Psycho-Babble Medication Thread 833453

Shown: posts 1 to 12 of 12. This is the beginning of the thread.

 

SNRI + Remeron question

Posted by bissie66 on June 7, 2008, at 10:36:04

Otherwise known as California Rocket Fuel. It's good stuff! The problem for me is, it poops out after 2-3 months, but then if I take a break of a month or so, it works again. It seems to be the Remeron that poops out, because in the past I would keep the Effexor on board and discontinue the Remeron temporarily. I've done this about 4 times, then my pdoc prescribed Cymbalta, which had no effect at all alone (for about 6-8 weeks), but when Remeron was added the magic happened. AFter 3 months the poop-out happened again. My pdoc just switched me to Pristiq which I've been on for about 5 days with no effect. My question: he says the Remeron + Pristiq can work but I think the Remeron has pooped out (so I stopped taking it temporarily). Do you think it's possible that by switching the SNRI, the combo will be effective again, without taking the Remeron holiday, i.e. the Prisiq will somehow kick the Remeron into effectiveness again? Doesn't make sense to me but why would the pdoc think it would work.

 

Re: SNRI + Remeron question

Posted by dbc on June 7, 2008, at 11:09:33

In reply to SNRI + Remeron question, posted by bissie66 on June 7, 2008, at 10:36:04

It seems like he thinks its the SNRIs that are the problem and is juggling them rather than your theory. I tried the effexor and remeron thing a few years back and while it was incredibly intense and kicked me into hypomania ended up not having the staying power so i gave it up.

 

Re: SNRI + Remeron question

Posted by Phillipa on June 7, 2008, at 11:59:14

In reply to Re: SNRI + Remeron question, posted by dbc on June 7, 2008, at 11:09:33

How come cymbalta did nothing at 60mg yet effexor when first out couldn't tolerate and remeron at l5 mg did nothing? How high was your dose? Can you judge if your're tx resistant by whether you get side effects? Seems like if thing go well in life meds work better think it's true? How trying to hyjack your thread just make some sense out of these meds. I think the pdocs should try them and then they would understand better the frustration patients go though. Love Phillipa

 

Re: SNRI + Remeron question

Posted by Molybdenum on June 8, 2008, at 18:45:57

In reply to SNRI + Remeron question, posted by bissie66 on June 7, 2008, at 10:36:04

Hi bissie66,

About 5 years ago I was taking citalopram 20mg, adding another 20mg every 6 months up to 80mg. I was very busy at work & very tired (& depressed) and so I didn't realise that the citalopram had pooped out on me. I didn't know about the concept - that it could just stop working for me(!). What other drugs do that??? I sure didn't know. The state of exhaustion & covert-poop-out coincided with me losing my job. So I decided to quit the citalopram, the methylphenidate & any benzos I was on. I tapered down the citalopram by 20mg each week. So in 4 weeks I was off everything. I didn't get any withdrawal effects, even though I was expecting some - tapering down so quickly. In hindsight, maybe the poop-out helped free me from withdrawals?

I felt REALLY DEPRESSED but I thought it was probably just rebound from taking them for so long. It just didn't get any better & so after 4 months of this hell I went back to the GP. He decided it wasn't rebound & put me on venlafaxine 75mg. Then I started doing a bit of research on the net. I'd felt so bad for at least the last year - even more so the last 4 months that I really wanted the biggest & strongest drugs to help me out. I had no more reserve of patience to draw upon. I wanted to feel OK again ASAP..!

That's when I got hold of a copy of Stephen M. Stahl's "Essential Psychopharmacology". It's available at torrent sites as a PDF if you're interested. When I read about the rocket fuel, I convinced my GP to increase my venlafaxine & add mirtazapine too. I don't know how much was the mix & how much was my positive anticipation - either way, I started to feel incredibly less depressed. Then after a few months I wanted to increase the doses a bit but the GP wouldn't do it because he had no patients on more than I was taking. So he referred me to a pdoc. He increased me to 300mg ven + 90 mirt. That worked great for a while. Especially the way the mirt effected me: if I took it at 8pm, I would literally be stumbling on my way to bed within 45 mins. It was like a knock-out pill. So I ended up getting 10 hrs sleep - which I think helped a lot.

Unfortunately every 6 months or so I'd start to lose the knock-out effect. Otherwise the mix was a fine AD. So each time the doc would bump up my mirt & again I'd get the great sleep. He said the sedative properties of mirt weren't supposed to work like that. They're only supposed to be so pronounced on very low doses. I didn't care 'cos it sure worked for me. BTW, I am one of those idiots that can't help thinking that "more is better", so I also told the pdoc occasionally that I was feeling depressed again (when I wasn't) just to get the ven increased.

So 2.5 years after starting, I peaked at 600mg venlafaxine & 225mg mirtazapine. So it's never actually pooped out on me that I know of - or maybe coincidentally I have countered that with the increased doses? Either way, it's still working really well although at doses that are probably a bit high. BTW, the ONLY side effect I've had in the last couple of years (after we got the ven up to 300mg) was a bit of high blood pressure. So I take a pill for that too now. Other than that, "nothing". So my point....oooh look - here comes the point..!! : If you think it could help, don't worry about increasing both parts of the rocket fuel to my levels. It certainly won't kill you.

I had planned on reducing the doses once my life got a little less stressed. I've actually already dropped my ven down to 450mg & the mirt to 180mg and other than one night feeling awful (maybe unrelated), I am fine & I feel no different. I've been on this new dose for a month, nearly 2 now. In another month or so I might cut it back to 300mg ven + 135mg mirt. That's the plan, assuming I feel no worse - which I was worried about but really haven't experienced so far (!).

So that point again is to consider simply increasing the doses of the mix that worked well for you rather than changing it. Even apparently similar meds within the same class can have very different effects on diff people.

BTW, I stopped taking methylphenidate (Ritalin) 6 months ago - really hated the speedy feeling, effected my judgement & made me feel like crap coming down. Now I take some modafinil instead. It is a WONDER DRUG for me. No speedy feeling, I don't feel that my judgement is impaired at all and it doesn't want to pay-out on you in the afternoon. It's very gentle. Just to keep my sensitivity going, I am taking every second weekend without it. I do feel very low on energy & mildly depressed for those 2 days, but nowhere like I'd feel after taking Ritalin for 5 days. I used to feel like HELL & sleep ALL weekend. Nowadays, on Monday I am all 100% fine again. So another HIGHLY recommended addition if you feel like it might help you.
Take Care.

"King of Rocketfuel".

{"For I am Costanza, King of the Idiots." - Seinfeld}

 

Re: SNRI + Remeron question » Molybdenum

Posted by Phillipa on June 8, 2008, at 21:12:06

In reply to Re: SNRI + Remeron question, posted by Molybdenum on June 8, 2008, at 18:45:57

But I love your posts. Don't stop posting. Love Phillipa

 

Re: SNRI + Remeron question

Posted by bissie66 on June 10, 2008, at 9:36:35

In reply to Re: SNRI + Remeron question, posted by Phillipa on June 7, 2008, at 11:59:14

> How come cymbalta did nothing at 60mg yet effexor when first out couldn't tolerate and remeron at l5 mg did nothing? How high was your dose? Can you judge if your're tx resistant by whether you get side effects? Seems like if thing go well in life meds work better think it's true? How trying to hyjack your thread just make some sense out of these meds. I think the pdocs should try them and then they would understand better the frustration patients go though. Love Phillipa

Hi Phillipa. I don't understand these meds, why Effexor has different side effects and efficacy than Cymbalta. Like you, Cymbalta did nothing for me at 30, 60, or 90 mg . . until I added Remeron. Had bad side effect of constipation and sleepiness. Effexor worked on depression very well . . for a while. It didn't make me sleepy . . it bothered my stomach but not in the same way. My dose of Remeron was up to 60 mg. Again, it didn't anything until mixed with Effexor or Cymbalta. Did you every try the 2 together? I don't know about correlation of tx resistant and side effects. It doesn't seem like it in my case. The worst side effects i ever got were mixed episode (bipolar) when I took SSRI's alone, without mood stabilizers. That was HELL. What side effects do you get?

 

Re: SNRI + Remeron question » Molybdenum

Posted by bissie66 on June 10, 2008, at 10:04:28

In reply to Re: SNRI + Remeron question, posted by Molybdenum on June 8, 2008, at 18:45:57

Hi! I want to thank you SO much for your post! I devoured it. :) And am going to print it and show it to my pdoc if need be. This is really a different angle to view things. The common way of looking at Remeron is always 'less is more' and perhaps that's why I've only ever gone up to 60 mg in my dose. But maybe I've given up on rocket fuel too soon in the past. Wouldn't that be wonderful news! Because that stuff is good! It's the best mix I've ever had. My pdoc is big on it too. I'm going to talk to him about this. Would you recommend increasing the Remeron by 15mg or 30mg at a time?

What about the SNRI? Right now I'm on Pristiq which I'm not holiding out very high hopes for. For one thing the evidence so far is there's no point in increasing the dose. But I've gone an expensive 30-day supply I'll finish out - about 3 weeks left. After that I could go back on Cymbalta which I know worked in the rocket fuel. That has an adjustable dosing.

Thanks for the info on Essential Psychopharm. too. I've found that on the web and will def. check it out.

Finally, Modafinil sounds awesome! What do you take it for? I don't think my pdoc would prescribe it due to hospitalization last year for substance abuse. Sigh. There was a time he freely game me benzos and Adderall. I know what you mean about Ritalin though. Adderall was good for a time but in the end made me crazy. I appreciate how much you want to feel good though and how you always think more will feel better. :)

Thanks again for your post. You really gave me hope! Bissie

> Hi bissie66,
>
> About 5 years ago I was taking citalopram 20mg, adding another 20mg every 6 months up to 80mg. I was very busy at work & very tired (& depressed) and so I didn't realise that the citalopram had pooped out on me. I didn't know about the concept - that it could just stop working for me(!). What other drugs do that??? I sure didn't know. The state of exhaustion & covert-poop-out coincided with me losing my job. So I decided to quit the citalopram, the methylphenidate & any benzos I was on. I tapered down the citalopram by 20mg each week. So in 4 weeks I was off everything. I didn't get any withdrawal effects, even though I was expecting some - tapering down so quickly. In hindsight, maybe the poop-out helped free me from withdrawals?
>
> I felt REALLY DEPRESSED but I thought it was probably just rebound from taking them for so long. It just didn't get any better & so after 4 months of this hell I went back to the GP. He decided it wasn't rebound & put me on venlafaxine 75mg. Then I started doing a bit of research on the net. I'd felt so bad for at least the last year - even more so the last 4 months that I really wanted the biggest & strongest drugs to help me out. I had no more reserve of patience to draw upon. I wanted to feel OK again ASAP..!
>
> That's when I got hold of a copy of Stephen M. Stahl's "Essential Psychopharmacology". It's available at torrent sites as a PDF if you're interested. When I read about the rocket fuel, I convinced my GP to increase my venlafaxine & add mirtazapine too. I don't know how much was the mix & how much was my positive anticipation - either way, I started to feel incredibly less depressed. Then after a few months I wanted to increase the doses a bit but the GP wouldn't do it because he had no patients on more than I was taking. So he referred me to a pdoc. He increased me to 300mg ven + 90 mirt. That worked great for a while. Especially the way the mirt effected me: if I took it at 8pm, I would literally be stumbling on my way to bed within 45 mins. It was like a knock-out pill. So I ended up getting 10 hrs sleep - which I think helped a lot.
>
> Unfortunately every 6 months or so I'd start to lose the knock-out effect. Otherwise the mix was a fine AD. So each time the doc would bump up my mirt & again I'd get the great sleep. He said the sedative properties of mirt weren't supposed to work like that. They're only supposed to be so pronounced on very low doses. I didn't care 'cos it sure worked for me. BTW, I am one of those idiots that can't help thinking that "more is better", so I also told the pdoc occasionally that I was feeling depressed again (when I wasn't) just to get the ven increased.
>
> So 2.5 years after starting, I peaked at 600mg venlafaxine & 225mg mirtazapine. So it's never actually pooped out on me that I know of - or maybe coincidentally I have countered that with the increased doses? Either way, it's still working really well although at doses that are probably a bit high. BTW, the ONLY side effect I've had in the last couple of years (after we got the ven up to 300mg) was a bit of high blood pressure. So I take a pill for that too now. Other than that, "nothing". So my point....oooh look - here comes the point..!! : If you think it could help, don't worry about increasing both parts of the rocket fuel to my levels. It certainly won't kill you.
>
> I had planned on reducing the doses once my life got a little less stressed. I've actually already dropped my ven down to 450mg & the mirt to 180mg and other than one night feeling awful (maybe unrelated), I am fine & I feel no different. I've been on this new dose for a month, nearly 2 now. In another month or so I might cut it back to 300mg ven + 135mg mirt. That's the plan, assuming I feel no worse - which I was worried about but really haven't experienced so far (!).
>
> So that point again is to consider simply increasing the doses of the mix that worked well for you rather than changing it. Even apparently similar meds within the same class can have very different effects on diff people.
>
> BTW, I stopped taking methylphenidate (Ritalin) 6 months ago - really hated the speedy feeling, effected my judgement & made me feel like crap coming down. Now I take some modafinil instead. It is a WONDER DRUG for me. No speedy feeling, I don't feel that my judgement is impaired at all and it doesn't want to pay-out on you in the afternoon. It's very gentle. Just to keep my sensitivity going, I am taking every second weekend without it. I do feel very low on energy & mildly depressed for those 2 days, but nowhere like I'd feel after taking Ritalin for 5 days. I used to feel like HELL & sleep ALL weekend. Nowadays, on Monday I am all 100% fine again. So another HIGHLY recommended addition if you feel like it might help you.
> Take Care.
>
> "King of Rocketfuel".
>
> {"For I am Costanza, King of the Idiots." - Seinfeld}

 

Re: SNRI + Remeron question » bissie66

Posted by Molybdenum on June 10, 2008, at 20:32:46

In reply to Re: SNRI + Remeron question » Molybdenum, posted by bissie66 on June 10, 2008, at 10:04:28

Hi Bissie66,

I'm so pleased you could get something useful from my little blurt. Sometimes I think I'm just writing my autobiography... ;)

It certainly seems to be a common idea that you only need to augment with a small dose of Remeron. My doc had quite a few patients on higher doses & he
believed it often was worthwhile increasing rather than changing it. I suppose you know that Remeron commonly causes weight gain - but it's not necessarily going to happen to you. And it doesn't make fat out of water & fresh air - you have to actually eat more too ;) So it's not an unmanageable side-effect is my point. Remeron can also cause some sedation into the next day, but that's supposed to be more prevalent on very low doses & from my experience & reading, it passes in a week or so. The "instant knock-out" effect I get doesn't take weeks to work. Like I said, 45 mins after taking it (8pm) I am "off to bed"..!

Whether you go up by 15mg or 30mg would be something you could safely experiment with. If the doc writes you a script for 30mg tabs you could start by taking 1/2 & see how it goes. If it doesn't appear to be helping after x weeks (ask doc what x equals), then increase up to 30, 45, 60... Remember that
every time I increased the Remeron it was to bring back the instant-sleep effect. And I would get that effect immediately I increased the dose. So I can't say how long the AD effects of it would take to kick in after an increase in dose, but your doc would have a good idea.

I've been an avid googler of ADs for years now and still, every day at babble I see another few names I've never heard of and at least one interesting one. So I looked up your Pristiq. I think it would be fair to say that Wyeth is in business to make money. There's no shame in that. And they probably DO time the release of one drug to coincide with another coming off patent. So some people claim that Pristiq is no different to Effexor. In Wyeth's defence, from the little I have read & can understand, although Effexor (venlafaxine) gets broken down into several things - one of which is Pristiq (desvenlafaxine), that doesn't necessarily mean that taking Effexor or Pristiq will have the same effect in the same person. Apparently biochemistry is not that simple. So it's probably fair to call it "a different drug with similarities to Effexor".

What I'm curious about is whether you need to be on Pristiq rather than Effexor. Particularly given Effexor will go off-patent this year & hence
there'll be cheap generics available. So if money is an issue, it might be worthwhile switching back to Effexor, knowing that you'll be saving a bundle in a few months time.

Effexor vs Cymbalta. Hmmm....Being ignorant of any other reasons, I would still probably want to have Effexor bundled with Remeron rather than Cymbalta & Remeron - simply because that's the combo Stahl suggested and so many people have tried it & gotten positive results. If it was me, I would be after the quickest / shortest / most likely path to feeling better. So unless you have a problem with Effexor, why be experimental?

Modafinil - yes indeed. Well, reason I get prescribed it is because I have central sleep apnoea. I stop breathing lots of times, then breathe rapidly & it stuffs up my sleep. End result is chronic tiredness. However, your doc should be aware that modafinil IS commonly used to help with depression too. And of
all the stimulants out there, it has a very low "abuse profile". Reason being you can't get high (well, most people can't anyway - I can't). You just feel "awake" & your "mood" is more positive. Taking double the effective dose has no increased effect in me & I have read that this is normal. I imagine that a very healthy, happy, young person after a good night's rest would probably not notice any effects at all from modafinil. Giving this person amphetamines for example - they'll DEFINITELY notice it. So there's a clear difference between modafinil & other stimulants. Have a read about it: http://en.wikipedia.org/wiki/Modafinil

You might be able to convince your doc that your desire now is a long term return to normality, that you have no wish to get high for a few hours, that you know that's destructive, blah, blah, blah. I would approach the doc with the idea of simply trialling it. See how that goes. :)

Cost - modafinil (brand name Provigil in the US) is not cheap. Good news is that there are very cheap sources of it from internet pharmacies. If you're in the US, you should make sure it's OK to import it though. I think that the FDA originally mis-classified it as a more dangerous drug than it really is. Not sure if they have fixed this. Point being that if you try to import it without a script & get busted, the DEA would get more upset than if it was classified as a "drug of less abuse potential". Read that link to Wiki. It mentions this issue. But here I am assuming you're in the US. Are you?

Post or message me if you want any more info re it or any more babbling drool. ;)

Take Care & good luck...!

Mr. M.

 

Re: SNRI + Remeron question » Molybdenum

Posted by bissie66 on June 11, 2008, at 16:03:51

In reply to Re: SNRI + Remeron question » bissie66, posted by Molybdenum on June 10, 2008, at 20:32:46

Hi! Oh yes, I got A LOT out of your post. I printed it out and everything. And, in fact, based on your post, last night I took 60 mg of Remeron (I say Remeron bc I can never remember how to spell mirt.:) I didn't feel this was risky b.c. my prescription actually *says* 60 mg but I never took that bc of the old "less is more" theory when it comes to this drug. I feel hopeful knowing that I can increase higher than my thinking was telling me I could, and also that maybe I should go back on Effexor for the reasons you state, and with which I agree.

re: weight gain. I have been *very* fortunate. This time around, I haven't gained a pound. The first several times I took it, I gained a little bit of weight and that was part of the reason I stopped it. I definitely got the "Remeron munchies". (I think you need to make sure you hit the pillow *before* the drug hits *you*.) The main was reason I discontinued it was that I felt it had stopped working well and I gave up. But later, talking to my doc about the weight gain and he asked how much I gained and I told him between 5 - 10 lbs at the most he looked at me like I was crazy and said he had patients that gained upwards of FORTY.

Plus, this time around, I am on Topamax (for alcohol cravings) and I'm convinced that is keeping me from having any weight gain whatsoever. I am not wanting to eat anymore that usual at all. I'm VERY grateful for this turn of events bc I do NOT want to gain even 5 lbs!

Thanks for pointing me in the direction of wiki. and Modafinil. I've just taken a quick look and will head back after this to read more. It looks really, really good though (especially for someone like you who really needs it ;) -- seriously, though, much better than freakin' ritalin. I used to literally stay up ALL night on Aderall and go to work the next day feeling *fine* as if I had slept *all* night. Scary.

But yes, my mind is already working on how to tell my doc that this is worth a trial. I like your idea for an approach . . . thanks! But .. .Provigil . . that is ringing a bell . . and the bell is telling me that I mentioned it to my pdoc after reading about it here and I got "the look" from him. I think he said there wasn't enough evidence about its use as an a/d.

Oh, well, anyway . . I do live in the US. Do you not live in the US?

> Hi Bissie66,
>
> I'm so pleased you could get something useful from my little blurt. Sometimes I think I'm just writing my autobiography... ;)
>
> It certainly seems to be a common idea that you only need to augment with a small dose of Remeron. My doc had quite a few patients on higher doses & he
> believed it often was worthwhile increasing rather than changing it. I suppose you know that Remeron commonly causes weight gain - but it's not necessarily going to happen to you. And it doesn't make fat out of water & fresh air - you have to actually eat more too ;) So it's not an unmanageable side-effect is my point. Remeron can also cause some sedation into the next day, but that's supposed to be more prevalent on very low doses & from my experience & reading, it passes in a week or so. The "instant knock-out" effect I get doesn't take weeks to work. Like I said, 45 mins after taking it (8pm) I am "off to bed"..!
>
> Whether you go up by 15mg or 30mg would be something you could safely experiment with. If the doc writes you a script for 30mg tabs you could start by taking 1/2 & see how it goes. If it doesn't appear to be helping after x weeks (ask doc what x equals), then increase up to 30, 45, 60... Remember that
> every time I increased the Remeron it was to bring back the instant-sleep effect. And I would get that effect immediately I increased the dose. So I can't say how long the AD effects of it would take to kick in after an increase in dose, but your doc would have a good idea.
>
> I've been an avid googler of ADs for years now and still, every day at babble I see another few names I've never heard of and at least one interesting one. So I looked up your Pristiq. I think it would be fair to say that Wyeth is in business to make money. There's no shame in that. And they probably DO time the release of one drug to coincide with another coming off patent. So some people claim that Pristiq is no different to Effexor. In Wyeth's defence, from the little I have read & can understand, although Effexor (venlafaxine) gets broken down into several things - one of which is Pristiq (desvenlafaxine), that doesn't necessarily mean that taking Effexor or Pristiq will have the same effect in the same person. Apparently biochemistry is not that simple. So it's probably fair to call it "a different drug with similarities to Effexor".
>
> What I'm curious about is whether you need to be on Pristiq rather than Effexor. Particularly given Effexor will go off-patent this year & hence
> there'll be cheap generics available. So if money is an issue, it might be worthwhile switching back to Effexor, knowing that you'll be saving a bundle in a few months time.
>
> Effexor vs Cymbalta. Hmmm....Being ignorant of any other reasons, I would still probably want to have Effexor bundled with Remeron rather than Cymbalta & Remeron - simply because that's the combo Stahl suggested and so many people have tried it & gotten positive results. If it was me, I would be after the quickest / shortest / most likely path to feeling better. So unless you have a problem with Effexor, why be experimental?
>
> Modafinil - yes indeed. Well, reason I get prescribed it is because I have central sleep apnoea. I stop breathing lots of times, then breathe rapidly & it stuffs up my sleep. End result is chronic tiredness. However, your doc should be aware that modafinil IS commonly used to help with depression too. And of
> all the stimulants out there, it has a very low "abuse profile". Reason being you can't get high (well, most people can't anyway - I can't). You just feel "awake" & your "mood" is more positive. Taking double the effective dose has no increased effect in me & I have read that this is normal. I imagine that a very healthy, happy, young person after a good night's rest would probably not notice any effects at all from modafinil. Giving this person amphetamines for example - they'll DEFINITELY notice it. So there's a clear difference between modafinil & other stimulants. Have a read about it: http://en.wikipedia.org/wiki/Modafinil
>
> You might be able to convince your doc that your desire now is a long term return to normality, that you have no wish to get high for a few hours, that you know that's destructive, blah, blah, blah. I would approach the doc with the idea of simply trialling it. See how that goes. :)
>
> Cost - modafinil (brand name Provigil in the US) is not cheap. Good news is that there are very cheap sources of it from internet pharmacies. If you're in the US, you should make sure it's OK to import it though. I think that the FDA originally mis-classified it as a more dangerous drug than it really is. Not sure if they have fixed this. Point being that if you try to import it without a script & get busted, the DEA would get more upset than if it was classified as a "drug of less abuse potential". Read that link to Wiki. It mentions this issue. But here I am assuming you're in the US. Are you?
>
> Post or message me if you want any more info re it or any more babbling drool. ;)
>
> Take Care & good luck...!
>
> Mr. M.

 

Re: SNRI + Remeron question

Posted by BGB on June 11, 2008, at 22:34:43

In reply to SNRI + Remeron question, posted by bissie66 on June 7, 2008, at 10:36:04

Just to throw in my two cents, I am currently taking 120mg of Cymbalta with 60mg of mirtazapine (Teva generic). It does nothing for me. It didn't at lower doses of Cymbalta, either. I've tried 30, 60, 90, and am now at 120mg of Cymbalta and it just does nothing for me. Neither does the Remeron. I'm also taking 600mg of bupropion SR and 50mcg of Cytomel for my depression. For my bipolar symptoms, I take Trileptal 1200mg and Lamictal 200mg. And to sleep, occasionally I take 50-150mg of Trazodone. And once in a blue moon I take 5-10mg of Valium. Needless to say, I am trying to get off of this crap since it's not working anyway!

I think that I tried Effexor and Remeron years ago and had a slight success with it. Neither one helped me by themselves. But, like I said, the Cymbalta and Remeron combo does nothing for me. So there may indeed be something magic about Effexor and Remeron that does not exist between Cymbalta and Remeron. Who knows what Pristiq will do?

Augmentation with Provigil is a great strategy. It not only helped me stay awake, but it slightly boosted my mood as well. If you can't afford Provigil, and many of us, even with insurance, can't, you could try adrafinil. It is legal to import it into the US (disclaimer: I'm an accountant not a lawyer). It is easy to find sources online with excellent prices. It costs me much less to import brand-name Olmifon from overseas than it does to pay my insurance co-pay for Provigil.

I have found that Olmifon (adrafinil) is identical to Provigil (modafinil). I have some of both and literally cannot tell the difference between the two. I know that many people do have a distinct preference for one or the other, but there's no doubt that they are very very similar. Again, I'm just a humble accountant and not a scientist but from what I understand the body converts adrafinil into modafinil. Of course, you should always ask your doctor, your mileage may vary, void where prohibited by law, and batteries are not included.

 

Re: SNRI + Remeron question » BGB

Posted by Molybdenum on June 12, 2008, at 3:55:34

In reply to Re: SNRI + Remeron question, posted by BGB on June 11, 2008, at 22:34:43

Hi BGB,

Last thing first - I liked your post :)

Now, re your lack of success with the ADs, sorry to hear that. I tell you, if they come up with a pill to make us live to 1000, it'll be worth taking it - just to find out why these damn ADs do or don't work in each person. I'd just love to find out what that's all about...well, that and I'd really like a flying car. ;) Ooops - I digress.

And you being on such a cocktail can't be good either, esp considering it's not working out. Have you looked into the older TCAs & MAOI ADs? From my reading, it seems like all the new SSRIs / SNRIs, etc are peddling like mad to prove that they have equivalent efficacy to the older meds. I mean the older ones definitely worked & probably more often that the new ones. The main trouble with them is that they're supposed to have more side effects and there are some that can't be combined with other drugs & some MAOIs have dietary restrictions too. In general, the newer ones are regarded as an overall improvement from the older classes, but I just thought that you might consider talking to your doc about trying one of the old "tried & true" drugs, because their mechanism of action is so different, they just might work well for you...?

Nice to hear that you find the adrafinil equal to the modafinil. Isn't just ridiculous though - that one has no import restrictions & the other too many? Madness... And I am in the same boat re health insurance too - it's much cheaper for me to buy modafinil tabs from India than it is to buy the local name brand & get a "partial rebate" from the insurer. And of course, they won't pay out on the Indian ones - any excuse not to pay out...

Take Care

Mr Be Damned.

 

Re: SNRI + Remeron question » BGB

Posted by bissie66 on June 12, 2008, at 9:10:42

In reply to Re: SNRI + Remeron question, posted by BGB on June 11, 2008, at 22:34:43

Hey, thanks for your post! It's so awesome to hear what other people are doing/taking/trying and what results. Funny how I learn more here often than from pdoc. Have you ever tried going higher on Mirtazapine? Ever since reading from comrade here about increasing that med, I tried it (just 2 days ago!) and I swear to God I feel so much better. I never would have thought that *that* would be the drug to increase - I was always trying to increase the Cymbalta because of the common 'wisdom' that 'less is more' with the mirtazapine.

I take a cocktail too (Pristiq - which I hate due to side effects, mirtazapine, Topamax, Lithium, Lamictal). I often wonder if I need it all, but when I took SSRI's alone I had horrible mixed episodes. I hope you find something SOON that works.

AND thank you SO much for the info on Provigil and Olmifil. Now that is something I could ONLY learn here. :)

> Just to throw in my two cents, I am currently taking 120mg of Cymbalta with 60mg of mirtazapine (Teva generic). It does nothing for me. It didn't at lower doses of Cymbalta, either. I've tried 30, 60, 90, and am now at 120mg of Cymbalta and it just does nothing for me. Neither does the Remeron. I'm also taking 600mg of bupropion SR and 50mcg of Cytomel for my depression. For my bipolar symptoms, I take Trileptal 1200mg and Lamictal 200mg. And to sleep, occasionally I take 50-150mg of Trazodone. And once in a blue moon I take 5-10mg of Valium. Needless to say, I am trying to get off of this crap since it's not working anyway!
>
> I think that I tried Effexor and Remeron years ago and had a slight success with it. Neither one helped me by themselves. But, like I said, the Cymbalta and Remeron combo does nothing for me. So there may indeed be something magic about Effexor and Remeron that does not exist between Cymbalta and Remeron. Who knows what Pristiq will do?
>
> Augmentation with Provigil is a great strategy. It not only helped me stay awake, but it slightly boosted my mood as well. If you can't afford Provigil, and many of us, even with insurance, can't, you could try adrafinil. It is legal to import it into the US (disclaimer: I'm an accountant not a lawyer). It is easy to find sources online with excellent prices. It costs me much less to import brand-name Olmifon from overseas than it does to pay my insurance co-pay for Provigil.
>
> I have found that Olmifon (adrafinil) is identical to Provigil (modafinil). I have some of both and literally cannot tell the difference between the two. I know that many people do have a distinct preference for one or the other, but there's no doubt that they are very very similar. Again, I'm just a humble accountant and not a scientist but from what I understand the body converts adrafinil into modafinil. Of course, you should always ask your doctor, your mileage may vary, void where prohibited by law, and batteries are not included.


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