The Dopamine Hypothesis Revisited THE DOPAMINE
A small dose is started at bedtime, after a patient is unlikely to purge, and the dosage should be gradually raised over the next few days to a therapeutic range, so that most patients have at least some symptomatic improvement.
Abstract
antidepressant regimen may be started immediately for patients who present with serious depression or for those whose disorder failed to resolve with competent eating-disorders counseling. The average medication doses are similar to those prescribed for depression-that is, 200 to 300 mg per day of tricyclic antidepressants or full therapeutic dosages of monoamine oxidase inhibitors, such as 45 to 90 mg per day of phenelzine. A small dose is started at bedtime, after a patient is unlikely to purge. The dosage should be gradually raised over the next few days to a therapeutic range. For any ofthese medications a minimum of six weeks is necessary for an adequate drug trial. Side effects occur with all of the antidepressant medications and may be particularly common with the monoamine oxidase inhibitors. Trials with several different medications may be necessary. As many as 50% ofpatients may become asymptomatic. Not every patient will respond, but most will have at least some symptomatic improvement.