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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Bruce Pehrson on February 12, 2000, at 12:04:01
I have been taking 30 mg of Remeron for 2 1/2 weeks
and am noticing little benefit. While I feel slightly
more motivated, I still feel depressed, have anxiety
(which is my main problem, followed by depression), and
have skipped heart beats throughtout the day. I know
that I am a bit commplex, as I have had a generalized
anxiety disorder for a little more than ten years, and
most of the medications that I have taken (except Xanex
) have failed to work! It has been very exacerbating!!
Now I am wondering how and when Remeron works? My
doctor felt that Remeron worked for depression "and"
anxiety... has anyone noticed this drug benefiting both?
Does anyone have any comments about "how long?" it takes
to work and at what point in time the maximum benefit
is reached? Would sure appreciate some comments!
Bruce.... e-mail is: blackice@bibbs.com
Posted by jd on February 12, 2000, at 14:51:20
In reply to Remeron Treatment, posted by Bruce Pehrson on February 12, 2000, at 12:04:01
Bruce,
While some people feel a benefit from Remeron rather quickly (within the first days to two weeks), it is not uncommon to need to wait at least 4 to 6 weeks to judge whether it's kicking in. This is true of most ADs, and full effects can often take 8 to 12 weeks or more.
Remeron is thought to have a good track record in mixed depression/anxiety, so I'd try to stick it out a while--You may well end up being pleasantly surprised. If it ends up not working out--and if you've already tried the obvious alternatives such as Buspar or SSRIs--there's still likely to be some novel meds out there that will work better.best,
jd> I have been taking 30 mg of Remeron for 2 1/2 weeks
> and am noticing little benefit. While I feel slightly
> more motivated, I still feel depressed, have anxiety
> (which is my main problem, followed by depression), and
> have skipped heart beats throughtout the day. I know
> that I am a bit commplex, as I have had a generalized
> anxiety disorder for a little more than ten years, and
> most of the medications that I have taken (except Xanex
> ) have failed to work! It has been very exacerbating!!
> Now I am wondering how and when Remeron works? My
> doctor felt that Remeron worked for depression "and"
> anxiety... has anyone noticed this drug benefiting both?
> Does anyone have any comments about "how long?" it takes
> to work and at what point in time the maximum benefit
> is reached? Would sure appreciate some comments!
> Bruce.... e-mail is: blackice@bibbs.com
Posted by JohnL on February 13, 2000, at 4:18:43
In reply to Remeron Treatment, posted by Bruce Pehrson on February 12, 2000, at 12:04:01
Bruce,
Remeron is similar to other antidepressants in the wait of 4 to 6 weeks for benefit. However, in clinical trials Remeron did show rapid onset, often within the first week. It is normally a good choice when the depression has an anxiety component. Clinical trials indicated it is 'stronger and faster acting' than SSRIs in the early weeks of treatment, and similar to SSRIs in later weeks. Since you haven't noticed much benefit yet, it may need more time. But I woulnd't be surprised at the possibility that all of the treatments you've tried so far (including Remeron) have addressed the wrong underlying problem.
Have you tried a low dose antipsychotic? Zyprexa for example? An often overlooked cause of anxiety and depression is excess dopamine, which is easily corrected by a low dose AP. If that's the situation, there isn't a serotonin, norepinephrine, or GABA drug in the world that will do the job with you. I know two people who had anxiety and depression unresponsive to just about everything for a decade. In one woman a low dose AP completely normalized her. In the other, Ritalin did the trick. I know it sounds strange to consider a stimulant for anxiety, but it calms down a lot of hyperactive children, right? In the old days stimulants were used to treat depression. And still today they are used to enhance the effectiveness of antidepressants.
Especially after multiple failures on the more straight forward approaches to anxiety, it makes sense to me to consider that we are assuming the wrong cause. And thus taking all the wrong drugs. It might be worth trying short trials of an antipsychotic and/or stimulants. Things are not always as they appear. And these two approaches have indeed worked in others with similar stories as yours. At this point, there's not much to lose in trying, right? Just some ideas to think about. JohnL
Posted by Bruce Pehrson on February 13, 2000, at 13:57:58
In reply to Re: Remeron Treatment, posted by jd on February 12, 2000, at 14:51:20
Dear JD and JohnL,
Thanks for the advice and thoughts. I will try the Remeron
for a while longer and if I don't get the benefits after 6 weeks
then I may try the AP approach. That is an interesting idea, and
certainly one that I have never thought of or pursued. By the way
does anyone know why sometimes I will go through a period of many
skipped heart beats per day (i.e., from 30 to 100) and then other
times never have any for a long period of time. The skipped heart
beat feeling (double, or triple beat, followed by a long pause) is
really perplexing and distrubing, especially for someone with GAD!
This is the end of the thread.
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