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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by lilblondone on September 3, 2004, at 21:30:27
Hi all,
Im so glad I stumbled onto this site!
As I write this I have an EfexorXR capsule(37.5mg) sitting in front of me, but I'm to chicken to take it. I have a few questions regarding the Remeron Efexor combo.
I began taking Remeron, 45mg at night, about 4 years ago. I now call it my miricle pill. I'd love to know why this particular AD works so well? I've tried just about everything else and nothing comes close. It has given me my life back. Unfortunatly, I've had to 'live' with the side effects of Remeron as well. 4 years ago I weighed about 94lbs. today I am close to 194lbs. No joke. No matter how much I diet or exercise the weight remains. I may be happy and productive now, but my health is suffering.
My doctor suggested I switch AD's. He has given me Efexor. I am to continue the Remeron at night and begin taking the Efexor in the morning. The plan is to stop the Remeron as soon as possible.
My questions are these;
After doing some investigating I see that the two can be taken together. Is this safe?
What is 'Serotonin syndrome'?
If I remain on the Remeron would a small dose of Efexor help with keeping the weight down?
As you can tell I am very weary of going off Remeron. Is there another AD thats close to its chemical makeup minus the weight gain?
And lastly, is Efexor, by itself a good AD?
I look forward to hearing your responses.
Much thanks,
lil
Posted by Sad Panda on September 4, 2004, at 4:40:27
In reply to Remeron+Effexor?, posted by lilblondone on September 3, 2004, at 21:30:27
> Hi all,
> Im so glad I stumbled onto this site!
> As I write this I have an EfexorXR capsule(37.5mg) sitting in front of me, but I'm to chicken to take it. I have a few questions regarding the Remeron Efexor combo.
> I began taking Remeron, 45mg at night, about 4 years ago. I now call it my miricle pill. I'd love to know why this particular AD works so well? I've tried just about everything else and nothing comes close. It has given me my life back. Unfortunatly, I've had to 'live' with the side effects of Remeron as well. 4 years ago I weighed about 94lbs. today I am close to 194lbs. No joke. No matter how much I diet or exercise the weight remains. I may be happy and productive now, but my health is suffering.
> My doctor suggested I switch AD's. He has given me Efexor. I am to continue the Remeron at night and begin taking the Efexor in the morning. The plan is to stop the Remeron as soon as possible.
> My questions are these;
> After doing some investigating I see that the two can be taken together. Is this safe?
> What is 'Serotonin syndrome'?
> If I remain on the Remeron would a small dose of Efexor help with keeping the weight down?
> As you can tell I am very weary of going off Remeron. Is there another AD thats close to its chemical makeup minus the weight gain?
> And lastly, is Efexor, by itself a good AD?
> I look forward to hearing your responses.
> Much thanks,
> lil
>
>Hi Lil,
Serotonin syndrome is an overdose of serotonin generally caused by combining two drugs that increase serotonin levels or by taking an overdose of an SSRI or Effexor. It is life threatening & causes severe body temperatures, confusion & mania. It is treatable if you go to a hospital.
The good news is Remeron doesn't raise serotonin levels & taking Effexor + Remeron combined is an excellent combination. I was taking them myself in combination for the last 10 months.
Weight gain: Did Remeron cause you to be hungry or do you truely can't loose weight? If you are dieting & excercising I would consult an endocrinologist first & get tested for thyroid, sugar, cholesterol & triglyceride problems because drugs like Remeron can cause metabolic problems.
> As you can tell I am very weary of going off Remeron. Is there another AD thats close to its chemical makeup minus the weight gain?
>Possibly Trazodone, but it's a stranger drug.
> And lastly, is Efexor, by itself a good AD?
>It can be, but it does have a problem of being hard to withdrawl from.
Cheers,
Panda.
Posted by lilblondone on September 6, 2004, at 1:46:14
In reply to Re: Remeron+Effexor? » lilblondone, posted by Sad Panda on September 4, 2004, at 4:40:27
Hey Panda,
Thanks sooo much for the info. I am calling my doctor in the morning to see if it is possible that the Remeron has wreaked havoc with my metabolism. I wouldn't doubt it. I did get my thyroid and cholesterol checked about a year ago. Nothing remarkable except my cholesterol was elevated, which I attributed to the weight gain. In answer to your question about weight loss; About an hour after taking the Remeron I become famished! I take it at night because, 1. it makes me sleepy, and 2. I hope I fall asleep before I get hungry. Believe it or not I've found myself sleep walking to the kitchen. And before I realize what Im doing I've eaten so much I actual will wake up in the morning and vomit. Pretty ugly huh?
You mentioned it was difficult to get off the Efexor? I find myself having a hard time even imagining myself off the Remeron. But I think its more pychological. I know what my life was like before AD's. and I never want to be there again.
Are you talking about actual physical symptoms of withdrawl with Efexor?
Also, can you explain what Remeron does in our brains Vs Efexor in relation to Serotonin and norephrinephrin ( I don't think I spelled this right, but I hope you get the idea) I'm wondering if there is a better AD for me. There are a few new ones that have come out in the last four years I have not tried. Serzone is one. Do you know anything about this one.
Again I want to thank you. I will take my Efexor capsule in the morning. I'll let you know how it goes.
Lil
Posted by bethesdabob on September 8, 2004, at 12:58:20
In reply to Re: Remeron+Effexor? » Sad Panda, posted by lilblondone on September 6, 2004, at 1:46:14
I have been trying to get some info about this combo too, my wife died last December from a seizure disorder, she was bipolar, an epileptic and had a bad liver from a bout of hepatitis.
My wife's shrink treated her epilepsy and bipolar, at the time of her death her psychiatrist prescribed 600 mgs of effexor XR, 90 mgs of remeron, 900 mgs. of trileptal, 3 mgs. of risperdal, 6 mgs. of clonazepam, 40 mgs. of adderall, and 10 mgs. of ambien; for migraine headaches shrink also prescribed stadol NS and imitrex nasal.
Am being informed that she was prescribed too many meds and that the doses of effexor and remeron were way in excess of manufacturer's recommedation, the combo is new and could be dangerous, it is considered experimental and not enough info is out about them.
Be careful---
Posted by lilblondone on September 8, 2004, at 22:46:47
In reply to Re: Remeron+Effexor?, posted by bethesdabob on September 8, 2004, at 12:58:20
Wow Bob,
Thats a lot of medication! I'm a nurse. If I had a patient on this much medication I'd be asking some questions. It sounds like your wife had some valid and serious medical conditions. Unfortunatley, when we see more than one doc at a time they don't share information, so the medication they prescribe can have horrible interactions. I am not blaming the docs, as it is our responsibility to disclose this information. As well as ask questions, and even demand proper care. The sad fact is, many of us see doctors as having all the right answers to whatever ails us. We need to remember they are people just like us, imperfect. It wasn't until I became a nurse that I realized this. However, still having to deal with my own depression I find myself desperatly wanting my doctor to 'cure me' And because of this I am now doing the AD dance. I still have many questions regarding the 'right' AD. And Im having a hard time finding any answers. Even with all the resources I have. I've determined that the only way I'm going to know if something works is to try it. I am trying to start on low doses. Although I don't know how thereputic this is, as I have found myself becoming very depressed again. I wonder if the weight problem is as bad as I think it is? Then I look in the mirror and think 100lbs! There has to be something else. I spoke to my doctor this morning and I am going to increase the Remeron back to 45mg and continue with the Effexor. He wanted to know if I would try a small dose of amitrptyline. He thought this may offset the 'speedyness' of the Effexor and help me get some sleep. I said no. It just seems like too much.
Bob, I am truly sorry to hear about your wife. I do hope life is treating you better, and your able to move on. You don't have to forget her, but you have to remember your number one now, start focusing on you. Your that important. As far as information on the Remeron Efexor combo, anyone?? So far I have only heard good things. I am curious why Efexor is so difficult to stop. And, if the 'speedy' side effect eventually disappears?
I am so grateful this site is here. I don't feel so isolated.Again much thanks,
Lil
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