Posted by Scars R. Stories on April 1, 2013, at 2:21:55
In reply to Re: Insomnia resolved after trying EVERYTHING..., posted by linkadge on March 31, 2013, at 18:59:50
> >Thanks for the info on Trazodone, I will look >into it. But, I must give you the info for >Remeron.
>
> First of all, your "info" is anecdotal. It does not prove anything conclusively.
>
> >First, MEDICAL RESEARCH does PROVE that Remeron >causes weight gain in many, and EVEN IF IT >DOESN'T affects the body of those that do not in >a couple of ways that lead to Diabetes.
>
> Weight gain is a possible side effect. What does that "prove"?
>
> >For one, cortisol suppression = higher insulin. >I found a good summary of some medical papers on >the web - to quote:
>
> Most effective antidepressants will normalize the HPA axis. Trazodone (as a 5-ht2a antagonist) will lower cortisol. Melatonin (the natural sleep hormone) will significantly lower cortisol. Does that mean melatonin is dangerous? Melatonin extends the lifespan of rodents. Elevated cortisol is linked to depression, PDSD, heart disease, weight gain (hence the 'relacore' adds) as well as insulin resistance. Normal cortisol levels are connected with normal insulin levels. However, elevated cortisol is characteristic of certain forms of depression. Mirtazapine might just help normalize that. Do you have any (actual) studies that suggest that remeron leads to prolonged, unnaturally low levels of cortisol? (probably not).
>
> >On Remeron, people tend to gain this layer of >fat, or that's how I describe it. I call it the >immovable layer of lard. It comes out of nowhere >and is very stubborn about leaving. Walk all you >want, hit that eliptical all you want....it >won't move.
>
> Dude, I'm 135 pounds, I've got washboard abs. I havn't gained a pound in over a year of using mirtazpaine. Give me your email if you want pics!
>
> >But then I happened upon some like that lead me >another link. And, that's when I put together >the cortisol + insulin connection.
>
> Many antidepressants (TCA's imipramine, amitriptyline, doxapin, fluoxetine, paroxetine etc. etc. have been linked to blood sugar abnormalities). Effexor has been linked to cholesterol issues as well as hypertension. Effexor at >75 mg put my heart rate above 120bpm! It also blocks sodium channels which can cause abnormal rhythm. Desvenlafaxine the metabolite of effexor has been linked to elevated rates of stroke and heart attack. Wellbutrin has been linked to neurotoxicity, liver damage, seizures, cardiovascular issues etc. So pick your debilitating side effect and live with it!
>
> >This is how it goes: Remeron supresses the >stress hormone cortisol. This is one of the >reasons it helps people sleep. It >basically 'powers down' your brain and slows >your metabolism a bit. But, more interestingly >is the relationship between cortisol and >insulin. Apparently, cortisol counteracts >insulin.
>
> In the short term yes. However, elevated levels of cortisol eventually lead to cortisol insensitivity which will screw up the whole metabolic system. Chronic insomnia alone more than doubles the risk of metabolic disorders!
> Deficiency of rem sleep (as strongly induced by effexor) is a risk factor of Alzheimer's and Parkinson's. So again, pick your debilitating side effect.
>
> >Insulin basically grabs sugar from your >bloodstream and stores it as fat. Your body >needs cortisol to counteract and balance this >effect of insulin, in addition to helping >processing lipids (fats) and proteins.
>
> This is way too over simplistic and not really accurate. According to wikipedia:
>
> [cortisol...] "Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat, protein and carbohydrate metabolism.[2] It also decreases bone formation. Various synthetic forms of cortisol are used to treat a variety of diseases."
>
>
> "When people say that can't stop eating carbs on Remeron, this may be why. Unabated, the insulin is grabbing sugar out of your blood, which leads you to think that you are carb depleted. So, you eat more carbs."
>
> Many antidepressants are linked to carbohydrate craving. Remeron like most 5-ht2c and/or histamine 1 antagonists increases appetite. Patients with certain forms of depression exhibit a super sensitivity of 5-ht2c receptors. Certain patients should not be prescribed mirtazapine. For atypical depression, mirtazapine is clearly the *wrong* choice!
>
> >Can I ask how much Remeron you take, for how >long you've taken it, and what your diet is >like? Body type? I'm interested in figuring out >the puzzle, that's all. I'm a psychotropic drug >researcher and journalist, and I would love to >collect my own information about Remeron's >effect according to these factors.
>
> I have had about 3 major depressive episodes. I am 30, am 6 foot 2 135 pounds. My depression is characterized by high anxiety, weight loss, apathy, concentration problems, suicidality (related to insomnia).
>
> I first took citalopram with helped a little with anxiety. I experienced remission when mirtazapine was added to the citalopram. My main issues were that the citalopram (or any SSRI / SNRI) caused wicked insomnia and constant nighttime awakenings. I have taken amitriptyline, trazodone and remeron as adjunctive. The remeron produced deeper sleep than amitriptyline or trazodone. Also, the mirtazapine helped restore my abnormally low appetite and aversion (literally fear) of food. I currently take 7.5 mg I occasionally go up to 15mg.
>
> I don't recommend mirtazapine as a sole antidepressant because (as you say, side effects often outweigh the antidepressant benefits. However in conjunction with say effexor, remeron basically eliminates the major side effects of effexor for me (nausea, restorative sleep, emotional numbness, loss of appetite etc).
>
> Linkadge
>
>
>
I didn't even think to compare what we're treating aside from insomnia. I'm bipolar. It's when I'm revved up that I don't sleep, which is luckily more often and not at all a separation from reality..."hypomania" I would call it, though I know some psychiatrists/psychologists that would find another way to argue that I'm "fully bipolar". LOL...they can fight amongst themselves.When I get depressed I sleep for weeks at a time. I just do not get out of bed, give up on life for some reason or another silly reason (so it seems when I'm on the other side).
I've always been skinny as hell, fast fast metabolism, 5'7" 120 lbs. 29. So when I gain...actually almost 60 lbs it's pretty extreme - it's an entire half of what I'm accustomed to weighing! I lose it once off the med that was causing the weight gain so fast I get weak. On 15 Remeron AND 450 mg Effexor XR I was still in a coma for 16 h and then groggy and couldn't concentrate for 3. I tried for 2 months. Then I took Imovane (zopiclone, not eszopiclone or Lunesta but similar) with limited success for a month, then I rediscovered Trazodone.
I'll be thinking about this when I have some spare time... I'm glad you're getting sleep above all else!
scars
poster:Scars R. Stories
thread:1041295
URL: http://www.dr-bob.org/babble/20130322/msgs/1041475.html