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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by SLS on October 10, 2001, at 0:45:57
Hi again.
Has anyone felt worse immediately after starting Remeron and eventually end up responding well to it?
This is the second time I have tried Remeron. Similar to the first time, I have experienced an immediate worsening of my depression. I feel worse now than I did before I started taking it.
For now, I ain't takin' it no more.
- Scott
Posted by petter on October 10, 2001, at 1:15:32
In reply to Remeron - Worse first and then better?, posted by SLS on October 10, 2001, at 0:45:57
> Hi again.
>
> Has anyone felt worse immediately after starting Remeron and eventually end up responding well to it?
>
> This is the second time I have tried Remeron. Similar to the first time, I have experienced an immediate worsening of my depression. I feel worse now than I did before I started taking it.
>
> For now, I ain't takin' it no more.
>
>
> - Scott
Hi Scott...Could it be because you start with a low dosage? As you know it is sedative on 15-30mg. When you raise the dosage perhapes it works better. Don´t take it to late at night.
Are you taking other meds at night?
By the way Scott. Since you are so well informed. Have you heard or read someting about Remeron can makes troath infections more common, without any change in serum, with blood cells etc..?
Take care...
Sincerely
Petter
Posted by Psychopharm Nut on October 10, 2001, at 2:22:01
In reply to Remeron - Worse first and then better?, posted by SLS on October 10, 2001, at 0:45:57
Maybe you can try Mianserin if Mirtazapine-like pharmacology is what you are looking for.
Posted by SLS on October 10, 2001, at 11:32:35
In reply to Re: Remeron - Worse first and then better? » SLS, posted by Psychopharm Nut on October 10, 2001, at 2:22:01
> Maybe you can try Mianserin if Mirtazapine-like pharmacology is what you are looking for.
I've decided not to continue with Remeron until I speak to my doctor. What I described as a worsening of depression is definitely not sedation. I think it might actually be the NE alpha-2 blockade that is responsible for this. I had the same negative reaction to idazoxan, an experimental NE alpha-2 antagonist devoid of antihistaminic properties.I took 7.5mg of Remeron about 1:00am. When I woke up at 8:00am, I thought I was feeling somewhat improved. I immediately became optimistic and was excited that it hadn't made me feel worse. I assumed that everything was going my way. There was to be no self-fulfilling prophecy here. However, by 12:00pm noon, I was significantly worse. I slept all day to escape it.
Now, I don't know what to do.
I appreciate all of the constructive feedback. Thanks.
- Scott
Posted by Mitch on October 10, 2001, at 13:25:03
In reply to Re: Remeron - Worse first and then better?, posted by SLS on October 10, 2001, at 11:32:35
> > Maybe you can try Mianserin if Mirtazapine-like pharmacology is what you are looking for.
>
>
> I've decided not to continue with Remeron until I speak to my doctor. What I described as a worsening of depression is definitely not sedation. I think it might actually be the NE alpha-2 blockade that is responsible for this. I had the same negative reaction to idazoxan, an experimental NE alpha-2 antagonist devoid of antihistaminic properties.
>
> I took 7.5mg of Remeron about 1:00am. When I woke up at 8:00am, I thought I was feeling somewhat improved. I immediately became optimistic and was excited that it hadn't made me feel worse. I assumed that everything was going my way. There was to be no self-fulfilling prophecy here. However, by 12:00pm noon, I was significantly worse. I slept all day to escape it.
>
> Now, I don't know what to do.
>
> I appreciate all of the constructive feedback. Thanks.
>
>
> - ScottScott,
When I was taking Remeron something similar happened as well. I would have trouble getting up, but once I was awake and two strong coffees to the wind I was fairly active and felt fairly decent. THEN, about four or five hours after I woke up I would get these "head rushes" of dizziness and then just become somnolent and just want to couch potato the rest of the day. It could have been the caffeine dropping out, but hell I can't drink coffee every hour! I wonder if instead of the alpha2 antagonism maybe it is the other NE receptor that is implicated with orthostatic hypotension causing the trouble?
Mitch
Posted by SLS on October 10, 2001, at 14:26:41
In reply to Re: Remeron - Worse first and then better? » SLS, posted by Mitch on October 10, 2001, at 13:25:03
> > I took 7.5mg of Remeron about 1:00am. When I woke up at 8:00am, I thought I was feeling somewhat improved. I immediately became optimistic and was excited that it hadn't made me feel worse. I assumed that everything was going my way. There was to be no self-fulfilling prophecy here. However, by 12:00pm noon, I was significantly worse. I slept all day to escape it.
> >
> > Now, I don't know what to do.
> >
> > I appreciate all of the constructive feedback. Thanks.
> When I was taking Remeron something similar happened as well. I would have trouble getting up, but once I was awake and two strong coffees to the wind I was fairly active and felt fairly decent. THEN, about four or five hours after I woke up I would get these "head rushes" of dizziness and then just become somnolent and just want to couch potato the rest of the day. It could have been the caffeine dropping out, but hell I can't drink coffee every hour! I wonder if instead of the alpha2 antagonism maybe it is the other NE receptor that is implicated with orthostatic hypotension causing the trouble?
Hi Mitch.Are you still taking Remeron? What I experienced was an exacerbation of the core depressive symptomology. I wasn't sedated or dizzy. Sometimes, a medication will make the depression itself worse. It seems that the following drugs have done this to me:
protriptyline
Cytomel
Wellbutrin
idazoxan
Remeron
Amoxapine
moclobemideI'm not too happy about things right now. The two treatments that my doctor thought would have the best chances of working for me were Effexor in combination with either Remeron or Wellbutrin.
I'm currently taking:
Lamictal 300mg
Effexor 300mg
nortriptyline 25mg
Geodon 40mgIf Geodon was helping, I don't think it is anymore. I put a call in to my doctor about an hour ago. Hopefully, he'll call me back this evening.
One thought did occur to me. If NE alpha-2 antagonists consistently make my depression worse, perhaps a NE alpha-2 agonist might help. Maybe I'll post a question about clonidine. If you can think of any other agonists, please let me know. Thanks.
I really appreciate your concern.
- Scott
Posted by Mitch on October 11, 2001, at 0:01:16
In reply to Re: Remeron - Worse first and then better? » Mitch, posted by SLS on October 10, 2001, at 14:26:41
> > > I took 7.5mg of Remeron about 1:00am. When I woke up at 8:00am, I thought I was feeling somewhat improved. I immediately became optimistic and was excited that it hadn't made me feel worse. I assumed that everything was going my way. There was to be no self-fulfilling prophecy here. However, by 12:00pm noon, I was significantly worse. I slept all day to escape it.
> > >
> > > Now, I don't know what to do.
> > >
> > > I appreciate all of the constructive feedback. Thanks.
>
>
> > When I was taking Remeron something similar happened as well. I would have trouble getting up, but once I was awake and two strong coffees to the wind I was fairly active and felt fairly decent. THEN, about four or five hours after I woke up I would get these "head rushes" of dizziness and then just become somnolent and just want to couch potato the rest of the day. It could have been the caffeine dropping out, but hell I can't drink coffee every hour! I wonder if instead of the alpha2 antagonism maybe it is the other NE receptor that is implicated with orthostatic hypotension causing the trouble?
>
>
> Hi Mitch.
>
> Are you still taking Remeron? What I experienced was an exacerbation of the core depressive symptomology. I wasn't sedated or dizzy. Sometimes, a medication will make the depression itself worse. It seems that the following drugs have done this to me:
>
> protriptyline
> Cytomel
> Wellbutrin
> idazoxan
> Remeron
> Amoxapine
> moclobemide
>
> I'm not too happy about things right now. The two treatments that my doctor thought would have the best chances of working for me were Effexor in combination with either Remeron or Wellbutrin.
>
> I'm currently taking:
>
> Lamictal 300mg
> Effexor 300mg
> nortriptyline 25mg
> Geodon 40mg
>
> If Geodon was helping, I don't think it is anymore. I put a call in to my doctor about an hour ago. Hopefully, he'll call me back this evening.
>
> One thought did occur to me. If NE alpha-2 antagonists consistently make my depression worse, perhaps a NE alpha-2 agonist might help. Maybe I'll post a question about clonidine. If you can think of any other agonists, please let me know. Thanks.
>
> I really appreciate your concern.
>
>
> - ScottScott,
Whew! This is a tough one to contemplate and answer. Your first question was whether I am currently taking Remeron or not? Not for several days now. These are my observations about what the med did to me:
Good for sleep (noone disputes this much!), but I increased it to 15mg one night and I had *disturbed* sleep. It also triggered very intense lucid and vivid dreaming episodes.
Drowsiness, somnolence and hypokinesia the next day *increased* with the dose, also I had trouble *grasping* glasses, etc., however I knew there was some NE boost (in the background) because libido was increased, and close to time to take the next dose the following nite I found myself doing trigonometry problems on scratch paper (not hypomanic at all). I have heard that it "turns on" the frontal lobes, and I have been previously diagnosed with adult ADHD so no big surprise there. What I am really curious about are the differing rates the various receptors Remeron affects become "unoccupied". It seems from my experience with it that the antihistaminic effect (which destroys attention) wears off sooner than the noradrenergic affects. This probably explains the "positive rebound withdrawal" effect I have noticed. This is something that andys here has posted about regarding (I think) this and some other meds. I can take the Remeron for a few days (i.e.) and then abruptly stop it. I feel increasingly more attentive as the med washes out. Then after about four or five days the noradrenergic effect starts to die off and I become unfocused during the day! I am considering an experiment where I take ONE large dose (say 30-45mg) per week. Let's say on Friday nite where I don't have to worry about being wiped at work the next day, THEN just let it wash out and get the benefits of the antihistamine falling out with a more persistent noradrenaline effect during the week. What do you think???Mitch
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