Question:

i would very much like to know, from somebody who knows, whether the prescription guidelines for a/d’s (or ohter psy. drugs) are formulated and practiced by the drug companies, by the hospitals, by the doctors or in cooperation… this is an important question for me and i don’t know the facts. thank you Squiggles

Response:

The guidlines for prescibing medications evolve over a period of time. The initial recommendations come as a result of the clinical trials that are presented to the drug monitoring body of a particular country (FDA in the United States, I am not sure if it the Ministry of Health in Canada or another, unrelated government organization). The doses are tested on human subjects after the safty of the drug has been established in laboratory tests on animals and usually human tissues donated for this purpose (kidney and liver cells are especially important as they are easily damaged by drugs). "Thereputic dosage" is recommended on the safer side of things. Then … it goes to the street … so to speak. Clinicians, aka Doctors, will find that there are differences in practice than on paper and will play with the dosages and report their findings, as well as unusual side effects to the companies which track them in a database for future reference (especially life threatening ones). Here is an example: the "book" say the upper dose of Seroquel is 750 mg. Fine … I was talking to a doctor today who has some patients on 1000 mg and he has never seen a case of TD with this medication. The experience of the doctor with a particular drug and its interactions with other drugs becomes more important in many cases than the original guidlines for dosage. However, those original guidlines are important for contraindications, interactions and adverse-effects. I hope this helps you. Peter

> i would very much like to know, from somebody who > knows, whether the prescription guidelines for > a/d’s (or ohter psy. drugs) are formulated and > practiced by the drug companies, by the hospitals, > by the doctors or in cooperation… this is an > important question for me and i don’t know the > facts.

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