Psycho-Babble Medication Thread 16165

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Re: Remeron

Posted by S. Suggs on December 3, 1999, at 18:33:16

In reply to Remeron, posted by Trish on December 3, 1999, at 17:42:21

Trish,

Remeron is a fairly potent ad and it may do the trick. What are your main symptoms? What are some of the ad's you have taken in the past 4 years with results / side effects? It is really frustrating, I can remember sitting on the floor and crying my eyes out (on more than one occasion over many years), not knowing what was wrong with me. Please stick with it, most people never hit the right ad on the first or second try. This forum is full of people who CAN RELATE WITH YOU. Please keep posting the questions since we will do all we can to help.

Blessings,

S. Suggs

 

Re: Remeron

Posted by JohnL on December 4, 1999, at 4:23:00

In reply to Remeron, posted by Trish on December 3, 1999, at 17:42:21

> My Dr. wants me to try remeron 30 mg a day. I have been on several ad in four years. I have never felt so down as I do today. I couldn't stop crying in the dr's office today. Has anyone has any experience with this drug? Did it work? Side effects? I feel so alone.

Hi Trish, sorry you're feeling so bad right now. But Remeron might help fairly quickly. I've used it for a long time in doses ranging from 7.5mg to 60mg, so I'm a little familiar with it.

In clinical studies where Remeron was compared to Paxil and Prozac in head to head double blind trials, Remeron was generally "faster acting" and stronger than both Paxil and Prozac. You might possibly feel it work as soon as the first week. Primary side effects are sedation and weight gain. The weight gain goes away after 2 or 3 months of use with many people. I only gained about 3 pounds. The sedation will give you good sleep, with a mild hangover sort-of feeling upon waking that goes away with the first coffee. If you are overly sedated on your first dose, don't worry, it will lessen in a few weeks. Personally I think 30mg is a lot to handle all at once. Even 15mg will seem like a lot at first. Without getting used to it first, 30mg might be a bit much to start with. The theory is that there is less sedation at higher doses, but I have yet to hear direct experience from anyone that could verify that. Didn't happen with me.

Overall Remeron is a fine antidepressent. Just don't let its sedating side effects scare you. Take it an hour to three before bedtime.(the earlier the better so it doesn't carry over into the next day) Daytime sedation is rare after a few weeks of getting used to it. I think Remeron is probably good in all despressive subtypes, especially those with some anxiety and insomnia, but not so helpful in those with melancholic traits...like me. But due to its track record of working rather quickly, it should help you out of that miserable mood in no time. Cheering for ya. JohnL

 

Re: Remeron

Posted by Trish on December 5, 1999, at 23:18:37

In reply to Remeron, posted by Trish on December 3, 1999, at 17:42:21

> My Dr. wants me to try remeron 30 mg a day. I have been on several ad in four years. I have never felt so down as I do today. I couldn't stop crying in the dr's office today. Has anyone has any experience with this drug? Did it work? Side effects? I feel so alone.


Thanks for the responses. I have been on it for two days and I feel like a zombie. Isn't there something out there that can counteract the sleepy effect. I am so out of it. I hate the feeling but I hate this depression even more. Any suggestions?

 

Re: Remeron

Posted by JohnL on December 6, 1999, at 3:16:51

In reply to Re: Remeron, posted by Trish on December 5, 1999, at 23:18:37

> > My Dr. wants me to try remeron 30 mg a day. I have been on several ad in four years. I have never felt so down as I do today. I couldn't stop crying in the dr's office today. Has anyone has any experience with this drug? Did it work? Side effects? I feel so alone.
>
>
> Thanks for the responses. I have been on it for two days and I feel like a zombie. Isn't there something out there that can counteract the sleepy effect. I am so out of it. I hate the feeling but I hate this depression even more. Any suggestions?

Trish, the daytime zombiness will subside in a couple weeks. For me it never went away completely at doses of 22.5mg or more, but it does lessen. Did you start at 30mg? If so, that was a pretty hefty dose to me. I don't think I could have started with any more than 15mg. Wellbutrin is commonly used with Remeron to counteract the effects. Sometimes psychostimulants too. Just keep in mind though that if Remeron is going to work for you, you should start feeling better than you do now in a week or so. Remeron is generally quicker acting than most other ADs, so relief may be right around the corner. Hang in there. JohnL

 

Re: Remeron

Posted by Kev on December 6, 1999, at 12:01:34

In reply to Re: Remeron, posted by JohnL on December 6, 1999, at 3:16:51

Hi everybody,

Have any of the folks that are taking, or have taken, Remeron have any anecdotes or comments about its effects on anxiety, cognition, and memory? I am about to switch meds after having been on Effexor since last May for anxiety and depression (with marked difficulties in concentration and memory). While Effexor proved to be very efficacious in blocking acute, heart-pounding anxiety (something like the fight-or-flight response), it seems to be useless for chronic, low-level anxiety, for ameliorating concentration and memory problems, and for re-energizing me. I am extremely interested in Remeron as it works on 2 mechanisms theoretically implicated in anxiety, but I find reports of what has been described in this thread as a "zombie-like" sedative effect very disconcerting. Comments?

Later,

-Kev

 

Re: Remeron

Posted by allison on December 6, 1999, at 12:07:56

In reply to Re: Remeron, posted by Kev on December 6, 1999, at 12:01:34

I've been on Remeron for almost 2 years as high as 45mg. At 30 now. It was sedating at first, then that effect went away. As JohnL said earlier, one has to take it not too late at night or there will be a slight fog in the morning that goes away with coffee.

As for memory, I don't think it's affected mine adversely. This depression kept me from concentrating. I'm surprised I got anything done. Remeron has helped my concentration, and I find my memory works better when I can concentrate.

Good luck to you.

 

Re: Remeron

Posted by Adam on December 6, 1999, at 12:52:23

In reply to Remeron, posted by Trish on December 3, 1999, at 17:42:21

Trish,

Is depression your only concern? Is anxiety also a problem for you? Do you suffer
from a comorbid anxiety disorder, like OCD, social phobia, panic disorder?

Remeron indirectly stimulates the release of serotonin. It also is an antagonist
of some serotonin receptors (specifically 5-HT2 and 5-HT3 receptors). This is great
for preventing sexual side effects, but, as I am learning, may be worrisome for some
specific anxiety disorders, like OCD.

I took Remeron for about three months, at as high as 45mg/day. I found it extremely
sedating, and of no help for obsessions. However, after tapering off Remeron, I
experienced a slight worsening of depression, which would put it, for me, in a rare
class: An antidepressant that actually did some antidepressing, however modest.

I've heard for some the somnolence goes away. For me it got better (when I started it
I couldn't even see straight), but I never got rid of the dopeyness completely. I
slept like I have never slept before, and actually experienced some strange effects
in regards to sleep, such as a little somnambulance (sleepwalking), and fantastically
vivid dreams that sometimes didn't wait for me to get completely asleep to begin.

Speak to your doctor about possible ways to counteract Remeron's antihistminergic
properties, if any such antidotes exist. This might help not only with somnolence,
but also with weight gain that is a common side effect of Remeron use.

> My Dr. wants me to try remeron 30 mg a day. I have been on several ad in four years. I have never felt so down as I do today. I couldn't stop crying in the dr's office today. Has anyone has any experience with this drug? Did it work? Side effects? I feel so alone.

 

Re: Remeron

Posted by torchgrl on December 6, 1999, at 15:06:34

In reply to Re: Remeron, posted by Adam on December 6, 1999, at 12:52:23

My experience with remeron was short, and all I remember is being nearly comatose after I took it and a zombie the rest of the time, and gaining about 10 pounds in as many days. That said, I've read so many posts about how it's helped people tremendously, so obviously there's potential there. They've found that the sedation decreases as the dose INCREASES, so you might talk to your doctor about upping the dose a bit and see what happens. I found the increase in dose to help somewhat, but not enough for me to keep going with it.

 

Re: Remeron

Posted by june on April 26, 2000, at 17:02:00

In reply to Re: Remeron, posted by torchgrl on December 6, 1999, at 15:06:34

>I would like to see more comments, personal expericences concerning weight gain. I have read just about everything I can find. Does the increased appetite usually go away after a period of time. Is "increased apetite" what causes the weight gain, or is it the drug itself. Is dieting less effective when taking Remeron? I need to lose about 30 lbs. Have taken Prozac about 3 yrs. prior to switching..reason for switching..the Prozac didn't seem to be working anymore. My symptoms are more like the "melancholy" sort that I have seen described, with feelings of hopelessness and guilt..not panic disorder at all. I am most definitely concerned about the weight gain symptom. Please help.

 

Re: Remeron/Adam, question??

Posted by Zannah on April 27, 2000, at 17:09:33

In reply to Re: Remeron, posted by Adam on December 6, 1999, at 12:52:23


Adam,
You mentioned the word 'antihistaminergic' (I think) when discussing Remeron (last Dec). What does this mean? Is it another way of saying sedating, in the way that antihistamines sometimes are?
I began Remeron 1 week ago. Took 7.5 for 2 days, then 15mgs. nightly for the next 4 (as I will do again tonight).
So far, I have not found it to be sedating, but I am pretty wound up right now, due to financial strains, and I am in the middle of moving-YUK.
And, did u mention that Remeron is known for being a pretty quick acting drug? Boy, wouldn't that be a blessing?
So far, I have noticed no difference in my mind-set/attitude. Hope something kicks in soon. I have samples to last 2 more weeks at 15 mgs. a day.We shall see...Thanks~Zannah

 

ZANNAH! ,Re: Remeron/Adam, question??

Posted by Adam on May 8, 2000, at 19:02:43

In reply to Re: Remeron/Adam, question??, posted by Zannah on April 27, 2000, at 17:09:33

Dear Zannah,

I'm sorry I missed your post. I came across it searching for
another old thread, and thus just realised that I missed it.
My apologies.

Anyway, to answer your question (I hope it's not too late), by
"histaminergic" (I must confess I don't remember what post this
was) I must have meant that Remeron is, in addition to its
other effects (5-HT2 & 3 antagonist, alpha-adrenergic receptor
agonist), has antihistamine properties. So, like other
antihistamines, it causes things like sedation, a mild anxiolytic
effect, and weight gain. It has been proposed that a "benefit"
of Remeron is this sedating/anxiolytic property, which, in a
nutshell, should help nervous patients sleep, and is realised
almost immediately.

I certainly can't argue with that logic, as Remeron does indeed
deliver those effects. However, at least for some, "sedation" is
seemingly a euphamism for "severe hypersomnolence". I found
this side effect more of a nuisance than anything. I will admit
there was one really cool, related side-effect: Incredibly vivid
dreams. I call Remeron "the dream pill" in the most literal sense.
It didn't help me greatly with depression, but I had simply
amazing dreams while on it, pretty much every night.

>
> Adam,
> You mentioned the word 'antihistaminergic' (I think) when discussing Remeron (last Dec). What does this mean? Is it another way of saying sedating, in the way that antihistamines sometimes are?
> I began Remeron 1 week ago. Took 7.5 for 2 days, then 15mgs. nightly for the next 4 (as I will do again tonight).
> So far, I have not found it to be sedating, but I am pretty wound up right now, due to financial strains, and I am in the middle of moving-YUK.
> And, did u mention that Remeron is known for being a pretty quick acting drug? Boy, wouldn't that be a blessing?
> So far, I have noticed no difference in my mind-set/attitude. Hope something kicks in soon. I have samples to last 2 more weeks at 15 mgs. a day.We shall see...Thanks~Zannah

 

Re: ZANNAH! ,Re: Remeron/Adam, question??

Posted by stjames on May 9, 2000, at 12:54:06

In reply to ZANNAH! ,Re: Remeron/Adam, question??, posted by Adam on May 8, 2000, at 19:02:43


> Anyway, to answer your question (I hope it's not too late), by
> "histaminergic" (I must confess I don't remember what post this
> was) I must have meant that Remeron is, in addition to its
> other effects

James here....

I've taken Remeron for some time and I don't think it works as an antihistamine. I taken allergy tests while on Remeron and I got a good responce to the control, histamine, when it was ingected under the skin.

james

 

re: stjames

Posted by Adam on May 9, 2000, at 14:50:49

In reply to Re: ZANNAH! ,Re: Remeron/Adam, question??, posted by stjames on May 9, 2000, at 12:54:06


This is just a random link I got off of hotbot:

http://pharminfo.com/pubs/msb/mirta.html

The relevant text...

Mirtazapine (Remeron/Akzo
Nobel, Organon) is a long-acting tetracyclic compound unrelated to the tricyclic antidepressants. It is a potent antagonist of central pre- and post-synaptic alpha2-adrenergic
receptors and also serotonin (5-HT2 and 5-HT3) and histamine (H1) receptors, and has a moderate effect on peripheral alpha1 adrenergic receptors. Antagonizing histamine
receptors explains its prominent sedative effect, and antagonizing peripheral adrenergic receptors explains its tendency to cause orthostatic hypotension.

I DID however, make a mistake above. Mirtazapine is not an alpha agonist, but an alpha antagonist. I keep getting that one mixed up for
some reason.


>
> > Anyway, to answer your question (I hope it's not too late), by
> > "histaminergic" (I must confess I don't remember what post this
> > was) I must have meant that Remeron is, in addition to its
> > other effects
>
> James here....
>
> I've taken Remeron for some time and I don't think it works as an antihistamine. I taken allergy tests while on Remeron and I got a good responce to the control, histamine, when it was ingected under the skin.
>
> james

 

Re: re: stjames

Posted by stjames on May 9, 2000, at 15:18:11

In reply to re: stjames, posted by Adam on May 9, 2000, at 14:50:49

>
> This is just a random link I got off of hotbot:
>


James here....

I read another monograph after I posted this and Remeron is indeed an antihistamine. Perhaps because i take a low dose, 15 mgs, it has little effect as when I was injected with histamine I had a good response.

james

 

Re:Remeron--Question

Posted by tina on May 11, 2000, at 21:34:02

In reply to Re: re: stjames, posted by stjames on May 9, 2000, at 15:18:11

I have more anxiety than I do depression. I think my depression is caused by the panic disorder cuz I can't go anywhere, do anything without the fear of having a panic attack. I do admit to depression but Remeron sounds like just the right thing for me. What do y'all think??? Need input--Thanks Tina> >
> > This is just a random link I got off of hotbot:
> >
>
>
> James here....
>
> I read another monograph after I posted this and Remeron is indeed an antihistamine. Perhaps because i take a low dose, 15 mgs, it has little effect as when I was injected with histamine I had a good response.
>
> james

 

Re:Remeron--Question, tina

Posted by Adam on May 14, 2000, at 18:16:42

In reply to Re:Remeron--Question, posted by tina on May 11, 2000, at 21:34:02

I'm not sure, but I think that Remeron has yet to be tested rigorously for anxiety. It might not hurt to try it, but you may either want to consider a safe augmentation strategy that more directly addressed your concerns with anxiety, or just look elsewhere.

It seems for many anxiety disorders, SSRIs are among the first-line treatments of choice, and venlafaxine may prove to be about as effective for the same spectrum of disorders.

Remeron does have the benefit of little or no sexual side-effects, which I think may be its most significant selling point. It might be possible to combine its use with an anxiolytic like buspirone or a benzodiazepine, though I think the combined sedating effect of Remeron and a benzo. might be too much.

The combination of Remeron and buspirone could be an interesting one. Buspar is thought to exert its anxiolytic effect by acting as a potent 5-HT1a receptor agonst. Mirtazapine (Remeron), meanwhile, is a 5-HT2 and 5-HT3 antagonist, and acts on the 5-HT1a receptor indirectly by a) not interfering with it, and b) increasing the secretion of serotonin, which then acts as the natural 5-HT1a agonist. In theory, the two should synergize nicely. In practice, who knows?

I'm not certain what the status of buspirone is as a treatment for, say, social anxiety. My feeling is, based on what I have seen in the literature, and what I have read here, that it is not a good first-line, or even second-line choice for this indication. I imagine benzos, SSRIs, and then phenelzine, more or less in that order, are the primary treatments. But as with everything in psychopharm., your miliage may vary greatly.

Talk to your doctor about it.

Best of luck!

> I have more anxiety than I do depression. I think my depression is caused by the panic disorder cuz I can't go anywhere, do anything without the fear of having a panic attack. I do admit to depression but Remeron sounds like just the right thing for me. What do y'all think??? Need input--Thanks Tina> >
> > > This is just a random link I got off of hotbot:
> > >
> >
> >
> > James here....
> >
> > I read another monograph after I posted this and Remeron is indeed an antihistamine. Perhaps because i take a low dose, 15 mgs, it has little effect as when I was injected with histamine I had a good response.
> >
> > james

 

Re:Remeron--Question, tina

Posted by juniper on May 15, 2000, at 22:33:02

In reply to Re:Remeron--Question, tina, posted by Adam on May 14, 2000, at 18:16:42

my mother began taking remeron as she has never been able to sleep well. remeron is the only medication that has worked for her without horrible drowziness. however, she has begun to gain weight though she believes that her diet and exercise have remained the same. she has always been thin, but is now 50 and going through menopause and she contributes these factors to her recent weight gain. the question here is whether remeron, or any medication for that matter, causes weight gain through some internal mechanism such as a slighting of metabolism, or does weight gain occur simply because those on remeron have an increased appetite and ingest more calories? could my mother be be taking in and exerting the same amount of calories as before (forgetting about the aging and menopause for the sake of example), yet be gaining weight simply because she is taking remeron?

advance thank-you's......juniper

 

Re:Remeron--Question, tina

Posted by SLS on May 16, 2000, at 7:17:01

In reply to Re:Remeron--Question, tina, posted by juniper on May 15, 2000, at 22:33:02

> my mother began taking remeron as she has never been able to sleep well. remeron is the only medication that has worked for her without horrible drowziness. however, she has begun to gain weight though she believes that her diet and exercise have remained the same. she has always been thin, but is now 50 and going through menopause and she contributes these factors to her recent weight gain. the question here is whether remeron, or any medication for that matter, causes weight gain through some internal mechanism such as a slighting of metabolism, or does weight gain occur simply because those on remeron have an increased appetite and ingest more calories? could my mother be be taking in and exerting the same amount of calories as before (forgetting about the aging and menopause for the sake of example), yet be gaining weight simply because she is taking remeron?
>
> advance thank-you's......juniper

-----------------------------------------


Hi Juniper,


Weight gain is one of the most common complaints of people who take Remeron. Remeron produces this weight gain in two ways:

1. It increases appetite, leading to the consumption of more calories.

2. It produces changes in metabolism through the blockade of histamine receptors (H1).


Even if your mother were to successfully limit her intake of calories, she might still gain weight.


- Scott

 

Weight Gain and AD's

Posted by Aylese on May 16, 2000, at 10:16:10

In reply to Re:Remeron--Question, tina, posted by SLS on May 16, 2000, at 7:17:01

AD's do indeed slow metabolism and often stimulate appetite. That is what sometimes makes them a valuable medication for Anorexics. I had a young anorexic friend who also suffered extreme anxiety and panic. Paxil was the drug she was given and she began gaining weight. Her panic and anxiety were well controlled and she looked much better but she then couldn't stand the weight gain and quit the medication. Now she is back to her own shaking, quaking self and losing the weight. The anorexia won.

Aylese

 

Re: Weight Gain and AD's

Posted by tina on May 16, 2000, at 10:36:25

In reply to Weight Gain and AD's, posted by Aylese on May 16, 2000, at 10:16:10

> AD's do indeed slow metabolism and often stimulate appetite. That is what sometimes makes them a valuable medication for Anorexics. I had a young anorexic friend who also suffered extreme anxiety and panic. Paxil was the drug she was given and she began gaining weight. Her panic and anxiety were well controlled and she looked much better but she then couldn't stand the weight gain and quit the medication. Now she is back to her own shaking, quaking self and losing the weight. The anorexia won.
>
> Aylese
**************************************************
I am so sorry for your friend's experience. I knew a few girls at my old job that were anorexic and it's a powerful disease. Sometimes depression is more powerful but sometimes it isn't. Your friend must be going through hell and you right along with her. Do you find it difficult to be with him/her when you are having your own troubles? I only ask because being with these girls at work always made me more depressed because I wanted to help them but knew I couldn't and it seemed to make them and me feel uncomfortable. Well, I wish you strength and courage and I wish your friend hope and love. Take care of yourself.

 

To Tina: Dealing with Anorexic Friend

Posted by Aylese on May 16, 2000, at 18:15:23

In reply to Re: Weight Gain and AD's, posted by tina on May 16, 2000, at 10:36:25

Tina,
Yes it was extremely difficult trying to help her. I supported her all that I could when she was willing to try to help herself. (I am old enough to be her mother and her own mother is extremely unhelpful to her.) When she was seeing her psychiatrist (OUR psychiatrist) and taking her meds there was so much improvement. Then she went off and became so very needy that she was sucking the life out of me. She would call and cry at all hours of the day and night. Finally I had to tell her I would be there for her if she would go back into therapy. She chose not to. I haven't heard from her since and worry about her and think of calling her, but put that out of my mind because there is no helping her until she is ready. I am trying hard to work on my own depression and must resist pulling myself down unnecessarily.

Happy trails to you!
Aylese

 

anorexia experiences

Posted by juniper on May 16, 2000, at 23:08:37

In reply to To Tina: Dealing with Anorexic Friend, posted by Aylese on May 16, 2000, at 18:15:23


Funny that this thread should spiral into the topic of anorexia...i became anorexic around the age of 13, and was strictly so until around 18. my weight at its lowest was a bit under 70 pounds (i am 5'5"). from anorexia i graduated (?) to bulimia and then to binge eating, becoming what outwardly looked to be a healthy weight, especially since i tend to be quite muscular. i still binge, but not nearly as much as i used to, and it is not the distressing occurance it used to be when i felt completely out of control. my binging all but stops now when i am in a positive environment, which happened to be the case for me during the last 2 months as i was traveling and having wonderful experiences in central america. coming home, i realize now i lost almost 15 pounds...through not binging and just the business of traveling.
this has placed me in a curious position....i would not be considered too thin now, and i believe that i like the way my new weight looks on me, but it is discomforting to look in the mirror and see my face and body closer to what i had looked like when anorexic. i have no inklings that i may once again fall into this, but it is an odd position to be in, where the very feel of my body as i take a bath (for instance) reminds me slightly of how it felt to bathe when i was so thin----bathtubs and bones don't work well together. of course the feeling runs deeper than physical, and i am also detatchedly remembering the self anger, hatred, and depression that so characterized me then. i do not feel to be falling back into it, but the situation leaves me pensive and introspective.
since i was anorexic, which most people in my life know, as it was painfully obvious for many years (most do not know of the bulimia or binge eating as this is easier to hide), i am often asked what should be done about friends or daughters or sisters who are anorexic. i hate that i cannot give any sort of coherant answer. however, i do remember fighting so hard to remain in control, especially not to be committed to the hospital, but also secretly longing for someone to come along and stand up to my paper thin facade, to just tell me that i was not going to call the shots anymore, remove all choice from the matter, and take over. ideally this would have been what my parents did, or what any anorexic's parents would do, but my parents hadn't the faintest idea what was happening and they were scared.
aylese----in my opinion you sound like you are doing the best thing for both yourself and your friend. while persistance and empathy can be wonderful, they can also make you an enabler. bravo on taking care of yourself and trying to get your friend back into therapy. good luck to you both.

juniper


 

Re: Remeron

Posted by Margaret D. on April 6, 2001, at 20:08:53

In reply to Re: Remeron, posted by allison on December 6, 1999, at 12:07:56

I have been taking Remeron for over three years, 60mg for over two. It has turned my life around. It was sedating at first but is much better. I do take it around two hours before I go to bed, it definitely makes me sleepy, but without it I don't sleep. I gained a lot of weight, but I don't want to kill myself anymore. As I told my psydr. yesterday, I rather be fat and happy then thin and have the life I had before. Being heavy is much better then spending the rest of my life in a psyh ward.

 

Re: Remeron Margaret D.

Posted by lois on April 7, 2001, at 12:04:00

In reply to Re: Remeron, posted by Margaret D. on April 6, 2001, at 20:08:53

Margaret,
Have you noticed an increase in the wt. gain problem at higher doses of remeron or the *same* amount of wt. gain problem? I need more for sleep so am increasing it from 30 to 45mgs and already feel more rested, but no increase in the wt. problem yet.We're all different.Just wondering about your experience? Thx.
Lois

 

Re: Remeron

Posted by Margaret D. on April 8, 2001, at 19:22:24

In reply to Re: Remeron Margaret D., posted by lois on April 7, 2001, at 12:04:00

Lois -
The weight has been the same since the original weight gain. Well worth the great sleep and my sanity!!!


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