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Re: Remeron Augmentation with Adderall » polly

Posted by Mitch on September 5, 2001, at 0:54:54

In reply to Remeron Augmentation with Adderall, posted by polly on September 4, 2001, at 21:34:47

> For major depression with comorbid panic disorder what
> would be the appropriate dosage and titration of Adderall?
> Don't have ADD/ADHD, but I may be BP II. I'm currently
> on 60mg of Remeron and 6 mg of Xanax. My depression has
> not responded significantly to Remeron- it knocks me out
> but I wake up with extreme lethargy -takes me 2 hours to get out
> of bed, and I still suffer from anhedonia. I'm aware that
> stimulants have been used to jump-start a response where
> a single antidepressant doesn't do the trick.
> Please share your knowledge/experience with this combo.

The smallest dose is a 5mg tab that can be broken into quarters. I have BPII and have had panic history. The Adderall worked great for depression and didn't aggravate cycling, and helped my comorbid ADHD, BUT it did set off panic later on-although I wasn't taking an AD for panic or any benzos with it. I also had headaches in the back of my head/neck and spiked blood pressure when I was exercising.
I would set your alarm clock for approx. 6-7 hrs after you typically go to sleep at nite and when the alarm goes off -GET UP- and take 1/2 of a 5mg tab first thing. Don't curl back up, fix a cup of coffee, find something to do. Don't take any naps during the day and wait for it to crash later on that evening. Try to stay awake until your normal bedtime (then take your Remeron) and repeat that for a few days to get a steady sleep-wake cycle going (that helps a lot). After four or five days if you are sleeping ok, not having any panic symptoms bump it to 5mg in the morning, and keep a steady schedule-don't nap! After you have been on 5mgs AM, for a week, then check your BP, heartrate, etc., see how it is affecting you. If you are still having fatigue, but no adverse physical effects and no panic, then consider adding a 2nd 5mg dose six hours after your first dose. Then take it from there.


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