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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by bissie66 on February 9, 2007, at 10:40:58
I'm taking Remeron (45 mg since end of Dec., and increased to 60 mg last night), along with Effexor 450 mg, for impossible-to-treat depression. The two together are supposed to pack a punch, and they did -- I've never felt better in my life -- but the effect wore off quickly, after probably 1.5 months. Nature is creul. The best way I can describe the way I felt was constant hypomania, and the sensation of being a completely different person (happy for once!) living in same body. Now I'm back to angry, depressed, self-destructive.
I would like to know if anyone else has experienced this poop-out, and/or what dose of Remeron is effective for you. (Specifically, will it do do many any good to raise the dose??)
I'm bipolar, btw, and take lithium 900mg and lamictal 200 mg. As far as I'm concerned they don't do anything for me but my pdoc begs to differ.
I would appreciate anything anyone wants to share.
Posted by med_empowered on February 9, 2007, at 11:05:08
In reply to Remeron dosage + poop-out, posted by bissie66 on February 9, 2007, at 10:40:58
remeron is notorious for poop-out. You can ramp up the dose above 60--some go up to 90--but thats not really guaranteed to help. You might want to try a different AD or a different augmentation strategy. Have you tried Provigil or any other stimulants? Or benzos? Some people find 1-3mgs/day Klonopin helps a lot. You could try switching it up w/ the mood-stabilizer...upping lithium and/or lamictal, lowering lithium/raising lamictal, that sort of thing. In Bipolar depression, some people respond when the mood stabilizer(s) dose is increased; other people end up getting flattened-out on effective dosages, and a dosage reduction and/or switch to another medication is a better idea.
Posted by bissie66 on February 9, 2007, at 11:39:48
In reply to Re: Remeron dosage + poop-out, posted by med_empowered on February 9, 2007, at 11:05:08
aaah, dumptruck! i didn't know remeron was notorious for poop-out. i've experienced it with other drugs but this felt so *clean* or something. to be honest with myself, i think if it were going to work again at an increased dose i'd feel it by now. i always feel effect of good A/D's within 24 hrs. i told my doc i was willing to be fat and happy, but if i'm miserable i'll be damned if i'm gonna keep taking this and keep gaining weight. at least i'll be depressed and thin.
thank you SO much for your words and advice. (I always get a lot more out of this site than my own doc!) i was on adderall for a while and i liked it for the depression but i think my dose was too high and it made me crazy/manic. also, my doc now doesn't want me to take it bc he knows i'm in AA. there go my refills of klonopin too, which he was so very liberal about for years. i still have a bunch left though, so i've been taking it for a couple days (another way i know i'm HAPPY is i don't even want to take a benzo and step on my 'buzz'.)
do you think klonopin helps some people with depression? i'd like to discuss this with my doc before he cuts me off. i've never even heard of provigil. is it better than adderal? i'll also try changing around the bipolar meds a bit.
thank you SO MUCH.
> remeron is notorious for poop-out. You can ramp up the dose above 60--some go up to 90--but thats not really guaranteed to help. You might want to try a different AD or a different augmentation strategy. Have you tried Provigil or any other stimulants? Or benzos? Some people find 1-3mgs/day Klonopin helps a lot. You could try switching it up w/ the mood-stabilizer...upping lithium and/or lamictal, lowering lithium/raising lamictal, that sort of thing. In Bipolar depression, some people respond when the mood stabilizer(s) dose is increased; other people end up getting flattened-out on effective dosages, and a dosage reduction and/or switch to another medication is a better idea.
Posted by med_empowered on February 9, 2007, at 14:26:13
In reply to Re: Remeron dosage + poop-out, posted by bissie66 on February 9, 2007, at 11:39:48
Klonopin can help with depression...in some people, adding in a couple mgs/day makes depression more amenable to treatment. If you're bipolar, the Klonopin can add some mood stabilizer action, which can be good or bad (improved depression or possibly drug induced depression). Provigil is new and expensive...its a drug designed for narcolepsy, but being used for **everything**. Basically, it isn't a Ritalin or Amphetamine-style stimulant, but it still helps some people with fatigue, lethargy, etc. Plus its schedule IV (most stims are schedule II), so your doc can give you refills.
If your doc's knowledge of your AA participation is preventing you from getting adequate care that helps you live your life, maybe you should get a new doc. Shrinks can be uppity, but they work for YOU--you can always get a new one.
I dont want to sound fruity, but supplements can help, too--if nothing else, you might get more mileage out of whatever you end up taking.Good luck!
Posted by bissie66 on February 12, 2007, at 11:16:29
In reply to Re: Remeron dosage + poop-out, posted by med_empowered on February 9, 2007, at 14:26:13
Thanks again, MedEmpowered. You've helped me a lot on several occasions. I am going to look for a new doc -- this just isn't working! I mean, I'm not even being treated it seems. I did experience an upswing over the weekend but it teetered into mania. Hell, it's better than depression!
This is the end of the thread.
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