![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by CareBear04 on January 13, 2008, at 22:41:05
Hi everyone! I'm interested in hearing about people's experiences with Remeron. I was started on it last week, but I haven't noticed really any effects from it, good or bad. My dr. told me that the lower the dose, the more sedating it is, so we started with 7.5. To give it a chance to work, I didn't take any other meds for sleep, and I couldn't fall asleep for hours until I finally took some Ambien. I thought maybe it takes a few days to build up and start working, but that hasn't been the case. Contrary to the lower dose-more sedating theory, 15mg has been slightly more effective, but it still takes almost two hours to work. I also heard that lower doses stimulate the appetite more and cause more weight gain, so I was interested to see whether it would do that to me. So far, my appetite hasn't seemed to be effective.
Any experiences or suggestions? I'm trying Remeron for sleep and not as an AD, although I definitely am depressed. I guess it was also prescribed with the hope of improving my eating, but I'm kind of ambivalent about that-- I know I need to eat more, but I hate the idea of using drugs to cause weight gain. Any responses would be great! Thanks!
CB
Posted by Phoenix1 on January 13, 2008, at 23:23:35
In reply to Experiences with Remeron?, posted by CareBear04 on January 13, 2008, at 22:41:05
> Hi everyone! I'm interested in hearing about people's experiences with Remeron. I was started on it last week, but I haven't noticed really any effects from it, good or bad. My dr. told me that the lower the dose, the more sedating it is, so we started with 7.5. To give it a chance to work, I didn't take any other meds for sleep, and I couldn't fall asleep for hours until I finally took some Ambien. I thought maybe it takes a few days to build up and start working, but that hasn't been the case. Contrary to the lower dose-more sedating theory, 15mg has been slightly more effective, but it still takes almost two hours to work. I also heard that lower doses stimulate the appetite more and cause more weight gain, so I was interested to see whether it would do that to me. So far, my appetite hasn't seemed to be effective.
>
> Any experiences or suggestions? I'm trying Remeron for sleep and not as an AD, although I definitely am depressed. I guess it was also prescribed with the hope of improving my eating, but I'm kind of ambivalent about that-- I know I need to eat more, but I hate the idea of using drugs to cause weight gain. Any responses would be great! Thanks!
> CBSome people are knocked ut by 7.5mg or less. Others need 15mg. It's not the same "sleepy" feeling as ambien or the traditonal sleep meds, so don't expect that. You may need to take it 1-2 hours before actually sleeping. I did. My problem was that during that 1-2 hours, I ate everything in sight... But it did make me sleep a bit better!
Phoenix1
Posted by Phillipa on January 14, 2008, at 0:09:36
In reply to Re: Experiences with Remeron?, posted by Phoenix1 on January 13, 2008, at 23:23:35
Wierd me l5 even with benzos and seroquel didn't make me sleepy and I was in the hospital too. I took it a month nothing no eating either. See told you I'm wierd. Phillipa
Posted by tensor on January 14, 2008, at 1:13:59
In reply to Experiences with Remeron?, posted by CareBear04 on January 13, 2008, at 22:41:05
I have been on Remeron for ten years, with doses ranging from 15 to 45mg. Although I have tried a *lot* of combos I have always kept Remeron in my regime. It always does something even when I'm not in remission, in my opinion it's smartest drug for depression, or better put, least dumb.
The only notable major drawback is weight gain, although daytime sedation seems to be an issue for some, I have never had a problem with that. I recently up'd to 30mg and now I don't need zopiclone for sleep anymore, 15mg just doesn't work for me for sleep./Mattias
Posted by bleauberry on January 14, 2008, at 18:09:02
In reply to Experiences with Remeron?, posted by CareBear04 on January 13, 2008, at 22:41:05
So, eating and sleeping are the problem areas. Two drugs I know of work well for that. One is remeron. Your early days with that do not seem encouraging. If someone is going to be knocked out by remeron, it will happen the first dose. Maybe it takes time to build up, but not in my own experience. I was on it for over a year along with prozac. It was fair, but nothing stellar.
The other drug is amazing for a lot of people and a wide variety of symptoms, including anxiety, panic, delusional thinking, depression (especially with an ssri), sleeping, and anorexia. It is Zyprexa. I was on it for 8 years. Though I still frown on antipsychotics in general, I find it hard to say anything bad about zyprexa. Most people complain about the weight gain. I needed it. I only gained 10lbs, but that was just right. And never slept better in my life. Daytimes were not drugged like other drugs did to me.
Basically, I was not overly impressed with remeron with doses ranging from 7.5mg to 30mg over a year. Sedation I did get from it pooped out in a few weeks. Didn't gain much weight. But I was surprised with zyprexa at 5mg for 8 years. It had me eating good, sleeping good, feeling better all around, and gaining a little much needed weight. After getting used to it, I did not have any side effects after about 3 weeks.
To put it in context, both of these drugs were in combination with 20mg prozac.
Posted by CareBear04 on January 14, 2008, at 18:16:11
In reply to Re: Experiences with Remeron?, posted by Phoenix1 on January 13, 2008, at 23:23:35
thanks phoenix! yeah, the one time i was able to sleep with just remeron, i didn't have the sleepy feeling i'm used to from ambien, seroquel, or any of the sleep benzos. that's interesting that your appetite was increased during the period in which it was kicking in. was it increased in general at other times? thanks again!
cb
Posted by CareBear04 on January 14, 2008, at 18:20:50
In reply to Re: Experiences with Remeron? » CareBear04, posted by tensor on January 14, 2008, at 1:13:59
that's interesting about 30mg being more sedating for you than 15mg-- what i heard was that there was an inverse relationship between dose and sedation. what about the increase in appetite? did your appetite increase more as the dose increased? about how much weight did you end up gaining? is the weight gain effect of remeron due to increased appetite, or does it do something to your metabolism as well?
thanks!
cb
Posted by CareBear04 on January 14, 2008, at 18:34:49
In reply to Re: Experiences with Remeron?, posted by bleauberry on January 14, 2008, at 18:09:02
thanks bleauberry!
i've tried zyprexa, but only for a few weeks. you're right-- it is a really effective drug, and it stabilized my mood. maybe i wasn't on it long enough, but i did expereince some pretty unpleasant side effects. zyprexa totally knocked me out, which was both good and bad, and i felt hungover the next day. and, even though i haven't been hit by the weight gain side effect of any other med, i definitely gained weight on zyprexa-- about ten pounds in three weeks, which amounts to about 10% of my body weight. do you know whether zyprexa causes weight gain by increasing appetite only or also by affecting metabolism in some way? although zyprexa caused me to eat a whole lot more, i don't put on weight that easily, so it's hard to believe that the whole 10 pounds were due to increased appetite. when i'm depressed or manic, i tend to lose weight, and i'm on that trajectory right now. i know that stopping weight loss and gaining some back would be a good thing, but i found the zyprexa weight gain troubling, with respect to the quantity, the rate, and the lack of control i felt i had over my body. maybe, like you, i would stop having the side effects after a certain point. that would be good since zyprexa did work well for my symptoms. thanks for the suggestion!
cb
Posted by bleauberry on January 14, 2008, at 19:20:49
In reply to Re: Experiences with Remeron? » bleauberry, posted by CareBear04 on January 14, 2008, at 18:34:49
I think we are sometimes overdosed just because of what the manufacturer or the drugrep or the clinical trial used as a reference. I don't know what dose zyprexa you did. If it was 5mg, try 1.25mg. If it was 2.5mg, try 1.25mg. If it was 10mg, try 2.5mg. You would need a pill splitter.
Zyprexa weight gain in my opinion is not just from appetite increase. It has been shown to turn on or off certain genes that are involved in metabolic processes, including genes related to weight control. Someone told me I am skinny because both my grandfathers were and it is genetic and there is nothing I can do about. I said yes there is, I can change those genes. They said, how? I said zyprexa. :-)
One method I found for reducing zyprexa side effects the next day was to take it at 4pm each day. That gave a relaxed evening with a definite need to sleep by 9pm, and not much leftover grogginess the next morning. Most people take zyprexa near bedtime which is a guaranteed way to maximize next day grogginess.
After a couple months I had no side effects anyway. I'm just saying I think most doctors prescribe doses that are higher than needed, and the instructions are to take it at bedtime which in my experience is bad advice.
> thanks bleauberry!
> i've tried zyprexa, but only for a few weeks. you're right-- it is a really effective drug, and it stabilized my mood. maybe i wasn't on it long enough, but i did expereince some pretty unpleasant side effects. zyprexa totally knocked me out, which was both good and bad, and i felt hungover the next day. and, even though i haven't been hit by the weight gain side effect of any other med, i definitely gained weight on zyprexa-- about ten pounds in three weeks, which amounts to about 10% of my body weight. do you know whether zyprexa causes weight gain by increasing appetite only or also by affecting metabolism in some way? although zyprexa caused me to eat a whole lot more, i don't put on weight that easily, so it's hard to believe that the whole 10 pounds were due to increased appetite. when i'm depressed or manic, i tend to lose weight, and i'm on that trajectory right now. i know that stopping weight loss and gaining some back would be a good thing, but i found the zyprexa weight gain troubling, with respect to the quantity, the rate, and the lack of control i felt i had over my body. maybe, like you, i would stop having the side effects after a certain point. that would be good since zyprexa did work well for my symptoms. thanks for the suggestion!
> cb
Posted by Phoenix1 on January 14, 2008, at 20:10:29
In reply to Re: Experiences with Remeron? » Phoenix1, posted by CareBear04 on January 14, 2008, at 18:16:11
> thanks phoenix! yeah, the one time i was able to sleep with just remeron, i didn't have the sleepy feeling i'm used to from ambien, seroquel, or any of the sleep benzos. that's interesting that your appetite was increased during the period in which it was kicking in. was it increased in general at other times? thanks again!
> cbMostly just in the period that it was kicking in. I was ravenous. I basically ate myself to sleep and woke up in a mess of half eaten food, crumbs, etc. Very weird. Seroquel does sort of the same thing to me except it kicks in so fast I don't have time to eat anything. I just fall asleep hungry and thinking of food.
Phoenix1
Posted by tensor on January 15, 2008, at 0:40:36
In reply to Re: Experiences with Remeron? » tensor, posted by CareBear04 on January 14, 2008, at 18:20:50
> that's interesting about 30mg being more sedating for you than 15mg-- what i heard was that there was an inverse relationship between dose and sedation. what about the increase in appetite? did your appetite increase more as the dose increased? about how much weight did you end up gaining? is the weight gain effect of remeron due to increased appetite, or does it do something to your metabolism as well?
> thanks!
> cbRemeron is only sedating when I take it at bedtime which perhaps lasts about a couple of hours. And yes, my weight gain increases with dosage, I think it's an effect of both incresed appetite and changed metabolism. I haven't ended up with a final weight as I'm still putting on :( I am though trying to fight appetite with ranitidine now as one babbler here recently suggested.
/Mattias
Posted by 4WD on January 20, 2008, at 19:07:42
In reply to Re: Experiences with Remeron? » CareBear04, posted by tensor on January 15, 2008, at 0:40:36
Just wondering if Remeron is a good choice for someone with severe anxiety. Actually it's not anxiety where I worry about stuff, it's fear. A feeling like 100 times too much adrenaline circulating in my body. The feeling is concentrated in my stomach and chest.
Anyway, Remeron users, does it help with anxiety?
Marsha
Posted by CareBear04 on January 21, 2008, at 0:11:47
In reply to What about anxiety? Does Remeron help?, posted by 4WD on January 20, 2008, at 19:07:42
hi-- i'm probably not the best person to attest to what remeron does or doesn't do, but it sounds like your anxiety is pretty panicky. for the most part, i usually have the constant worrying and jumpiness, but occasionally, i've had more physical reactions like what you described. for those, i found benzos and beta blockers more helpful, at least as far as immediate relief. not directly on point as to what you could expect from remeron, but just my experience...
cb
Posted by KarenRB53 on March 4, 2008, at 13:33:50
In reply to Re: Experiences with Remeron? » CareBear04, posted by bleauberry on January 14, 2008, at 19:20:49
> I think we are sometimes overdosed just because of what the manufacturer or the drugrep or the clinical trial used as a reference. I don't know what dose zyprexa you did. If it was 5mg, try 1.25mg. If it was 2.5mg, try 1.25mg. If it was 10mg, try 2.5mg. You would need a pill splitter.
>
> Zyprexa weight gain in my opinion is not just from appetite increase. It has been shown to turn on or off certain genes that are involved in metabolic processes, including genes related to weight control. Someone told me I am skinny because both my grandfathers were and it is genetic and there is nothing I can do about. I said yes there is, I can change those genes. They said, how? I said zyprexa. :-)
>
> One method I found for reducing zyprexa side effects the next day was to take it at 4pm each day. That gave a relaxed evening with a definite need to sleep by 9pm, and not much leftover grogginess the next morning. Most people take zyprexa near bedtime which is a guaranteed way to maximize next day grogginess.
>
> After a couple months I had no side effects anyway. I'm just saying I think most doctors prescribe doses that are higher than needed, and the instructions are to take it at bedtime which in my experience is bad advice.
>
I agree with you about doctors starting people on meds at too high of a dosage. My doctor just added Zyprexa to Prozac because the Prozac had pooped out again. I've been taking it for a week and I can't believe how much better I feel. I'm wondering though, are there any studies or just personal experience that Zyprexa works at a low dose of 1.25mg (I split the 2.5mg).Thanks, Karen
Posted by g_g_g_unit on March 6, 2008, at 4:15:46
In reply to Re: Experiences with Remeron?, posted by KarenRB53 on March 4, 2008, at 13:33:50
i used ranitidine to curb hunger while on 15mg remeron - based on the advice of a poster here - and it worked. sedation did wear off somewhat, though not to a degree i would've liked, and overall remeron did nothing to stop my anxiety attacks. 30mg meanwhile was incredibly mentally agitating.
Posted by actvj on March 11, 2008, at 7:44:18
In reply to Re: Experiences with Remeron?, posted by g_g_g_unit on March 6, 2008, at 4:15:46
I'm guessing that Remeron is Mirtazapine in the UK. I've got to say that when I first went on it over two years ago it helped me out of a hole. Other than the weight gain it brought me down a notch or two and I have managed to get on my feet again;-)
The problem is my Doc has me on a reduction to come off it. About two months ago I reduced from 30mg to 15 overnight. Had a couple of weeks of feeling horrible and it seemed to level off a bit. Untill recently. The levels of anxiety that i am experiencing are horriffic. I'm battling like a maniac just to stay afloat! I had to surrender and up the dose two nights ago and hey presto i'm coming out of it. Once i settle out I think i'm going to try and wean me off over a longer period and a lower dose reduction. I can tell you this I forgot how bad it can get when anxiety/depression hits as i've had two years that have been relatively free of major anxiety etc. Keep going troops we'll get there in the end.
Posted by actvj on March 11, 2008, at 7:55:23
In reply to Re: Experiences with Remeron?, posted by KarenRB53 on March 4, 2008, at 13:33:50
Guys
Apologies for that posting. It was my first post and I posted to the wrong board. Once again my apologies.
actvj
Posted by Phillipa on March 11, 2008, at 20:09:47
In reply to Re: Experiences with Remeron?, posted by actvj on March 11, 2008, at 7:55:23
If it was for withdrawal it also seems to apply here so it's great. Thanks for the contribution and welcome to babble. Love Phillipa
Posted by Chazzzer on March 14, 2008, at 23:08:48
In reply to Experiences with Remeron?, posted by CareBear04 on January 13, 2008, at 22:41:05
> Hi everyone! I'm interested in hearing about people's experiences with Remeron. I was started on it last week, but I haven't noticed really any effects from it, good or bad. My dr. told me that the lower the dose, the more sedating it is, so we started with 7.5. To give it a chance to work, I didn't take any other meds for sleep, and I couldn't fall asleep for hours until I finally took some Ambien. I thought maybe it takes a few days to build up and start working, but that hasn't been the case. Contrary to the lower dose-more sedating theory, 15mg has been slightly more effective, but it still takes almost two hours to work. I also heard that lower doses stimulate the appetite more and cause more weight gain, so I was interested to see whether it would do that to me. So far, my appetite hasn't seemed to be effective.
>
> Any experiences or suggestions? I'm trying Remeron for sleep and not as an AD, although I definitely am depressed. I guess it was also prescribed with the hope of improving my eating, but I'm kind of ambivalent about that-- I know I need to eat more, but I hate the idea of using drugs to cause weight gain. Any responses would be great! Thanks!
> CBI used Remeron (aka Mirtazapine) 15mg about three years ago for insomnia. Boy, did it work great! It was my first sleep wonder drug, it made me sleep without any side-effects. The problem was that it stopped working about three months in. I told the doctor and she said "yeah, that happens." I didn't sleep well again with no side-effects until a doctor recently prescribed me Seroquel. I'd tried every known sleep medication in the years since, and the only one that worked was Ambien. Unfortunately, I had horrible hangovers from it. I was willing to put up with them though, as otherwise I was only sleeping about two hours a night. I usually only used Ambien about twice a week, just to get a couple of full nights of sleep so I could survive the rest of the week.
The Remeron never caused any weight gain for me, nor has the Seroquel so far (despite it being a common side-effect of both). I'm taking 12.5mg of Seroquel early in the evening, then another 12.5mg around midnight to fall asleep around 2:00 a.m. The doctor didn't tell me to do this, I figured out on my own that the oversleeping in the morning wasn't as bad if I spread out the dose this way. I'm slowly altering the times to be earlier, trying to get more sleep without sleeping through the alarm in the morning. So far, even at only five hours of sleep a night, Seroquel is a godsend. Sorry, I started talking about Remeron and then went on and on about Seroquel. I guess I just can't help talking about my current wonder drug.
From what I remember, there was no ramp-up period for Remeron. If it isn't working at your current dose, try a different one. In your case, maybe 3.25mg? Or maybe 45mg? Everybody's different.
Also, you mentioned that you finally gave up and took Ambien. Do you take Ambien a lot? One of the common side-effects of prolonged use is the inability to sleep when you don't take it...even when you're taking something else that should make you sleep. Ambien is a powerful drug, and you may need to wean yourself off of it while you continue to take the Remeron.
Posted by Molybdenum on March 15, 2008, at 17:46:41
In reply to Experiences with Remeron?, posted by CareBear04 on January 13, 2008, at 22:41:05
I take 225mg mirtazapine - 5 x 45mg tabs every night. I also take venlafaxine.
I have heard too that the sedative action is supposed to be more pronounced at the lower dosages. But for me, it's always helped me to get to sleep - at least for a few months at each new dosage. When it stopped knocking me out at night the the Dr would increase my dose again & again I would get the sedative effect.
He said its not supposed to work that way but it does for me. Unfortunately, I think I'm on the max he'll prescribe now. So when this stops helping me sleep I HAVE NO IDEA WHAT WILL HAPPEN..!
Will I need to taper down to nothing over months? All the time not sleeping? I look forward to this NOT.
Anyway, I'm male & 6' tall. I weighed 89kg before I stated taking it. Then I peaked at 110kg. I blame the mirtazapine for that 20kg.
I'm back to 100kg now but I think a lot of people have cravings for sugary things on this drug, so maybe watch out...!
I remember when I started taking it I got a little sedated the next day. That passed over the first few weeks.
At the height of my sensitivity to it, the good thing was that I could take the tabs at 8pm & be falling on my way to the bed by 9pm. I got a good 10hrs sleep every night. It's been a few years now & although it still helps me to sleep (I've always had trouble), it's nowhere near as powerful as it was in the early days for me.
It's one of the few ADs that isn't supposed to have "sexual" side effects. Just the weight gain & sedation issue.
Good Luck ;)
Posted by 4WD on March 15, 2008, at 20:51:28
In reply to Re: Experiences with Remeron?, posted by Molybdenum on March 15, 2008, at 17:46:41
Have you considered taking Trazadone for sleep? I mean if the Remeron poops out on you again. Trazadone is my miracle drug. Allows me to get 8-9 hours every night with no side effects except a bit of morning grogginess.
Just a thought...
Marsha>
Posted by yxibow on March 16, 2008, at 20:24:30
In reply to Re: Experiences with Remeron?, posted by Molybdenum on March 15, 2008, at 17:46:41
> I take 225mg mirtazapine - 5 x 45mg tabs every night. I also take venlafaxine.
You're serious ? 225mg mirtazapine is almost 4 times what psychiatrists would prescribe normallyIts way below the LD50 but thats a massive Serotonin surge. I hope your doctor knows what he is doing.
> I have heard too that the sedative action is supposed to be more pronounced at the lower dosages. But for me, it's always helped me to get to sleep - at least for a few months at each new dosage. When it stopped knocking me out at night the the Dr would increase my dose again & again I would get the sedative effect.The sedative and weight gain is rarely more pronounced at lower vs. higher doses, weight gain just increases for the most part.
> He said its not supposed to work that way but it does for me. Unfortunately, I think I'm on the max he'll prescribe now. So when this stops helping me sleep I HAVE NO IDEA WHAT WILL HAPPEN..!
The max I ever was prescribed was 52.5
> Will I need to taper down to nothing over months? All the time not sleeping? I look forward to this NOT.
>
> Anyway, I'm male & 6' tall. I weighed 89kg before I stated taking it. Then I peaked at 110kg. I blame the mirtazapine for that 20kg.
>
> I'm back to 100kg now but I think a lot of people have cravings for sugary things on this drug, so maybe watch out...!It may change metabolism... I certainly got over 100kg, but primarily I think just like Seroquel or Zyprexa or Trazodone for some people it increases appetite
> I remember when I started taking it I got a little sedated the next day. That passed over the first few weeks.
>
> At the height of my sensitivity to it, the good thing was that I could take the tabs at 8pm & be falling on my way to the bed by 9pm. I got a good 10hrs sleep every night. It's been a few years now & although it still helps me to sleep (I've always had trouble), it's nowhere near as powerful as it was in the early days for me.
>
> It's one of the few ADs that isn't supposed to have "sexual" side effects. Just the weight gain & sedation issue.
>
> Good Luck ;)
See one of my postings about sleep disorders -- if you've gotten up to that dose, you may be very tolerant to it -- Trazodone is better for medium term sleep, but it too catches up after a few months or so.Basically to really rid a sleep disorder, one has to sleep with no aids and relax the best one can over a period of a few weeks. But Trazodone would be a better bet.
Now I'm sure you're getting a whopper of antidepressant effect at that dose, I can't imagine how full the 5HTx blockade is.
Good luck
tidings
-- Jay
Posted by Molybdenum on March 16, 2008, at 21:15:09
In reply to Re: Experiences with Remeron? » Molybdenum, posted by 4WD on March 15, 2008, at 20:51:28
> Have you considered taking Trazadone for sleep? I mean if the Remeron poops out on you again. Trazadone is my miracle drug. Allows me to get 8-9 hours every night with no side effects except a bit of morning grogginess.
> Just a thought...
>
>
> Marsha
>
Hi Marsha,Do you mean Trazodone..?
http://en.wikipedia.org/wiki/TrazodoneI've never heard of it either way. And unfortunately it looks like its not available in my country.
Thanks though ;)
Posted by Molybdenum on March 16, 2008, at 22:01:54
In reply to Re: Experiences with Remeron? » Molybdenum, posted by yxibow on March 16, 2008, at 20:24:30
Yes I;m a bit of a "horse" when it comes to certain meds. Other's I am quite sensitive to. And I also can't help having this stupid belief that "more is better". The theory has always worked with toys, chocolate, hifi amplifiers, money, sex.....right?????? :)
Apart from the 225mg mirtazapine, I take 600mg venlafaxine, 6mg melatonin, 500mcg clonazapine, 12.5mg Stilnox CR and 32mg of Atacand (for the hypertension we blame on the venlafaxine).
I'd really like to wean myself down to a more reasonable mirtazapine dose but I'm in a bit of a stressful situation at the moment - divorcing, custody battle, poor, no job - need I go on? And guns are impossible to get in my country (Aust) so there's no quick way out if I ever can't stand it anymore. And I can't just run down to Tijuana & pickup some Nembutal like US people can. The Northern Territory (aka state) gov't here was leading the world in "assisted suicide" legislation a few years back. Then the federal gov't chickened out & wound us back to the dark ages. I think you have to be a VET to get Nembutal here nowadays.
Hence I'll just keep on the current combo & try to reduce it back when I'm settled in 6 months or so (unless I'm dead by then of course ;:)
My p-doc is very senior in his field. Has been practicing for yrs & is a senior whatever at 2 Universities, blah, blah, blah. So I don't think he's a bad doc.
I think his belief is that different people need different amounts and that there's a limit to how much effect the drug can have (at least over time gradually increasing it) on a given brain. He also believes that some ADs do poop out over time. And honestly, I'm not getting any new side effects at these doses.
One bad thing happened the other night though - instead of taking 5 x 45mg, I just took 3. I was already sleepy & I thought maybe it wouldn't be so hard to bring down the dose rapidly.
Well......I woke up at 3am in a state of DREAD bordering on physical PANIC - really WEIRD & BAD feeling. I've never felt so bad in my life. So I popped the other 2 x 45mg tabs plus 1mg of Xanax.
When I woke up in the morning I felt "normal" again. But I'm sure not going to try such a drastic reduction ever again...!
The p-doc says my combo is the most he's ever had anyone on & he won't be upping it any more. He says "there's no scientific evidence that supports increasing it further".
Lastly, I recall when he agreed to the "California rocket fuel" (venlafaxine & mirtazapine combo) for me years ago, he used some medical service he subscribes to to send him the "latest medical data". I read what he got back. He got back two lots of articles from two different drug companies, as I believe they're each manufactured by different orgs. Neither company claimed there was any conclusive evidence that the 2 drugs worked well together. ie neither company has any interest in paying for or even promoting a study involving a competitor's product...!
What a load of b*llsh*t.. ;)
So all that aside, I know it's a common combo & it DOES seem to be still working for me. At least here it doesn't cost any more to be on higher doses. So as I'm currently unemployed, I get one month's worth of venlafaxine for $5. Same for mirtazapine $5/mth, etc - no matter how many actual mgs of tabs he says I need per day.
All I know about the US (are you in the US?) health-care system is from watching that Michael Moore movie "Sicko". I sure hope it was fiction, 'cos if it's 1/2 true, then I think it's really time you need to either have another revolution or else move to Canada...!
Thanks for caring :)
Good Luck with your meds ;)
Posted by yxibow on March 17, 2008, at 2:48:19
In reply to Re: Experiences with Remeron? » yxibow, posted by Molybdenum on March 16, 2008, at 22:01:54
> Yes I;m a bit of a "horse" when it comes to certain meds. Other's I am quite sensitive to. And I also can't help having this stupid belief that "more is better". The theory has always worked with toys, chocolate, hifi amplifiers, money, sex.....right?????? :)
Oh toys of all kind, if you can afford it I suppose. Sex, safely -- its an important part of adult development and Freud wasn't all wrong. Chocolate, sure, if it is calorie free :)
> Apart from the 225mg mirtazapine, I take 600mg venlafaxine, 6mg melatonin, 500mcg clonazapine, 12.5mg Stilnox CR and 32mg of Atacand (for the hypertension we blame on the venlafaxine).The clonazapine is trivial -- Stilnox (Ambien) CR has the potential like all sleeping agents to eventially decline in use over time. I can imagine that much Effexor can cause severe sleep issues (at least I couldn't take it).
I had nightmares at 5mg of Melatonin, but that could have been a starting transient. I tried Ramelteon, but it wasn't particularly potent.
Atacand, that's pretty potent and a new ARB (successors or variants on ACE inhibitors).
> I'd really like to wean myself down to a more reasonable mirtazapine dose but I'm in a bit of a stressful situation at the moment - divorcing, custody battle, poor, no job - need I go on? And guns are impossible to get in my country (Aust) so there's no quick way out if I ever can't stand it anymore. And I can't just run down to Tijuana & pickup some Nembutal like US people can. The Northern Territory (aka state) gov't here was leading the world in "assisted suicide" legislation a few years back. Then the federal gov't chickened out & wound us back to the dark ages. I think you have to be a VET to get Nembutal here nowadays.
Oh please dear god -- you're lucky to live in a country that doesn't allow guns (including Canada and the UK, although they're starting to trickle in more unfortunately and from Northern Ireland to the present UK officers have no longer had the no-gun carrying appearance, they have standing orders now to have SWAT like squads.)
I won't even further this conversation with the Nembutal -- barbiturates are a an ancient medication and becoming a citizen of Oregon isn't going to change anything -- its for people who are truly incapacitated.
I've had suicidal ideations, I'm sure a number of people have here -- and one can't really stop someone determined but I would think many times about it and the people around you. I suffer from a number of things and can't see through the tunnel my disorder has gotten so complicated I feel like damaged goods sometimes, but I have to know that that is a constructed ideation, yes, there are neurological things that are going on but one can reinterpret the lines from Trainspotting and not go to the extreme on "Choose Life."
> Hence I'll just keep on the current combo & try to reduce it back when I'm settled in 6 months or so (unless I'm dead by then of course ;:)
>
> My p-doc is very senior in his field. Has been practicing for yrs & is a senior whatever at 2 Universities, blah, blah, blah. So I don't think he's a bad doc.No, that's fine... especially if he has university credentials -- doctors attached to teaching situations have seen more patients with unusual cases typically than others -- not always the case, but often true.
> I think his belief is that different people need different amounts and that there's a limit to how much effect the drug can have (at least over time gradually increasing it) on a given brain. He also believes that some ADs do poop out over time. And honestly, I'm not getting any new side effects at these doses.Definately would agree with that -- and yet there are new views on neuroplasticity -- there is a lag time also on how psychotropics affect the brain, and that's why its generally better to have the minimum effective dose to see how it progresses, because it may be up to a few months for progress to occur with certain medications, which is why some doctors are and probably rightly so in their practice, to immediately up dosage, because one can never appreciate the current amount.
> One bad thing happened the other night though - instead of taking 5 x 45mg, I just took 3. I was already sleepy & I thought maybe it wouldn't be so hard to bring down the dose rapidly.
>
> Well......I woke up at 3am in a state of DREAD bordering on physical PANIC - really WEIRD & BAD feeling. I've never felt so bad in my life. So I popped the other 2 x 45mg tabs plus 1mg of Xanax.
>
> When I woke up in the morning I felt "normal" again. But I'm sure not going to try such a drastic reduction ever again...!Yes, one can't try a drastic reduction of anything or one's ... ugh, medical terminology... "functionality" can go wild and decompensation occurs (the byproducts and worsening of a mental health state.)
> The p-doc says my combo is the most he's ever had anyone on & he won't be upping it any more. He says "there's no scientific evidence that supports increasing it further".
Thankfully... it is a lot, my doctor would fall out of his chair.
> Lastly, I recall when he agreed to the "California rocket fuel" (venlafaxine & mirtazapine combo) for me years ago, he used some medical service he subscribes to to send him the "latest medical data". I read what he got back. He got back two lots of articles from two different drug companies, as I believe they're each manufactured by different orgs. Neither company claimed there was any conclusive evidence that the 2 drugs worked well together. ie neither company has any interest in paying for or even promoting a study involving a competitor's product...!
As a denizen of this fair state I have never heard of our rocket fuel -- but if it works for you, then so much the better. I also tend to have what you describe -- its basically called being a "high metabolizer" (meaning you eat through medicine and out it goes), but I am also very sensitive to certain others.
> What a load of b*llsh*t.. ;)
>
> So all that aside, I know it's a common combo & it DOES seem to be still working for me. At least here it doesn't cost any more to be on higher doses. So as I'm currently unemployed, I get one month's worth of venlafaxine for $5. Same for mirtazapine $5/mth, etc - no matter how many actual mgs of tabs he says I need per day.
>
> All I know about the US (are you in the US?) health-care system is from watching that Michael Moore movie "Sicko". I sure hope it was fiction, 'cos if it's 1/2 true, then I think it's really time you need to either have another revolution or else move to Canada...!Oh, don't remind me about it. Canada took on a lot of the social revolution in the 60s, [while the US had a more dampened response as a whole except for important movements of race equality, Title IX and the 24th and 26th Amendment], creating a system of National universal health care (Federal -- some provinces grumble about it), eliminating the death penalty, first the Canadian Constitution of 1960 ultimately culminating in the Charter of Rights and Freedoms (after a supreme court ruling about the Quebecois in 1982) which it never had spelled out language, and now gay marriage which is Federal so it doesn't matter of any provincial objection.
Which is to say, there are definately conservative forces in Canada -- I wouldn't want to live in the prairies particularly although I've visited Canada many times, it's beautiful, relatively clean, and there's a general sense of civility. It's definately not however a socialist state whatever one's view might be.
I haven't seen Sicko yet, I imagine it will be like his other film at GM, investigative and provocative. Of course Canada suffers from triage, meaning that there can be a wait for crucial procedures for months on end. This ends up with some Canadians hocking money together to get special insurance or even paying for the entire procedure, just across in the US.
This is a problem too in the NHS in the UK -- its not perfect, it tends to use older medication....
(Canada generally has most but not all US medication, its oversight board has taken longer to let certain things in like Cymbalta and on the opposite has a few things not available in the US)
....and also has a triage problem, but then it has more than twice the population of Canada.
That creates a problem with how to build a system of fair health care (that includes a definite, non loopholed, aka Mental Health Parity Act, that provides true coverage for what is a biological illness) in a country 10 times the population of Canada and 5 times that of the UK.
Other countries carry it out to the extent that their monetary and sometimes caste systems create, such as Brazil, Mexico, and India, but it of course falls below acceptable standards often.
Anyhow, that's my soapbox.
> Thanks for caring :)
no problem
> Good Luck with your meds ;)Thanks
-- tidings
This is the end of the thread.
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