which in general ? increase dose or decrease it

[adel_ezz]

My father has just hang off from a phone conversation with a pdoc (we know a bloody herd of them) the guy said according to the British school of psychiatry we give a high dose then seeing that the pt is improving we reduce the dose until we reach a prophilactic dose (maintenace dose). Yet i think Bernie40 our community leader mentioned that one can start on 200mg to reach say 0.3 blood level in lithium then increase it say to 0.5-0.6 subtoxic level.

In general how the levelling is usually done ?. I remember one of the pdocs (can't remember now which one and of what rank in the herd) he wanted to put me on depakine (the egyptian depakote) maximum dose from day 1. He said this is the latest theory or approach in psychiatry. I bet he meant gambling or pocker perhaps. because Bernie40 is British and did the opposite exactly. That was sometime ago and my parents decided he was stupid because suppose the diagnosis is wrong and i have say panick attack and not BP then how come he put me on the max dose on the day he first saw me for an illness i might not display.

Why i am asking this is because i am waiting for my pdoc to return from abroad, i mean my last pdoc, meanwhile i did a blood test for the kidneys, creatinine, thyroid T3, T4, TSH and waiting for him, so i will suggest the smallest dose to start with

finally abt BP in general each time i hear or read: a severe progressive illness, i panick. this pdoc said all of his BP patients their BP was aborted and all of them cured with time. I wish to believe him, his last position was the head of the main egyptian governmental psychiatric hospital, i.e. containing all of the insane egyptians supposedly. my father asked him about lithium too he said half of our pts we them lithium.

what do you think 1st abt the dosage increase it or decrease it ?. PERHAPS giving the max dose is like ATTACKING the illness with all your weapons. A friend of the family has asperger a category of autism he takes 20mg zyprexa (max dose) for 3 years now and is doing very well without changing the med. Whereas i was living on the min dose of AP's but i am getting more insane and increased my seroquel 4 times and losing control.

thanks ezz

[starbunny]

In my experience, the medication I have taken has been started at a low dose and gradually increased. The advantage being that this limits side effects and gives time to 'get used to' the tablets, the disadvantage being that it takes longer to reach stability.

[Athena_M]

The psychiatrists that I have had in the past have put me on a high dose at first (lithium, depakote, and or Seroquel)  and then will gradually lower the dosage down to the therapeutic range once I get stable.  

Once my lithium was too high, I started vomitting.  So the doctor had to adjust it  With lithium there are alot of blood test that one will go through to find the right dosage.  

With the aspergers patient the dosage for Zyprexa will be totally different than for bipolar.  

You are right the high dose is suppose to kinda ATTACK the illness.  The high dosages though will kinda put a person in a catatonic state.  

[ILADVOCATE]

From what I know in general lithium is increased gradually to monitor for potential side effects and to find what is the correct blood level but not go above it.