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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by X-ray on November 24, 2009, at 11:38:27
Hi,
I have been on 150 mg of Wellbutrin XL for a couple of weeks.
Im pleased with this drug that gives me a lot of energy.For sleep I take 30 mg of Remeron and 25 mg of Lyrica.
However, I often wake up after two hours.The question is whether I would benefit from a dose increase of Remeron.
Its well known that this drug is less sedating at higher doses.It might be better to double the dose of Lyrica.
Here are my options:
1.Increase Remeron to 45 mg
2.Increase Lyrica to 50 mg
3.Make no changesI would very much appreciate all comments.
Best regards,
X-ray
Posted by zana on November 24, 2009, at 15:46:20
In reply to Remeron - 30 mg or 45 mg?, posted by X-ray on November 24, 2009, at 11:38:27
Hi X-Ray,
Since Remeron is more stimulating at higher doses, maybe you want to try a lower dose. I have seen posts of people taking as little as 12.5mgs for sleep.
Just a thought.
Zana
Posted by tensor on November 25, 2009, at 0:57:53
In reply to Remeron - 30 mg or 45 mg?, posted by X-ray on November 24, 2009, at 11:38:27
An increase from 30mg to 45mg Remeron improves my sleep. Although you could increase both Remeron and Lyrica.
Only way to find out is to try :-)
/tensor
Posted by X-ray on November 25, 2009, at 3:13:57
In reply to Re: Remeron - 30 mg or 45 mg?, posted by zana on November 24, 2009, at 15:46:20
Hi,
I appreciate your reply, but 15 mg of Remeron is definitely too low a dose for me.
Best regards,
X-ray
Posted by X-ray on November 25, 2009, at 3:23:50
In reply to Re: Remeron - 30 mg or 45 mg? » X-ray, posted by tensor on November 25, 2009, at 0:57:53
Hi,
Thanks for your input!
I have slept well on 45 mg of Remeron tonight.
My only concern now is that 150 mg Wellbutrin + 45 mg Remeron + 25 mg Lyrica
will be too much medication.Best regards,
X-ray
Posted by manic666 on November 25, 2009, at 6:33:30
In reply to Re: Remeron - 30 mg or 45 mg? - Zana, posted by X-ray on November 25, 2009, at 3:13:57
sounds cool, but i bet burger king an macdonalds profits start to rise. seriouse munchies with that med.
Posted by tensor on November 25, 2009, at 11:02:20
In reply to Re: Remeron - 30 mg or 45 mg? - Tensor, posted by X-ray on November 25, 2009, at 3:23:50
I'm not sure what you mean with too much. Are you afraid it would be harmful? I have recently been on 45mg Remeron + 300mg Wellbutrin + Zoloft + clonazepam. And 60mg Remeron + 450mg Wellbutrin is not unusual. However, talk to your pdoc if you are concerned.
/tensor
> My only concern now is that 150 mg Wellbutrin + 45 mg Remeron + 25 mg Lyrica
> will be too much medication.
>
> Best regards,
> X-ray
>
Posted by SLS on November 25, 2009, at 11:12:54
In reply to Re: Remeron - 30 mg or 45 mg? - Tensor, posted by X-ray on November 25, 2009, at 3:23:50
Hi X.
Forgive me for not knowing your case history. I am sure you have described it on Psycho-Babble numerous times.
> My only concern now is that 150 mg Wellbutrin + 45 mg Remeron + 25 mg Lyrica
> will be too much medication.In your mind, what constitutes "too much" medication and why?
I need 5 medications at high dosages in order to receive benefit from treatment. In my mind, that's exactly the right number.
What is the Lyrica for?
If you were to fail to respond fully to Wellbutrin and Remeron, you might actually consider adding a third antidepressant. I would choose either Lexapro or Effexor. If you don't respond to that, you can get rid of the Remeron and replace it with nortriptyline. If that fails, then it might be time to consider an MAOI.
- Scott
Posted by X-ray on November 26, 2009, at 3:55:19
In reply to Re: Remeron - 30 mg or 45 mg? - Tensor, posted by SLS on November 25, 2009, at 11:12:54
Hi Scott,
Thanks for your input!
About: too much medication
I realize that I didnt use the correct word.
Im Swedish, so my English isnt perfect.Here are my thoughts:
The proper dose of Remeron: 15 45 mg
The proper dose of Wellbutrin XL: 150 mg 300 mgI have been on 45 mg of Remeron in the past, which was fine.
Now I take Wellbutrin in the morning.It might not be wise to take the maximum dose of Remeron in combination with Wellbutrin.
Stephen M. Stahl singles out Wellbutrin + Remeron as one of 13 successful combinations of drugs in his book Essential pharmacology.
But I dont know what Stahl thinks about the dosages of these two drugs in combination.Im on a small dose of Lyrica that augments Remeron for sleep.
This is my own off-label idea, but it works great.I suffer from personality disorders which disrupt my sleep.
Sleep has always been my main problem.Ive been struggling to come off Elavil for 36 years, but Ive failed 99 times.
Now Ive finally made it!Best regards,
X-rayWellbutrin XL 150 mg
Remeron 45 mg
Lyrica 25 mg
Fluanxol 0,5 mg
Posted by X-ray on November 26, 2009, at 4:16:32
In reply to Re: Remeron - 30 mg or 45 mg? - Tensor » X-ray, posted by tensor on November 25, 2009, at 11:02:20
Hi,
Thanks for your reply!
If you have been doing okay on 45 mg Remeron and 300 mg Wellbutrin, I shouldnt need to worry about 45 mg Remeron and 150 mg Wellbutrin.
Im very happy with my present combo of Wellbutrin, Remeron, Lyrica and Fluanxol.
Best regards,
X-ray
Posted by SLS on November 26, 2009, at 6:33:49
In reply to Re: Remeron - 30 mg or 45 mg? - SLS, posted by X-ray on November 26, 2009, at 3:55:19
You speak excellent English!
I understand your concerns. I think you can raise the dosage of Wellbutrin to 300mg with no problems. You could even go to 60mg on the Remeron if you think that it would help.
Be well.
- Scott
Posted by SLS on November 26, 2009, at 6:36:20
In reply to Re: Remeron - 30 mg or 45 mg? - SLS, posted by X-ray on November 26, 2009, at 3:55:19
> Stephen M. Stahl singles out Wellbutrin + Remeron as one of 13 successful combinations of drugs in his book Essential pharmacology.
Can you do us a big favor?
Could you post the 13 combinations here.
I am sure that everyone would appreciate it very much.
Thanks.
- Scott
Posted by mtdewcmu on November 26, 2009, at 11:36:43
In reply to Re: Remeron - 30 mg or 45 mg? - SLS » X-ray, posted by SLS on November 26, 2009, at 6:36:20
X-ray: I'm glad that you are doing well on 45mg Remeron + Lyrica for sleep.
You could also try other sedating antidepressants, such as trazodone, amitriptyline, and doxepin for sleep.
As alternatives to Lyrica, you could try Ambien (zolpidem), Lunesta (eszopiclone or zopiclone), Halcion (triazolam), Restoril (temazepam), or Serax (oxazepam). They are the best of the available hypnotics, IMO, due to their reduced likelihood of causing next-day sedation. My favorites are Ambien and zopiclone, with the next being Halcion. Ambien and zopiclone seemed more resistant to tolerance than Halcion.
This is the end of the thread.
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