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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 nala on August 5, 2002, at 13:44:39
My diagnosis as follows: major depression, social anxiety, and BP traits. I know I've posted a similiar question, but I have recently had my remeron dosage up to 60mg and after week #4 at this dose I'm about to give up altogether. I take it in the evening, however, sedation the following day is interfering with my life. I have a hard time getting up even after 10 or more hours of sleep. Is there another med that can be added to increase my energy level? I'm a personal trainer and I can't even bring "myself" to exercise in the a.m. anymore. My pdoc is on vacation for the next 3 weeks and I don't know what to do. In addition, I'm unable to take the following AD's: Zoloft, Celexa = diarrhea. Wellbutrin=extreme anxiety, and Serzone=bugs crawling all over me. If anyone has tried anything that works in combo with lower dose Remeron, or perhaps a drug that is well-tolerate on it's own (except above) please help me.
Nala
Posted by allisonm on August 5, 2002, at 14:40:17
In reply to remeron, again; help, posted by nala on August 5, 2002, at 13:44:39
If you pdoc is on vacation for 3 weeks, wouldn't he/she have someone covering for him/her? Can you contact them? Otherwise, maybe it would be helpful to reduce your Remeron dose to what it was until your pdoc returns.
Good luck.
Posted by Shawn. T. on August 7, 2002, at 0:11:58
In reply to remeron, again; help, posted by nala on August 5, 2002, at 13:44:39
Remeron works better if you only take 7.5mg-15mg/day. High levels of noradrenaline and sedation caused by such high doses do not result in an effective antidepressant. I take Wellbutrin with a low dose of Remeron (7.5mg). The Remeron is effective at easing the Wellbutrin caused anxiety.
Shawn
Posted by michael on August 7, 2002, at 15:46:20
In reply to remeron, again; help, posted by nala on August 5, 2002, at 13:44:39
Regarding the sleepiness - perhaps reducing your dose to the previous level, until you can talk to your doc?
> My diagnosis as follows: major depression, social anxiety, and BP traits. I know I've posted a similiar question, but I have recently had my remeron dosage up to 60mg and after week #4 at this dose I'm about to give up altogether. I take it in the evening, however, sedation the following day is interfering with my life. I have a hard time getting up even after 10 or more hours of sleep. Is there another med that can be added to increase my energy level? I'm a personal trainer and I can't even bring "myself" to exercise in the a.m. anymore. My pdoc is on vacation for the next 3 weeks and I don't know what to do. In addition, I'm unable to take the following AD's: Zoloft, Celexa = diarrhea. Wellbutrin=extreme anxiety, and Serzone=bugs crawling all over me. If anyone has tried anything that works in combo with lower dose Remeron, or perhaps a drug that is well-tolerate on it's own (except above) please help me.
>
> Nala
Posted by sleepy lizard on August 10, 2002, at 10:27:55
In reply to Re: remeron, again; help, posted by michael on August 7, 2002, at 15:46:20
I'm sorry to hear you are having such a difficult time with the Remeron, and other drugs. It is hard enough to live without these things too. I take Effexor XR 150 mg once daily (comes in 37.5, 75, 150) and it does not make me sleepy, except for an occassional relaxed yawn. I run two miles a day and feel refreshed in the morning (male age 49). I've tried Paxil which made me feel spaced out, and Celexa, which didn't do much at all. The AD's that reduce energy levels are: Serzone and Remeron. Some that increase energy levels are: Wellbutrin and Effexor XR. You have tried Wellbutrin and Serzone to no avail, and the Remeron is too sedating. Paxil is sedating, and Prozac is activating (haven't tried Prozac). There is also Desyrel (trazodone) but it is a more sedating one because it is prescribed for sleep disorders. There is Manerix (moclobemide) good for depression with anxiety, and not sedating. Also Vestra (reboxetine) -- may not be available in US -- which increases NE. (I'm assuming you are avoiding tricyclics and MAOI's entirely.)
My best guess is Effexor XR.
Check out the free medication chart at the following url:
http://www.psyd-fx.com/html/quick_reference_medications.html
Posted by Nala on August 10, 2002, at 16:48:01
In reply to Re: remeron, again; help » michael, posted by sleepy lizard on August 10, 2002, at 10:27:55
> I'm sorry to hear you are having such a difficult time with the Remeron, and other drugs. It is hard enough to live without these things too. I take Effexor XR 150 mg once daily (comes in 37.5, 75, 150) and it does not make me sleepy, except for an occassional relaxed yawn. I run two miles a day and feel refreshed in the morning (male age 49). I've tried Paxil which made me feel spaced out, and Celexa, which didn't do much at all. The AD's that reduce energy levels are: Serzone and Remeron. Some that increase energy levels are: Wellbutrin and Effexor XR. You have tried Wellbutrin and Serzone to no avail, and the Remeron is too sedating. Paxil is sedating, and Prozac is activating (haven't tried Prozac). There is also Desyrel (trazodone) but it is a more sedating one because it is prescribed for sleep disorders. There is Manerix (moclobemide) good for depression with anxiety, and not sedating. Also Vestra (reboxetine) -- may not be available in US -- which increases NE. (I'm assuming you are avoiding tricyclics and MAOI's entirely.)
>
> My best guess is Effexor XR.
>
> Check out the free medication chart at the following url:
>
> http://www.psyd-fx.com/html/quick_reference_medications.htmlthank you so much for your help. I've decreased to 45mg until doc returns from France.
Posted by sleepy lizard on August 11, 2002, at 6:07:17
In reply to Re: remeron, again; help, posted by Nala on August 10, 2002, at 16:48:01
Remeron is unusual in that it will act differently with different doses. At low doses, 15 mg, it blocks mainly the histamine receptors, and that is what causes the sleepiness. At larger doses, 30 mg, it also blocks the NE alpha-2 sites, which is activating, and counters some of the sleepiness. It also blocks 5HTP2a (Serotonin) which gives the AD effects at both doses. There are actually 5 receptor sites that it works on, and three uptake pumps. If you are technically minded, and curious, you can read about it at: http://www.preskorn.com/columns/0003.html
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