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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by rainbowlight on April 30, 2002, at 16:27:04
Hi again 3 beers! Today I have upped my dosage of Zoloft from 37.5 to 50 mgs. and have slightly reduced my 30 mgs. of Remeron. My pdoc wants to bring my Remeron down and increase the Zoloft. The more I raise the Zoloft, the more sedated I am. My question is this: if I stay on the Zoloft and increase it, will I get more and more sedated or will it subside? My pdoc said I would feel BETTER on a higher dose. I am wondering if the sedation is the combo of both meds? Will I get the same anti-depressant effect from either med? I'm scared. I have been on the Remeron for 6 months, and playing with the dosage is a little frightening. Thanks for all your support and for answering my questions. I really appreciate it!
Posted by Phil on April 30, 2002, at 18:36:39
In reply to 3 Beers: Question for you and others re: Zoloft, posted by rainbowlight on April 30, 2002, at 16:27:04
rainbowlight (till 3 beers gets here)
The sleepiness with Zoloft should level out after a few weeks.
My experience with Remeron is that it is more activating at a higher dose and I lost weight at 60 mg. Put me on 15mg and it's get fat and go to bed. It's sort of a paradox with Remeron.
Posted by 3 Beer Effect on May 1, 2002, at 0:17:36
In reply to 3 Beers: Question for you and others re: Zoloft, posted by rainbowlight on April 30, 2002, at 16:27:04
If you lower your Remeron dose you will be MORE, not less sedated. The only way to lessen Remeron sedation is to INCREASE the dose (45-60 mg), or stop taking it.
Upping the Zoloft to 75 mg or more will cause LESS to NO sedation & will likely be activating (which could induce hypomania/mania in bipolars).
You should probably quit the Remeron & take Klonopin instead (since Klonopin is a 2nd line anti-manic agent) & either stay at 50 mg of Zoloft or cautiously up the dose to 75 mg if the Zoloft sedation doesn't subside.
OR keep the Remeron atleast at 30 mg (or even increase it to 45 mg-60 mg for less sedation) & Up the Zoloft dose to 75 mg.
Keep in mind that the Zoloft sedation could really be Remeron sedation,
OR the Remeron could potentiate the Zoloft sedation,
OR since Remeron blocks the 5-ht2 & 5-ht3 serotonin receptors that Zoloft acts on, Remeron may cancel out the 'activating' effect people normally experience at Zoloft 75-100+ mgs.
[When you combine two different anti-depressants the pharmacology becomes much more complex & it is often difficult even for psychiatrists to predict the likely outcome of a combination or to predict the best (optimal) dose when dealing with two different anti-depressants which interact with each other & can potentiate or even antagonize each other's effects.]Keep in mind that each time you change the Zoloft dose it will take about 3-4 weeks to notice the full effect, it is not going to change in a few days.
As you have probably read before, the lower the dose of Remeron, the higher the sedation. This is because the higher the dose, the greater ability Remeron has to raise norepinephrine. At 45 to 60 mg the activating effects of norepinephrine cancel out/overpower the strong anti-histamine/drowsiness effect of Remeron.
15 mg is much more sedating than 30 mg while 45 mg is either not sedating or somewhat sedating, & for many 60 mg is activating. Keep in mind that women may be less sedated at a given dose since the elimination half life of Remeron is longer in females than males.3 Beers.........................
Posted by MoBe on October 1, 2002, at 17:18:47
In reply to reducing the Remeron will cause more sedation, posted by 3 Beer Effect on May 1, 2002, at 0:17:36
> If you lower your Remeron dose you will be MORE, not less sedated. The only way to lessen Remeron sedation is to INCREASE the dose (45-60 mg), or stop taking it.
>
> Upping the Zoloft to 75 mg or more will cause LESS to NO sedation & will likely be activating (which could induce hypomania/mania in bipolars).
>
> You should probably quit the Remeron & take Klonopin instead (since Klonopin is a 2nd line anti-manic agent) & either stay at 50 mg of Zoloft or cautiously up the dose to 75 mg if the Zoloft sedation doesn't subside.
>
> OR keep the Remeron atleast at 30 mg (or even increase it to 45 mg-60 mg for less sedation) & Up the Zoloft dose to 75 mg.
>
> Keep in mind that the Zoloft sedation could really be Remeron sedation,
> OR the Remeron could potentiate the Zoloft sedation,
> OR since Remeron blocks the 5-ht2 & 5-ht3 serotonin receptors that Zoloft acts on, Remeron may cancel out the 'activating' effect people normally experience at Zoloft 75-100+ mgs.
> [When you combine two different anti-depressants the pharmacology becomes much more complex & it is often difficult even for psychiatrists to predict the likely outcome of a combination or to predict the best (optimal) dose when dealing with two different anti-depressants which interact with each other & can potentiate or even antagonize each other's effects.]
>
> Keep in mind that each time you change the Zoloft dose it will take about 3-4 weeks to notice the full effect, it is not going to change in a few days.
>
>
> As you have probably read before, the lower the dose of Remeron, the higher the sedation. This is because the higher the dose, the greater ability Remeron has to raise norepinephrine. At 45 to 60 mg the activating effects of norepinephrine cancel out/overpower the strong anti-histamine/drowsiness effect of Remeron.
> 15 mg is much more sedating than 30 mg while 45 mg is either not sedating or somewhat sedating, & for many 60 mg is activating. Keep in mind that women may be less sedated at a given dose since the elimination half life of Remeron is longer in females than males..I'm currently taking remeron and have a question for those of you out there who take 60 mg a day. I keep hearing that this amount counteracts the antihistamine sedated feeling. I wondered though, if it made you feel nicely awake of that weird kind of awake you get if you have an Irish coffee, kind of sedated from the alcohol and agitated from the coffee. In other words - not really such a desirable state. Thanks.
MoBe
>
> 3 Beers.........................
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