Posted by linkadge on June 4, 2008, at 21:08:45
In reply to Re: Linkadge? » linkadge, posted by johnj on June 4, 2008, at 18:53:57
I know what you are talking about since I have had the same side effects on remeron.
Depression with obsessive tendancies or rumination can be hard to treat especially if the depression has hints of anhedonia. On the one hand you want you may want to increase activity in the frontal cortex to improve motivation and vigilance, but if the activity here gets to be too much it can be hard to stop or let go, thoughts can go over and over again.
The 5-ht2a/c receptors put the breaks on activity in the frontal cortex. When you block them with remeron you decrease the ability of gaba to inhibit the frontal cortex. SSRI's work in part for OCD by increasing 5-ht2a/c agonism in the frontal cortex and incresing inhibition there which reduces repetitive types of thoughts.
You might give clomipramine a try. Remeron is not very good for obsessive type of thinking.
Somtimes a combination of low dose SSRI plus nortrpytaline can allow individuals to fine tune the ratio of certain chemicals. If you find your thoughts are too repetitive you can take more SSRI, but if you become too apathetic you can lower the SSRI in relation to nortryptaline.
Linkadge
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