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Re: Remeron 7.5 mg or 15 mg? » joslynn

Posted by yxibow on January 22, 2007, at 13:26:57

In reply to Remeron 7.5 mg or 15 mg?, posted by joslynn on January 22, 2007, at 12:55:29

> I was taking Lexapro 10 mg in a.m. and 15 mg Remeron at night. But it was getting hard to wake up unless I got nine hours of sleep, which seems excessive. So I decided to cut Remeron to 7.5. (I have been without any Remeron at all at times, so it seemed safe to cut down on my own, though I know pdoc will give me the Stern Slightly Annoyed Look when I reveal this. But it is also annoying to need nine to ten hours of sleep!)
>
> Anyway, on the 7.5 mg, I still feel very tired in the morning if I get only 8 hours of sleep. Then I read on this board that 7.5 can be even MORE sedating.
>
> I do not feel a marked change of mood since going down to 7.5...maybe a teeny bit less happy? But I am under some stress, nothing bad, just busyness. I do not feel depressed though, considering that it's so dark and cold here now! Hello January. Bleah.
>
> My question is...at the 7.5, am I even getting any of those receptor blocking actions that could offset side effects that could come with the SSRIs? (I may be miswording this.) Or, is 7.5 just a sleep aid, and it does not affect the things that could cause depression, nor offset SSRI side effects?
>
> I am wondering next steps, because I am getting married soon, which is wonderful, but I don't want to have any sexual SE from SSRIs, since I will be married, and I want to be in the best mood possible. Remeron could help with both those things, but is 7.5 enough?
>
> On the other hand, since we may try to get pregnant in a year or two, it seems unwise to go back to 15 mg of something when 7.5 seems to work ok. The fact is, if we do decide to try have a child, I will want to get off BOTH meds for the pregnancy.
>
> But, for the short term happiness of my marriage and myself, should I go back up to 15 mg? Does 7.5 Remeron even work as an antidep or is it strictly a sleep aid at that point?
>
> Could the 7.5 still offset any sexual SE I may have from the lexapro (assuming I have SE in this department, maybe I should just think positive).
>
> It's hard to weigh the different pieces of one's life and how to make med decisions. And pdoc's don't always consider all the nuances of things.
>
> Thanks.

I'm not sure about the sexual SE re Remeron from SSRIs -- I know more that people who wish to engage in sexual activity either skip a day of a short acting SSRI or use Wellbutrin.

At 7.5mg, one is getting mostly sedating and some alpha-adrenergic action.

At around 30mg+, the 5HT blockade starts coming in weakly and more strongly past 45mg.

At least according to my doctor, in his practice he has not observed any decrease in sedation with higher doses, in fact the opposite, if anything neutral or greater sedation. But as they say, your miles may vary.


I understand your concern for pregnancy, as they are both in Category C, meaning it is unknown what they will do to a fetus (I'm assuming you're the female in this from the screen name and not concerned about sperm damage.)


Some people really do need 9 hours of sleep. I know I do, but I scarcely get 7-7.5 with quite a collection of soporific medications. I do get hypnagogic hallucinations however at times.


Not to be pessimistic or pejorative, but you should seriously discuss with your doctor about any antidepressant options or psychotherapy during your pregnancy as a) 9 months is a long period of time without psychiatric care and b) there is a small chance of post-partum depression which can lead to all sorts of issues I don't really want to describe here, but I'm sure you're aware of.


Hope that helps

-- Jay

 

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poster:yxibow thread:725220
URL: http://www.dr-bob.org/babble/20070119/msgs/725245.html