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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 linkadge on July 22, 2008, at 13:23:08
I had been using remeron periodically for a sleep aid, but am becoming increasingly aware of how utterly crappy it makes me feel the next day.
I am dismayed by the lack of good medications for sleep. Theres virtually nothing that gives a good sleep and a decent next day.
Seroquel is good for sleep but it still makes me feel pretty worthless the next day.
Anyhow,
Linkadge
Posted by Phillipa on July 22, 2008, at 13:38:29
In reply to beginning to hate remeron, posted by linkadge on July 22, 2008, at 13:23:08
Remeron never made me tired and even with seroquel and benzos no sleep. Didn't know you had insomnia? Love Phillipa
Posted by Amigan on July 22, 2008, at 14:11:41
In reply to beginning to hate remeron, posted by linkadge on July 22, 2008, at 13:23:08
How about cyproheptadine? It's a decent sleep inducer with a short half-life.
Posted by Sigismund on July 22, 2008, at 15:14:29
In reply to beginning to hate remeron, posted by linkadge on July 22, 2008, at 13:23:08
My opinion exactly, but I only used Remeron twice and figured I'd skip Seroquel. Cyproheptadine was dreadful too.
Posted by Bob on July 22, 2008, at 16:09:36
In reply to Re: beginning to hate remeron » linkadge, posted by Sigismund on July 22, 2008, at 15:14:29
> My opinion exactly, but I only used Remeron twice and figured I'd skip Seroquel. Cyproheptadine was dreadful too.
My doctor mentioned something about Trazodone being used for promoting sleep. Has anyone tried this?
Posted by Justherself54 on July 22, 2008, at 17:10:37
In reply to beginning to hate remeron, posted by linkadge on July 22, 2008, at 13:23:08
how much seroquel are you taking Link? I take 25 mg along with 7.5 zopiclone..I was taking .05 clonazapam but am almost off it. I'm a little groggy in the morning but after a java I'm usually OK.
Posted by rvanson on July 23, 2008, at 0:12:29
In reply to Re: beginning to hate remeron » Sigismund, posted by Bob on July 22, 2008, at 16:09:36
> > My opinion exactly, but I only used Remeron twice and figured I'd skip Seroquel. Cyproheptadine was dreadful too.
>
>
> My doctor mentioned something about Trazodone being used for promoting sleep. Has anyone tried this?Yes, In fact the Pdoc don't even use it for depression much anymore, its considered so weak.
Trazadone is pretty much like a tri-cyclic AD for me, which means it hits the histamine receptor system and makes me feel like death warmed over the next day.
You may as well use benedryl if you are anything like me and my problems with the older anti-histamines.
At least its cheaper :-)
Posted by linkadge on July 23, 2008, at 10:53:05
In reply to Re: beginning to hate remeron » Bob, posted by rvanson on July 23, 2008, at 0:12:29
Remeron worked well at first but pooped out very quickly. I think its initial effect was mainly due to improvement in insomnia. It might be more tollerable if it wasn't so sedating.
The dose I need for sleep makes me feel very drowsy and irritable the next day.
Linkadge
Posted by Leo Brazil on July 23, 2008, at 12:26:39
In reply to Re: beginning to hate remeron, posted by linkadge on July 23, 2008, at 10:53:05
I too hate the sedation of Remeron. It makes you useless. You just cant concentrate. Especially if you are on a low dose like me: 7.5mg. I'm just going to ditch it and try to live without meds. Exercising is going to be my antidepressant.
Maybe you should try something like going to bed always at the same time to help you sleep. I would stay away from meds because there's just no perfect one. You'll always have to deal with side effects.
Posted by linkadge on July 23, 2008, at 13:06:28
In reply to Re: beginning to hate remeron, posted by Leo Brazil on July 23, 2008, at 12:26:39
Remeron has helped some in the past so I hate to ditch it entirely. I exercise every day, on meds or off. It certainly helps but its not a cure and often doesn't last more than a few hours (for me at least). If I can exercise multiple times a day then I'm ok, but if I am at a full time job there can be problems.
I've tried exercise plus coffee. I exercise in the morning or evening and then use coffee as a pick me up when the exercise effect wears off.
I would just like a little more control over how I feel.
Linakdge
Posted by NegCreep on July 23, 2008, at 18:12:40
In reply to Re: beginning to hate remeron, posted by Leo Brazil on July 23, 2008, at 12:26:39
I tried Remoron as an alternative to SSRIs when i developed intolerable gastritis from long term use. At first it worked well to treat my anxiety disorder and low mood and put me out like a light every night without fail. I was assured that any side effects like sedation and weight gain would level out after time.
It became apparent after a few months of heavy sedation throughout the day, food cravings and really smelly f*rts (they didnt warn me about that one) that this drug was definetly not for me. I did try to lower the dosage but I then found thatmy anxiety returned very quickly.
I would not recommend this drug to anyone except those who have not responded/tolerated to any other class of antidepressant (SSRI, tricyclics, SNRIs etc) and who have a condition severe enough to warrent use of medication. If your in a pit of dispair and nothing else works then this could be the drug for you. If not, try something else, or stick with what works for you.
Thats was my experience, hope its been helpful.
Posted by Leo Brazil on July 23, 2008, at 19:56:14
In reply to Re: beginning to hate remeron, posted by NegCreep on July 23, 2008, at 18:12:40
Definitely Remeron is not for anyone. The irritability, hunger, sedation, etc. Who can live a normal life with all these burdensome side effects? I can't.
Leo
Posted by linkadge on July 23, 2008, at 20:57:54
In reply to Re: beginning to hate remeron, posted by NegCreep on July 23, 2008, at 18:12:40
I found the drug usefull, but only if I could afford to sleep the day away.
It did initially lift some intense depression, but it made me sleep till like 2pm and then still be irritable and groggy.
I think it works better as an adjunctive med.
Linkadge
Posted by Bob on July 23, 2008, at 22:34:37
In reply to Re: beginning to hate remeron » NegCreep, posted by linkadge on July 23, 2008, at 20:57:54
> I found the drug usefull, but only if I could afford to sleep the day away.
>
> It did initially lift some intense depression, but it made me sleep till like 2pm and then still be irritable and groggy.
>
> I think it works better as an adjunctive med.
>
> Linkadge
An adjunct to what, specifically? Something like Effexor?
Posted by Negcreep on July 24, 2008, at 3:49:31
In reply to Re: beginning to hate remeron » NegCreep, posted by linkadge on July 23, 2008, at 20:57:54
Oh yeah you just reminded me of something Id forgotten. When I realised Remeron wasnt for me I switched to Citalopram and for a while I was on both. I found that taking Remoron vastly increased the time taken for citalopram to become effective and gave a overall better effect than either one alone for my anxiety/depression. But the side effects still stand, and if you take both you get the combined side effects of both drugs (not fun). But yeah, I agree its usefull as an adjunctive agent when SSRIs alone arent doing the trick.
Posted by linkadge on July 24, 2008, at 21:25:06
In reply to Re: beginning to hate remeron » linkadge, posted by Bob on July 23, 2008, at 22:34:37
I'm going to see if perhaps I could take a low dose of citalopram again with the remeron. That combo seemed to help somewhat.
Linakdge
Posted by linkadge on July 24, 2008, at 21:26:48
In reply to Re: beginning to hate remeron, posted by Negcreep on July 24, 2008, at 3:49:31
I hadn't realized you had taken this combinaiton. Yes I did find it good. I was able to take less of both to have an effect. I was also able to keep the remeron dose down to like <1mg or so.
Linkadge
Posted by linkadge on July 24, 2008, at 21:27:19
In reply to Re: beginning to hate remeron, posted by Negcreep on July 24, 2008, at 3:49:31
It offset the sleep disruption I got on citalopram alone.
Linkadge
Posted by yxibow on July 29, 2008, at 1:16:32
In reply to beginning to hate remeron, posted by linkadge on July 22, 2008, at 13:23:08
> I had been using remeron periodically for a sleep aid, but am becoming increasingly aware of how utterly crappy it makes me feel the next day.
>
> I am dismayed by the lack of good medications for sleep. Theres virtually nothing that gives a good sleep and a decent next day.
>
> Seroquel is good for sleep but it still makes me feel pretty worthless the next day.
>
> Anyhow,
>
> Linkadgeever try 10mg of amitriptyline? Doxepin is a distant second but usually acclimates quickly. Still it allows one to go back to sleep again.
Both would add eventually a slight antidepressive to a polypharmacy.
In the end, all sleep agents have their end of life, for a number of people. There really is no true fountain of sleep, other than natural acclimation to a sleep pattern which may take a month, (e.g. no naps, excercise, etc.) But sometimes a sleep study can afford some knowledge for some people.Of course, as they say, your miles may vary.
The one caveat is stacking multiple sleep agents, it ends up not being the best idea and can increase the chance of respiratory depression.
-- tidings
Jay
Posted by linkadge on July 29, 2008, at 21:22:09
In reply to Re: beginning to hate remeron » linkadge, posted by yxibow on July 29, 2008, at 1:16:32
I would like to try amitryptaline at some point, can't find a doctor to support that decision at the momeny. I found surmontil and doxapin very effective but both are purportedly genotoxic. Amitryptaline is supposedly not..
Anyhow,
Linkadge
Posted by Bob on July 29, 2008, at 22:03:18
In reply to Re: beginning to hate remeron, posted by linkadge on July 29, 2008, at 21:22:09
> I would like to try amitryptaline at some point, can't find a doctor to support that decision at the momeny. I found surmontil and doxapin very effective but both are purportedly genotoxic. Amitryptaline is supposedly not..
>
> Anyhow,
>
> LinkadgeWhat does "genotoxic" mean?
Posted by yxibow on July 30, 2008, at 0:40:59
In reply to Re: beginning to hate remeron » linkadge, posted by Bob on July 29, 2008, at 22:03:18
> > I would like to try amitryptaline at some point, can't find a doctor to support that decision at the momeny. I found surmontil and doxapin very effective but both are purportedly genotoxic. Amitryptaline is supposedly not..
> >
> > Anyhow,
> >
> > Linkadge
>
> What does "genotoxic" mean?Theoretically cancer causing through genetic manipulation of a cell. Its a personal decision as to whether to take a medication, but millions of prescriptions for Doxepin have been written without people dropping dead. In fact it is the only agent that completely blocks H1 and H2, for iatrogenic allergy sufferers like my mother.
Posted by ricker on August 2, 2008, at 13:41:11
In reply to Re: beginning to hate remeron, posted by linkadge on July 29, 2008, at 21:22:09
> I would like to try amitryptaline at some point, can't find a doctor to support that decision at the momeny. I found surmontil and doxapin very effective but both are purportedly genotoxic. Amitryptaline is supposedly not..
>
> Anyhow,
>
> LinkadgeHey Link,
Interesting thread. I'm kinda in the same boat with sleep issues.
My firts A/D was surmontil, back in 1988. The doc said it would make me feel like I was clobbered by a baseball bat when I woke up. I took 100mg to start. His remarks were an understatement.
I stayed on it for a couple of years as it was an excellent sleeping agent, but my weight was an issue, exspecially when playing hockey, tennis etc.I switched to annafranil and remained on it for approx. 7 years along with rivitrol.
My sleep was really good, but then came the new and improved ssri's. Good grief! I sometimes wonder if all these new and improved drugs are all that they're are cracked up to be.Sure they may have less physical side-effects...and that could be debated too, but I really don't think they offer more in the way of therapeutic value?
I've been taking remeron for 3 years - 15 mg as my sleeping pill. I also take zoloft 100mg and they seemed to work fairly well together... as long as I was taking rivitrol - 0.5mg tid.
Now, I'm sure they've run their course. I've been down for probably 6 months, maybe more. Funny how it sometimes takes a family members input to make you wakeup and realize just how lathargic you have become??
Not to mention I believe these 2 meds are probably the primary cause of my mind blastin tinnitus!
With that said, I've decide to try cymbalta and stick with my rivitrol.
I'm not sure how my sleep will be effected?
I read one post where nortrypiline sp? is recognized in augementation with zoloft. I think it was in the knowledge is power post?I've never tried it so I'm not quite sure if it has sedating properties as a sleep aid and if it would mesh well with cymbalta?
I am certain it is time to "at least" take a medication vacation from the remeron and zoloft.
Regards, Rick
Posted by dcruik518 on August 4, 2008, at 15:02:42
In reply to Re: beginning to hate remeron, posted by ricker on August 2, 2008, at 13:41:11
It seems as if many in this thread are of the opinion that no really satisfactory sleep agents are available. Apparently, Remeron makes many here feel lethargic in the morning. Trazodone and Seroquel also can cause bad morning lethargy. (Seroquel is particularly bad in this regard--made me feel like a zombie.) And of course the problem with most of the benzo-type sleep aids, including the newer ones, is that one quickly develops a tolerance to them and they therefore are not particularly effective for long-term use.
Recently, however, I have discovered a few drugs that not only help sleep without too much morning grogginess but also improve the quality of sleep. They mainly do this by increasing slow wave or delta sleep, which is the most restorative, and which stimulants, antidepressants, and benzos can interfere with.
In terms of sedating capacacity, I have found the new drugs for restless leg syndrome: Requip and Mirapex to be excellent sleep inducers. The same can be said for Bromocriptine. None of these produces the degree of morning grogginess that the sedating ADs do.
Two drugs that increase slow wave sleep are gabapentin/neurontin and cyproheptadine. Lyrica, of course, has the same effect as gabapentin. It's true that Neurontin and Lyrica are not sedating enough on their own for people with moderate to severe insomnia, but they are worth taking at night to improve the quality of one's sleep. Cyproheptadine is a benign antihistamine often used to treat anorgasmia, but it also fairly sedating and increases slow wave sleep.
I don't believe there is a single drug that can solve insomnia and poor sleep. After years of the most intractable insomnia, I am now able fall asleep easily and wake up with hardly any hangover effects. Here's my current cocktail:
1. Trazodone 50-100 mg
2. Requip 1-2 mg
3. Gabapentin 600 mg
I should say that I have tried all of the standard sleep meds and none of them were potent enough for me. High dose trazodone and seroquel both worked but left me feeling too drowzy the next day. The above works much better and I also know I'm getting deeper, better quality sleep than before. Most people, with less severe insomnia than I, would probably find the trazodone in the above cocktail unnecessary.
~DRC
Posted by yxibow on August 4, 2008, at 20:07:34
In reply to Hark! Better sleep meds are out there!!, posted by dcruik518 on August 4, 2008, at 15:02:42
> It seems as if many in this thread are of the opinion that no really satisfactory sleep agents are available. Apparently, Remeron makes many here feel lethargic in the morning. Trazodone and Seroquel also can cause bad morning lethargy. (Seroquel is particularly bad in this regard--made me feel like a zombie.) And of course the problem with most of the benzo-type sleep aids, including the newer ones, is that one quickly develops a tolerance to them and they therefore are not particularly effective for long-term use.
>
> Recently, however, I have discovered a few drugs that not only help sleep without too much morning grogginess but also improve the quality of sleep. They mainly do this by increasing slow wave or delta sleep, which is the most restorative, and which stimulants, antidepressants, and benzos can interfere with.
>
> In terms of sedating capacacity, I have found the new drugs for restless leg syndrome: Requip and Mirapex to be excellent sleep inducers. The same can be said for Bromocriptine. None of these produces the degree of morning grogginess that the sedating ADs do.
>
> Two drugs that increase slow wave sleep are gabapentin/neurontin and cyproheptadine. Lyrica, of course, has the same effect as gabapentin. It's true that Neurontin and Lyrica are not sedating enough on their own for people with moderate to severe insomnia, but they are worth taking at night to improve the quality of one's sleep. Cyproheptadine is a benign antihistamine often used to treat anorgasmia, but it also fairly sedating and increases slow wave sleep.
>
> I don't believe there is a single drug that can solve insomnia and poor sleep. After years of the most intractable insomnia, I am now able fall asleep easily and wake up with hardly any hangover effects. Here's my current cocktail:
>
> 1. Trazodone 50-100 mg
> 2. Requip 1-2 mg
> 3. Gabapentin 600 mg
>
>
> I should say that I have tried all of the standard sleep meds and none of them were potent enough for me. High dose trazodone and seroquel both worked but left me feeling too drowzy the next day. The above works much better and I also know I'm getting deeper, better quality sleep than before. Most people, with less severe insomnia than I, would probably find the trazodone in the above cocktail unnecessary.
>
> ~DRC
Do remember that (if the above is only for sleep), stacking sleep medications together without the advice of a psychiatrist can be dangerous if not fatal. E.g., I'll take the Ambien and the Benadryl and the Chloral Hydrate from another doctor... etc....... and respiratory depression and coma.
I'm not saying that the above poster doesn't need his regime nor do people as I am afflicted with a sleep disorder might need a particular regime but I would warn not to go down one's own road of multiple medications for sleep. It has killed numerous people including celebrities.
-- Jay
This is the end of the thread.
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