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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 polly on August 21, 2001, at 20:55:07
Pdoc wants to raise remeron dose up to 90mg before
moving on to another med or augmenting.Is this an acceptable dosage?
Posted by JahL on August 21, 2001, at 21:22:18
In reply to Remeron - what is the maximum safe dose?, posted by polly on August 21, 2001, at 20:55:07
> Pdoc wants to raise remeron dose up to 90mg before
> moving on to another med or augmenting.
>
> Is this an acceptable dosage?From Dr Bob's psychopharmacology tips:
"Subject: Mirtazapine effects and dosage
So far I've had good luck with mirtazapine (Remeron) in 3 cases of previously treatment-resistant (failures on multiple medication classes, plus ECT) depression.
The Organon recommendation is 45 mg max -- I have one patient who is a partial responder on 60 mg/day.
------------------------------------------------------------------------
Subject: Mirtazapine effects and dosage
I've had 6 or so patients who were non-responders to several prior antidepressant classes (and in 2 cases to ECT) who've remitted on Remeron (mirtazapine). After talking to the drug manufacturer and getting reprints from them on European research, I'm more comfortable pushing the dose up (in 1 case to 90 mg) where tolerated."
J.
Posted by SalArmy4me on August 21, 2001, at 22:49:24
In reply to Remeron - what is the maximum safe dose?, posted by polly on August 21, 2001, at 20:55:07
I took 90 mg of it...it doesn't do anything clinically after 45 mg, but increased dosage lessens the side-effects (Noradrenalin kicks in only at high-doses)/
> Pdoc wants to raise remeron dose up to 90mg before
> moving on to another med or augmenting.
>
> Is this an acceptable dosage?
Posted by Realist on December 5, 2004, at 6:47:38
In reply to Re: Remeron - what is the maximum safe dose? » polly, posted by SalArmy4me on August 21, 2001, at 22:49:24
I'm on 60 though I normally only need 45. I think I have built up a tolerance and am wanting to try 75 or 90 for the noradrenaline effect. I am worried about the increased renal load though. What self supervision of that can I do?
Should I take my daily dose buffered in the middle of the night to increase the length of the anxiolytic? Its soporific effect seems to pass after an hour or two. Maybe an early snack and then back to bed?
Is the anxiolytic related to the noradrenaline increase at higher doses?
"has also been suggested that noradrenaline (norepinephrine) is crucial in certain cognitive functions associated with the frontal lobes, particularly the prevention of distractibility by irrelevant stimuli."
I really should get valium as an anxiolytic but the addictiveness is off putting. I'm worried about the renal warning though. Would valium have a similar load on my kidneys? I don't notice any extra load currently because the mirtazapine makes me less stressed. Stress can make me hyperacid from chronic overbreathing (sighing) which puts a strong constant load on my kidneys.
This occurs when I can't escape from the depression for a longer period (invalided).For the past 2 days I have had a double dip episode and the mitazapine ain't working. I know I will get over it more quickly with the mirtazapine but...
is it worth taking an increased dose for up to 4 days for the noradrenaline? The misery is distracting. Would the noradrelaine make me imprint more strongly (risky ATM)?
> I took 90 mg of it...it doesn't do anything clinically after 45 mg, but increased dosage lessens the side-effects (Noradrenalin kicks in only at high-doses)/
>
> > Pdoc wants to raise remeron dose up to 90mg before
> > moving on to another med or augmenting.
> >
> > Is this an acceptable dosage?
>
>
This is the end of the thread.
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