wacko to me.

That DOES sound ridiculous. I would give a med 6 weeks minimum, unless the side effects are just too much to deal with. It took 6 weeks just to get my depakote to the level it is now. I've started on Lamictal, but he wrote me a month's script for 25mg, and I don't see him til the 24th. *Especially* Lamictal, you have to titrate VERY slowly on that.

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2 weeks doesn't sound very reasonable a time frame to expect results for most meds.

I did have a noticeable effect from lithium after the first week, and it continued to increase with time. My feeling is that it took over a month for lithium to reach its full stabilizing effect.

Lamictal was very slow to develop.  I didn't notice any effect until I reached 100mg, which on standard starter pack titration takes 4 weeks.  The effects from lamictal were very subtle and honestly took about 3 months to fully develop.

Have never taken depakote.

I don't think it is realistic to expect most mood stabilizers to have much effect in 2 weeks. It takes about 6 weeks for the brain to grow new neurons in response to the meds' stimulus, and then the minds thought patterns can begin to truly change.

Good luck, 

a.m.

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Or maybe I'm wrong, meds do work in 2 weeks, and I've just been med-resistant so far?

<{POST_SNAPBACK}>

No. 2 weeks is really unreasonable to expect any kind of results.  I really am not sure what sort of plan your doctor has for you, but switching meds constantly really can do more harm than good:

it doesn't give you a chance to see if the med is actually working.

it can be physically rough on your body.

it can be psychologically rough, throwing your moods way off.

5-6 weeks is generally a minimum as far as meds go. There are exceptions, but 2 weeks really is very short.

Perhaps the way to figure out what is going to work best for you is to have a clear discussion with your doctor and ask what the plan is for your treatment. No, you didn't go to school for psychiatry, but it is your health at issue and you do have a say. 

~navy~

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Wow, IMHO you should run, not walk, away from this guy.  He sounds like the first guy I saw.  Here's my first pdoc experience:

Figured out I had depression.  Went to a nice man.  He prescribed ADs.  I had nasty side effects, "anxiety," "irritability," sleeplessness, etc.  I started wigging out on wellbutrin.  He added depakote.  I was tired and dull and 2 weeks later he switched me to another med.  Then another.  I can't even remember the meds because I was completely out of it.  Finally after about two months of bouncing around from med to med he left me on wellbutrin alone.  I sped along for 3-4 months before going into a psychotic mixed state mania.  Terrified, I called a BP friend who made me take 500mg depakote (followed by another 500 twice a day).  I found a new pdoc who gave me 10 days of zyprexa, continued the depakote and reduced the wellbutrin.  After about a month I adjusted to the depakote; after 2 months my cognitive functioning came back up.  Yay for new pdoc.

Anyhow, the first guy was a dangerous man, as far as I'm concerned.  In order to tell if a med works you need to give it a good trial.  For most meds that means around 6 weeks.  You have to get through initial titration and the transient side effects that come with many meds.  Lamictal takes more like 2 months or more because of the slow titration.  Everyone's chemistry is different; I take 400 lamictal, but many take 200 and do great.  1000 depakote was the number for me, but many take 750 or 1250 or 1500.  Until you give it several weeks, you won't know how much you need, and whether it works for you.

Your pdoc sounds skittish.  It takes a bit of balls to pick a med and get a patient to keep taking it until you can see if it works.  Sure, my second pdoc turned out to be too conservative and stuck, and after years with him I've switched to a younger, more creative guy (who still will only make one change at a time and won't switch a med until we've tried everything we can with it).  But conservative is way better than the treatment you're getting.

End of rant.  Sorry, I just get pissed off at screwy pdocs.

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After 2 weeks, you may start to see a slight change. But I don't think 2 weeks is enough to know that if you are on the right med. Lamictal took over a month for hubby to get up to a good level, then another month or two of fine tuning.

Now, let me play devil's advocate for a minute. How many post have you read where someone is on a med for 2 or 3 DAYS and complaining about it not working yet, or about how they don't like the side effects, etc... and they want to switch meds again and again and again. Maybe your doctor has had one too many FIX ME NOW DAMMIT patients?

Either way, I think he is doing you a diservice.

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