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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Franz on January 29, 2013, at 16:18:25
Hello, I continue with 5 mg fluoxetine to avoid tinnitus from higher dose but although mild, it is still there. Too dab because I think fluoxetine is good and inexpensive.
I am considering asking the Dr for another drug.
The only one I read does not cause tinnitus is mirtazapine (remeron).
http://www.psychologytoday.com/articles/200305/living-under-medication-0Dr told me it is sedating, which I do not like. How about a low dose? Any other side effect?
I wonder if tianeptine can be another choice. It is expensive.
Please comment, thanks.
Posted by jono_in_adelaide on January 29, 2013, at 16:48:20
In reply to Need an AD w/o tinnitus: mirtazapine,tianeptine?, posted by Franz on January 29, 2013, at 16:18:25
Higher doses of mirtazapine are less sedating than low doses - at low doses it is just a sedating antihistamine - I would start off with 15mg and move up to 30mg after a week or so
Posted by rjlockhart37 on January 29, 2013, at 18:11:00
In reply to Re: Need an AD w/o tinnitus: mirtazapine,tianeptine?, posted by jono_in_adelaide on January 29, 2013, at 16:48:20
have you though of other SSRI's antidepre? like Paxil...Paxil is sedating, maybe not as much as Remeron....but it works on serotonin, but too much serotonin makes everything seem like mental fog....paticulary with Paxil.
TCA AD's?
5mg of Prozac....lol thats not even a baby dose....i take 60mg, sometimes it works...get a warm feeling makes me have a better persoality.
Check into Luvox too....good for anxiety
r
Posted by Phillipa on January 29, 2013, at 18:24:26
In reply to Re: Need an AD w/o tinnitus: mirtazapine,tianeptine?, posted by rjlockhart37 on January 29, 2013, at 18:11:00
At one time or another minus the tricyclics and Maois, I've taken most of the available ad's and antiaxiety meds and never experienced tinnitis? Have you seen an ENT? Phillipa
Posted by Franz on January 29, 2013, at 19:01:05
In reply to Re: Need an AD w/o tinnitus: mirtazapine,tianeptine?, posted by rjlockhart37 on January 29, 2013, at 18:11:00
> have you though of other SSRI's antidepre? like Paxil...Paxil is sedating, maybe not as much as Remeron....but it works on serotonin, but too much serotonin makes everything seem like mental fog....paticulary with Paxil.
>
> TCA AD's?
>
> 5mg of Prozac....lol thats not even a baby dose....i take 60mg, sometimes it works...get a warm feeling makes me have a better persoality.
>
> Check into Luvox too....good for anxiety
>
> rThanks. If Paxil is sedating I an not sure I want it. I tried escitalopram and same ear problems plus sedating. I need energy. Of course anxiety is a problem too, but I need to move, not stay in bed like with the sedating SSRIs.
Posted by Franz on January 29, 2013, at 19:03:30
In reply to Re: Need an AD w/o tinnitus: mirtazapine,tianeptine?, posted by Phillipa on January 29, 2013, at 18:24:26
> At one time or another minus the tricyclics and Maois, I've taken most of the available ad's and antiaxiety meds and never experienced tinnitis? Have you seen an ENT? Phillipa
yes and it was confirmed, also had other petients with same problem.
Posted by rjlockhart37 on January 29, 2013, at 19:45:34
In reply to Re: Need an AD w/o tinnitus: mirtazapine,tianeptine? » rjlockhart37, posted by Franz on January 29, 2013, at 19:01:05
ohhh....the stimulating AD's are wellbutrin effexor, and pristiq, and then some TCA's
have you check with your doctor maybe a low dose of a stimulant? i think low dose damphetamine would help you wake up. Provigil is off the charts...i mean ultra stupid ridculous prices...
Posted by schleprock on January 29, 2013, at 19:55:04
In reply to Need an AD w/o tinnitus: mirtazapine,tianeptine?, posted by Franz on January 29, 2013, at 16:18:25
If you're current medication is successfully treating your condition and the only side-effect is tinnitus, I'd consider that a blessing. There are potentially worse debilitations... unforeseen debilitations that can come with other medications. I'm fairly certain that I've had (undiagnosed) tinnitus for 20 years, and it's never really bothered me. I'm having some right now, as a matter of fact, and you don't see me complaining.
Posted by schleprock on January 29, 2013, at 19:56:49
In reply to Need an AD w/o tinnitus: mirtazapine,tianeptine?, posted by Franz on January 29, 2013, at 16:18:25
Wait... now that you mention it, it is kind of annoying.
Posted by Franz on January 29, 2013, at 20:38:04
In reply to Re: Need an AD w/o tinnitus: mirtazapine,tianeptine?, posted by schleprock on January 29, 2013, at 19:56:49
> Wait... now that you mention it, it is kind of annoying.
Of course it is annoying, especially when you try to fall asleep. Plus it reduces your hearing. I fear permanent damage if taken long term.
Posted by Franz on January 29, 2013, at 20:39:45
In reply to Re: Need an AD w/o tinnitus: mirtazapine,tianeptine? » Franz, posted by rjlockhart37 on January 29, 2013, at 19:45:34
> ohhh....the stimulating AD's are wellbutrin effexor, and pristiq, and then some TCA's
>
> have you check with your doctor maybe a low dose of a stimulant? i think low dose damphetamine would help you wake up. Provigil is off the charts...i mean ultra stupid ridculous prices...
>
>Thanks. Yes I tried modafinil. First days are good but then I do not like it much.
Posted by Franz on January 29, 2013, at 20:50:02
In reply to Re: Need an AD w/o tinnitus: mirtazapine,tianeptine?, posted by jono_in_adelaide on January 29, 2013, at 16:48:20
> Higher doses of mirtazapine are less sedating than low doses - at low doses it is just a sedating antihistamine - I would start off with 15mg and move up to 30mg after a week or so
Is it too sedating at 15 mg if I take it at night? Does the sedating effect last during the day?
Posted by jono_in_adelaide on January 29, 2013, at 20:55:02
In reply to Re: Need an AD w/o tinnitus: mirtazapine,tianeptine? » jono_in_adelaide, posted by Franz on January 29, 2013, at 20:50:02
I'd try it and see, the sedation is bad for the firat few days, but the body adjusts fairly quickly and it passes within a couple of weeks.
There is some suggestion that 30mg is less sedating than 15mg as at 30mg it starts to act as a stimulant by releasing noradrenalin, which overides the antihistamine mediated sedation.
Posted by Franz on January 29, 2013, at 21:01:49
In reply to Re: Need an AD w/o tinnitus: mirtazapine,tianeptine?, posted by jono_in_adelaide on January 29, 2013, at 20:55:02
> I'd try it and see, the sedation is bad for the firat few days, but the body adjusts fairly quickly and it passes within a couple of weeks.
>
> There is some suggestion that 30mg is less sedating than 15mg as at 30mg it starts to act as a stimulant by releasing noradrenalin, which overides the antihistamine mediated sedation.
Thanks. I will ask the Dr. I will consider tianeptine also but he does not have experience with it.Do I have to quit fluoxetine to start mirtazapine? I read thay can be taken together
http://www.drugs-forum.com/forum/showpost.php?p=955262&postcount=4
Posted by Phillipa on January 29, 2013, at 21:22:26
In reply to Re: Need an AD w/o tinnitus: mirtazapine,tianeptine? » jono_in_adelaide, posted by Franz on January 29, 2013, at 21:01:49
They can be taken together. Phillipa
Posted by Franz on January 29, 2013, at 21:39:48
In reply to Re: Need an AD w/o tinnitus: mirtazapine,tianeptine? » Franz, posted by Phillipa on January 29, 2013, at 21:22:26
> They can be taken together. Phillipa
Thanks Phillipa, very convenient.
Posted by SLS on January 29, 2013, at 22:02:46
In reply to Need an AD w/o tinnitus: mirtazapine,tianeptine?, posted by Franz on January 29, 2013, at 16:18:25
> Hello, I continue with 5 mg fluoxetine to avoid tinnitus from higher dose but although mild, it is still there. Too dab because I think fluoxetine is good and inexpensive.
>
> I am considering asking the Dr for another drug.
>
> The only one I read does not cause tinnitus is mirtazapine (remeron).
> http://www.psychologytoday.com/articles/200305/living-under-medication-0
>
> Dr told me it is sedating, which I do not like. How about a low dose? Any other side effect?
>
> I wonder if tianeptine can be another choice. It is expensive.
>
> Please comment, thanks.
Actually, nortriptyline is sometimes used to treat tinnitus. It makes for a good antidepressant and is very inexpensive.
- Scott
Posted by jono_in_adelaide on January 29, 2013, at 23:10:05
In reply to Re: Need an AD w/o tinnitus: mirtazapine,tianeptine? » jono_in_adelaide, posted by Franz on January 29, 2013, at 21:01:49
You can take fluoxetine and mirtazepine together, yes.
SLS's idea about nortriptyline might be a good one, it is less sedating than mirtazepine for most people
Posted by gpznos on January 30, 2013, at 2:34:58
In reply to Need an AD w/o tinnitus: mirtazapine,tianeptine?, posted by Franz on January 29, 2013, at 16:18:25
Actually a low dose mirtazapin (less than 5 mg) is supposed to be even more sedating. I have used this effect myself to fall asleep more easy. But at higher doses (more than 30 mg) the sedating effect goes away as far as I remember from when I was on 30-50 mg Mirtazapin a few years back.
This is the end of the thread.
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