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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by jono_in_adelaide on October 3, 2012, at 18:00:54
Given some of the recent talk about the off label use of atypicals fior insomnia, anxiety, panic disorder and OCD, it occured to me that Mirtazapine might be a much better option for many of these patients.
It posesses many of the same properties (Blocking the 5HT2 receptors to releive anxiety and depression, sedation though the H1 receptor, as well as its Alpha 2 effect on noradrenalin. And no metabolic syndrome or tarvide dyskensia (although this seems to be rare with low dose atypicals)
Seems it would be sensible to try most of these patients on mirtazapine before moving to an atypical. As a nice side benifit, it is far cheaper for society/the health system
Posted by phillipa on October 3, 2012, at 18:26:53
In reply to Miratzapine vs atypicals in neurotic disorders, posted by jono_in_adelaide on October 3, 2012, at 18:00:54
Jono didn't make me tired when took 15mg with benzos and also no weight gain, Took for a month. Just stopped it no withdrawal. I do see many others that respond well to it. Phillipa
Posted by gadchik on October 3, 2012, at 18:39:21
In reply to Re: Miratzapine vs atypicals in neurotic disorders » jono_in_adelaide, posted by phillipa on October 3, 2012, at 18:26:53
Remeron was part of the formula that got me well. I was able to stop it with no withdrawals,and it felt very mild,calming. I had hangover feeling for a few days,but it stopped. I did gain weight,thats why I stopped it, along with zoloft. Also had restless legs after dose increase.
Posted by gadchik on October 3, 2012, at 18:53:03
In reply to Re: Miratzapine vs atypicals in neurotic disorders, posted by gadchik on October 3, 2012, at 18:39:21
I had a memory just now thinking about remeron. The day after I took my first dose, I had a conversation with a stranger, I laughed and enjoyed the interaction. I had been isolated for months before that day,very depressed and extremely anxious. I was really going through the worst depression. I guess that first dose gave me my first real sleep in a month,maybe thats what helped.I was also able to eat after weeks of barely touching food.
Posted by Christ_empowered on October 3, 2012, at 19:23:17
In reply to Miratzapine vs atypicals in neurotic disorders, posted by jono_in_adelaide on October 3, 2012, at 18:00:54
atypicals are used off label (at least here in the US) waaaaaay too often, when there are less expen$ive, less noxious alternatives. BuSpar, vistaril, benzos, remeron, gabapentin, so on and so forth...
If it was really just getting results fast, not Big Pharma pushing, then we'd see lots of low-dose perphenazine and maybe some other typical Rxs (loxapine, maybe?). But its pretty much trendy to use atypicals for...everything. I read one article for shrinks comparing them to broad spectrum antibiotics. Can you imagine?
Posted by jono_in_adelaide on October 4, 2012, at 0:04:42
In reply to i agree, posted by Christ_empowered on October 3, 2012, at 19:23:17
They are used much more sparingly in Australia, because insurance will only cover them for mania or schitzophrena, though there is some leekage, but yes, i get the impression that they are overused in North America, and can see the beginings of it here
Posted by ChicagoKat on October 4, 2012, at 10:00:39
In reply to Miratzapine vs atypicals in neurotic disorders, posted by jono_in_adelaide on October 3, 2012, at 18:00:54
> Given some of the recent talk about the off label use of atypicals fior insomnia, anxiety, panic disorder and OCD, it occured to me that Mirtazapine might be a much better option for many of these patients.
>
> It posesses many of the same properties (Blocking the 5HT2 receptors to releive anxiety and depression, sedation though the H1 receptor, as well as its Alpha 2 effect on noradrenalin. And no metabolic syndrome or tarvide dyskensia (although this seems to be rare with low dose atypicals)
>
> Seems it would be sensible to try most of these patients on mirtazapine before moving to an atypical. As a nice side benifit, it is far cheaper for society/the health systemI completely agree Jono. As I have stated in previous posts, I think anispychotics, atypical or not have too many side effects to be used casually; that they should only be used by those who truly need them, ie people with schizophrenia, psychotic bipolar disease, depressives with psychotic features, and the like. I believe many atypicals cause akathisia in pts, even though they're not supposed to as often as non-atypicals, but that pts. who get akathisia often interpret it as worsening or the start of anxiety.
So I agree with you that Remeron is a much safer choise, and in most cases, probably more effective as well.
Have you decided to try it then?
Kat
Posted by JONO_IN_ADELAIDE on October 4, 2012, at 19:56:50
In reply to Re: Miratzapine vs atypicals in neurotic disorders » jono_in_adelaide, posted by ChicagoKat on October 4, 2012, at 10:00:39
I'm being indicisive and procrastinating about the mirtazapine....... I know i should probably try it, but I'm paranoid about getting even fatter (my BMI is 29)
Ugh, why cant there be one pill that you take every morning, with no side effects, that makes everything ok (like prozac was going to be :))
Posted by ChicagoKat on October 4, 2012, at 20:28:31
In reply to Re: Miratzapine vs atypicals in neurotic disorders, posted by JONO_IN_ADELAIDE on October 4, 2012, at 19:56:50
> I'm being indicisive and procrastinating about the mirtazapine....... I know i should probably try it, but I'm paranoid about getting even fatter (my BMI is 29)
>
> Ugh, why cant there be one pill that you take every morning, with no side effects, that makes everything ok (like prozac was going to be :))Prozac was that for me, for many years....it made me a different person, a confident, vibrant, active, happy person. But that was decades ago. Now it does squat for me.
And I always wonder, why do side effects always have to be bad...why can't they give us whiter teeth, or glossier hair or something? :)
Kat
Posted by jono_in_adelaide on October 5, 2012, at 1:23:51
In reply to Re: Miratzapine vs atypicals in neurotic disorders » JONO_IN_ADELAIDE, posted by ChicagoKat on October 4, 2012, at 20:28:31
"And I always wonder, why do side effects always have to be bad...why can't they give us whiter teeth, or glossier hair or something? :)
Kat"Well, actualy, there is one example...... they quickly found thatt he SSRI's caused sexual side effects including delayed orgasm in men..... an enterprising drug company developed a short acting SSRI with a 2 hour half life, and is now marketing it as a treatment for men with premature ejeculation...... if you're a normal guy, the side effect is bad, but if you're a 60 second wonder, it could be very welcome!
Posted by ChicagoKat on October 5, 2012, at 7:32:44
In reply to Positive side effects, posted by jono_in_adelaide on October 5, 2012, at 1:23:51
> "And I always wonder, why do side effects always have to be bad...why can't they give us whiter teeth, or glossier hair or something? :)
> Kat"
>
> Well, actualy, there is one example...... they quickly found thatt he SSRI's caused sexual side effects including delayed orgasm in men..... an enterprising drug company developed a short acting SSRI with a 2 hour half life, and is now marketing it as a treatment for men with premature ejeculation...... if you're a normal guy, the side effect is bad, but if you're a 60 second wonder, it could be very welcome!Thanks so for that info Jono, you are always a fount of useful information. I''m so glad I read this post first thing in the AM ;)
Posted by phidippus on October 5, 2012, at 16:25:01
In reply to Miratzapine vs atypicals in neurotic disorders, posted by jono_in_adelaide on October 3, 2012, at 18:00:54
It doesn't address dopaminergic concerns.
Eric
This is the end of the thread.
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