dosage of medication advice please

[Linny]

i have 10mg cipralex tablets but as i have been unable to take them before i decided to go slow.
i have had 2.5mg every other day for a week and now 2.5mg each day for a week.
i am feeling worse than ever though. i am worried to up the dose but am wondering if taking a smaller dose is making the side effects worse?

[amandaj]

hi i think its prob best to discuss if it is them with your gp maybe you could give him her a ring just to make sure let us know how you get on if you do sorry your feeling rubbish atm

amanda

[alias_kev]

Hiya, Based on the published data taking a dose every other day may not have helped to much as the drug is heavily metabolised in about 36 hours. That could (I am no expert) mean that in effect your active dose in the body would be bouncing up and down even more than on a normal daily one.

Initially the level in our body must logically increase a bit each day since not all of it will have been metabolised or excreted before the next dose. Think of it like pouring water into a leeky bucket. So one reason we get side effects may be that the drug level is always increasing day to day. In addition (except on some other slow release meds) we obviously get a big jolt of the medication some time after taking it and then this reduces a fair bit over the next day. So the average is rising BUT there are peaks and troughs too.

So while starting on a low dose is good, every other day may be too infrequent as you get adaption side effects followed by withdrawal side effects. If you refer to this (http://emc.medicines.org.uk/medicine/9360/SPC/Cipralex++5%2c+10+and+20+mg+Film-Coated+Tablets+and+10+mg+ml+oral+drops%2c+solution ./) section 4.2 the normal minimum dose seems to be 5mg DAILY unless you are over 65, or have other medical conditions or sensitivities.

So do discuss this with your GP or a pharmacist. I'd guess you would have been better on 2.5mg EACH day, followed then by 5mg. Most people use 10mg eventually and a few of us get to 20mg. There are arguments within the literature about whether 20mg makes any difference. Some conditions and patients appear to get a benefit on 5mg DAILY.

[Yvonne]

Hi

How do you manage a 2.5mg dosage? What I mean is how are you managing to cut the tablet or whatever?? I can't remember now if that med is a capsule or a tablet.

You would have been better off taking 5mgs a day then upping to the 10 a couple of weeks later. Every other day is not a good idea at all as Kev has indicated not on start up for sure.

I don't think your gp would be pleased if he knew you were taking such a small dosage to be honest this really isn't way to get on a med I don't think.

Take care and don't be afraid of the meds - side effects last about two weeks and you just have to go through it.