Posted by JohnX2 on March 8, 2002, at 6:15:35
In reply to Doctors and medications » JohnX2, posted by lizzyg on March 7, 2002, at 7:19:21
Hi there,Rats about the health care in your country.
I've been saddened to hear all the stories coming
out of Europe.I read your note carefully. I have a quick idea (Sorry I'm
about to go to bed, but i'll send a quick reply).
Mind you, I'm not a doctor.It sounds like if you have some good leftovers the
Celexa and Mirtazepine (Remeron, US) may work well *together*.
The Celexa is causing insomnia, agitation, weight loss.
And the Remeron is causing sedation. I don't know what dose
you took Remeron at, but at 15 mg it is sedating, as you
bump it to 30+ mg, it is less sedating and more of an anti-depressant.
Now, I've seen a lot of people *combine* an SSRI like Celexa with Remeron and get
a nice effect where Remeron wipes out the agitation/insomnia caused
by the SSRI. Also the Remeron increases appetite. Sounds like
a good balancing act. Also the 2 medicines would work well
synergistically at the serotonin system to get a very good anti-depressant
effect, fewer side effects, less anxiety, quicker response. If you feel drowsy,
you can raise the Remeron dose to get more anti-depressant response as
this boosts a 2nd stimulant chemical (norepinephrine).Believe me taking the Remeron with the SSRI will substantially
change the feeling the SSRI gives you.You can do this and also augment it with SAM-E
Your other ideas sounded reasonable too, but all the medicines
have their quirks to deal with. It just looked like the
Remeron + Celexa combo could balance out nicely.What doses did you take of those meds?
Please hang in there. You'll feel better soon.
-John
> Dear John - I wonder if I, too, could ask for the benefit of your wisdom, please? Here in the UK, because our medical treatment is 'free', it's difficult to have consumer choice in doctors and psychiatrists. All the GPs (family doctors) I've had have been uninformed on the subject of depression, and it's quite difficult to get referred to a psychiatrist. I only have once - he was good, but the setting was distressing.
>
> I had my first attack of depression and anxiety 19 years ago at the age of 20. Experiences with doctors were bad, but I was eventually treated with amitriptyline and a benzo which worked fine. Next two times - three and five years later - I was loath to get medical help and just waited for the episodes to resolve, which they did over a period of months. Ten years ago I had a bad attack and saw a psychiatrist. Tried a couple of SSRIs which drove me up the wall, but had success with Lofepramine (third generation tricyclic not available in US) and a short course of Diazepem. This treatment also worked well in my last spate of depression six years ago.
>
> I have been symptom free since, until a couple of months ago. All previous attacks have been totally endogenous in nature, but this depression/anxiety was triggered by bereavement. I tried the Lofepramine again, but found I couldn't tolerate it. Could it be that my metabolism has changed in the intervening years (I've had two more babies in the meantime)? I gave Citalopram a go for two weeks, but couldn't cope with the increased anxiety, agitation, insomnia, and weight loss (7 pounds). So I tried Mirtazapine, but found the sedation a real problem and didn't stick with it. This depressive episode also doesn't seem as severe as previously, so maybe that's why the side effects are proving such a barrier: I guess when you're more desperate you can put up with more. I'm cutting my unhelpful GP out of the loop and trying SAM-e, but if that doesn't work I think I'll have to push to see a psychiatrist. Maybe I should have another go with the tricyclic with something to counteract side effects, or give Nefadazone a try...
>
> I'd be very grateful for any insights you may have, John.
>
> With thanks
>
> Lizzy
poster:JohnX2
thread:96683
URL: http://www.dr-bob.org/babble/20020307/msgs/97024.html