Guest Column: Rebuttal to Gatekeepers to Pharmaceuticals

Jane H. Feldman, MD

In This Article


There is a similar problem involving lack of supervision of a medication trial regarding dosing. Most over-the-counter medications do not have particularly variable dosing ranges. Most people take the same amount of aspirin, ibuprofen, or cold remedies. For better or for worse, the same cannot be said for psychotropic medications, particularly antidepressants. Dosing ranges for these medications can vary a great deal from patient to patient. Very often, a lack of response at the initial dose for an antidepressant trial indicates that higher doses are needed. While this is a relatively straightforward and easy determination for a treating physician, patients often have reasonable and appropriate concern about taking too much medication on their own and may be considerably less inclined to increase their doses, even when it is indicated. Alternatively, they may increase dosages too rapidly when discouraged by lack of immediate response.


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