[Guest]

Dr.,

Each time my dose of Celexa is raised, there is marked additional benefit, but continued mild symptoms (milder and less frequent with each dose increase). Occasionally there is a more severe breakthrough like the past 2 days, but that is out of almost 9 weeks at 40mg. of Celexa without such a breakthrough and I am feeling better as the day goes on.

I have read some relatively recent studies, one that showed an increase in fluoxetine to higher than standard dosages was more effective than augmentation in depression partial responders (quite a bit more). I have seen similar studies in partial responses for OCD The "flat dose-response curve" seems less clear than in the past. If response is improved with each dose increase, but remission is still elusive and breakthroughs occur, which becomes the better-supported approach - augmenting/adjunctive therapy, or maximizing dose to highest tolerable limits within manufacturer recommendations? Thanks as always.

[Guest]

It is unknown which is better. There are no head to head trials and opinions vary by region.
[quote] Dr. ,

Each time my dose of Celexa is raised, there is marked additional benefit, but continued mild symptoms (milder and less frequent with each dose increase)... [/quote]