Psycho-Babble Medication Thread 16165

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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!!!

 

Re: Remeron

Posted by Bob on April 14, 2001, at 12:11:44

In reply to Re: Remeron, posted by Margaret D. on April 8, 2001, at 19:22:24

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

> > > > > > > > > > > > > > > > > > > > > > > > > >


Does anybody have anything comments on Remeron withdrawl experiences? I took Effexor for over a year, and that withdrawl was something I will, of course, never forget. There is always dicussions of Effexor withdrawl on this board as a matter of fact, but I have really noticed it for Remeron. I would have thought Remeron would have withdrawl problems though being that it has norepinephrine components to it. Also, does Remeron act on domapamine at all? Lastly, what kind of average percentage body weights increases are people stabilizing at after being on a stable dose for an extended period of time. E.g., 20% increase in body weight after taking stable therapeutic dose for a minimum of 1yr?

Has anybody experience increased energy and drive on Remeron at all? What about loss of goal-driven behavior and onset of general malaise and apathy after being on the medecine for longer periods, such as 6 months to a year?

Bob

Bob

 

Re: Remeron

Posted by SalArmy4me on April 15, 2001, at 1:45:47

In reply to Re: Remeron, posted by Bob on April 14, 2001, at 12:11:44

I highly doubt that any intermediate to severe withdrawal problems will occur after discontinuing Remeron...

These antidepressants regularly poop-out in an unknown manner called "tachyphlaxis"--no one knows why. But its best to get back on a different and decent antidepressant with a psychiatrist's guidance before your life is ruined by the relapse of depression...

 

Re: Remeron

Posted by JohnL on April 15, 2001, at 4:19:17

In reply to Re: Remeron, posted by Bob on April 14, 2001, at 12:11:44

> > Lois -
> > The weight has been the same since the original weight gain. Well worth the great sleep and my sanity!!!
>
> > > > > > > > > > > > > > > > > > > > > > > > > > >
>
>
> Does anybody have anything comments on Remeron withdrawl experiences? I took Effexor for over a year, and that withdrawl was something I will, of course, never forget. There is always dicussions of Effexor withdrawl on this board as a matter of fact, but I have really noticed it for Remeron. I would have thought Remeron would have withdrawl problems though being that it has norepinephrine components to it. Also, does Remeron act on domapamine at all? Lastly, what kind of average percentage body weights increases are people stabilizing at after being on a stable dose for an extended period of time. E.g., 20% increase in body weight after taking stable therapeutic dose for a minimum of 1yr?
>
> Has anybody experience increased energy and drive on Remeron at all? What about loss of goal-driven behavior and onset of general malaise and apathy after being on the medecine for longer periods, such as 6 months to a year?
>
> Bob
>
> Bob

Hi Bob,
I was on Remeron for almost two years. I can share my comments with you.

My withdrawals were mild and consisted of heartburn, lack of appetite, and difficulty falling asleep. The gut symptoms cleared up in three days. Another sedating med (Zyprexa) provided much better sleep than Remeron ever did.

If Remeron has any effect on dopamine at all, it is probably indirect and very slight.

I did not gain weight on Remeron.

I did not experience increased drive or energy with Remeron. Those were the primary symptoms I was trying to fix. Remeron didn't do the trick. It didn't make me numb and apathetic like SSRIs did, but still it did nothing for motivation, for me.

I have found the combination of Prozac+Zyprexa+Adrafinil to be miraculous.
John

 

Re: Remeron

Posted by jbisch on May 25, 2001, at 11:33:02

In reply to Re: Remeron, posted by JohnL on April 15, 2001, at 4:19:17

For 18 months a 15 mg dose of Remeron has successfully alleviated my general anxiety/depression. Rather suddenly during the past month, the effectiveness has worn off. I have increased the dose to 45 mg to regain control, but I fear this control is only temporary, and that the increased dose will also be ineffective after a shortwhile. Has anyone had a similar experience with Remeron? I am rather worried because I have tried all the SSRI's, Effexor, and Serzone without relief, and Remeron seemed to be the only remedy.

Jbisch

 

Re: Remeron

Posted by Josh23 on June 21, 2001, at 20:29:49

In reply to anorexia experiences, posted by juniper on May 16, 2000, at 23:08:37

> I started taking this drug after some very unsuccessful attempts at Celexa, Zoloft and Prozac. After my first dose (15 mg) I felt like my brain had been dipped in ether. I went into a very dark place, began to feel much lower than I had before, and could barely put two thoughts together. I cut the dosage in half the next night. This reduced the sedating side effects signifcantly. I stuck with it for the next week at 7 1/2 mg, and soon the sedation went away. I'm back up to 15 mg now, in my second week and I feel pretty good. I'm certainly sleeping better and my concentration has improved a great deal.
I also don't feel depressed for the first time in a long while. I know that's pretty remarkable for just a week and a half of medication - but I'm told the drug does act more quickly than many SSRI's.


 

Re: Remeron

Posted by Bex on June 17, 2003, at 11:23:49

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

I was on 30mg for nearly two weeks, but I've had to stop taking it as of last night, as it's suspected it's giving me a reduced white blood cell count, hence the sore throat & mouth ulcers. This is apparently one of the rarer side effects though. Apart from that, I obviously didn't notice much of a change in mood in such a short space of time, but I did sleep better than I have for ages... having had pretty bad insomnia for many years up until I started taking it!

I have heard others say that it worked very well for them, though, for many months xx

 

Re: Remeron

Posted by SandyWeb on December 22, 2003, at 15:02:25

In reply to Re: Remeron, posted by Bex on June 17, 2003, at 11:23:49

I am on Day 5 with Remeron, 30mg at night. I do not find it to be too sedating. I have insomnia where I wake up many times during the course of the night. Remeron helps me to wake up less often.

I am finding Remeron to be a very gentle med. I am so glad that I tried it. I do believe that it does help to keep me calmer.

 

Re: Remeron » SandyWeb

Posted by Flipsactown on December 23, 2003, at 12:06:31

In reply to Re: Remeron, posted by SandyWeb on December 22, 2003, at 15:02:25

Hello,

I have been taking remeron for 3 months and have had positive results in decreasing my depression. However, 2 weeks ago, when I had it refilled, they gave me the generic version. I thought nothing of it until my depression started coming back this week. I have a call in to my pdoc to see if maybe the generic version is not as effective as the brand remeron. Are you on brand or generic? Thanks.

Flipsactown


> I am on Day 5 with Remeron, 30mg at night. I do not find it to be too sedating. I have insomnia where I wake up many times during the course of the night. Remeron helps me to wake up less often.
>
> I am finding Remeron to be a very gentle med. I am so glad that I tried it. I do believe that it does help to keep me calmer.

 

Re: Remeron

Posted by SandyWeb on December 23, 2003, at 16:09:56

In reply to Re: Remeron » SandyWeb, posted by Flipsactown on December 23, 2003, at 12:06:31

Yes, I am taking the Brand name of Remeron and not the generic. I've heard stories of people not having the best results from the generic versions. It's such a shame that dollars determine the degree of our well-being.

By the way, I'm on Remeron for anxiety and not depression. Once I get over the initial fog-brain, I think this will be a wonderful med!!! I am so pleased that I finally got my doc to prescribe it for me. She refused to because she says it makes people "profoundly tired".....but that has not been the case for me. In fact, I still have some difficulty with sleeping. But I do believe that I feel a little calmer already, and I haven't even been on it a week yet.

 

Re: Remeron » SandyWeb

Posted by Flipsactown on December 23, 2003, at 22:18:19

In reply to Re: Remeron, posted by SandyWeb on December 23, 2003, at 16:09:56

Have you noticed an increase in appetite? I have gained at least 15 lbs over a 3 month period. I take it for unipolar depression and also take prozac and lamictal with it. I have been on ADs for over 12 years and have taken numerous ADs. Remeron intensifies the effectiveness of prozac, and lamictal, generally an anti-seizure med, has been added to also increase effectiveness. I have been taking this combo for 3 months and was relatively depression free, until two weeks ago when the pharmacy refilled my script with generic remeron. I will be seeing my pdoc on 1/5/04 and by then I will definitely know if the generic remeron is as effective as the brand.

Flipsactown

> Yes, I am taking the Brand name of Remeron and not the generic. I've heard stories of people not having the best results from the generic versions. It's such a shame that dollars determine the degree of our well-being.
>
> By the way, I'm on Remeron for anxiety and not depression. Once I get over the initial fog-brain, I think this will be a wonderful med!!! I am so pleased that I finally got my doc to prescribe it for me. She refused to because she says it makes people "profoundly tired".....but that has not been the case for me. In fact, I still have some difficulty with sleeping. But I do believe that I feel a little calmer already, and I haven't even been on it a week yet.
>

 

Re: Remeron

Posted by SandyWeb on December 24, 2003, at 9:17:26

In reply to Re: Remeron » SandyWeb, posted by Flipsactown on December 23, 2003, at 22:18:19

Actually, I haven't noticed an increase in appetite. I've read where most people seem to gain a lot of weight due to feeling hungry all the time, though. I guess this is from the anti-histamine effect, which is more pronounced at and below 30mgs. When you are above 30mgs, the anti-histamine effects are not as strong as the norepinephrine effects....so less sedation, less hunger.

But, everyone is different because I am at 30 mgs and my appetite has not increased.

 

Re: Remeron » SandyWeb

Posted by lois on December 24, 2003, at 16:19:43

In reply to Re: Remeron, posted by SandyWeb on December 24, 2003, at 9:17:26

> Actually, I haven't noticed an increase in appetite. I've read where most people seem to gain a lot of weight due to feeling hungry all the time, though. I guess this is from the anti-histamine effect, which is more pronounced at and below 30mgs. When you are above 30mgs, the anti-histamine effects are not as strong as the norepinephrine effects....so less sedation, less hunger.

> I was up to 90 mgs and still ravenous!! But felt soooo much better. I had to quit because I gained 50 pounds in about 7-8 months. Sorry to relate my experience. But boy did it help me sleep and a lot more! Lois



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