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Dr. Bob is Robert Hsiung, MD,
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Posted by Jen on April 16, 2000, at 13:38:53
I am thinking of increasing from 30 to 45mgs of Remeron. I presently take it at night as it seems to make me sleepy, although
this effect has lessened with time. Should I take 45mg in the morning or continue it in the
evening? I'm hesitant to try it on a weeknight in case I don't get to sleep. Also, how much of a problem is
constipation at this dosage? I suffered from it horribly on Reboxetine and do NOT want a repeat of it. Is nausea
a problem at 45mg? I've heard that because it blocks some of the 5HT sites that this inhibits or prevents the nausea. So far I've had
no trouble with it. I've heard that NE is more in effect at higher doses, is this true? Thanks in advance for all replies.Jen
Posted by caroline on April 16, 2000, at 16:48:33
In reply to Remeron dosage increase side effects?, posted by Jen on April 16, 2000, at 13:38:53
Jen,
I've been on 30mg of remeron for the past year. Last week I upped the dose to 45mg because I was still depressed and anxious - but sleeping great. All I can say is: I had always thought of remeron as this wonderful sedative and now I have no choice but to think of it as a stimulant! I've not had more than two hours sleep a night since increasing the dose - I also feel incredibly energized during the day. I did try taking 30mg at night (just to get to sleep) and 15mg in the morning (to make up the dose), but I felt heavily sedated all of that day.
On a positive note, I'm not having any particular problems with constipation!Caroline
Posted by allisonm on April 16, 2000, at 17:37:38
In reply to Remeron dosage increase side effects?, posted by Jen on April 16, 2000, at 13:38:53
I've been on Remeron for two years. It was prescribed in part because I had bad insomnia. For this reason, I take it at night. I cannot imagine taking it in the daytime as it makes me quite drowsy approx. 30 min. after taking it.
I was taking 45mg, but that dose was reduced to 30mg last June when Wellbutrin SR 200mg/day was added. At 45mg, the Remeron made me drowsy AND unsettlingly woosie/dizzy. Weight gain was worse at 45, but then the Wellbutrin decreased appetite, too.
No constipation problems that I noticed at any level. I've always had to be careful about taking it too late as it caused a fog in the morning. Wellbutrin helps this, tho.
Posted by allisonm on April 16, 2000, at 17:39:41
In reply to Re: Remeron dosage increase side effects?, posted by allisonm on April 16, 2000, at 17:37:38
No nausea. Sorry, what's NE?
Posted by Jen on April 17, 2000, at 5:24:23
In reply to p.s., posted by allisonm on April 16, 2000, at 17:39:41
> No nausea. Sorry, what's NE?
NE is norepinephrine. Hmmm I've heard from two different
people with two different experiences at 45mg level. I was taking
Reboxetine which is a very strong NE inhibitor at just 8 mgs a day so this
is probably going to be less than that...which i can deal with. I'm just feeling
a bit low at the moment. Last week was horrible, crying all the time, etc. I think that it's just showing
that the Reboxetine was not covering as well as it was months ago..although I never felt quite happy on it.
I'm hoping for a more complete recovery on Remeron. On the plus side the increase in NE with reboxetine made
me lose weight because it was such a stimulant. Perhaps I'll get a good effect off
Remeron too. I've heard that some people after going to 45 - 60mgs lose their apetite. That would be ok
Thanks for the reply..sorry to be so long winded!Jen
Posted by amayer on April 17, 2000, at 8:49:31
In reply to Re: p.s., posted by Jen on April 17, 2000, at 5:24:23
>Thanks for the reply..sorry to be so long winded!
You're not long-winded.
Good luck, Jen!
Posted by caroline on April 20, 2000, at 15:02:58
In reply to Re: Remeron dosage increase side effects?, posted by caroline on April 16, 2000, at 16:48:33
Jen,
I might not be sleeping much, but I thought I ought to let you know that on this dose, the Remeron is making me feel great. Really Great. Better than I can remember. It has smashed most of my anxiety and depression to pieces. I just wish I could sleep a bit!
Anyway, I hope that if you've started on the higher dose, you're getting every bit as much out of it as I am!
Best of luck with it - oh, and by the way, it does decrease your appetitie (or, rather it has mine), so even more good news!
Take care
Caroline
Posted by Jen on April 21, 2000, at 4:57:58
In reply to Re: Remeron dosage increase side effects?, posted by caroline on April 20, 2000, at 15:02:58
> Jen,
>
> I might not be sleeping much, but I thought I ought to let you know that on this dose, the Remeron is making me feel great. Really Great. Better than I can remember. It has smashed most of my anxiety and depression to pieces. I just wish I could sleep a bit!
>
> Anyway, I hope that if you've started on the higher dose, you're getting every bit as much out of it as I am!
>
> Best of luck with it - oh, and by the way, it does decrease your appetitie (or, rather it has mine), so even more good news!
>
> Take care
>
> CarolineCaroline,
I started the 45mg four days ago. It had an immediate kick! It has decreased my appetite alot too. I keep playing around with the time that I take it
to see what effect it has on my sleep at night. So far I've taken it as early as 5 pm and still gotten to sleep around 11 and slept through the night. The only problem is
that I'm not waking up til 11 AM! This is not good news considering I'm starting work on Tuesday and need to be up around 7AM! I'll try taking it at noon and see what happens then if that works, I'll try taking it when I get up in
the morning. It definitely has made a difference in my attitude! The only downside is that it may be another battle with constipation. The only way I know this is cuz I was going every day just about on the 30mg and now it's been
a few days with no result (except I broke and finally used laxatives) Perhaps it seems worse cuz i'm still a bit depressed, but getting better cuz I'm not panicked over it like I waas on the Rebox. All in all this is turning out to be
a positive experience. Thanks for sharing Caroline!Jen
Posted by annie8 on September 8, 2000, at 13:05:16
In reply to Re: Remeron dosage increase side effects?, posted by Jen on April 21, 2000, at 4:57:58
you are all having the opposite side effects of me, I have only take 15 mg one night, and it completely knocked me out for 12 hours!!! Now I feel completely out of it... I could not have functioned in the day, I completely passed out!!
about weight gain? anyone had it on this, that is what the doctor told me was a side effect, I think just because of increased appetite, anyone know about this?
my dose is low, hopefully it will work okay!!
thanks
annie
Posted by JaneST on September 10, 2000, at 13:04:11
In reply to Re: Remeron dosage increase side effects?, posted by annie8 on September 8, 2000, at 13:05:16
Jen:
Good luck on the 15mgs...it affected me the same way...so my pdoc upped it to 30mgs and it doesn't send me to bed immediately...but I've gained 20 pounds in 4 months!
The theory is that the higher the dosage, the less sedation, weight gain, etc. I have tried to take it to 45mgs but I ended up with too much of the zombie effect to function.
Sorry, no real answers here, but this has been my experience.
Jane
Posted by Mania on September 24, 2000, at 7:07:37
In reply to Re: Remeron dosage increase side effects?, posted by annie8 on September 8, 2000, at 13:05:16
Hi...
When I started to take Remeron I did not feel any side effects.
I'm on 45mg/day and I sleep well on them and I'm not tired or have a hangover the day after.
I went happy when I heard that I maybe could put some more kilos on my spinky body...
But not.
=(
I'm still loosing weight.
But I feel god when I'm on Remeron beside Lithium, Seroxat(SSRI), Absenor(Like Tegretol).I think you must give a new med a couple of weeks before you know how it works on you.
Big Hug From Sweden
Mania
Posted by JoeW on January 22, 2001, at 15:05:36
In reply to Re: Remeron without side effects...!!!, posted by Mania on September 24, 2000, at 7:07:37
My doc increased my dosage from 45 to 60mg at my
suggestion because I was stilling having mild
nausea which I thought might be some anxiety
coming through. I can't say for sure if it has
helped because it has only been a couple of days,
but there is no nausea today. I'm hopeful that
was the problem.Even at 15mg the day I started I got a good night's
sleep finally after waking up weeks of waking up
in the middle of the night anxious for no reason
in particular. The dosage was increased over time
through 30 and 45 to deal with mild depression.
I'm not sure it had any affect. Nothing got worse,
but I'm not sure anything got better either.Even before I started the Remeron, though, I had
changed all my eating habits from junk food to health
food. I also started the Zone diet as a healthy
maintenance diet. I find that matching the protein
with carbs stops the craving for candy, etc. Plus,
I started working out every day...aerobics one day,
weight training the next. Half an hour of the workout
plus some 5-15 minutes of walking. At present I
have more energy than I know what to do with since
my favorite hobby is reading.Oh, and I try to keep my fiber intake to 25-35 grams
a day...fruits and vegetables and whole grains, etc.
If I think a meal was too light on fiber I take
part of a teaspoon of Yerba Prima Colon Care which
is mainly phyllium husks with some bran.Hope some of this helps.
JW
Posted by necro on March 4, 2001, at 15:22:06
In reply to Re: Remeron dosage increase side effects?, posted by caroline on April 20, 2000, at 15:02:58
I was just prescribed Remeron after being taken to the ER for Valium and Oxycontin overdose.I am only into my 3rd week of therapy at 15mg/day and I feel lost all the time. I forget to do rutine things like let the dog out, bathe, who I talked to and what was said,etc. I find myself wanting to cry all the time and the tears just won't form. I actually feel like I'm a zombie and watching myself do all this rediculous shit in 3rd person. Is this normal for the inital phase of treatment or do I need some help? I cannot work, I lost my job because I could not drive to work one night while I was on call,I got divorced, lost my house, and had to file bankruptcy. Also, met a new girl threw a friend and she ended up leaving me because of the above symptoms. Help guys...In a bit of a predicament here...getting in fights at the drop of a dime and then fine the next second with no emotion at all...HELP!!!
Posted by pat123 on March 4, 2001, at 16:47:45
In reply to Just started taking Remeron and feel like crap!!!, posted by necro on March 4, 2001, at 15:22:06
> I was just prescribed Remeron after being taken to the ER for Valium and Oxycontin overdose.I am only into my 3rd week of therapy at 15mg/day and I feel lost all the time.
Are you doing any thearpy ? It does not sound like meds alone will be a total cure. Don't expect
any antidepressant to start working before week 4
but you should notice something by week 6, if the dose and medication are right. Do you have a doc to consult with about your medication ? You should at around 4 weeks time, 15 mgs is the lowest dose of Remeron so you might need a doc to adjust dose to make this med effective for you.Pat
Posted by SalArmy4me on March 4, 2001, at 18:06:36
In reply to Re: Just started taking Remeron and feel like crap!!!, posted by pat123 on March 4, 2001, at 16:47:45
Yeah, once you get to 45 mg, your side-effects disapeare.
Posted by necro on March 5, 2001, at 13:26:32
In reply to Re: Just started taking Remeron and feel like crap!!!, posted by SalArmy4me on March 4, 2001, at 18:06:36
> Yeah, once you get to 45 mg, your side-effects disapeare.
Are you guys telling me that the more I take of this stuff the better I will feel? I mean if I can't tell what's real or not on 15mg what the hell is 45mg going to do to me. Yes, I have a doctor but I don't have a follow-up appointment until mid april. No therapy though...just medication through the VA Clinic after my OD. No health insurance because of my bankruptcy, divorce, and loss of job. All which I might add is related to this stuff. Sorry to ramble...
NECRO
Posted by JohnL on March 6, 2001, at 4:49:52
In reply to Just started taking Remeron and feel like crap!!!, posted by necro on March 4, 2001, at 15:22:06
> I was just prescribed Remeron after being taken to the ER for Valium and Oxycontin overdose.I am only into my 3rd week of therapy at 15mg/day and I feel lost all the time. I forget to do rutine things like let the dog out, bathe, who I talked to and what was said,etc. I find myself wanting to cry all the time and the tears just won't form. I actually feel like I'm a zombie and watching myself do all this rediculous shit in 3rd person. Is this normal for the inital phase of treatment or do I need some help? I cannot work, I lost my job because I could not drive to work one night while I was on call,I got divorced, lost my house, and had to file bankruptcy. Also, met a new girl threw a friend and she ended up leaving me because of the above symptoms. Help guys...In a bit of a predicament here...getting in fights at the drop of a dime and then fine the next second with no emotion at all...HELP!!!
Hi,
My thoughts on this type of situation are a bit different than mainstream. Normally we are instructed to stay with a medication for 6 weeks, no matter what, come hell or highwater. But when medicine causes overly troublesome side effects, or when it causes worsening of symptoms, then I disagree with staying with it. In similar sitations my pdoc always had me discontinue immediately and start something else. These days there are so many meds to choose from, it makes no sense at all to stay with one that is dud right from the get-go, with just a blind faith that it might somehow miraculously start working great if given more time.I absolutely do not like staying with an obvious dud med because there is too much at stake. Suicide is a real and serious risk. Not to mention lost jobs, lost marriages, impact on friends and family, on and on. It is difficult enough to be told to wait 6 weeks for a med to work. But when that med is an obvious troublemaker early on, that is a very risky 6 week wait. Sometimes a medicine will suddenly kick in after a long dedicated wait. That is just a sign it is not targeting the real problem, but is instead working through a series of chain reactions. A good response and a faster response is always awaiting with a different med choice. I disagree with the 6 week wait when a particular med obviously sucks for you.
I have been in your shoes. I never had a lousy medicine eventually turn good later on. I guess it happens, but never with me.
All medicines can actually cause you to get worse. If the med happens to be working on the wrong chemistry for the particular situation, intolerable side effects and/or worsening can occur. I've experienced a lot of antidepressants that made me more depressed, sometimes terrifyingly depressed.
So just because Remeron is a good antidepressant and it works for someone else doesn't at all mean it is right for you. Based on your 3 week reaction to it so far, I would say it is not a good match for your chemistry. In your shoes I would dump it immediately and start something else instead. In clinical trials most patients who responded to Remeron experienced improvement in the first week. Nonresponders generally did not.
Granted you have many environmental circumstances making the situation even worse. However, the right medication usually works fairly fast, has few side effects, and makes dealing with all life's problems quite manageable. What to try next? I don't know what you've already tried. There are clues though from other drugs you've tried that can help decide what to try next.
John
Posted by RandyP on March 25, 2001, at 10:15:59
In reply to Just started taking Remeron and feel like crap!!!, posted by necro on March 4, 2001, at 15:22:06
I will begin taking Remeron this coming Friday. I have had difficulty adjusting to many antidepressants. I will say that I'm working with a psychiatrist that I trust and this is what she told me about Remeron: It tends to work for patients for whom nothing else has worked; it has one of the highest remission rates, along with Effexor; it does have two main side effects at the starting/lower doses (30-45mg) which are heavy sedation and significantly increased appetite. The key, I'm told, is to rapidly increase the dose (15mg every 3-4 days) over the first week. This usually eliminates these side effects. For most that's at 60mg, for some 75mg.
I wouldn't write it off yet. It sounds like you haven't had the opportunity to see if this med is right for you. It seems that it has not been administered properly by your doctor. Check with your current doctor or find another, better informed one. Good luck.
Posted by derick on January 5, 2003, at 5:36:12
In reply to Re: Just started taking Remeron and feel like crap!!!, posted by necro on March 5, 2001, at 13:26:32
> > Yeah, once you get to 45 mg, your side-effects disapeare.
>
> Are you guys telling me that the more I take of this stuff the better I will feel? I mean if I can't tell what's real or not on 15mg what the hell is 45mg going to do to me. Yes, I have a doctor but I don't have a follow-up appointment until mid april. No therapy though...just medication through the VA Clinic after my OD. No health insurance because of my bankruptcy, divorce, and loss of job. All which I might add is related to this stuff. Sorry to ramble...
> NECRO
>
> Maybe you don't need this "crap" at all.I started taking wellbutrin approx.3 months ago with absolutely no results then began atleast one month of Effexor and 2 days of Remeron. I didn't sleep the first 48 hrs.+ with Effexor (pupils dilated) and seemed to exacerbate my depression, kill my libido and constant annoying "tingling" sensations on the frontal lobe of my brain. The side effects seem to outway any benefit. I thought those side effects were unpleasant until I tried Remeron. Just 2 days of Remeron and I became an emotional moron. On day 2 Remeron treatment I had a phsyciatric evaluation and apparently I met a counselor that day--I have absolutely NO memory of our encounter except for my counselor's account. I felt shaky and I am convinced I had a mild seizure. Earlier that day I went to Burger King and when they forgot my ketchup for my hashbrowns at the drive-through I burst into tears. I also cried hysterically at every song I heard on the radio and had several uncontrolable outbursts of crying for no particular good reason. Also seemed to cause bloating/ (atleast now I have a greater appreciation for female's PMS symtoms.) Remeron turned me into a drooling moron practically overnight. I had a hard time completing thoughts and sentences and once again front lobe of my brain constantly tingling --even several days after I discontinued use. Anyway---my new counselors and myself came to the simple conclusion that this stuff is definately not for me. Bottom line--consult with a physician immediately...maybe there are some alternatives for you to battle your depression ie...exercise, meditation. I even think marijuana would be better than this garbage. They should have called this stuff "Re-MORON" because I fell pretty stupid for trying it. Good luck
Posted by BrittPark on January 7, 2003, at 15:48:58
In reply to Re: Just started taking Remeron and feel like crap!!!, posted by RandyP on March 25, 2001, at 10:15:59
>The key, I'm told, is to rapidly increase the dose (15mg every 3-4 days) over the first week. This usually eliminates these side effects. For most that's at 60mg, for some 75mg.
According to the prescribing information (and my psychiatrist) the effective dosage range for Remeron is 15-45mg. I'm sure some people need more but 75mg seems a bit high. YMMV
Somewhere around 30-45mg Remeron usually switches from being sedating to activating. People who have co-morbid anxiety, like me, will tend to react badly to higher doses.
Everybody feel better,
Britt
Posted by steviegirl on December 30, 2003, at 22:19:57
In reply to Re: Just started taking Remeron and feel like crap!!! » necro, posted by derick on January 5, 2003, at 5:36:12
i had to laugh when you said that remeron turned you into a drooling mess!It did the same to me,didnt know where reality was and felt so dizzy all the time...stopped it slowly after seeing the doc for advice and it got worse as the dose decreased,45 mg to nothing and its been three days since i stopped and i feel like i have gastro!!!and indigestion,will it ever end???Im sick of being house bound for the above mentioned reasons!!!!!!!!
Posted by brussell on December 31, 2003, at 11:55:24
In reply to Re: Just started taking Remeron and feel like crap!!! » necro, posted by derick on January 5, 2003, at 5:36:12
I loved your account of Remeron. I lasted for only one dose. I passed out for twelve hours, and when I woke up thought I had been poisoned. I couldn't think, feel, and everything was numb. That was the first day.
I spent the second day on the floor of my apartment in a horribly uncomfortable position, but I couldn't get the energy to move. I actually felt like accounts I had read of heroin withdrawal, and I had a dull desire to cut myself open so I could watch myself bleed to death.
My psychiatrist was horrified, and told me not to take any more. LOL!
I hope I haven't scared anyone too much, but I could really relate to some of the bad reactions I've read here.
I guess I feel that if Remeron makes you sleepy and feel a little weird, try sticking it out.
If it makes you want to kill yourself to escape the side effects, quit and call your doctor! There are other drugs out there. I'm pretty happy with Parnate so far.
Posted by SandyWeb on January 1, 2004, at 9:05:57
In reply to Re: Just started taking Remeron and feel like crap!!!, posted by brussell on December 31, 2003, at 11:55:24
It's so interesting how people have such diverse reactions to the same medication. No wonder it's so difficult to find a medication regime that works for each patient.
I've been taking Remeron 30mg for a little over 2 weeks now. I've not had any adverse reactions. In fact, I'm even wondering if it's doing anything helpful at all. It does not make me sleepy, and it has not improved my sleep architecture. And I don't believe that it has helped make me calmer.
The only real effect I've noticed is that it appears to make my Celexa work better. I used to take Celexa 60mg in the morning, but since I've been taking the Remeron at night, I find that taking the whole Celexa dose at once makes me a little buzzed. So now I take Celexa 30mg in the morning and 30mg at supper. It seems to work very well this way....and I'm happy that the Remeron makes it work better.
Would raising the Remeron to 45mg help me sleep?
Posted by SandyWeb on January 2, 2004, at 18:03:50
In reply to Re: Just started taking Remeron and feel like crap!!!, posted by SandyWeb on January 1, 2004, at 9:05:57
I just switched from 30mg of Remeron to 45mg. What a difference! I actually feel a little bit on the "good" side of the meter!
Can someone explain to me, physiologically, why I feel sooo much better (almost instantly!) on 45mg as opposed to 30mg? I know that norepinephrine is triggered more than histamine when a person goes to a higher dose. But what exactly is the med doing to it? Increasing or decreasing its life? And does it mean that I have an over-abundance or shortage of NE?
Curious minds want to know! *big smile*
Posted by caroline on January 4, 2004, at 3:22:44
In reply to REMERON 45mg, posted by SandyWeb on January 2, 2004, at 18:03:50
Sandy, hi,
I'm afraid I have no answers for you, but a little over 4 years ago the exact same thing happened to me. I upped to 45mg and overnight my whole life changed. I felt good, often great. The good news is that I still do. This affect has not pooped out for me. I did however need to add anafranil 75mg to keep me asleep at nights, as I started waking real early. Since adding it (about 4 years ago) I've slept great, and felt great.
I never dreamed a med change could have such a powerful effect overnight. It seemed like a miracle! I suspect you're right in that those of us it affects this way have NE issues, but all my research has yet to reveal exactly what these may be. I've come across totally contradictory theories.
I'd be more than interested if anyone's come across research that can explain this overnight NE phenomenom!
Best, Caroline
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