Posted by SLS on June 17, 2014, at 7:50:03
In reply to Polypharmacy/How many is too many?, posted by MuseMemento on June 15, 2014, at 15:09:34
> For whatever reason, I'd been opposed to using more than two meds at a time to treat my condition until last fall. Even with additional meds I haven't had anywhere near the type of relief I believe I could. I wonder, though, if each med in one's cocktail has a clear and distinct purpose, and mode of action, how many meds is too many? In hindsight, I can determine that approximately 7 meds have helped to some degree. If there are minimal interactions between them all and side effects aren't overwhelming, would it be in my best interest to take them all simultaneously? Any opinions are welcome!
How many is too many? To answer that question, one would have to set an arbitrary number that may not reflect the optimal clinical treatment for an individual. Some people think that there is no reason to take more than one antidepressant. Other people demonstrate an absolute need for two or more. The people who subscribe to a school of thought rejecting polypharmacy may waste their entire lives suffering as they stubbornly adhere to a personal opinion that is not supported by neuroscience.
I don't think that taking a combination of the 7 drugs that individually produced a partial improvement is the most rational method of choosing a treatment regime. First of all, most antidepressants have multiple modes of action, even though they may not be well understood. It is conceivable that two drugs in combination would replicate all of the mechanisms found additively in your 7 drugs. It is also conceivable that the actions of your 7 drugs overlap such that taking all 7 would produce redundant and toxic effects.
If you list the 7 drugs that you found helpful, perhaps someone can parse their properties and suggest more rational treatments. It may be that the addition of a mood stabilizer or an antipsychotic with antidepressant properties would convert a modest improvement into a robust improvement.
- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1066950
URL: http://www.dr-bob.org/babble/20140609/msgs/1066988.html