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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 DBT is hard. on June 3, 2014, at 22:13:18
I don't know what to do. My depression/anxiety is really bad right now. I just did a Parnate washout. My doctor prescribed both Prozac (20 mg) and Remeron (15 mg).
I want relief as fast as possible, so that tells me to start both at the same time right away, as prescribed.
But part of me wants to know if one will work on its own and how will I ever know if I start both at the same time. I don't want to take more drugs than necessary.
That being said, I've tried every class of drug out there over the past 23 years, including a couple of MAOIs. I also failed a course of 19 ECT treatments. Clearly treatment resistant. My anxiety is through the roof and the 5 mg of Klonopin a day that I take doesn't seem to do anything.
Since these two drugs take a while to work, and I need the best chance of relief as possible, should I just start them both at the same time, or should I try and bear just starting with one of them and waiting to see if it works before adding the second drug. Does my situation/question make sense? If someone feels really strongly that it's best to just start with one, which one would you start with?
Thank you.
Posted by Christ_empowered on June 4, 2014, at 10:23:41
In reply to Prozac and Remeron - start both at same time?, posted by DBT is hard. on June 3, 2014, at 22:13:18
Remeron is/was more popular in Europe. For whatever reason, Euro shrinks use higher doses (sometimes 60+ mgs/day). Now, to your situation...
...remeron doesn't work like other ad drugs, so it can be added as a booster. There's limited research. I was considering remeron, so I looked it up. SSRI+remeron=better results than either alone. Same for remeron+wellbutrin, remeron+effexor, and remeron+cymbalta.
I'd take both. I'd personally think about asking about a dosage bump in the remeron to 30 or so, to reduce the risk of heavy sedation and weight gain, but...I'm not you. I'm not a doc, either.
Good luck!
Posted by Phillipa on June 4, 2014, at 15:28:14
In reply to Prozac and Remeron - start both at same time?, posted by DBT is hard. on June 3, 2014, at 22:13:18
I know 15mg of remeron did nothing for sleep for me. But either did it cause weight gain. If you can handle the anxiety well I had it anyway of prozac. It seems to be an energizing med to me. Phillipa
Posted by Lamdage22 on June 6, 2014, at 8:11:29
In reply to Re: Prozac and Remeron - start both at same time?, posted by Christ_empowered on June 4, 2014, at 10:23:41
Too much at once!
Posted by tom2228 on June 6, 2014, at 9:10:05
In reply to Prozac and Remeron - start both at same time?, posted by DBT is hard. on June 3, 2014, at 22:13:18
> I don't know what to do. My depression/anxiety is really bad right now. I just did a Parnate washout. My doctor prescribed both Prozac (20 mg) and Remeron (15 mg).
> I want relief as fast as possible, so that tells me to start both at the same time right away, as prescribed.
> But part of me wants to know if one will work on its own and how will I ever know if I start both at the same time. I don't want to take more drugs than necessary.
> That being said, I've tried every class of drug out there over the past 23 years, including a couple of MAOIs. I also failed a course of 19 ECT treatments. Clearly treatment resistant. My anxiety is through the roof and the 5 mg of Klonopin a day that I take doesn't seem to do anything.
> Since these two drugs take a while to work, and I need the best chance of relief as possible, should I just start them both at the same time, or should I try and bear just starting with one of them and waiting to see if it works before adding the second drug. Does my situation/question make sense? If someone feels really strongly that it's best to just start with one, which one would you start with?
> Thank you.I encourage you to follow through with both medications. Not only combination of Remeron and an SSRI/SNRI has been found to be more effective than either agent alone, but the combination has also found to be more tolerable -- fewer side-effects -- than being on either alone. So trying either by itself may lead to a premature negative idea of what it would be like to take both together.
Without knowing you, I feel like this is an example of why you are treatment-resistant. You are literally resisting a treatment that has been prescribed to you based on your medical needs and desire to feel better. I conjecture that part of resistance to meds is resistance to feeling better and accepting the help much needed.
Once you experience the relief, you won't care as much about the finite details because you will have found something that's finally doing the job -- and why tear it apart at that point? You will have achieved your goal of feeling better -- that is the point.
Good luck,
Tom
Posted by phidippus on June 7, 2014, at 13:18:29
In reply to Prozac and Remeron - start both at same time?, posted by DBT is hard. on June 3, 2014, at 22:13:18
I would start with one in case you get side effects you'll know which medication is the culprit. Starting two medications at once can make things unclear, as you don't knowwhich medication is doing what.
It doesn't really matter whichmedication you start first but studies show Remeron is probably the stronger of the two medications.
Eric
Posted by herpills on June 8, 2014, at 18:22:00
In reply to Prozac and Remeron - start both at same time?, posted by DBT is hard. on June 3, 2014, at 22:13:18
I would go with the doctor's suggestion and start both. As you've said, you're looking for fast relief. Remeron starts working much faster than Prozac. herpills
Posted by Lamdage22 on June 11, 2014, at 12:13:52
In reply to Re: Prozac and Remeron - start both at same time? » DBT is hard., posted by herpills on June 8, 2014, at 18:22:00
> I would go with the doctor's suggestion and start both. As you've said, you're looking for fast relief. Remeron starts working much faster than Prozac. herpills
I can second that. Remeron is fast.
This is the end of the thread.
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