![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by med_empowered on January 6, 2006, at 1:57:45
hi! So, I've been thinking about possibly trying to Remeron to help with sleep and to take care of some anxiety/OCD/depression (basically generalized neurotic stuff) I still have going on. Anyway, I do **not** want to gain weight--I'm actually trying to lose weight. I just need to be less anxious right now. So, if I quickly titrated up to 30mgs or 45mgs, would I still gain weight? I understand the sedative effects tend to lessen at higher doses...what about the weight gain?
Here's my problem, btw--I have this weird obsession that I'm balding (I'm not--and my friends are getting exasperated by this particular obsession) and that people are staring at me, talking about me, etc. Its really irritating, and I think I can work through it but...I'm starting school again soon, so I need to minimize the anxiety and OCD at least for a while so I can focus on more important things. What should I do?
Posted by Sarah T. on January 6, 2006, at 2:31:59
In reply to Remeron dosing and weight gain, posted by med_empowered on January 6, 2006, at 1:57:45
Hi med-empowered,
I'm sorry, I can't be of much help regarding your Remeron question, although I will be interested to read the replies.
Regarding your feeling that you're balding. . . Why do you think that? Are you losing hair? Are you seeing many more hairs on your brush or on your clothes? There are many possible causes of hair loss, which you probably know.
Do you really see less hair on your head and more on your brush and elsewhere?
Posted by xbunny on January 6, 2006, at 4:45:31
In reply to Remeron dosing and weight gain, posted by med_empowered on January 6, 2006, at 1:57:45
> if I quickly titrated up to 30mgs or 45mgs, would I still gain weight? I understand the sedative effects tend to lessen at higher doses...what about the weight gain?
I dont find that 30mg is any less weight gain and hunger inducing than 15mg, if anything I would say its slightly more. 30mg is less sedating though. Buns
Posted by med_empowered on January 6, 2006, at 5:16:44
In reply to Re: Remeron dosing and weight gain, posted by xbunny on January 6, 2006, at 4:45:31
hi! My hair's really short right now. I'd say I think I have hair loss that is diffuse (I think that's the term)..it seems to be (to me, at least) generalized thinning on the top, rather than BALDING--bald spots, receeding hairline--per se. Some of the medications I've taken--anticonvulsants, Klonopin, and stimulants, in particular--could have caused/contributed to hair loss. I just dont know what to do. I'm afraid that with my pscyh. history and minor degree of hair loss a dermatologist would refer me to a pscyhiatrist rather than RX Propecia or something.
As for the other thing..people talking about me, etc...That seems to be getting better, but only b/c I **handle** it better. Like, today--for some reason, I had in my mind that these guys off to the corner knew me from somewhere (for some reason, I thought it was from the mental hospital, although they didn't look at all familiar) and they were discussing my particular case. Crazy, huh? But...I just focused on what other people at my table were saying and although I still had those bizarre thoughts in my head, I was able to disconnect from them emotionally.
I'm just concerned now that I'm going back to school that I'll freak out b/c of these sorts of thoughts..I simply can't have anymore interruptions in my education due to mentall illness issues. It just *CANNOT* happen.
Posted by Declan on January 6, 2006, at 12:28:45
In reply to Remeron dosing and weight gain, posted by med_empowered on January 6, 2006, at 1:57:45
Then there's rage/anger. I suppose it's not common, but I'd really not want that.
Declan
Posted by Racer on January 6, 2006, at 13:08:59
In reply to Re: Remeron dosing and weight gain, posted by Declan on January 6, 2006, at 12:28:45
> Then there's rage/anger. I suppose it's not common, but I'd really not want that.
> DeclanI started on half a tablet, which set off some weird rage response -- and I rarely raise my voice for any reason, thus the depression :-) -- and tried raising the dose to see if that would calm down. It got worse.
By the last day I took it, I was telling my husband to stay away and keep the cats away, because I was so afraid I'd hurt one of them.
I still think, though, that the circumstances under which I took it had a lot to do with my reaction. I know that that is one possible reaction, but I think it might not have been nearly so severe in other circumstances.
For me, it also came with pretty profound insomnia. Talk about idiopathic response, huh?
Posted by linkadge on January 6, 2006, at 16:03:03
In reply to This was my response, posted by Racer on January 6, 2006, at 13:08:59
Anger response to remeron is not that uncommon.
Similar reactions have been commonly noted with other alpha-2 antagonists such as yohimbine.
I would not really recomend remeron as a first line treatement for OCD.
I found it did help sleep but that it worsened obsessive type thinking.
I would recomend anafranil since it is generally a better anti-OCD agent, and insomnia is generally milder than that caused by SSRI's.
Linkadge
Posted by Declan on January 6, 2006, at 16:07:23
In reply to This was my response, posted by Racer on January 6, 2006, at 13:08:59
Hello Racer
Pretty profound insomnia?? Wow. I only ever took 7.5mg and that's hard to imagine. I'd read some of your old exchanges with Sad Panda on the subject of rage.
Declan
Posted by Phillipa on January 6, 2006, at 20:05:52
In reply to Re: This was my response » Racer, posted by Declan on January 6, 2006, at 16:07:23
Med why would a dermatologist refer you to a psychiatrist? Are you becoming delusional? You recently posted on Social that you were off all meds. For how long? Did you feel you were losing hair while on meds? Fondly, Phillipa
Posted by yxibow on January 7, 2006, at 3:56:53
In reply to Remeron dosing and weight gain, posted by med_empowered on January 6, 2006, at 1:57:45
> hi! So, I've been thinking about possibly trying to Remeron to help with sleep and to take care of some anxiety/OCD/depression (basically generalized neurotic stuff) I still have going on. Anyway, I do **not** want to gain weight--I'm actually trying to lose weight. I just need to be less anxious right now. So, if I quickly titrated up to 30mgs or 45mgs, would I still gain weight? I understand the sedative effects tend to lessen at higher doses...what about the weight gain?
I never recommend "quick titrations", you could have some idosyncractic reaction. In my experience, neither the sedative effect nor the weight gain changed at a lower dose or a higher dose, it just compounded it. I never got to 60, so I wouldn't know -- that would be an awfully high dose and I don't know if any psychiatrist would prescribe it.
> Here's my problem, btw--I have this weird obsession that I'm balding (I'm not--and my friends are getting exasperated by this particular obsession) and that people are staring at me, talking about me, etc. Its really irritating, and I think I can work through it but...I'm starting school again soon, so I need to minimize the anxiety and OCD at least for a while so I can focus on more important things. What should I do?No form of OCD is "wierd", trust me. I've heard of the strangest form of OCD and my personal worst OCD, while not out of the ordinary, had a YBOCS (test measurement) of 39, I believe. That's one less than off the scale. I can sympathise with the feeling of baldness though if there is any actual real component to it -- it is a male pride, and I do have what sounds similar, slightly thinning, with just a small patch of loss. Who knew? There's no baldness history in my family but I suppose you could trace back generations.
It sounds like you have OCD mixed with some paranoia. But you seem to be managing the paranoia by rationalization. Otherwise I would suggest a low dose Seroquel addition, it would make an SSRI more powerful. I would suggest any of the SSRIs that are tolerable to you -- I dont know if I would mix Anafranil and Seroquel although I'm sure it has been done, its just more risk of side effects I think because its an older medication. But the TCA Anafranil, for severe OCD, is extremely effective, even though it is 26 years old give or take, although it wasn't approved until more recently. I might also add a pinch of Klonopin, Xanax, or Valium while titrating up an SSRI to reduce anxiety effects.
Hope you feel better.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.