Posted by jrbecker on May 5, 2003, at 12:31:35
In reply to Re: Period for Remeron's benefits to kick-in? » jrbecker, posted by CharlieL on May 5, 2003, at 11:18:39
using Soltabs. By the way, I am highly sensitive to most meds too, mostly the SSRIs. Can only handle very very low doses. this is not the case with remeron though. my suggestion would be to go up to 30mg right away and stick it out. no need to acclimate by staying with 15mg for an adjustment period. what you want is the adrenergic effect to start to cancel out the antihistamine effect and you can only really start to have this balance at 30mg. Then, the more you go up, the more balance in favor of the noradrenergic effect begins. Also, the antihistamine effect levels off by 1) tolerance and adaption -- in other words, waiting it out; and 2) by saturation of the histamine receptors, so it won't be getting worse the more you go up after 30mg.
here's my own experience:
7.5mg: good for sleep, no problem with sedation at all.
15mg: good for sleep, mild sedation throughout the day. very little AD effect.
30mg: great for sleep, mild to moderate sedation. Good AD effect. Good for anxiety
45mg: mild sedation. Great AD effect.
This is purely subjective though. It could be that you find your optimal range at 30mg or maybe even higher 60mg. You can also experiement by cutting the 15mg tabs in half (with the aid of a sharp razor) and experiment with 37.5 mg or 52.5mg. Remember, the higher you go the more dopaminergic, noradrenergic and serotonergic activty increases, but it seems that the antihistamine effect levels out. see more for details...Behavioral and memory improving
effects of mirtazapinehttp://biopsychiatry.com/mirtazmem.html
Mirtazapine substitution in
SSRI-induced sexual dysfunctionhttp://biopsychiatry.com/mirtazvssris.html
Mirtazapine enhances frontocortical dopaminergic and corticolimbic adrenergic, but not serotonergic, transmission by blockade of alpha2-adrenergic and serotonin2C receptors: a comparison with citalopram [only SSRI that slightly mimics this effect is Fluoxetine]
http://biopsychiatry.com/mirtazrecep.html
Effects of mirtazapine on reducing cortisol secretion
http://biopsychiatry.com/mirtazremeron.htm
Higher levels of drug do not produce higher histamine interaction
poster:jrbecker
thread:223661
URL: http://www.dr-bob.org/babble/20030505/msgs/224468.html