![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by BettyM on April 26, 2004, at 6:05:52
Has anyone tried the combination of Remeron (Mirtazapine) and St Johnswort?
Betty
Posted by Sad Panda on April 26, 2004, at 6:33:13
In reply to Remeron and St Johnswort, posted by BettyM on April 26, 2004, at 6:05:52
> Has anyone tried the combination of Remeron (Mirtazapine) and St Johnswort?
>
> Betty
>Hi Betty,
I haven't, but it would be safe. Are you currently taking one or the other?
Cheers,
Panda.
Posted by linkadge on April 26, 2004, at 7:48:38
In reply to Re: Remeron and St Johnswort » BettyM, posted by Sad Panda on April 26, 2004, at 6:33:13
It should be safe, I had serotonin syndrome on SJW alone (which is a very rare reaction).
Linkadge
Posted by BettyM on April 26, 2004, at 7:52:37
In reply to Re: Remeron and St Johnswort » BettyM, posted by Sad Panda on April 26, 2004, at 6:33:13
> I haven't, but it would be safe. Are you currently taking one or the other?
>
I'm taking Remeron now.
Posted by Zena on April 26, 2004, at 10:05:44
In reply to Re: Remeron and St Johnswort, posted by BettyM on April 26, 2004, at 7:52:37
> > I haven't, but it would be safe. Are you currently taking one or the other?
> >
> I'm taking Remeron now.
>
>
Betty,
I have been on remeron for 2 yrs. & last week they came out with the generic so I tried it. I am not having good results with it. Which one are you on?
Zena
Posted by SLS on April 26, 2004, at 17:36:39
In reply to Re: Remeron and St Johnswort, posted by Zena on April 26, 2004, at 10:05:44
Hi.
> I have been on remeron for 2 yrs. & last week they came out with the generic so I tried it. I am not having good results with it.
Hopefully, a simple dosage adjustment will be all that is necessary. The mirtazepine molecule should be identical in both preparations. It's all of the other stuff that goes into making the pill that can make a difference as to how much gets into your blood stream and is transported into the brain.Good luck!
- Scott
Posted by BettyM on April 27, 2004, at 6:07:56
In reply to Re: Remeron and St Johnswort, posted by SLS on April 26, 2004, at 17:36:39
I'v been taking Remeron 45 mg for 6 weeks (for insomnia). Still don't feel quite well. I feel tired at daytime. But maybe I just have to take it for another couple of weeks, en then see what the effect is?
Posted by Sad Panda on April 27, 2004, at 6:32:08
In reply to Re: Remeron and St Johnswort, posted by BettyM on April 27, 2004, at 6:07:56
> I'v been taking Remeron 45 mg for 6 weeks (for insomnia). Still don't feel quite well. I feel tired at daytime. But maybe I just have to take it for another couple of weeks, en then see what the effect is?
>
>Hi Betty,
If you are only taking it for insomnia then 45mg is way too much, 15mg is the best amount for sleep generally. 30mg to 60mg is for antidepressant purposes. For me 15mg makes me sleep for 8 hours, 30mg didn't make me any more sedated, but makes me sleep for 9 hours.
Cheers,
Panda.
Posted by ravenstorm on April 28, 2004, at 22:46:48
In reply to Re: Remeron and St Johnswort, posted by BettyM on April 27, 2004, at 6:07:56
Hi betty--
Did you start out at 45mg all at once, or titrate up?
Just wondering, as usually people do feel more activated at higher doses and more sedated at lower (but some people actually have the opposite response). If you did start off lower, did you feel any less daytime sedation with that? (Again, usually it is the other way around, but not always!)
Any other side effects so far?Good Luck!
Posted by BettyM on May 3, 2004, at 2:33:42
In reply to Re: Remeron and St Johnswort, posted by BettyM on April 27, 2004, at 6:07:56
I was taking 30 mg (not 45, typing error). Last weeks I took 2 portions of 15 mg; 15 mg at bedtime and 15 mg in the middle of the night. The problem is, that I wake up after an hour or 5, even after taking 15 mg. Crazy; I've read most people are in coma for at least 8 hours when they take Remeron.
But I will try one tablet of 15 mg. this week. Maybe it will be better after a few days. If not, I will stop taking Remeron. I still suffer from insomnia.
But except tiredness and sometimes dizziness no further side effects.
(I've tried Paxil too, but the side effects were horrible: trembling, muscle pains, etc.)Betty
Posted by Sad Panda on May 3, 2004, at 3:44:08
In reply to Re: Remeron and St Johnswort, posted by BettyM on May 3, 2004, at 2:33:42
> I was taking 30 mg (not 45, typing error). Last weeks I took 2 portions of 15 mg; 15 mg at bedtime and 15 mg in the middle of the night. The problem is, that I wake up after an hour or 5, even after taking 15 mg. Crazy; I've read most people are in coma for at least 8 hours when they take Remeron.
> But I will try one tablet of 15 mg. this week. Maybe it will be better after a few days. If not, I will stop taking Remeron. I still suffer from insomnia.
> But except tiredness and sometimes dizziness no further side effects.
> (I've tried Paxil too, but the side effects were horrible: trembling, muscle pains, etc.)
>
> Betty
>Hi Betty,
You are much better off taking 30mg in one hit rather than splitting it through the night. Remeron has two actions which cause sleep, first is it's anti-histamine activity that gives you the initial sedation feeling, after a month this feeling subsides. At low doses of 15mg that's all it does. At 30mg it's second action kicks in, 5-HT2A blockade, this will keep you in a deeper sleep longer & is said to actually improve sleep patterns when tested in sleep studies. I usually suggest people start at 15mg because it can be incredibly sedating if you aren't use to it. Remerons third action which happens at high doses is 'Alpha-2 NE antagonism' which is said to be stimulating, but can be rather irratting.
Cheers,
Panda.
Posted by BettyM on May 3, 2004, at 3:47:59
In reply to Re: Remeron and St Johnswort » BettyM, posted by Sad Panda on May 3, 2004, at 3:44:08
It activates me when I take 30 mg at once....
Posted by Sad Panda on May 3, 2004, at 4:02:24
In reply to Re: Remeron and St Johnswort, posted by BettyM on May 3, 2004, at 3:47:59
> It activates me when I take 30 mg at once....
>That is Alpha-2 NE antagonism, you get use to that too after awhile just like getting use to the H1 blockade, thankfully the 5-HT2A effect continues to work long after tolerance towards the other effects has been built. I would be tempted to cut the tablet up & experiment with 22.5mg.
Cheers,
Panda.
Posted by ravenstorm on May 3, 2004, at 9:26:18
In reply to Re: Remeron and St Johnswort, posted by BettyM on April 26, 2004, at 7:52:37
Hi Betty--
Sorry you're having difficulty finding the right dosage. It is frustrating, isn't it.
I'm not sure how long you have been trying the Remeron. I know for me I was knocked out the first two days at 15mg but then I had several days where I actually slept worse: awake/asleep/awake/asleep all night long. That eventually passed.
I have noticed now that I am waking up at 6:00am and have some difficulty falling back asleep. I know I should get up at that time for a couple of days and maybe I'll get tired enough not to do it anymore. (I work from 1pm-8pm approx. so I usually don't get up that early). Sleeping until 7:30 or 8 would be perfect for me.
I'd talk to your doctor and see what they suggest.
Good Luck and let us know how you are doing!
Posted by BettyM on May 4, 2004, at 4:21:29
In reply to Re: Remeron and St Johnswort, posted by ravenstorm on May 3, 2004, at 9:26:18
> Hi Betty--
>
> Sorry you're having difficulty finding the right dosage. It is frustrating, isn't it.
--Yes, very frustrating.> I'm not sure how long you have been trying the Remeron.
>
I've been taking it for 8 weeks now. Must be long enough. Some nights a sleep rather well, others I don't. And the most important: I don't feel fitter then before taking Remeron. Maybe I should switch to another drug?
Posted by ravenstorm on May 4, 2004, at 9:13:29
In reply to Re: Remeron and St Johnswort, posted by BettyM on May 4, 2004, at 4:21:29
I am sort of in the same boat as you. On Friday I will have four weeks in at 15mg and was doing somewhat better in terms of anxiety but seemed to have a big set back this weekend. (Lots of crying, feeling hopeless). I had the stomach flu last week, so I don't know if that is what threw a wrench into everything. It is just frustrating because when I started paxil I felt better than I'd ever felt in my life in three weeks!
I am currently deciding whether to up to 30mg now or wait it out the full six or even eight weeks. My only hesitancy at going up at this stage is that the only side effects I have now are dry mouth and some dizzyness and it took four weeks to get rid of the others. Not looking forward to going through the side effects again when I up my dosage (especially losing an entire weekend to extreme drowsiness). The extreme hunger thing subsided (maybe because i had the flu last week and three days of not eating somehow short circuited that) and I am worried about it starting again if I up my dose and it not going away. That was torture.
What does your doc say? I would think if you have had no improvement whatsoever after eight weeks it is probably not the drug for you.
I have seen some improvement but not as much as I would like.
Hang in there and let us know what you decide to do.
Posted by Sad Panda on May 4, 2004, at 12:23:17
In reply to Re: Remeron and St Johnswort, posted by BettyM on May 4, 2004, at 4:21:29
> > Hi Betty--
> >
> > Sorry you're having difficulty finding the right dosage. It is frustrating, isn't it.
> --Yes, very frustrating.
>
> > I'm not sure how long you have been trying the Remeron.
> >
> I've been taking it for 8 weeks now. Must be long enough. Some nights a sleep rather well, others I don't. And the most important: I don't feel fitter then before taking Remeron. Maybe I should switch to another drug?
>
>
>Hi Betty,
Have you tried 22.5 or 30mg for a couple of weeks? For me the activation subsided & the sedation also subsided, but I still manage to sleep like a log & can go to sleep instantly. If you have been taking the higher dose for a couple of weeks & you still have trouble staying asleep, then you will need to look elsewhere.
Insomnia is also a part of depression, is SJW treating your problems? You may need something stronger for depression before anything can help you with sleep.
Cheers,
Panda.
Posted by BettyM on May 16, 2004, at 8:01:53
In reply to Re: Remeron and St Johnswort, posted by BettyM on May 4, 2004, at 4:21:29
Have been taking higher dosage (45 mg) for about 2 weeks. But it still activates. No dizziness anymore, but I still feel tired. I feel like a don't get my 'deep sleep'. I dream a lot, but do'nt feel refreshed when I wake up.
Maybe I switch to trazodone now. Maybe this drug works better for deep sleep?Betty
Posted by Sad Panda on May 16, 2004, at 9:47:50
In reply to Remeron vs trazodone, posted by BettyM on May 16, 2004, at 8:01:53
> Have been taking higher dosage (45 mg) for about 2 weeks. But it still activates. No dizziness anymore, but I still feel tired. I feel like a don't get my 'deep sleep'. I dream a lot, but do'nt feel refreshed when I wake up.
> Maybe I switch to trazodone now. Maybe this drug works better for deep sleep?
>
> Betty
>Hi Betty,
Did you try lower dosages? It's a strange drug as it produces better sleep at the lower doseages.
Cheers,
Panda.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.