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Dr. Bob is Robert Hsiung, MD,
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Posted by ravenstorm on May 31, 2004, at 19:07:52
In reply to Bumped up Remeron dosage and feel stoned! HELP!, posted by ravenstorm on May 31, 2004, at 14:33:55
I guess that is what I really want to know! Got a little carried away in the last post.
Am I just getting more side effects (ie more histamine affect ect by bumping up but still being at a lower dose?)
Do you have to go over 30mg to get less sedation?(ie hit the noradreg (can't spell it-so I'll stop half way through))
Or am I just continuing in the med-freak tradition and having an opposite reaction to the drug then everybody else?
Thanks!
P.S. Still haven't decided if I should stay with the bumped up dose tonight. Have never had more side effects with a bump up than when starting a drug!!
Posted by Chairman_MAO on May 31, 2004, at 20:16:59
In reply to how can 22.5 of remeron be more sedating than 15mg, posted by ravenstorm on May 31, 2004, at 19:07:52
Yes, typically one needs 30mg or more to engage the adrenergic effect.
Posted by Sad Panda on May 31, 2004, at 22:48:36
In reply to how can 22.5 of remeron be more sedating than 15mg, posted by ravenstorm on May 31, 2004, at 19:07:52
> I guess that is what I really want to know! Got a little carried away in the last post.
>
> Am I just getting more side effects (ie more histamine affect ect by bumping up but still being at a lower dose?)
>
> Do you have to go over 30mg to get less sedation?(ie hit the noradreg (can't spell it-so I'll stop half way through))
>
> Or am I just continuing in the med-freak tradition and having an opposite reaction to the drug then everybody else?
>
> Thanks!
>
> P.S. Still haven't decided if I should stay with the bumped up dose tonight. Have never had more side effects with a bump up than when starting a drug!!>
>
>Hi Ravenstorm,
Remeron is a Alpha-2 Adrenergic antagonist & this effect becomes stronger as you go higher. A-2 antagonism raises insulin levels which lowers blood sugar.
For me 15mg was the best amount for sleep, adding extra doesn't sedate deeper, but it does sedate longer. If I were you I would stay at 15mg & try an SSRI again. Remeron by itself is rarely a good AD, but it is a good sleep aid & it makes SRI's much more tolerable by block it's effects on 5-HT2 & 5-HT3
Cheers,
Panda.
Posted by ravenstorm on May 31, 2004, at 23:24:09
In reply to Re: how can 22.5 of remeron be more sedating than 15mg » ravenstorm, posted by Sad Panda on May 31, 2004, at 22:48:36
Sad Panda--
Are you saying that an increased dosage would actually make the blood sugar thing worse??
Before seeing your post, I decided to only take 15mg tonight, anyway, so I can go to work tomorrow. The sedation was just incredible today at 22.5mg. I couldn't even do anything until 4pm, even after 12 hours of sleep. I feel guilty now though. . .like maybe I should try 30mg for a week and then 45mg.
I don't want to add an SSRI. I just can't seem to tolerate them anymore after the severe paxil withdrawal. I have taken every one of them except effexor-SNRI (several for only a few days, however). I won't take effexor, because if I had severe protracted paxil withdrawal that made me worse then I'm sure I'd have the same problem with effexor.
Also, I want to switch to the ensam patch if it ever comes out and I don't want to go through a wash out period.
On 15mg I wake up early (6:00am) and struggle to get back to sleep.
I know everybody thinks manerix is weak, but I'm toying with buying it online and trying it. I would think it would be safe with the 15mg remeron since apparently even nardil and parnate are.
I really didn't expect all this trouble bumping up a crummy 7.5mg. In fact, I thought by going slow I would avoid all unpleasant side effects and then bump up to 30mg the next week.
I was looking back over old remeron posts and there were a lot of people on 45mg who had never felt better than on remeron. I never thought I'd never have the chance to increase my dosage!!!!!!!!!!!!! I was actually slurring my words on 22.5.
Until my pdoc gets back, I'm going to add some fish oil and maybe order some manerix.
As always Sad Panda, thanks for your time.
Chairman MAO thanks for the input as well. Maybe next weekend I'll consider trying 30mg instead. But seeing as I just missed the enitre holiday weekend with no benefits to show for it, I don't know if I'll be willing to do it again!
Posted by Sad Panda on June 1, 2004, at 0:35:52
In reply to Re: how can 22.5 of remeron be more sedating than 15mg, posted by ravenstorm on May 31, 2004, at 23:24:09
> Sad Panda--
>
> Are you saying that an increased dosage would actually make the blood sugar thing worse??
>
> Before seeing your post, I decided to only take 15mg tonight, anyway, so I can go to work tomorrow. The sedation was just incredible today at 22.5mg. I couldn't even do anything until 4pm, even after 12 hours of sleep. I feel guilty now though. . .like maybe I should try 30mg for a week and then 45mg.
>
> I don't want to add an SSRI. I just can't seem to tolerate them anymore after the severe paxil withdrawal. I have taken every one of them except effexor-SNRI (several for only a few days, however). I won't take effexor, because if I had severe protracted paxil withdrawal that made me worse then I'm sure I'd have the same problem with effexor.
>
> Also, I want to switch to the ensam patch if it ever comes out and I don't want to go through a wash out period.
>
> On 15mg I wake up early (6:00am) and struggle to get back to sleep.
>
> I know everybody thinks manerix is weak, but I'm toying with buying it online and trying it. I would think it would be safe with the 15mg remeron since apparently even nardil and parnate are.
>
> I really didn't expect all this trouble bumping up a crummy 7.5mg. In fact, I thought by going slow I would avoid all unpleasant side effects and then bump up to 30mg the next week.
>
> I was looking back over old remeron posts and there were a lot of people on 45mg who had never felt better than on remeron. I never thought I'd never have the chance to increase my dosage!!!!!!!!!!!!! I was actually slurring my words on 22.5.
>
> Until my pdoc gets back, I'm going to add some fish oil and maybe order some manerix.
>
> As always Sad Panda, thanks for your time.
>
> Chairman MAO thanks for the input as well. Maybe next weekend I'll consider trying 30mg instead. But seeing as I just missed the enitre holiday weekend with no benefits to show for it, I don't know if I'll be willing to do it again!
>
>
>Hi Ravenstorm,
Remerons stimulating effect is all due to A-2 blockade, if you are having troubles with sugar at 22.5mg, it will only get worse at higher doses. Some people get a good effect from A-2 blockade, but others including myself complain of irritaion & crankiness.
What diagnosis & symptoms do you have? Paxil is an ugly medicine, I wouldn't take it or Luvox. Some Zoloft or Lexapro would be worth trying. Remeron smoothes out all the ugly side effects of Effexor for me.
Cheers,
Panda.
Posted by TheOutsider on June 1, 2004, at 10:14:56
In reply to Re: how can 22.5 of remeron be more sedating than 15mg » ravenstorm, posted by Chairman_MAO on May 31, 2004, at 20:16:59
Personaly I didn't find that higher doses were more stimulating.
I tried 60mg and it turned me into a zombie!
Completely zonked.Perhapse if I'd kept at 60mg it would have become stimulating, who knows........
just my experience
Posted by BobS, on June 1, 2004, at 18:49:05
In reply to Re: how can 22.5 of remeron be more sedating than 15mg, posted by TheOutsider on June 1, 2004, at 10:14:56
Does anyone have any hard evidence regarding Remeron and blood sugar levels? Does anyone monitor their blood glucose levels?
I have been on Remeron at 15 mg for 41 days and have not gained weight, other than what was lost trying Zoloft and then Lexapro. Remeron has been very kind to me, bringing me back from a dreadful state. I spent years losing weight from Paxil and am now at the weight I should be.
Also, during the time on Remeron I was able to reduce my Xanax from 3.5/4.0 mgs to 2.0 mgs per day. This has helped with mild sedation. Remeron and Xanax are the only two drugs I take.
Am I in for a big (fat) surprise?
Kind regards,
BobS.
Posted by ravenstorm on June 1, 2004, at 22:52:52
In reply to Re: remeron and blood sugar????????????, posted by BobS, on June 1, 2004, at 18:49:05
I have not gained any weight either (on my eighth week currently), but have to eat every two to three hours because the drug has made my hypoglycemia worse. (I used to have to eat every four hours). I did not experience this on paxil or when on no medication.
There have been published cases of people suffering diabetic ketosis on Remeron, but it appears that was caused by exorbitantly high triglycerides (another rare side effect of remeron). One such case is listed at:
www.antideprressantsfacts.com/remeron-pancreatitis-diabetic.htmThe study suggests that all patients receiving remeron have serum glucose and triglyceride levels measured at baseline and monitored regularly thereafter. My pdoc has not done this and I will bring it up at our next meeting. Again, I am not having diabetic type symptoms(at least I hope not), I am having worsening of my hypoglycemia, to the point that I may not be able to stay on this drug. (Which does NOT make me happy. . .I don't have much left to try).
I am not knocking remeron at all. In fact, the reason I wanted to increase my dosage was because I had had good results on 15mg but still needed a little more. Also, I had heard that you actually get less side effects as you increase dosage. I guess I am one of the odd balls that doesn't respond to the drug that way.
Hope you have continued success on Remeron.
Posted by Nusbu on June 2, 2004, at 2:34:34
In reply to Re: how can 22.5 of remeron be more sedating than 15mg, posted by ravenstorm on May 31, 2004, at 23:24:09
> I know everybody thinks manerix is weak, but I'm toying with buying it online and trying it. I would think it would be safe with the 15mg remeron since apparently even nardil and parnate are.
I would definitely disagree Manerix being weak. For me it kicked at 150 mg (half the minimun dosage) extremely well ands I felt better than for years. Unfortunately the insomnia was terrible and when raised at 300 mg, I felt OD'd and drugged, serotonin overload, or something. Never felt worse. Due to insomnia I was told to quit it, because lowering the dose back to 150mg did not give back the good feeling.
Now just started wellbutrin+ remeron.Anyhow I would say that Manerix is very effective on atypical depression, if it suits you. (my friend has been on for 5 years with tremendous success)
I would say, go for. If it good, it is really good. If bad, just kick it. The wash out period is so quick, you don't even notice it passing yor system.
Good luck.
Posted by crazychickuk on June 2, 2004, at 4:19:32
In reply to Re: manerix weak - I do not think so!!, posted by Nusbu on June 2, 2004, at 2:34:34
I have been on this drug for over a year, would i of realized by now if my blood sugar was low?
30mg
Posted by Sad Panda on June 2, 2004, at 6:29:01
In reply to Re: remeron and blood sugar????????????, posted by BobS, on June 1, 2004, at 18:49:05
>Does anyone have any hard evidence regarding Remeron and blood sugar levels? Does anyone monitor their blood glucose levels?
>
>I have been on Remeron at 15 mg for 41 days and have not gained weight, other than what was lost trying Zoloft and then Lexapro. Remeron has been very kind to me, bringing me back from >a dreadful state. I spent years losing weight from Paxil and am now at the weight I should be.
>
>Also, during the time on Remeron I was able to reduce my Xanax from 3.5/4.0 mgs to 2.0 mgs per day. This has helped with mild sedation. Remeron and Xanax are the only two drugs I take.
>
>Am I in for a big (fat) surprise?>Kind regards,
>BobS.
>
>
>Hi fellow Remeron users,
Looks like I have stirred up some worries with one of my posts. :) Sorry if I have caused anyone undue worry or panic.
Remeron does try to lower blood sugar as a side effect. For the majority of people this is a transient side effect & your body adapts & normalizes. For people like Ravenstorm who suffer hypoglycemia it would be a problem, but I suspect her body will adapt eventually.
How Remeron lowers blood sugar is by the way it effects norepinephrine(NE or NA-Noradrenaline) in your body. The known NE receptors are Alpha-1, Alpha-2, Beta-1 & Beta-2. These receptors are situated around the body but in particular they effect the heart & circulation. The primary purpose of NE is to set your body in to fight or flight mode so you can run really fast from whatever is frightening your prehistoric inner person. The TCA antidepressants & nearly all antipsychotic drugs have the unwanted side effect of major Alpha-1 antagonism with some minor Alpha-2 antagonism. Remeron has very mild Alpha-1 antagonism & major Alpha-2 antagonism. Blocking(antagonising) the Alpha-1 NE receptors from receiving NE causes your perphial blood vessels to relax which cause your blood pressure to drop badly when you standup(orthastatic hypotension) this then causes your heart to beat faster to compensate(reflex tachycardia). What mother nature intented when she invented NE was that the sudden burst of adrenaline agonizes the Alpha-1 receptors to divert blood away from your periphery, organs & brain so that the maximum amount is available for your large leg & arm muscles so that you can run really fast or fight. Cutting to the chase, NE agonism of Alpha-2 receptors in your pancreas inhibits the release of insulin which has the effect of raising blood sugar levels & preventing fat production for the purpose of having maximum energy available to run really fast. Logically, Alpha-2 antagonism has the opposite effect of raising insulin which lowers blood sugar. Also, Alpha-2 antagonism causes the release of NE which is the source of stimulation from high dosages of Remeron. This effect could possibly also push someone who is hyperglycemic into diabetes or cause triglyceride problems to those that are susceptible. I myself am very susceptible because I am very obese & my sugar levels are always at the maximum level allowed, but after 6 months of Remeron I have had no problems with diabetes, trigycerides or cholesterol. Also of interest, hunger/craving problems involving carbs can be caused by both hyper & hypoglycemia. So if Remeron, TCA's or AP's make you crave carbs, I would monitor your sugar & fat metabolism closely.
Hope I haven't bored anyone to sleep.
Cheers,
Panda.
Posted by ravenstorm on June 2, 2004, at 9:27:50
In reply to Re: Remeron Blood Sugar., posted by Sad Panda on June 2, 2004, at 6:29:01
Posted by ravenstorm on June 2, 2004, at 9:33:48
In reply to THANKS SAD PANDA! (nm), posted by ravenstorm on June 2, 2004, at 9:27:50
Interesting that you are starting wellbutrin and remeron as I am considering that combo myself after my unsuccessful attempt to up my remeron. Please keep us posted how the combo works for you. What dosage of each will you be taking?
As for manerix. What dosage is your friend taking?
When you took manerix and had insomnia, did they offer you any meds to take with it to try to mitigate that side effect?
Posted by Sad Panda on June 2, 2004, at 9:38:54
In reply to Re: manerix weak - I do not think so!!, posted by Nusbu on June 2, 2004, at 2:34:34
> > I know everybody thinks manerix is weak, but I'm toying with buying it online and trying it. I would think it would be safe with the 15mg remeron since apparently even nardil and parnate are.
>
> I would definitely disagree Manerix being weak. For me it kicked at 150 mg (half the minimun dosage) extremely well ands I felt better than for years. Unfortunately the insomnia was terrible and when raised at 300 mg, I felt OD'd and drugged, serotonin overload, or something. Never felt worse. Due to insomnia I was told to quit it, because lowering the dose back to 150mg did not give back the good feeling.
> Now just started wellbutrin+ remeron.
>
> Anyhow I would say that Manerix is very effective on atypical depression, if it suits you. (my friend has been on for 5 years with tremendous success)
>
> I would say, go for. If it good, it is really good. If bad, just kick it. The wash out period is so quick, you don't even notice it passing yor system.
>
> Good luck.
>
>
>Hi Nusbu,
When people refer to an AD as being weak we are generally refering to it efficacy, not it's potency. I frequently describe Remeron, Wellbutrin, Serzone, Trazodone & Buspar as weak, but they are still usefull. For the majority, using one of these by itself rarely gives any real AD effect, but for a minority of people, they are a godsend. All of them are great when added to an effective SSRI. Wellbutrin is said to be great for countering SSRI induced lethargy, I wish it was available here. Trazodne & Serzone are great sleep aids with some anxiolytic effects. Remeron is great for countering SSRI induced insomnia, anorgasmia & nausea. Manerix is regarded as the last choice when compared to it's brothers Nardil & Parnate, but I am sure there are people that have failed some SSRI's, some TCA's, Nardil & Parante & then in desperation tried Manerix & found success.
Cheers,
Panda.
Posted by ravenstorm on June 2, 2004, at 9:53:32
In reply to nusbu-manerix questions. also, wellbutirn Rem, posted by ravenstorm on June 2, 2004, at 9:33:48
What is the starting dosage of manerix? I read you take it twice a day. What time of day? Can you take manerix with remeron. I read an article indicating remeron was considered OK with parnate, nardil, marplan and selegiline. Does that mean its safe with manerix?
Thanks in advance for any information!
Posted by Nusbu on June 2, 2004, at 13:48:01
In reply to nusbu-manerix questions. also, wellbutirn Rem, posted by ravenstorm on June 2, 2004, at 9:33:48
Hi,
I am extremely sensitive to meds, so we started very low and easy. Started first 3.75 mg Remeron and wellbutrin (Zyban, a quater) 37.5 mg. Two days like that and then upped 7.5 mg Remeron in the evening and 75 mg Wellbutrin in the morning. Upping the wellbutrin next monday 150 mg, keeping Remeron 7.5 mg, in case needed go to 15 mg, Remeron for me is only a sleeping pill. Getting bad dreams from it so bit upset about it, but dislike benzos for sleep. So far feeling ok, not quite not depressed, but a bit better. (no side-effects, which is ubelievable, i always get them all) First two day I just slept because of Remeron, tried to combat that with provigil, did not help. I let you know how I progress. I am fairly optimistic, even after 10 years of hit and misses.> As for manerix. What dosage is your friend taking?
my friend is taking 300 mg a day, 150 mg in the morning and the same at 4 p.m.> When you took manerix and had insomnia, did they offer you any meds to take with it to try to mitigate that side effect?
they offered temazepam 20-40 mg, oxazepam as well as zopiclon, did not help that much. one nite I when I took 40 mg temazepam+ zopiclon + oxazepam, and could not sleep I knew I wanted to stop manerix, I thought that was insane. I was waking during the night, and felt really bad, I was a walking zombie, a nervous wreck. I feel so much better now. I took three weeks to sleep without benzos after that episode of my life.
In case you are interested I know my share on efficacy of ADs. I have tested and taken during last 10 years all the SSRIs, Lamictal, Neurontin, Benzos, Manerix, Topamax, Ritalin, Provigil you name it, I have been on it. Based on that I would say that Manerix is an effective and well working drug compared to many others. And I have seen closely it helping a person with serious depression and eating disorder. We are unique when it comes to drugs and their efficacy.
Take care you all,
Nusbu
Posted by Nusbu on June 2, 2004, at 13:51:10
In reply to More manerix questions, posted by ravenstorm on June 2, 2004, at 9:53:32
I think the normal starting dose is 300 mg a day,
taken spit in two doses. Morning and afternoon, not too late. (at least in this corner of Europe I live in)After 900 mg it has been said to act more like a stimulant.
Posted by Sad Panda on June 2, 2004, at 13:57:33
In reply to Re: nusbu answers Ravenstorm, posted by Nusbu on June 2, 2004, at 13:48:01
> keeping Remeron 7.5 mg, in case needed go to 15 mg, Remeron for me is only a sleeping pill. Getting bad dreams from it so bit upset about it, but dislike benzos for sleep.
>
>Slowly increase Remeron as you get use to it. At low doses it is just a potent antihistamine, it will knock you out, but doesn't improve quality. At medium strength doses it blocks 5-HT2A receptors which improve time spent in deep sleep & quality overall. Remeron blocks SSRI induced vivid dreams & nightmares for me that are caused
by Effexor.Cheers,
Panda.
Posted by Nusbu on June 2, 2004, at 15:08:09
In reply to Re: Remeron for sleep. » Nusbu, posted by Sad Panda on June 2, 2004, at 13:57:33
Thanks a lot for that information. I will try it 15 mg later on. I wonder if 15 mg Remeron with 150 mg wellbutrin is a lot "AD-power" together? I am really sensitive, so I am a bit worried.
In case someone has an opinion, it is appreciated.
Nusbu
> > keeping Remeron 7.5 mg, in case needed go to 15 mg, Remeron for me is only a sleeping pill. Getting bad dreams from it so bit upset about it, but dislike benzos for sleep.
> >
> >
>
> Slowly increase Remeron as you get use to it. At low doses it is just a potent antihistamine, it will knock you out, but doesn't improve quality. At medium strength doses it blocks 5-HT2A receptors which improve time spent in deep sleep & quality overall. Remeron blocks SSRI induced vivid dreams & nightmares for me that are caused
> by Effexor.
>
> Cheers,
> Panda.
>
Posted by ravenstorm on June 2, 2004, at 16:20:03
In reply to Re: Remeron for sleep., posted by Nusbu on June 2, 2004, at 15:08:09
Just Curious--What type of wellbutrin are you on?
I've never tried it before. I think there is regular SR and XL(or something with an X).
You are lucky you have access to manerix. I'm from the states and so will have to order it over the internet. The thought of doing that is making me feel a bit like a criminal. And then God forbid it does work and then something goes on and I can't order it any more!!!!!
Do you know if manerix has a discontinutation (ie withdrawal) syndrome. I went through paxil hell and hope never to go through anything like that again. (Manerix seems to have a short half life, so I'm worried about it).
I wish this hypoglycemia problem would go away! I feel "wonky" a good deal of the day from low blood sugar. And eating every two hours is getting ridiculous.
Good Luck to you on the combo!
Posted by Nusbu on June 3, 2004, at 1:01:14
In reply to Re: nusbu: what type of wellbutrin, SR etc?, posted by ravenstorm on June 2, 2004, at 16:20:03
> Just Curious--What type of wellbutrin are you on?
I am it in a form of Zyban as we do not have brand name Wellbutrin over here and here normally Zyban is prescribed only for smoking cessation. Lucky me I have a pdoc, who is aware of Zyban's AD usage. I am not completely sure but I think it is slow realease form.
Manerix does not have any withdrawal symthoms, at least did not have for me, except depression creeping back.
I know your feeling about mail- ordering. I was considering ordering Amineptine earlier, but I could not. I felt too guilty even thinking about doing something illegel.
I let you know about my progress.
Take care!
Posted by BobS, on June 3, 2004, at 7:26:13
In reply to Re: remeron and blood sugar????????????, posted by ravenstorm on June 1, 2004, at 22:52:52
Ravenstorm,
What is the cause of your hypoglycemia? Do you monitor it? Have you seen an endocrinologist?I am curious about hypoglycemia as a reaction to vigorous exercise.
Thanks,
BobS.
Posted by Nusbu on June 6, 2004, at 14:13:56
In reply to More manerix questions, posted by ravenstorm on June 2, 2004, at 9:53:32
> What is the starting dosage of manerix? I read you take it twice a day. What time of day? Can you take manerix with remeron. I read an article indicating remeron was considered OK with parnate, nardil, marplan and selegiline. Does that mean its safe with manerix?
>
> Thanks in advance for any information!I had to answer once more as I read from an internet page of one European Pdoc about successfully combining Remeron and Manerix. so go ahead. He said the combo works very efficiently. Unfortunaly in was in a foreign language that it is no use of referring the page for you. (my mother tongue)
Posted by ravenstorm on June 6, 2004, at 18:56:13
In reply to Re: remeron and blood sugar for ravenstorm, posted by BobS, on June 3, 2004, at 7:26:13
Bob-
No I've never been to an endocrinologist. My hypoglycemia was easily controlled by making sure I ate every four hours (sometimes I could squeak to five hours). By eating every four hours, sometimes even if I wasn't that hungry yet, I kept my blood sugar level.
On Remeron I've had to eat every 2.5 to three hours and am getting all the hypogly. symptoms by three hours.
Interestingly enough, I started taking chromium picolinate this Friday to help even out the blood sugars and it worked!!!!!!!! I was thrilled, until it started causing stomach distress. I have GERD, and spent a couple of days really not feeling well until I just figured out today it must be the chromium.
ARGHHHHHHHHHHHHH. I thought I'd finally found a way to stay on this drug.
As far as exercise. Before Remeron my blood sugar was always helped by exercise. In other words, I could make it maybe an hour longer inbetween eating.
On Remeron, exercise seems to actually make it a little worse. Makes absolutely no sense to me!!
Posted by ravenstorm on June 6, 2004, at 18:57:48
In reply to Re: More manerix questions, posted by Nusbu on June 6, 2004, at 14:13:56
Thanks Nusbu. Much appreciated!
Just curious, what is your native tongue?
Hope you are doing well on your combo!
This is the end of the thread.
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