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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by ravenstorm on April 8, 2004, at 22:15:07
OK, I've read about the paradoxical thing (less=more sedation). My old pdoc had mentioned this but my new pdoc doesn't seem to agree with this.
He was going to start me at 7.5mg but I asked to start at at least 15mg to keep from lapsing into a coma (LOL)!! But I'm wondering if maybe I should start even higher than 15mg? On other boards I've noticed people either start at 15mg or 30mg and I even found some who started right off at 45mg.
Any opinions or experiences?
Have cleared the whole weekend for the BIG SLEEP :(
Sigh. Thanks in advance for any support.
Posted by Sad Panda on April 8, 2004, at 23:07:17
In reply to HELP! Starting remeron tomorrow, what dosage?, posted by ravenstorm on April 8, 2004, at 22:15:07
> OK, I've read about the paradoxical thing (less=more sedation). My old pdoc had mentioned this but my new pdoc doesn't seem to agree with this.
>
> He was going to start me at 7.5mg but I asked to start at at least 15mg to keep from lapsing into a coma (LOL)!! But I'm wondering if maybe I should start even higher than 15mg? On other boards I've noticed people either start at 15mg or 30mg and I even found some who started right off at 45mg.
>
> Any opinions or experiences?
>
> Have cleared the whole weekend for the BIG SLEEP :(
>
> Sigh. Thanks in advance for any support.
>Hi Ravenstorm,
More does not always mean less sedation. I would start a 7.5mg if I was you. Are you using it as an AD or a sleep aid? Make sure you have showered, etc & are ready for sleep before you take it. I have been on it for a few months now & 15mg gives me 8 hours sleep while 30mg gives me 9 hours.
Cheers,
Panda.
Posted by seanwrx on April 9, 2004, at 0:05:55
In reply to HELP! Starting remeron tomorrow, what dosage?, posted by ravenstorm on April 8, 2004, at 22:15:07
I just came off a 6 month course of Remeron. I always figured that GAD was my real issue and Remeron didn't help much with that so I quit. I think it helps some people more then others. If anxiety isn't an issue then it might work good for you.
I ended up at 60mg, which is the max dose. I started at 15mg and didn't feel much better so they moved me up. I was at 45mg for most of the time. It does help with sleep, that's for sure. I felt groggy however and had a hard time getting out of bed at the higher doses.
It changes your metabolism and most people seem to put on weight, I did.
I would start at 7.5 if your depression is mild. Just getting the solid sleep might be a good start. I would slowly move up though, especially if weight is an issue.
-Sean
Posted by crazychickuk on April 9, 2004, at 4:33:23
In reply to Re: HELP! Starting remeron tomorrow, what dosage?, posted by seanwrx on April 9, 2004, at 0:05:55
My opinion its good for anxiety and not good for depression, i been on it for over a year started at 15 now i am at 30mg... it works wonders for sleep and worked wonders for my anxiety cus of its sedating affect...
Posted by ravenstorm on April 9, 2004, at 16:25:11
In reply to Re: HELP! Starting remeron tomorrow, what dosage?, posted by crazychickuk on April 9, 2004, at 4:33:23
Thanks for the input everybody. Anxiety and depression are the problems.
CrazychickUK, did you gain a lot of weight on this drug?
Thanks so much everybody!
Posted by ravenstorm on April 9, 2004, at 16:27:53
In reply to Re: HELP! Starting remeron tomorrow, what dosage?, posted by ravenstorm on April 9, 2004, at 16:25:11
Sean, when you stopped taking it did you have to go through many withdrawal symptoms?
Posted by crazychickuk on April 11, 2004, at 7:16:04
In reply to Sean, did you have withdrawal symptoms from Remero, posted by ravenstorm on April 9, 2004, at 16:27:53
YES i did gain alot of weight which is coming of now as i am dieting... just dont give in to cravings.. it works wonders for anxiety it really does give it a shot..
Posted by ravenstorm on April 11, 2004, at 11:33:41
In reply to Re: HELP! Starting remeron tomorrow, what dosage?, posted by ravenstorm on April 9, 2004, at 16:25:11
Wow, am I tired. I saw from postings on another board that the first day is the worst and then you start to feel a little more with it.
I think I feel more tired today! :( Does this take a couple of weeks to pass?
Thanks for the info on weight crazychick. How long were you on it. Did you have any withdrawal from stopping it?
Posted by crazychickuk on April 11, 2004, at 11:41:41
In reply to 2nd day on Rem, so tired. More ?'s for crazychi, posted by ravenstorm on April 11, 2004, at 11:33:41
Hi, i havent stopped taking it, i been on it for little over a year now.. you will feel tired for the first 2 weeks atleast its the sedating affect.. if you raise your dose to 30mg after a week or so you will not be as tired... or you could add something else to it like a stimulant..... i gained loads of weight mind you because i was lazy, and ate alot.. i am loosing it now though by dieting and i am still taking it.. its good for anxiety cus of the sedating affect stick with it.. you will be pleased you did..
Good luck to u.. xx
Posted by ravenstorm on April 11, 2004, at 11:53:13
In reply to Re: 2nd day on Rem, so tired. More ?'s for crazychi, posted by crazychickuk on April 11, 2004, at 11:41:41
Thanks for the speedy reply. I have continued to take .5mg of Lorazepam at night with the remeron. Do you think that is making the sedation worse?
I'm just a little concerned because posts on another board I go to indicated that day one was the worst and after that it got progressively better, but I am definitely more tired on day two than I was on day one!! Will have to go lie down again after typing this!
If this doesn't pass, I will try your suggestion of bumping up to 30mg next weekend. I just don't know how I'm going to work this week!!
Posted by crazychickuk on April 11, 2004, at 12:04:30
In reply to Re: 2nd day on Rem, so tired. More ?'s for crazychi, posted by ravenstorm on April 11, 2004, at 11:53:13
I do think Lorazepam adds to the sedation.. what do you take Lorazepam for? if its for slep you dont need to take it anymore as the rem does that..
Posted by ravenstorm on April 11, 2004, at 13:05:37
In reply to Re: 2nd day on Rem, so tired. More ?'s for crazychi, posted by crazychickuk on April 11, 2004, at 12:04:30
Well, I always said I would never take a benzo. But my last pdoc convinced me to take it as a sleep aid/anti-anxiety when I tried to get on prozac (tried it for 4-6 weeks at only 10mg every other day and had the worst stomach upset/gerd ever. the sad thing is, I had been able to take prozac before without this problem (used it to try to help with Paxil withdrawal)but after I took a bunch of supplement stuff from a naturopath, my stomach was shot and couldn't handle the prozac anymore. I was really bummed about that because I REALLY wanted to take prozac because there is not a discontinuation syndrome and after the hell I went through with paxil, I never want to go through that again!!
Anyway, back to the benzos. I was taking 1.0mg at night and then got scared about addiction so cut back to .75mg and now to .5mg which I have been at for 4 weeks. The only reason I haven't stopped taking it with the remeron is fear of withdrawal or bounce back anxiety.
FEAR, FEAR, FEAR. That is all I have about all these drugs since paxil.
I actually cried for 20 mins and had to have my husband hold me when I took the first remeron tablet. That is sooooo pathetic!! (OOPS, no negative self talk allowed).
Maybe I'll skip the lorazepam tonight or just take .25mg for a few days and then down to 0mg (?)
Everything that I've read about reducing says to go by a quarter of a tab at a time. But it would be nice to go faster, especially if it is adding to the day time grogginess.
Thanks so much for replying to my posts. It really means a lot to me. I have posted other times and not gotten a response at all, so this has been really great.
Posted by Sad Panda on April 11, 2004, at 13:21:12
In reply to Re: 2nd day on Rem, so tired. More ?'s for crazychi, posted by ravenstorm on April 11, 2004, at 13:05:37
> Well, I always said I would never take a benzo. But my last pdoc convinced me to take it as a sleep aid/anti-anxiety when I tried to get on prozac (tried it for 4-6 weeks at only 10mg every other day and had the worst stomach upset/gerd ever. the sad thing is, I had been able to take prozac before without this problem (used it to try to help with Paxil withdrawal)but after I took a bunch of supplement stuff from a naturopath, my stomach was shot and couldn't handle the prozac anymore. I was really bummed about that because I REALLY wanted to take prozac because there is not a discontinuation syndrome and after the hell I went through with paxil, I never want to go through that again!!
>
> Anyway, back to the benzos. I was taking 1.0mg at night and then got scared about addiction so cut back to .75mg and now to .5mg which I have been at for 4 weeks. The only reason I haven't stopped taking it with the remeron is fear of withdrawal or bounce back anxiety.
>
> FEAR, FEAR, FEAR. That is all I have about all these drugs since paxil.
>
> I actually cried for 20 mins and had to have my husband hold me when I took the first remeron tablet. That is sooooo pathetic!! (OOPS, no negative self talk allowed).
>
> Maybe I'll skip the lorazepam tonight or just take .25mg for a few days and then down to 0mg (?)
>
> Everything that I've read about reducing says to go by a quarter of a tab at a time. But it would be nice to go faster, especially if it is adding to the day time grogginess.
>
> Thanks so much for replying to my posts. It really means a lot to me. I have posted other times and not gotten a response at all, so this has been really great.
>
>Hi Ravenstorm,
Have no fear of Remeron, it is a safe drug. Once you get up to 30mg you will find Prozac will be easy to take as Remeron has activity in the digestive track that can can counter act problems with drugs like Prozac, Paxil & Effexor. I wouldn't skip your Lorazepam, but I would encourage you to take .25mg for a week & then take .125 for a week.
Cheers,
Panda.
Posted by crazychickuk on April 11, 2004, at 13:25:16
In reply to Re: 2nd day on Rem, so tired. More ?'s for crazychi » ravenstorm, posted by Sad Panda on April 11, 2004, at 13:21:12
Just taper of the benzo slowely.. you dont need now for sleep as u got the rem and taking 2 will add to the sedating affect..
Dont be scared we r here for u xx ((HUGS))
Posted by ravenstorm on April 11, 2004, at 13:59:59
In reply to Re: 2nd day on Rem, so tired. More ?'s for crazychi, posted by crazychickuk on April 11, 2004, at 13:25:16
Thanks crazychickuk and sad panda!
I'm actually feeling the sluggishness clearing somewhat this afternoon (well, I don't feel like I'm in a walking coma anyway!) (thank God!).
Sad Panda--I've actually stopped the prozac, it was just making me way too sick (also, I was crying on it all the time). Am hoping the remeron will be enough on its own.
Will keep you all updated on my progress. I have been trying to find a new med and a way out of this paxil withdrawal induced depression and severe anxiety for 6 months.
Keeping my fingers crossed that Remeron will be the one and that I won't turn into the good year blimp on it!!!!
Hugs back!! I feel so much better just knowing others are out there. My husband is totally anti-med, hence the trip to the naturopath that screwed up my stomach!
Posted by Sad Panda on April 11, 2004, at 14:16:05
In reply to Re: 2nd day on Rem, so tired. More ?'s for crazychi, posted by ravenstorm on April 11, 2004, at 13:59:59
> My husband is totally anti-med, hence the trip to the naturopath that screwed up my stomach!
>
>My wife is anti-med too.
When natural remedies work it's usually because of the drugs they contain(funny that). The problem with natural things is it's hard to know what works & what is snake oil & when you do find something that works the active ingredient varies from batch to batch.
Cheers,
Panda.
Posted by crazychickuk on April 11, 2004, at 14:49:18
In reply to Re: 2nd day on Rem, so tired. More ?'s for crazychi » ravenstorm, posted by Sad Panda on April 11, 2004, at 14:16:05
I am gonna see about acupunture wat ever the spelling is.. lol u know where they stick needles in you i would love that..
I take remeron 30mg alone fpr my anxiety it has so calmed me down.. although i do get depressed sometimes and i know i need a med for my depression and i do get panicky still but not as bad i used to.. god no where near it..
I hate ssri's and trylics and i will never try any of them again..
Do keep us posted xx
Posted by seanwrx on April 11, 2004, at 23:33:46
In reply to Sean, did you have withdrawal symptoms from Remero, posted by ravenstorm on April 9, 2004, at 16:27:53
Nothing compared to coming off of Effexor or some of the others over the years.
I was already depressed, and started eating better, taking vitamins, and small does of Klonopin to prep myself. The depression came on very severe though and its taken alot of will power to get through the day.
Posted by ravenstorm on April 12, 2004, at 20:20:14
In reply to Re: Sean, did you have withdrawal symptoms from Remero » ravenstorm, posted by seanwrx on April 11, 2004, at 23:33:46
Thanks for the info, Sean. Are you currently taking anything? I hope you are doing better.
Posted by ravenstorm on April 12, 2004, at 20:35:58
In reply to Re: Sean, did you have withdrawal symptoms from Remero » ravenstorm, posted by seanwrx on April 11, 2004, at 23:33:46
OK, why do I ALWAYS have to react to meds in such a wierd way!!!!!!!!!!
I was awake/asleep/awake/asleep all night and for a portion of the night I was awake for quite some time. On remeron, for God's sake!!
What is worse is my sleep had finally stabilized so I was sleeping through the night (although it was taking me 1-2 hours to fall asleep). SIGH.
The good news is that I had lots of energy today. The bad news is that I had a lot of anxiety.
Also, my "belly" (I'm 5'5", 115lbs) is protruding and pants that have been falling off of me from weight loss were snug around the middle. Have not gained weight, so it must be water retention. Don't really give a damn about this at the moment. Much more concerned about the sleep and anxiety.
Can remeron make your anxiety worse before it gets better, or is this drug just going to be too activating for me?
It would just be nice if I would react to something in the predictable fashion!
OK, bitch-fest over. Sorry, sorry, sorry.
P.S. Crazy-chick if you read this, I think acupuncture can actually be really helpful for a lot of things.
Sad panda-I hear you about the natural stuff. Although, I have to say that the stuff the naturopath had me trying (5htp, l-tyrosine) I think works well for a lot of people, but I just couldn't take it on an empty stomach anymore and it just didn't have the same good effect when I took it with food. Also, I think the naturopath I went to was sort of irresponsible in that he told me that every person he had tried the products on had gotten better and then had a person with a weak stomach and GERD take the pills on an empty stomach.
In fact, the reason I'm having to try remeron right now is because I couldn't take prozac due to stomach upset after the natural supplements, even though in the past I was able to use prozac with no problems (I took it while trying to get off paxil). SIGH
Thanks again you guys for the support. I really appreciate it!
Posted by Sad Panda on April 12, 2004, at 21:31:45
In reply to wierd reaction to remeron, posted by ravenstorm on April 12, 2004, at 20:35:58
> OK, why do I ALWAYS have to react to meds in such a wierd way!!!!!!!!!!
>
> I was awake/asleep/awake/asleep all night and for a portion of the night I was awake for quite some time. On remeron, for God's sake!!
>
> What is worse is my sleep had finally stabilized so I was sleeping through the night (although it was taking me 1-2 hours to fall asleep). SIGH.
>
> The good news is that I had lots of energy today. The bad news is that I had a lot of anxiety.
>
> Also, my "belly" (I'm 5'5", 115lbs) is protruding and pants that have been falling off of me from weight loss were snug around the middle. Have not gained weight, so it must be water retention. Don't really give a damn about this at the moment. Much more concerned about the sleep and anxiety.
>
> Can remeron make your anxiety worse before it gets better, or is this drug just going to be too activating for me?
>
> It would just be nice if I would react to something in the predictable fashion!
>
> OK, bitch-fest over. Sorry, sorry, sorry.
>
> P.S. Crazy-chick if you read this, I think acupuncture can actually be really helpful for a lot of things.
>
> Sad panda-I hear you about the natural stuff. Although, I have to say that the stuff the naturopath had me trying (5htp, l-tyrosine) I think works well for a lot of people, but I just couldn't take it on an empty stomach anymore and it just didn't have the same good effect when I took it with food. Also, I think the naturopath I went to was sort of irresponsible in that he told me that every person he had tried the products on had gotten better and then had a person with a weak stomach and GERD take the pills on an empty stomach.
>
> In fact, the reason I'm having to try remeron right now is because I couldn't take prozac due to stomach upset after the natural supplements, even though in the past I was able to use prozac with no problems (I took it while trying to get off paxil). SIGH
>
> Thanks again you guys for the support. I really appreciate it!
>
>What doseage did you actually end up taking? At low doses it solely blocks H1 receptors (anti-histamine), as the dosage increases it rapidly saturates these recptors(because it is the strongest antihistamine on the market) & then it overflows into the 5-HT2A, 5-HT2C & 5-HT3 receptors. These are good to block & are known to reverse SSRI induced side effects. At still higher doses it starts to block Alpha-2 NE recptor which can be stimulating, but for me the stimulation was causing me to be crank & irritable, it is most likely to be what is waking you up. It took me ages to tolerate 30mg & the only reason I increased from 15 to 30mg was for a further decrease in Effexor side effects. It also causes me fluid retention around the feet at 30mg, which I wasn't getting at 15mg.
Cheers,
Panda.
Posted by ravenstorm on April 12, 2004, at 22:15:37
In reply to Re: wierd reaction to remeron » ravenstorm, posted by Sad Panda on April 12, 2004, at 21:31:45
I started and am still at 15mg. Don't think I'll be trying 30mg at this point!!
Posted by Sad Panda on April 12, 2004, at 23:33:32
In reply to Re: wierd reaction to remeron, posted by ravenstorm on April 12, 2004, at 22:15:37
> I started and am still at 15mg. Don't think I'll be trying 30mg at this point!!
>Cut the tablet up and try a 7.5 mg dose. It will likely be the best dose for the best sleep. 15mg was the perfect amount for me for sleep & I am 6'1" & 400 pounds(yes, lots). Knocked me out & get me asleep. In the past I have taken 60mg of Temazepam with Scotch or 50mg of Valium & not had sleep.
Cheers,
Panda.
Posted by seanwrx on April 13, 2004, at 13:20:36
In reply to Re: Sean, did you have withdrawal symptoms from Remero, posted by ravenstorm on April 12, 2004, at 20:20:14
> Thanks for the info, Sean. Are you currently taking anything? I hope you are doing better.
Well, after a few weeks of hell I am diving into another few weeks of hell. :)
I went back on Prozac 10mg on Saturday. I take .5 klonopin in the morning. I can tell I am on the Prozac already...my anxiety has increased quite a bit and I feel a little dissoriented (sp). Hopefully this will pass over the next week. Ultimetly I will have to go up to 20 or 30mg but I am fine with that. I am just going to ease into it and see where it takes me. Looking back over the years, Prozac seemed to do the best for me. I am not seeing anyone, so the sexual side-effects aren't an issue right now - in fact, I just need to get where I can leave the house and have a decent conversation with a girl :) (I used to be able to...)
Unfortunetly, though Prozac is a stimulant (right?) I have a tendancy to 'shut down' as I get uncomforable so I sleep when I get home from work which isn't good for getting back to bad later that night. I tried to take the prozac at night last night, and didnt notice much of a difference. Though I am yawning less today....
I saw a therapist yesterday, and another today...burned two of my allowed visits from my insurance, but whatever. I liked them both, and they made me realize how TERRIBLE my old therapist was. I didn't know how 'not for me' he was until I met these guys. I am picking the one that is closer to my place of work and home, other (a little more experienced maybe too). Other then that they both seem great. So I am kind of excited about that really.
Now, if I could just sleep through the night an not wake up so anxious/nervous... :(
Posted by ravenstorm on April 13, 2004, at 22:52:27
In reply to Re: Sean, did you have withdrawal symptoms from Remero, posted by seanwrx on April 13, 2004, at 13:20:36
You are so lucky you can still take prozac!! That is what I wanted to take (So I wouldn't have to worry about withdrawal) And i could take it before I messed up my stomach with the "natural remedies". SIGH. Hang in there with the increased anxiety. I know it is NO FUN.
The weird thing for me is I'm actually having much more anxiety on the remeron than I had on the prozac (which I was trying to get on before I had to switch to remeron) but my tummy couldn't take it anymore.
As far as sexual side effects etc, maybe when you are feeling better you'll meet a girl who is on AD's too, so she'll have some understanding of the whole issue. Sometimes I wish my husband was on AD's just so he'd have a frickin' clue once in a while. (lol)
The biggest mistake I have ever made in my life was not going back on the paxil when the withdrawal got severe. Believe it or not, I was on only 2mg for the last year I was on it. Just enough to keep from going through withdrawal. The withdrawal was so severe that I ended up in a suicidal clinical depression (and this is after I was functioning just fine and dandy on 2mg for a year!!!!!) Mind you, I was originally put on paxil for panic attacks and insomnia, NOT depression.
Anyway, I haven't been able to get back on meds since then. My body just doesn't seem to be able to handle the meds. Remeron is kind of my last hope before the tricyclics, but it doesn't seem to be helping at all with my anxiety. I really have a feeling that an SSRI is the only thing that will help with my anxiety, and I just don't seem to be able to take one anymore.
I think its great that you "shopped" around for therapists. I had to fight my insurance tooth and nail to get to see another pdoc when the first one I went to was an absolute idiot.
Stay in touch. Hope you do well on the prozac. Hoping I do well on the remeron, but am not holding my breath at this point.
Don't you wish there was a magic wand and you could just make your brain better without all these meds?!
P.S. have found some really scary posts on another site about people going through horrible remeron withdrawal. Makes me want to stop taking it, except I don't really have another alternative right now.
There is a drug called nemefitmide (or something like that) in phase II/III clinical trials that is some kind of peptide delivered in the form of a shot with very few side effects and an 80% efficacy rate versus the SSRI 50-60%. You only have to get the shot once every 4-6 months.
Knowing the FDA it will probably never get approved!!!!!!!!!!!!!!!!!!!
OOPS, sorry to be so far off topic. . .just wanting a miracle now. Hoping brain has not been permanently screwed by the paxil.
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