Areas › Low mood and hard feelings › When everything feels flat
Raising a dose does not simply raise the benefit. It raises everything the drug does, including the parts nobody was asking for.
As the amount climbs, a medicine begins touching things it barely touched before, which is why new side effects can appear at a higher dose of something that suited you at a lower one. That is not the drug turning against you. It does mean an increase should come with a plan: what you are watching for, when you will review it, and a willingness to go back down if the extra is not buying anything.
Qur’an and Sunnah
When We give people a taste of Our blessing, they rejoice (Quran 30:36). The verse goes on to the despair that follows when something bad happens, and expecting both sides of a change keeps you steadier when the second one shows up.
وَإِذَآ أَذَقۡنَا ٱلنَّاسَ رَحۡمَةࣰ فَرِحُواْ بِهَاۖ وَإِن تُصِبۡهُمۡ سَيِّئَةُۢ بِمَا قَدَّمَتۡ أَيۡدِيهِمۡ إِذَا هُمۡ يَقۡنَطُونَ
When We give people a taste of Our blessing, they rejoice, but when something bad happens to them- because of their own actions- they fall into utter despair
Qur’an 30:36read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
More input does not reliably mean more result. In a meta analysis of randomised trials, resistance exercise training reduced depressive symptoms, and the benefit was largely independent of how much strength participants actually gained. The size of the dose and the size of the return can come apart.
Gordon BR, McDowell CP, Hallgren M, Meyer JD, Lyons M, Herring MP. (2018). Association of Efficacy of Resistance Exercise Training With Depressive Symptoms: Meta-analysis and Meta-regression Analysis of Randomized Clinical Trials.. JAMA psychiatry doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
More of a substance means more of all its actions, not only the one you want.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Match the tablet to the person rather than to the diagnosis. For someone flattened and slowed who has said clearly that they will not accept sexual side effects, paroxetine is close to the worst choice available.
When the same medicine keeps turning up for unrelated problems, that usually means one action touches all of them. It does not mean somebody has found a cure for everything.
Whether a medicine works can turn on something as ordinary as taking it with food or moving it to bedtime.