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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by old pro on May 7, 2002, at 20:44:48
I would like to receive input from members of this group re which antidepressant medication might be the most sedating. I would like to take an antidepressant with the greatest sedative effects.
Insomnia (including early morning awakening, difficulty in falling asleep, and difficulty in staying asleep) is one of the most troubling symptoms of my depression. I have done some research into the sedative effects of depression. According to the book "Drug facts and comparisons, 1999 edition" amitriptyline has the greatest sedative effects of tricyclic drugs. According to a book titled "The management of depression" edited by Stuart Checkley, trimipramine has the greatest sedative effects of the tricyclic antidepressants. The format of the table re sedative effects (actually the table is titled "Comparison of adverse effects of tricyclic drugs") in the Checkley book is quite similar to the format of the info. in the book titled "Drug facts and comparisons". Perhaps the info. in the Checkley book was taken from an edition of "Drug facts and comparisons" that was different from the edition that I have.
I am currently taking doxepin (and I have taken it for several years). The sedative effects of doxepin are the best of any antidepressant drug that I have taken. But, I would like to know if there is something better.
I do know that different persons taking a given drug can have vastly different side effects. I have read some posts from members of this group that Effexor caused marked sedation. I recently received samples of that drug from my pdoc. The drug caused me to have elevated BP and my insomnia was worse, and I soon discontinued taking it.
I would like to have members of this group know that doxepin has helped me a lot. However, when I am having an episode of depression, it doesn't completely eliminate the depression. But, it does allow me to function fairly well. I would like to find some drug or other antidepressant therapy that would completely eliminate my symptoms of depression. At the present time I am into my fifth month of depression. I have suffered periodic episodes of depression (unipolar major depression) for about 42 years. And, I would like to find something that would relatively quickly cure my depression. For several years I have taken doxepin as a preventative when my symptoms of depression have gone away. But, it hasn't prevented recurrences of depression.
Posted by Ritch on May 7, 2002, at 22:21:14
In reply to Antidepressants and sedation, etc., posted by old pro on May 7, 2002, at 20:44:48
> I would like to receive input from members of this group re which antidepressant medication might be the most sedating. I would like to take an antidepressant with the greatest sedative effects.
>
> Insomnia (including early morning awakening, difficulty in falling asleep, and difficulty in staying asleep) is one of the most troubling symptoms of my depression. I have done some research into the sedative effects of depression. According to the book "Drug facts and comparisons, 1999 edition" amitriptyline has the greatest sedative effects of tricyclic drugs. According to a book titled "The management of depression" edited by Stuart Checkley, trimipramine has the greatest sedative effects of the tricyclic antidepressants. The format of the table re sedative effects (actually the table is titled "Comparison of adverse effects of tricyclic drugs") in the Checkley book is quite similar to the format of the info. in the book titled "Drug facts and comparisons". Perhaps the info. in the Checkley book was taken from an edition of "Drug facts and comparisons" that was different from the edition that I have.
>
> I am currently taking doxepin (and I have taken it for several years). The sedative effects of doxepin are the best of any antidepressant drug that I have taken. But, I would like to know if there is something better.
>
> I do know that different persons taking a given drug can have vastly different side effects. I have read some posts from members of this group that Effexor caused marked sedation. I recently received samples of that drug from my pdoc. The drug caused me to have elevated BP and my insomnia was worse, and I soon discontinued taking it.
>
> I would like to have members of this group know that doxepin has helped me a lot. However, when I am having an episode of depression, it doesn't completely eliminate the depression. But, it does allow me to function fairly well. I would like to find some drug or other antidepressant therapy that would completely eliminate my symptoms of depression. At the present time I am into my fifth month of depression. I have suffered periodic episodes of depression (unipolar major depression) for about 42 years. And, I would like to find something that would relatively quickly cure my depression. For several years I have taken doxepin as a preventative when my symptoms of depression have gone away. But, it hasn't prevented recurrences of depression.
Hi,I have never tried trimipramine, but I have found doxepin to be more sedative than amitritpyline in my experience. I have found that Remeron (an atypical antidepressant) to be as sedative as amitriptyline or doxepin, but I had less daytime drowsiness with either tricyclic (esp. amitriptyline) than Remeron. You could try that and see what happens. I don't think there is any contraindication to taking Remeron with your doxepin (if you wanted to continue the doxepin and add-on Remeron). You mentioned a desire to *prevent* recurrences. Are the recurrences-predictable?
Mitch
Posted by Lia Mason on May 7, 2002, at 23:01:36
In reply to Antidepressants and sedation, etc., posted by old pro on May 7, 2002, at 20:44:48
Hi,
I have the opposite problem. I'm battling fatigue constantly. So, I've looked into the sedation issue from the other side.
I have been told to stay away from remeron because the sedation can be severe. I'm also told (by more than one doc) that it's a very effective drug. I would love to take it as it does not have sexual side effects, but... I don't think we're a good match.
I tried serzone and had to stop due to sedation.
I believe this to be an atypical response, but... Neurontin sedated me at a tiny dose. My doctor said that happens to some people. I mention it only because it was so pronounced at such a tiny dose, I can't imagine if I'd gone higher.
Good Luck.
Lia
Posted by rainbowlight on May 8, 2002, at 1:52:09
In reply to Antidepressants and sedation, etc., posted by old pro on May 7, 2002, at 20:44:48
I take Remeron, 30 mgs. and have no sedation, go figure! LOL! I have found Luvoz and Paxil to be the most sedating. Seroquel, an anti-psychotic is sometimes prescribed for anxiety and insomnia. It was so sedating I had to stop taking it.
Posted by JohnX2 on May 8, 2002, at 2:08:45
In reply to Re: Antidepressants and sedation, etc., posted by rainbowlight on May 8, 2002, at 1:52:09
> I take Remeron, 30 mgs. and have no sedation, go figure! LOL! I have found Luvoz and Paxil to be the most sedating. Seroquel, an anti-psychotic is sometimes prescribed for anxiety and insomnia. It was so sedating I had to stop taking it.
I found that Remeron improved my sleep greatly, but did not make me
feel sedated during the day.Serzone has also been a God send for sleep. It is more likely to induce
sedation during the day.Many people combine Remeron or Serzone with other AD's to get a booster
effect and help with AD induced sleep disturbances.Of the SSRI's, I found Paxil to be sedating (this seems to be a common
trend).You could do something like a Paxil + Remeron or a Paxil + Serzone
combo, etc.Just some thoughts if you want to try the newer generation of
medications.Seroquel of the APs has a good reputation for sedation.
I found that Zyprexa augmentation improved my sleep.Neurontin is another option.
Or can take a sleep pill, ambien, etc...
Or a benzodiazepine like Klonopin...Lots o' options.
John
Posted by Carlos on May 8, 2002, at 9:34:34
In reply to Re: Antidepressants and sedation, etc., posted by JohnX2 on May 8, 2002, at 2:08:45
Well for me. I've tried Zoloft, Paxil, Wellbutrin, Klonopin, and Dexedrine. The last two are not ADs, but I'll mention them just for the sake of discussion.
Paxil was the worst. It was effective in treating depression and some anxiety, but make me very sluggish and tired 24/7. I also gained 20 lbs in less than 2 months.
Posted by DonnaM on May 8, 2002, at 12:15:23
In reply to Antidepressants and sedation, etc., posted by old pro on May 7, 2002, at 20:44:48
I have had severe insomnia of and on for several years and found Doxepin(30 mg) the best for a restful sleep without daytime sedation but like you found it did nothing for depression, actually made it worse in my case, and I gained 25 lbs in two months. Paxil also worked great for sleep but I was extremely tired during the day, even at 5 mg, and totally unmotivated. Zoloft(not by itself) with Epival(Depakote) worked great for me for a couple of years, for sleep and depression, but then I became unmotivated again. I tried Amitriptyline once at 50 mg and it did such a number (numbness, dizzy, oversedated) that I never tried it again. If Doxepin doesn't help your depression then I would say that all the tricyclics would be a poor choice for you according to my experience. I tried a few of them with poor results. If your like me then Paxil would be a good try or combine Doxepin with another class of anti-dpressant so the Doxepin can help your sleep but the other AD can deal with your depression. I would consider this for myself if it weren't for the weight gain. I personally do good with a sleep med Imovane (Canadian but similar to Ambien in the US) but have the side effects of heart palpitations (which I have been putting up with for a good niight's sleep)
> I would like to receive input from members of this group re which antidepressant medication might be the most sedating. I would like to take an antidepressant with the greatest sedative effects.
>
> Insomnia (including early morning awakening, difficulty in falling asleep, and difficulty in staying asleep) is one of the most troubling symptoms of my depression. I have done some research into the sedative effects of depression. According to the book "Drug facts and comparisons, 1999 edition" amitriptyline has the greatest sedative effects of tricyclic drugs. According to a book titled "The management of depression" edited by Stuart Checkley, trimipramine has the greatest sedative effects of the tricyclic antidepressants. The format of the table re sedative effects (actually the table is titled "Comparison of adverse effects of tricyclic drugs") in the Checkley book is quite similar to the format of the info. in the book titled "Drug facts and comparisons". Perhaps the info. in the Checkley book was taken from an edition of "Drug facts and comparisons" that was different from the edition that I have.
>
> I am currently taking doxepin (and I have taken it for several years). The sedative effects of doxepin are the best of any antidepressant drug that I have taken. But, I would like to know if there is something better.
>
> I do know that different persons taking a given drug can have vastly different side effects. I have read some posts from members of this group that Effexor caused marked sedation. I recently received samples of that drug from my pdoc. The drug caused me to have elevated BP and my insomnia was worse, and I soon discontinued taking it.
>
> I would like to have members of this group know that doxepin has helped me a lot. However, when I am having an episode of depression, it doesn't completely eliminate the depression. But, it does allow me to function fairly well. I would like to find some drug or other antidepressant therapy that would completely eliminate my symptoms of depression. At the present time I am into my fifth month of depression. I have suffered periodic episodes of depression (unipolar major depression) for about 42 years. And, I would like to find something that would relatively quickly cure my depression. For several years I have taken doxepin as a preventative when my symptoms of depression have gone away. But, it hasn't prevented recurrences of depression.
Posted by old pro on May 9, 2002, at 20:40:46
In reply to Re: Antidepressants and sedation, etc. » old pro, posted by Ritch on May 7, 2002, at 22:21:14
> > I would like to receive input from members of this group re which antidepressant medication might be the most sedating. I would like to take an antidepressant with the greatest sedative effects.
> >
> > Insomnia (including early morning awakening, difficulty in falling asleep, and difficulty in staying asleep) is one of the most troubling symptoms of my depression. I have done some research into the sedative effects of depression. According to the book "Drug facts and comparisons, 1999 edition" amitriptyline has the greatest sedative effects of tricyclic drugs. According to a book titled "The management of depression" edited by Stuart Checkley, trimipramine has the greatest sedative effects of the tricyclic antidepressants. The format of the table re sedative effects (actually the table is titled "Comparison of adverse effects of tricyclic drugs") in the Checkley book is quite similar to the format of the info. in the book titled "Drug facts and comparisons". Perhaps the info. in the Checkley book was taken from an edition of "Drug facts and comparisons" that was different from the edition that I have.
> >
> > I am currently taking doxepin (and I have taken it for several years). The sedative effects of doxepin are the best of any antidepressant drug that I have taken. But, I would like to know if there is something better.
> >
> > I do know that different persons taking a given drug can have vastly different side effects. I have read some posts from members of this group that Effexor caused marked sedation. I recently received samples of that drug from my pdoc. The drug caused me to have elevated BP and my insomnia was worse, and I soon discontinued taking it.
> >
> > I would like to have members of this group know that doxepin has helped me a lot. However, when I am having an episode of depression, it doesn't completely eliminate the depression. But, it does allow me to function fairly well. I would like to find some drug or other antidepressant therapy that would completely eliminate my symptoms of depression. At the present time I am into my fifth month of depression. I have suffered periodic episodes of depression (unipolar major depression) for about 42 years. And, I would like to find something that would relatively quickly cure my depression. For several years I have taken doxepin as a preventative when my symptoms of depression have gone away. But, it hasn't prevented recurrences of depression.
>
>
> Hi,
>
> I have never tried trimipramine, but I have found doxepin to be more sedative than amitritpyline in my experience. I have found that Remeron (an atypical antidepressant) to be as sedative as amitriptyline or doxepin, but I had less daytime drowsiness with either tricyclic (esp. amitriptyline) than Remeron. You could try that and see what happens. I don't think there is any contraindication to taking Remeron with your doxepin (if you wanted to continue the doxepin and add-on Remeron). You mentioned a desire to *prevent* recurrences. Are the recurrences-predictable?
>
> MitchHi Ritch or Mitch:
Thank you for your reply to my post. I am a newbie to this group, and I am unsure of the protocol to follow for replies. I checked the FAQ, but I couldn't find anything re replies.
My recurrences of depression are unpredictable. There is no pattern to them. The periods between my episodes of depression vary between a few months to a few years. In your post to me you asked "Are the recurrences predictable?"
old pro
Posted by Ritch on May 9, 2002, at 23:17:05
In reply to Re: Antidepressants and sedation, etc., posted by old pro on May 9, 2002, at 20:40:46
> My recurrences of depression are unpredictable. There is no pattern to them. The periods between my episodes of depression vary between a few months to a few years. In your post to me you asked "Are the recurrences predictable?"
>
> old pro
I suppose it might have been clearer to ask something like: "Do they have a seasonal pattern or do they occur in a cyclic fashion (more often than once annually)?". Apparently you "like" the sedative AD's. You probably ought to give Remeron a try. BarbaraCat (another poster here) has had very good success with Remeron and Lithium. Since your major d's recur, you might consider that kind of combination. You might find the Lithium "protects" you from recurrence, who knows? It might be worth a try. One thing for sure, getting a supply of lithium isn't going to break your bank account!good luck,
Mitch
Posted by old pro on May 10, 2002, at 21:17:27
In reply to Re: Antidepressants and sedation, etc. » old pro, posted by Ritch on May 9, 2002, at 23:17:05
> > My recurrences of depression are unpredictable. There is no pattern to them. The periods between my episodes of depression vary between a few months to a few years. In your post to me you asked "Are the recurrences predictable?"
> >
> > old pro
>
>
> I suppose it might have been clearer to ask something like: "Do they have a seasonal pattern or do they occur in a cyclic fashion (more often than once annually)?". Apparently you "like" the sedative AD's. You probably ought to give Remeron a try. BarbaraCat (another poster here) has had very good success with Remeron and Lithium. Since your major d's recur, you might consider that kind of combination. You might find the Lithium "protects" you from recurrence, who knows? It might be worth a try. One thing for sure, getting a supply of lithium isn't going to break your bank account!
>
> good luck,
>
>
> MitchI did take Remeron for a few days within recent weeks, but it resulted in my having severe insomnia. I soon discontinued the drug. I know it is paradoxical but the same drug can cause some persons to experience insomnia and others to be sedated.
For several months I did take Eskalith, which is a member of the lithium class of drugs, along with doxepin. I think that the Eskalith helped relieve my symptoms of depression some. But, I discontinued taking it when my symptoms of depression went away. I discontinued it, because I didn't think I needed it. However, I did continue to take doxepin in hopes that it would prevent a recurrence of depression. Unfortunately it didn't prevent the recurrence.
old pro
Posted by Ritch on May 10, 2002, at 21:28:09
In reply to Re: Antidepressants and sedation, etc., posted by old pro on May 10, 2002, at 21:17:27
> > > My recurrences of depression are unpredictable. There is no pattern to them. The periods between my episodes of depression vary between a few months to a few years. In your post to me you asked "Are the recurrences predictable?"
> > >
> > > old pro
> >
> >
> > I suppose it might have been clearer to ask something like: "Do they have a seasonal pattern or do they occur in a cyclic fashion (more often than once annually)?". Apparently you "like" the sedative AD's. You probably ought to give Remeron a try. BarbaraCat (another poster here) has had very good success with Remeron and Lithium. Since your major d's recur, you might consider that kind of combination. You might find the Lithium "protects" you from recurrence, who knows? It might be worth a try. One thing for sure, getting a supply of lithium isn't going to break your bank account!
> >
> > good luck,
> >
> >
> > Mitch
>
> I did take Remeron for a few days within recent weeks, but it resulted in my having severe insomnia. I soon discontinued the drug. I know it is paradoxical but the same drug can cause some persons to experience insomnia and others to be sedated.
>
> For several months I did take Eskalith, which is a member of the lithium class of drugs, along with doxepin. I think that the Eskalith helped relieve my symptoms of depression some. But, I discontinued taking it when my symptoms of depression went away. I discontinued it, because I didn't think I needed it. However, I did continue to take doxepin in hopes that it would prevent a recurrence of depression. Unfortunately it didn't prevent the recurrence.
>
> old proHi,
It sounds like you might want to revisit the lithium again, and stick with it after the depression goes away the next time. What dose of lithium were you taking? Just from personal experience, I didn't need any more than 600mg/day for a decent antidepressant response. Even 300-450mg/day taken as a long-term regimen wasn't that bad. Interesting that the Remeron aggravated insomnia for you. I found that 7.5mg knocked me on my ass for 12 hrs straight (no matter how long I took it), and 15mg pretty much did the same thing, however when I increased to 30mg I noticed some nighttime awakenings (lucid dreams), that may have contributed to my daytime drowsiness the following day. Maybe that is why the *brain fog* never lifted during the day with increasing doses of Remeron (it was actually *waking* me up at nite!). Tricyclic antidepressants like doxepin, etc. tend to diminish REM sleep stages, so maybe that is where your trouble lies. If you haven't done so already, you might consider getting a polysomnogram (sleep study) with EEG to rule out a sleep disorder (sleep apnea, etc.). I would retry the lithium and just keep taking it, IMO.
Mitch
Posted by old pro on May 11, 2002, at 15:10:51
In reply to Re: Antidepressants and sedation, etc., posted by Lia Mason on May 7, 2002, at 23:01:36
> Hi,
>
> I have the opposite problem. I'm battling fatigue constantly. So, I've looked into the sedation issue from the other side.
>
> I have been told to stay away from remeron because the sedation can be severe. I'm also told (by more than one doc) that it's a very effective drug. I would love to take it as it does not have sexual side effects, but... I don't think we're a good match.
>
> I tried serzone and had to stop due to sedation.
>
> I believe this to be an atypical response, but... Neurontin sedated me at a tiny dose. My doctor said that happens to some people. I mention it only because it was so pronounced at such a tiny dose, I can't imagine if I'd gone higher.
>
> Good Luck.
>
> LiaIs Seroquel the brand name or generic name? I can't find it listed in the '94 edition of "Drug facts and comparisons."
I am somewhat concerned about taking an antipsychotic drug due to the possibilty of developing tardive dyskinesia. According to my copy of "Drug facts and comparisons" that is one of the warnings listed in the discussion of antipsychotic drugs.
old pro
Posted by old pro on May 11, 2002, at 15:28:13
In reply to Re: Antidepressants and sedation, etc., posted by JohnX2 on May 8, 2002, at 2:08:45
> > I take Remeron, 30 mgs. and have no sedation, go figure! LOL! I have found Luvoz and Paxil to be the most sedating. Seroquel, an anti-psychotic is sometimes prescribed for anxiety and insomnia. It was so sedating I had to stop taking it.
>
> I found that Remeron improved my sleep greatly, but did not make me
> feel sedated during the day.
>
> Serzone has also been a God send for sleep. It is more likely to induce
> sedation during the day.
>
> Many people combine Remeron or Serzone with other AD's to get a booster
> effect and help with AD induced sleep disturbances.
>
> Of the SSRI's, I found Paxil to be sedating (this seems to be a common
> trend).
>
> You could do something like a Paxil + Remeron or a Paxil + Serzone
> combo, etc.
>
> Just some thoughts if you want to try the newer generation of
> medications.
>
> Seroquel of the APs has a good reputation for sedation.
> I found that Zyprexa augmentation improved my sleep.
>
> Neurontin is another option.
> Or can take a sleep pill, ambien, etc...
> Or a benzodiazepine like Klonopin...
>
> Lots o' options.
>
> JohnThanks for your reply to my post.
I was especially interested in your suggestions of Serzone, Zyprexa, and Neurontin. I will do some research into them.
I have taken Paxil, and it helped neither my depression nor my insomnia. I have also taken Remeron, and it caused my insomnia to be worse.
Your suggestion of a benzodiazepine was good. I do occasionally take alprazolam when I have difficulty falling asleep. It some times helps me.
old pro
Posted by old pro on May 11, 2002, at 15:39:04
In reply to Re: Antidepressants and sedation, etc., posted by DonnaM on May 8, 2002, at 12:15:23
> I have had severe insomnia of and on for several years and found Doxepin(30 mg) the best for a restful sleep without daytime sedation but like you found it did nothing for depression, actually made it worse in my case, and I gained 25 lbs in two months. Paxil also worked great for sleep but I was extremely tired during the day, even at 5 mg, and totally unmotivated. Zoloft(not by itself) with Epival(Depakote) worked great for me for a couple of years, for sleep and depression, but then I became unmotivated again. I tried Amitriptyline once at 50 mg and it did such a number (numbness, dizzy, oversedated) that I never tried it again. If Doxepin doesn't help your depression then I would say that all the tricyclics would be a poor choice for you according to my experience. I tried a few of them with poor results. If your like me then Paxil would be a good try or combine Doxepin with another class of anti-dpressant so the Doxepin can help your sleep but the other AD can deal with your depression. I would consider this for myself if it weren't for the weight gain. I personally do good with a sleep med Imovane (Canadian but similar to Ambien in the US) but have the side effects of heart palpitations (which I have been putting up with for a good niight's sleep)
>
>
> > I would like to receive input from members of this group re which antidepressant medication might be the most sedating. I would like to take an antidepressant with the greatest sedative effects.
> >
> > Insomnia (including early morning awakening, difficulty in falling asleep, and difficulty in staying asleep) is one of the most troubling symptoms of my depression. I have done some research into the sedative effects of depression. According to the book "Drug facts and comparisons, 1999 edition" amitriptyline has the greatest sedative effects of tricyclic drugs. According to a book titled "The management of depression" edited by Stuart Checkley, trimipramine has the greatest sedative effects of the tricyclic antidepressants. The format of the table re sedative effects (actually the table is titled "Comparison of adverse effects of tricyclic drugs") in the Checkley book is quite similar to the format of the info. in the book titled "Drug facts and comparisons". Perhaps the info. in the Checkley book was taken from an edition of "Drug facts and comparisons" that was different from the edition that I have.
> >
> > I am currently taking doxepin (and I have taken it for several years). The sedative effects of doxepin are the best of any antidepressant drug that I have taken. But, I would like to know if there is something better.
> >
> > I do know that different persons taking a given drug can have vastly different side effects. I have read some posts from members of this group that Effexor caused marked sedation. I recently received samples of that drug from my pdoc. The drug caused me to have elevated BP and my insomnia was worse, and I soon discontinued taking it.
> >
> > I would like to have members of this group know that doxepin has helped me a lot. However, when I am having an episode of depression, it doesn't completely eliminate the depression. But, it does allow me to function fairly well. I would like to find some drug or other antidepressant therapy that would completely eliminate my symptoms of depression. At the present time I am into my fifth month of depression. I have suffered periodic episodes of depression (unipolar major depression) for about 42 years. And, I would like to find something that would relatively quickly cure my depression. For several years I have taken doxepin as a preventative when my symptoms of depression have gone away. But, it hasn't prevented recurrences of depression.Hi DonnaM,
Thanks for your reply to my post.
I was especially interested in your mention of Imovane (Ambien). I will do some research into that drug.
The drugs that I have taken and discontinued taking due either to bad side effects or failure to help my depression are as follows: amitriptyline, Prozac, Paxil, Luvox, Anafranil, Effexor, and Remeron. I did take Eskalith for awhile, and it did help relieve my symptoms of depression some. I discontinued taking it when my depression went away.
old pro
Posted by old pro on May 11, 2002, at 15:52:05
In reply to Re: Antidepressants and sedation, etc. » old pro, posted by Ritch on May 10, 2002, at 21:28:09
I have never taken plain lithium. I have taken Eskalith CR which is in the class of lithium drugs. (Actually I just now checked my copy of "Drug facts and comparisons", and found that Eskalith contains lithium carbonate. And that is plain lithium.) I took 225 mg. twice a day.
I do like your suggestion re a polysonogram. I have thought about getting that done, but haven't done so yet.
My wife tells me that I do sometimes snore. Thus, I do have a sleep disorder.
old pro
Posted by Bob on May 13, 2002, at 22:51:52
In reply to Re: Antidepressants and sedation, etc. » old pro, posted by Ritch on May 10, 2002, at 21:28:09
>
> Hi,
>
> It sounds like you might want to revisit the lithium again, and stick with it after the depression goes away the next time. What dose of lithium were you taking? Just from personal experience, I didn't need any more than 600mg/day for a decent antidepressant response. Even 300-450mg/day taken as a long-term regimen wasn't that bad. Interesting that the Remeron aggravated insomnia for you. I found that 7.5mg knocked me on my ass for 12 hrs straight (no matter how long I took it), and 15mg pretty much did the same thing, however when I increased to 30mg I noticed some nighttime awakenings (lucid dreams), that may have contributed to my daytime drowsiness the following day. Maybe that is why the *brain fog* never lifted during the day with increasing doses of Remeron (it was actually *waking* me up at nite!). Tricyclic antidepressants like doxepin, etc. tend to diminish REM sleep stages, so maybe that is where your trouble lies. If you haven't done so already, you might consider getting a polysomnogram (sleep study) with EEG to rule out a sleep disorder (sleep apnea, etc.). I would retry the lithium and just keep taking it, IMO.
>
> MitchMitch:
Did you ever get beyond 30mg of Remeron per day?
Bob
This is the end of the thread.
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