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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 28. This is the beginning of the thread.
Posted by ronaldo on April 25, 2007, at 3:42:26
Hi All,
On Monday pdoc put me on 7.5 mg Mirtazapine for sleep. Had read here that only minimal dose is needed, hence cut 15 mg tablet down to 3.75 mg. Slept better. Still up at customary 3am for a wee but felt more relaxed and less anxious, and even managed to doze off after 3 am which is unusual for me. Felt very groggy at 3am and a bit groggy when I got up at 8.30am.
Tonight I am thinking of taking 7.5 mg. Will I sleep better? Will I break the 3am barrier? Will it leave me feeling too groggy in the morning?
I would really appreciate any advice any experienced users of this drug can give me. On reflection I think I will take the 7.5 mg tonight. But then maybe half of 3.75 would do the trick?
thanx
ronaldo
Posted by ronaldo on April 25, 2007, at 7:14:06
In reply to First night Remeron 3.75 mg for sleep, posted by ronaldo on April 25, 2007, at 3:42:26
Forgot to say. I took it for the first time on Tuesday, yesterday, night (+/- 3.75 mg).
Posted by Phillipa on April 25, 2007, at 11:33:42
In reply to Re: First night Remeron 3.75 mg for sleep, posted by ronaldo on April 25, 2007, at 7:14:06
Ronaldo your lucky. They gave me l5mg with benzos and still no sleep. I guess try and see what happens for one night at least? Love Phillipa
Posted by Declan on April 25, 2007, at 16:30:57
In reply to First night Remeron 3.75 mg for sleep, posted by ronaldo on April 25, 2007, at 3:42:26
Hi Ronaldo
It has a long half-life, maybe 40-60 hours, so hangover sedation is a real problem with 7.5mg for me.
This lasted till after lunch next day, and I took it earlyish.
It's good for deepening sleep though.
Posted by saturn on April 25, 2007, at 22:29:07
In reply to Re: First night Remeron 3.75 mg for sleep, posted by ronaldo on April 25, 2007, at 7:14:06
> Forgot to say. I took it for the first time on Tuesday, yesterday, night (+/- 3.75 mg).
Hey Ronaldo,
If you're not opposed I'm very interested to here how this trial of low-dose Remeron goes for you, as I may consider the same. Thanks...Peace...Saturn.
Posted by ronaldo on April 26, 2007, at 9:00:50
In reply to Re: First night Remeron 3.75 mg for sleep, posted by Declan on April 25, 2007, at 16:30:57
Hi Declan,Took the 7.5 mg last night at 9.30 pm. Yep, still feel hung over now at 2.30 pm London time. I think I will take just the 3.75 mg tonight and see how that goes.
I slept from about 11 pm through till 8.30 am on the Wednesday morning on 3.75 mg. I was awake, as usual, at 3 am to go for a pee but then slept on in a sort of broken, interrupted sleep until 8.30 am but without the usual attendant anxiety I had before the Remeron. I felt refreshed. Felt very groggy at 3 am. A bit groggy at 8.30 am, but recovered quickly.
This morning after 7.5 mg at 9.30 pm last night I got up at 10.00 am. Again my sleep from 3 am till 10 am was intermittent but without anxiety.
Now I feel hung over and feel the urge to go back to sleep but won't in case that messes up tonight's sleep.
Here in the UK the smallest tablet they make is a 15 mg. I wish they made something smaller. With my pill cutter the finest I can go is 3.75 mg which I suppose is adequate, though not accurate.
Declan, how long have you been taking Remeron? My pdoc reckons the hang-over should diminish with time. Have you experienced this?
Saturn it's still very early days but I hope you find the above interesting. I will keep you posted on how things progress. I think my pdoc said something about going to a larger dose if the sedation is too great but this is not my experience going from 3.75 to 7.5 mg. I may give him a ring next week to let him know how I am getting on.
good luck and better health
ronaldo
> Hi Ronaldo
>
> It has a long half-life, maybe 40-60 hours, so hangover sedation is a real problem with 7.5mg for me.
>
> This lasted till after lunch next day, and I took it earlyish.
>
> It's good for deepening sleep though.
Posted by Declan on April 26, 2007, at 16:17:12
In reply to Re: First night Remeron 3.75 mg for sleep » Declan, posted by ronaldo on April 26, 2007, at 9:00:50
Ronaldo, I've only taken Remeron a couple of times.
I'd rather have my poor sleep pattern than the hangover feeling until after lunch.It felt a bit like cyproheptadine to me.
It is impressive though in the way it deepens sleep.
Not so many things do that.
Posted by ronaldo on April 27, 2007, at 14:11:42
In reply to Re: First night Remeron 3.75 mg for sleep, posted by Declan on April 26, 2007, at 16:17:12
Hi Declan, Saturn,
Today I felt the full force of the hangover feeling but with me it lasted until say 5 pm.
Last night I took a small 3.75 mg at my usual 9.30 pm and was asleep about 11 pm. This morning I was up at 6.30 am. I had a lot to do. I think the 3.75 was too small, therefore too sedating. I was going to try even smaller tonight, say 2 mg, but I am afraid that will give me even more of a hangover the next day. They say the smaller the dose the more sedating = the bigger the hangover the next day??? Since starting Tuesday night the 7.5 mg has given me the best results. But then again with the 7.5 mg I was only up at 10 am. On the 3.75 mg last night I was up at 6.30 am. Well I will go for the 7.5 mg tonight and go to bed early and possibly sleep late. I wonder how long it takes the system to get used to it? Maybe I should persevere for a while and see whether I start to cope better.I keep thinking that my pdoc told me to go higher if I found it too sedating. Advice to cut it down really small to 1/4 of 7.5 mg may not be such good advice at all. Everyone is different. Like they say milage varies.
One thing for sure, used for insomnia, this is a very dose-sensitive medication. I will just have to keep trying different doses until I find what's best for me.
I will let you know how the 7.5 mg works for me tomorrow.
ciao for now
ronaldo
> Ronaldo, I've only taken Remeron a couple of times.
> I'd rather have my poor sleep pattern than the hangover feeling until after lunch.
>
> It felt a bit like cyproheptadine to me.
>
> It is impressive though in the way it deepens sleep.
> Not so many things do that.
Posted by ronaldo on April 28, 2007, at 4:32:12
In reply to Re: Today was a real bummer... » Declan, posted by ronaldo on April 27, 2007, at 14:11:42
Hi Declan, Saturn,
Took 7.5 mg Remeron at 9 pm last night. Was asleep at 10 pm. Slept right through to 6.30 am without customary awakening at 3 am. Got up to pee at 7.45 am. Got out of bed at 8.40 am. Slight grogginess but dissipated after eating breakfast.
This proves, in my mind at least, the theory that
smaller dose = more sedation = worse hangover
larger dose = less sedation? = less hangover (for sure)
The fact is that last night for the very first time in possibly years I did not wake up at 3 am.
This could be due to a number of factors. Reduced Lithium from 900 mg to 800 mg to reduce polyuria and polydypsia. I have built up a steady concentration of Remeron in my body. I took 7.5 mg. I went to bed earlier.If anyone out there has experience with Remeron which confirms or contradicts my theories I would be glad to hear from you. After all this is why we are all here: to share our experiences of various drugs and to formulate a beneficial practice for their use.
From now on it is my intention to persist with a 7.5 mg dose. I think I might try taking it earlier at say 8.30 pm. Perhaps that might reduce my early morning grogginess. I have yet to try getting up at say 7.30 am (my usual time) on a dose of 7.5 mg. That is my next assignment.
Will keep you posted. I feel quite upbeat about the Remeron deal. I think, with a few adjustments here and there I can make this drug work for me.
ciao for now
ronaldo
Posted by ronaldo on April 28, 2007, at 6:00:39
In reply to Re: Update day 4...things improve!, posted by ronaldo on April 28, 2007, at 4:32:12
Posted by saturn on April 28, 2007, at 10:45:40
In reply to Re: Update day 4...things improve!, posted by ronaldo on April 28, 2007, at 4:32:12
Awesome Ronaldo! Glad to hear. I've personally taken Remeron perhaps a total of 7 doses--either 15 or 30 mg. Always a big hangover and somnolence, but it did let me sleep, and I also experienced a very welcome anxiolytic effect.
I have read in previous posts that it takes about a month to develop tolerance to the daytime sedation/somnolence. I wonder, however, if this holds true at the 7.5 and 15 mg dosages. I hope so.
Thanks for the update---please keep us posted, and hope things continue to improve for you. Peace...Saturn.
Posted by ronaldo on April 28, 2007, at 11:05:55
In reply to Re: Update day 4...things improve! » ronaldo, posted by saturn on April 28, 2007, at 10:45:40
Hi Saturn,
Thanks for your post and good wishes. It's good to hear "that it takes about a month to develop tolerance to the daytime sedation/somnolence." There is light at the end of the tunnel. Today I have just been feeling generally mellow, quite a pleasant feeling but might grow wearisome with time. Also there is a slight ambient sort of chemical taste and smell. I guess I will get used to that in time as well. 7.5 mg seems to be my optimum dose but it's still early days. Things may change.
Will keep you posted. Peace...
ronaldo
Posted by Phillipa on April 28, 2007, at 19:00:01
In reply to Re: Update day 4...things improve! » saturn, posted by ronaldo on April 28, 2007, at 11:05:55
Ronaldo congrats seems like things are on the upswing for you. Love Phillipa yes keep us posted
Posted by ronaldo on April 29, 2007, at 2:09:15
In reply to Re: Update day 4...things improve! » ronaldo, posted by Phillipa on April 28, 2007, at 19:00:01
Thanks Phillipa,
I still have to wean off the Valium. But I do feel confident. Last night was not so good. Only slept 10.30 pm till 3.40 am but this may have been because I reduced Valium from 4 mg to 3 mg. I expect/hope to sleep better again tonight. Will stay with the 7.5 mg Remeron dose and the 3 mg Valium. Good thing is I don't feel at all hung over this morning. It would just have been nice to have slept longer. I was up at 7.00 am. From 3.40 till 7.00 I was half asleep, ie relaxed without anxiety. I guess I can count myself lucky.
How are you? Good I hope. Will email.
Best wishes
ronaldo
> Ronaldo congrats seems like things are on the upswing for you. Love Phillipa yes keep us posted
Posted by ronaldo on April 30, 2007, at 2:36:56
In reply to Re: Update day 5...set back » Phillipa, posted by ronaldo on April 29, 2007, at 2:09:15
It was the same last night. Remeron 7.5 mg at 8.37 pm, lithium 850 mg and valium 3 mg at 9.20 pm. To bed 9.37 pm. Awake at 3.09 am. Little further sleep. Out of bed at 7.30 am. What to do? Will phone pdoc at lunch time. Increase remeron to 15 mg or reduce; or restore 4 mg Valium? Have also recently stopped Cetirizine, anti-hystamine for hay-fever. Maybe that has had an effect. Oh well other people have worse problems.
ronaldo
Posted by ronaldo on May 1, 2007, at 3:09:35
In reply to Re: Update day 6...set back, posted by ronaldo on April 30, 2007, at 2:36:56
Took 850 mg Lithium, 4 mg Valium, 7.5 mg Remeron at 9.30 am. Into bed 10.20 pm. Slept through till about 5.30 am. Pee. Slept on till about 6.30 - 7.00 am.
Better sleep due to increasing Valium back up to 4 mg? Possibly. Also took Cetirizine 10 mg for hay fever which being an anti-hystamine may also have helped. Also took 2 x Co-proxamol for relief of sinusitis pain - also due to hay fever. Also taking Alomide eye drops for hay fever.
Reduced Valium from 5 mg to 4 mg on Wednesday 25, and then again from 4 mg to 3 mg on Saturday 28 April. Obviously this reduction in Valium was far too hasty. I will try reducing down to 3 mg again on Monday 7 May. Hopefully that will be enough time. My pdoc wrote to my GP as follows: "The Diazepam doesn't seem to be helping and this could be becoming more of a problem than it is worth and we suggested he start reducing and wean off of this." I will just have to wean off SLOWLY.
So far it seems that 7.5 mg of Remeron is the optimum dose. I don't intend to change this, unless my pdoc says so. No luck contacting my pdoc yesterday. Will try again this pm. I don't know how much of my sleep was due to the Remeron and how much was due to the extra 1 mg of Valium, the Cetirizine and the Co-proxamol. I suspect these last three played a significant role. I am going to continue with the Cetirizine. Have run out of Co-proxamol. Hopefully the sinusitis will not hit so hard today. Hay fever has been bad in the South of England this year. Global warming?
ronaldo
Posted by ronaldo on May 1, 2007, at 3:11:34
In reply to Re: Update day 6...set back, posted by ronaldo on May 1, 2007, at 3:09:35
Posted by ronaldo on May 1, 2007, at 8:05:08
In reply to Re: Sorry the above should be: Update day 7 (nm), posted by ronaldo on May 1, 2007, at 3:11:34
Hi
Just spoke to pdoc on phone. He says take 15 mg Remeron tonight. Will see how it goes!
ronaldo
Posted by ronaldo on May 2, 2007, at 5:55:50
In reply to pdoc says take 15 mg Remeron tonight, posted by ronaldo on May 1, 2007, at 8:05:08
Hi All, (if anyone is actually following )
Yeah, took 15 mg Remeron, 850 mg Lithium, and 4 mg Valium at 9 pm last night. Awake at 2.55 am this morning. Little, if any, further sleep. Out of bed at 7.00 am. Seems better for my mood if I get up and don't stay in bed trying fruitlessly to get back to sleep.
I don't know what to do tonight. Give 15 mg a second chance or revert to 7.5 mg? 7.5 mg was successful several times until I messed things up with reducing my Valium too fast (from 4 mg down to 3 mg). I am now back on the 4 mg Valium, have been for the last 2 days. I think I will try the 7.5 mg again. Maybe it will work. In my handwritten diary I have got 'slept well'(last night) for Tuesday 1 May. Monday I took 850 mg Lithium, 4 mg Valium, and 7.5 mg Remeron at 9.30 pm. So why am I messing around with 15 mg Remeron? I MUST be crazy!
So tonight its going to be 850 mg Lithium, 4 mg Valium, and 7.5 mg Remeron. And I should sleep like a baby!
ronaldo
> Hi
>
> Just spoke to pdoc on phone. He says take 15 mg Remeron tonight. Will see how it goes!
>
> ronaldo
Posted by ronaldo on May 2, 2007, at 6:08:53
In reply to Aftermath of taking 15 mg Remeron - day 8, posted by ronaldo on May 2, 2007, at 5:55:50
Yeah, forgot to say. Today I feel pretty sedated. Quite calm. A lot more so. Have been quite agitated the last two days. Urgently needed to speak to pdoc. Just speaking to him for a couple of minutes made me relax. There's nothing worse than thinking you are all alone with your problem. I guess that's what keeps me tapping away at this keyboard. LOL.
ronaldo
Posted by saturn on May 2, 2007, at 15:07:16
In reply to Afterthought - day 8, posted by ronaldo on May 2, 2007, at 6:08:53
> Yeah, forgot to say. Today I feel pretty sedated. Quite calm. A lot more so. Have been quite agitated the last two days. Urgently needed to speak to pdoc. Just speaking to him for a couple of minutes made me relax. There's nothing worse than thinking you are all alone with your problem. I guess that's what keeps me tapping away at this keyboard. LOL.
>
> ronaldo
Sounds like you've got a decent pdoc, Ronaldo. Hope you have better luck tonight. Peace...Saturn.
Posted by ronaldo on May 3, 2007, at 2:03:34
In reply to Afterthought - day 8, posted by ronaldo on May 2, 2007, at 6:08:53
MEDS. 9.30 pm last night: 850 mg Lithium, 4 mg Valium, 7.5 mg Remeron.
Fell asleep rapidly till 3 am, pee, went back to sleep. Disturbed sleep, brief awakenings, till about 6.30 - 7.00 am.
Out of bed 7.30 am.Now 7.53 am feel tired and a bit hung-over. Still have to have breakfast and a cup of tea.
CONCLUSION: 7.5 mg is a lot better than 15 mg. I think I will be staying with 7.5 mg from now on. This is as good as it gets. Though once I did sleep right through from 11 pm to about 6.30 am without awakening on 7.5 mg. My diagnosis by the way is "Manic depression - currently in remission"
Posted by saturn on May 3, 2007, at 17:32:09
In reply to Re: Update day - 9, posted by ronaldo on May 3, 2007, at 2:03:34
> MEDS. 9.30 pm last night: 850 mg Lithium, 4 mg Valium, 7.5 mg Remeron.
>
> Fell asleep rapidly till 3 am, pee, went back to sleep. Disturbed sleep, brief awakenings, till about 6.30 - 7.00 am.
> Out of bed 7.30 am.
>
> Now 7.53 am feel tired and a bit hung-over. Still have to have breakfast and a cup of tea.
>
> CONCLUSION: 7.5 mg is a lot better than 15 mg. I think I will be staying with 7.5 mg from now on. This is as good as it gets. Though once I did sleep right through from 11 pm to about 6.30 am without awakening on 7.5 mg. My diagnosis by the way is "Manic depression - currently in remission"Hopefully the morning hangover feeling will subside. Sounds like 3am is a common awakening time for you and that 7.5 is less sedating than 15 for you also. This seems reasonable because I think you're mainly getting an antihistamine effect at both doses. Peace...Saturn.
Posted by ronaldo on May 5, 2007, at 2:16:16
In reply to Re: Update day - 9 » ronaldo, posted by saturn on May 3, 2007, at 17:32:09
> > MEDS. 9.30 pm last night: 850 mg Lithium, 4 mg Valium, 7.5 mg Remeron.
> >
> > Fell asleep rapidly till 3 am, pee, went back to sleep. Disturbed sleep, brief awakenings, till about 6.30 - 7.00 am.
> > Out of bed 7.30 am.
> >
> > Now 7.53 am feel tired and a bit hung-over. Still have to have breakfast and a cup of tea.
> >
> > CONCLUSION: 7.5 mg is a lot better than 15 mg. I think I will be staying with 7.5 mg from now on. This is as good as it gets. Though once I did sleep right through from 11 pm to about 6.30 am without awakening on 7.5 mg. My diagnosis by the way is "Manic depression - currently in remission"
>
> Hopefully the morning hangover feeling will subside. Sounds like 3am is a common awakening time for you and that 7.5 is less sedating than 15 for you also. This seems reasonable because I think you're mainly getting an antihistamine effect at both doses. Peace...Saturn.
>
Are you sure? I think 7.5 mg is more sedating than 15 mg. Smaller doses are supposed to be more sedating. Strange but that is how this med works. Smaller doses make me much more groggy next day. Last 2 nights have woken at 4 and 5 am. Back to sleep but only intermittent. Will persevere with 7.5 mg see what happens.ciao
ronaldo
Posted by saturn on May 5, 2007, at 9:07:39
In reply to Re: Update day - 9, posted by ronaldo on May 5, 2007, at 2:16:16
> Are you sure? I think 7.5 mg is more sedating than 15 mg. Smaller doses are supposed to be more sedating. Strange but that is how this med works. Smaller doses make me much more groggy next day. Last 2 nights have woken at 4 and 5 am. Back to sleep but only intermittent. Will persevere with 7.5 mg see what happens.
>
> ciaoYou're definitely getting antihistamine effect at both doses. Theoretically, the higher doses become less sedating once you start getting the noradrenergic effect. Perhaps you're getting this noradrenergic effect at 15 mg, but not much at 7.5 mg. I've heard it often claimed that the Noradrenaline kind of reaches a threshold in terms of really kicking in at 30 mg, but this is just hearsay. I say stick with what works best for you. Thanks again for the updates. Peace...Saturn.
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