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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by hansi555 on May 25, 2008, at 7:35:01
Hi all
Been on Remeron for 4½ months now, initially for insomnia and then depression (stress induced). It took 6-7 weeks for the Remeron to work, but when it did, I had a real good period for 2-3 weeks, then followed 3 weeks of not-so-good but indeed acceptable. Then followed 4 very good weeks - I was my old self, not thinking about the depression, just taking care not to stress my self and taking the pills.
Then 2 weeks ago, out of no where a new not-so-good period begun again. Cannot find any good explanation for this, upped the dose a bit from 55 mg to 60 mg 3 days ago - been on 55 mg of Remeron for 13 weeks until now.
Is this a normal pattern so deep into the treatment?
My psyc wants to add 10 mg of Lexapro to take in the morning, but I am not that crazy about it - also when reading about the side effects and then compare them to how I feel right now; its okay for most of the days, I am maybe at 80% of my normal happy mood.
Will the Remeron soften the side effects of the Lexapro?
What would you advise me to do? stay w. the Remeron alone or add the Lexapro?Thanks!
Posted by Phillipa on May 25, 2008, at 11:40:54
In reply to Need advice: Adding Lexapro to Remeron treatment?, posted by hansi555 on May 25, 2008, at 7:35:01
Don't want to sound selfish and by the way welcome to babble a lot of great knowledge here but if I felt 80% myself I'd be very happy. But if your doc feels lexapro at l0mg may make the difference between 80-l00% remission try it. And good luck to you. No l3 weeks into treatment isn't that long to me. Phillipa
Posted by Phillipa on May 25, 2008, at 11:42:05
In reply to Need advice: Adding Lexapro to Remeron treatment?, posted by hansi555 on May 25, 2008, at 7:35:01
OOps you're not new but welcome anyway. Haven't seen your name before been awhile since you posted? Phillipa
Posted by hansi555 on May 25, 2008, at 11:56:21
In reply to Re: Need advice: Adding Lexapro to Remeron treatment?, posted by Phillipa on May 25, 2008, at 11:42:05
Hi phillipa
thanks for your words. No, I havent been around that much since everything was going great until 2 weeks ago.
BTW: I am 17 weeks into the treatmentWhat is your experience regarding setbacks (80% feeling)?
I am working, doing sports and most of my normal things, just not like when I was in the good periods - but i am struggeling a bit at the moment...
Posted by bleauberry on May 25, 2008, at 18:00:42
In reply to Need advice: Adding Lexapro to Remeron treatment?, posted by hansi555 on May 25, 2008, at 7:35:01
This is a tough call because there is no way to predict. One good thing is that in a metastudy at pubmed they looked to find drugs of probable superiority, and both remeron and lexapro were on the list of top performers, along with milnacipran and effexor. Details not given though, so I imagine their superiority is probably only by a few percentage points.
Anyway, some people go as high as 90mg remeron. That is an option. Doses can be kept lower sometimes by doing two drugs that work in harmony, so maybe lexapro and remeron would be good for that. Personally I would probably start with 5mg (half a pill) instead of 10mg. Remeron should soften the start-up anxiety and the sexual side effects of lexapro.
Either way...increase remeron, or add lexapro...there is no way to know until you actually try. Everyone is different.
I have no facts to back it up, but just based on anecdotal reports I've seen here over time, remeron by itself seems to have a higher poopout effect than other drugs, unless it is combined with another drug such as effexor, lexapro, prozac, etc, where when things work good they seem to keep working good for a lot longer.
Posted by hansi555 on May 26, 2008, at 0:57:15
In reply to Re: Need advice: Adding Lexapro to Remeron treatment?, posted by bleauberry on May 25, 2008, at 18:00:42
Thank you so much for this answer, blueberry!
I have another two for you:"to have a higher poopout effect" - does this mean "not working anymore"? You mean Remeron has a greater risk of suddenly not working when taken alone?
Regarding Lexapro: I never had any anxiety problems before, "just" an unipolar depression. Is it likely to get anxiety attacks from Lexapro alone?
So if you were to choose, would you go higher Remeron or add Lexapro?
Posted by bleauberry on May 26, 2008, at 17:01:07
In reply to Re: Need advice: Adding Lexapro to Remeron treatment?, posted by hansi555 on May 26, 2008, at 0:57:15
You ask some tough questions. I wish I had some genius answers for you, but I don't. I can try to share my opinion is about the best I can do.
> "to have a higher poopout effect" - does this mean "not working anymore"? You mean Remeron has a greater risk of suddenly not working when taken alone?
When I said that, it was based on subjective anecdotal evidence from reading ratings and reviews of meds at other forums. There are some meds that people can take for years and years without it pooping out (not working anymore). I can't recall very many people still on remeron alone after years. Lexapro, prozac, wellbutrin, yes, zoloft somewhat, but remeron not much. Keep in mind though, all these drugs can poop out. I'm just referring to ones that sometimes didn't.
>
> Regarding Lexapro: I never had any anxiety problems before, "just" an unipolar depression. Is it likely to get anxiety attacks from Lexapro alone?Hard to predict. Some people get uncomfortable anxiety when starting, but some people get calmed down right away. I think it has to do with how sensitive the serotonin receptors are.
>
> So if you were to choose, would you go higher Remeron or add Lexapro?Oh geez. I don't know. It would be nice to stay with just one medicine. Perhaps set your ceiling of remeron at 75mg or 90mg. If those don't do the trick, then go back down lower and add something else. On the other hand, lexapro could work like magic. You just don't know till you try.
Hey, you could do this. Get the lexapro, cut the pills to 5mg and give it a go. Who knows, it might be great, or it might have a hint of being great, or it might be a disaster. No matter what happens, you would know what to do with remeron. Increase it, keep it the same, whatever.
Posted by hansi555 on May 27, 2008, at 10:56:52
In reply to Re: Need advice: Adding Lexapro to Remeron treatment?, posted by bleauberry on May 26, 2008, at 17:01:07
Hi blue, thnaks
I think that was a very usefull piece of advice. I upped my dose from 55 to 60 mg remeron 5 days ago and there seem to be some positive reaction but nothing decisive just yet. I will let it run for some more days, past the weekend maybe, then begin the lexapro 5 mg to begin with and see what happens.
Also I am looking for annother type of psykologist so I could get some day-to-day tools to get througt the not-so-good-times.
As it is now I have a good feeling more or less half of the time, but I have trouble keeping it good - maybe because I have had some long periods of good which by it self turned aroud and I cannot quiet reconize when it turns around from bad to good again...does it make any sense?
This is the end of the thread.
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