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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Jane9 on April 12, 2005, at 2:29:44
This happened to me with mirtazapine (Remeron). Does anyone have any similar stories or remedies? Thanks.
Posted by SLS on April 12, 2005, at 6:50:50
In reply to Discontinuation-induced refractoriness: Remeron, posted by Jane9 on April 12, 2005, at 2:29:44
> This happened to me with mirtazapine (Remeron). Does anyone have any similar stories or remedies? Thanks.
It seems as if every antidepressant (along with lithium) has produced stories of a failure to recapture the response to it after having stopped taking it. This is the first time I have seen this described for Remeron, though. It seems most common among the SSRIs.
What dosage had you been taking when it worked?
For how long had you discontinued it?
What dosage are you trying now?If no other drug represents an alternative for you, perhaps you can try augmenting Remeron with drugs like Effexor. That particular combination is deemed particularly effective and has been tagged as "California Rocket Fuel". Even lithium might be worth a try.
- Scott
Posted by Phillipa on April 12, 2005, at 18:39:32
In reply to Re: Discontinuation-induced refractoriness: Remeron, posted by SLS on April 12, 2005, at 6:50:50
I'd like to follow this Thread as I was taking remeron. Thanks Phillipa
Posted by Jane9 on April 13, 2005, at 2:37:05
In reply to Re: Discontinuation-induced refractoriness: Remeron, posted by Phillipa on April 12, 2005, at 18:39:32
I had only been taking the Remeron for 3 or 4 days, at a very small dose - I think it was 7.5mg, as the 15 mg. gave me nightmares the first night. Within a day I was "like a new person" - I had never had such success in 15 years of different ADs. After stopping, I started it again after just a week or so, to no effect (no side effects anymore either, interestingly). Also tried greater doses at later times to no effect.
Effexor produced very bad side effects. I am now starting on lithium for the first time, to be combined with Remeron -does anyone know whether the order I take these two meds (or starting them both at the same time) makes a difference? Thanks everyone for your feedback.
Posted by SLS on April 13, 2005, at 7:11:56
In reply to Re: Discontinuation-induced refractoriness: Remeron, posted by Jane9 on April 13, 2005, at 2:37:05
> I had only been taking the Remeron for 3 or 4 days, at a very small dose - I think it was 7.5mg, as the 15 mg. gave me nightmares the first night. Within a day I was "like a new person" - I had never had such success in 15 years of different ADs. After stopping, I started it again after just a week or so, to no effect (no side effects anymore either, interestingly). Also tried greater doses at later times to no effect.
>
> Effexor produced very bad side effects. I am now starting on lithium for the first time, to be combined with Remeron -does anyone know whether the order I take these two meds (or starting them both at the same time) makes a difference? Thanks everyone for your feedback.
>
>I doubt your system has become refractory to Remeron after a few days' exposure to it. Your "blip" improvement is not rare and sometimes happens withing the first 3 days of beginning a new drug. It usually doesn't last for more than a day or two. The true response occurs much later, at least two weeks after beginning treatment. You might have "tickled" the brain with Remeron.
These blip responses are often a good prognosis for later response.I don't think it matters what order you start the two drugs (Remeron and lithium). It's a great question, though. If it were me, I would probably try the Remeron as monotherapy first and add the lithium later on if you don't respond.
How much lithium was your doctor talking about having you take?
- Scott
Posted by Jane9 on April 14, 2005, at 15:10:41
In reply to Re: Discontinuation-induced refractoriness: Remeron, posted by Jane9 on April 13, 2005, at 2:37:05
The dose is 300mg. of Lithobid, 30mg Remeron.
Posted by SLS on April 14, 2005, at 15:29:42
In reply to Re: Discontinuation-induced refractoriness: Remeron, posted by Jane9 on April 14, 2005, at 15:10:41
> The dose is 300mg. of Lithobid, 30mg Remeron.
This is a conservative strategy. He's starting you at the lowest dosages of each medication that would place them within the effective range. This leaves you room to work up to perhaps lithium 600mg and Remeron 60mg.
Please post of your progress. Unfortunately, taking things one step at a time can be tedious and downright frustrating. It sounds like you have a good doctor.
Good luck.
- Scott
Posted by Jane9 on April 15, 2005, at 20:33:07
In reply to Re: Discontinuation-induced refractoriness: Remeron » Jane9, posted by SLS on April 14, 2005, at 15:29:42
Thanks; I'll be sure to post again as things develop.
This is the end of the thread.
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