Dose Reduction in CNS Toxicity

In practice I tend to start still let 100 milligrams with the exception of patients who might have less cognitive reserve for example the older patients. Probably somewhere between a third and a half of patients end up having dose reductions, often relatively early. It's important to discuss some the the issue of CNS toxicity with not just the patient but also their family so you get an accurate reflection on what is going on there.