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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Rainbowlight on February 28, 2003, at 18:34:42
Saw the pdoc. Here is the plan. She is putting my back on Remeron, however on a higher dose, 45 mgs. She says it affects different transmitters at this dose and reacts differently and should help with the weight gain issues. (Here's hopin'!!!) I am thrilled to be able to give it another try. I feel so awful right now. She ditched the Elavil altogether (says it CAN cause agitation), left the Zoloft the same, 25 mgs. 2 x day, and gave me Ativan 1 mg. in the morning,1 mgs. at night if needed. She did not add back the Restoril, she wants to see if the Remeron will be enough, which I agreed with. SO, looks like we are back to square one. Gosh, I hope it works. I am finally losing some weight. You know what I have found is easing the bloating/weight, drinking tons of water. Like 12 glasses a day. I am much less bloated, so I look skinnier! Tee Hee! I asked her about the Topamax and her reaction was "well the Lamictal is going so well for you". From the tone of her voice it seems she prefers the Lamictal to Topamax. She said she was happy that I do my homework on these meds and know what I am getting into. Let me know what ya think!
Posted by missinglynxx on February 28, 2003, at 20:32:51
In reply to Ritch, posted by Rainbowlight on February 28, 2003, at 18:34:42
COOL Rainbowlight.. It sounds like you are starting a new "regimine" with the Remeron!
We can exchange notes , since Spring is cummming up this March and Im in a hurry to recover before the birds are singing and the Sun is Shining in Oregon................
I just started Remeron about a week ago.. Did you know you can get Generic Remeron @ 30 and 15 mgs.. Thats in case you pay some money out of pocket........... I hope the Remeron is A "Keeper" and solves all you psychiatric dilemmas! GOOD luck......
Posted by Rainbowlight on February 28, 2003, at 22:29:17
In reply to Re: Ritch, posted by missinglynxx on February 28, 2003, at 20:32:51
Thanks for the good wishes. This will be my second time on Remeron. I loved it, it worked great but I gained alot of weight on it. Now my pdoc is upping the dose, she says it should solve the weight gain issue. I didn't know you could get Remeron in generic, that's great to know. It sure would help my copay be alot lower. How are you feeling on the Remeron so far? What dose are you at? From what I have read on these boards, the higher the dose, the less sedating.
Posted by Ritch on February 28, 2003, at 23:33:37
In reply to Ritch, posted by Rainbowlight on February 28, 2003, at 18:34:42
> Saw the pdoc. Here is the plan. She is putting my back on Remeron, however on a higher dose, 45 mgs. She says it affects different transmitters at this dose and reacts differently and should help with the weight gain issues. (Here's hopin'!!!) I am thrilled to be able to give it another try. I feel so awful right now. She ditched the Elavil altogether (says it CAN cause agitation), left the Zoloft the same, 25 mgs. 2 x day, and gave me Ativan 1 mg. in the morning,1 mgs. at night if needed. She did not add back the Restoril, she wants to see if the Remeron will be enough, which I agreed with. SO, looks like we are back to square one. Gosh, I hope it works. I am finally losing some weight. You know what I have found is easing the bloating/weight, drinking tons of water. Like 12 glasses a day. I am much less bloated, so I look skinnier! Tee Hee! I asked her about the Topamax and her reaction was "well the Lamictal is going so well for you". From the tone of her voice it seems she prefers the Lamictal to Topamax. She said she was happy that I do my homework on these meds and know what I am getting into. Let me know what ya think!
There are some people that find the higher doses of Remeron not to cause as much weight gain as the lower ones. Given that you tolerated it well other than the weight gain, that makes sense to me. She probably doesn't want you on *two* mood stabilizers simultaneously (Topamax and Lamictal). It is kind of odd though, that she doesn't have any trouble with two high-dose antidepressants for a bipolar person?? Wonder what her rationale is?
Posted by Rainbowlight on March 1, 2003, at 0:42:08
In reply to Re: Ritch » Rainbowlight, posted by Ritch on February 28, 2003, at 23:33:37
I don't know why she didn't like the Topomax idea? She kinda gave me a look like "don't we have enough med problems here without changing the mood stabilizers?, LOL" The poor lady, I have put her through hell, and she is a saint. She will let me call her anytime and if I have a question they page her and she calls me back within a few minutes. How many pdocs can ya find that will do that? So I don't want to push my luck with her ya know? It's hard to find a good pdoc huh? My last one was very good but he went into private practice and is so good he doesn't even take insurance, only cash! And he's over $300 an hour I last heard. Anyway, now I just have to figure out how to stay away from the fridge once the "grazing" starts! Yikes! I have been drinking a ton of water, I am finding it curbs my appetite. I guess at night I will have to drink myself into a coma before bed! God I hope she's right and the weight issue goes away, that would be so awesome.
p.s. It IS weird that she will give me the two AD's. She watches me like a hawk though looking for mania. You should have seen how hard it was to convince her to start me on a stimulant. She made me try Effexor and Wellbutrin first (yuck and YUCK!!!!) before she would give me Ritalin, etc. I asked her about Klonopin today, no go, said it's too sedating. (Can you tell she's not a benzo fan???LOL!)
Posted by Ritch on March 1, 2003, at 10:02:51
In reply to Re: Ritch, posted by Rainbowlight on March 1, 2003, at 0:42:08
> I don't know why she didn't like the Topomax idea? She kinda gave me a look like "don't we have enough med problems here without changing the mood stabilizers?, LOL" The poor lady, I have put her through hell, and she is a saint. She will let me call her anytime and if I have a question they page her and she calls me back within a few minutes. How many pdocs can ya find that will do that? So I don't want to push my luck with her ya know? It's hard to find a good pdoc huh? My last one was very good but he went into private practice and is so good he doesn't even take insurance, only cash! And he's over $300 an hour I last heard. Anyway, now I just have to figure out how to stay away from the fridge once the "grazing" starts! Yikes! I have been drinking a ton of water, I am finding it curbs my appetite. I guess at night I will have to drink myself into a coma before bed! God I hope she's right and the weight issue goes away, that would be so awesome.
>
> p.s. It IS weird that she will give me the two AD's. She watches me like a hawk though looking for mania. You should have seen how hard it was to convince her to start me on a stimulant. She made me try Effexor and Wellbutrin first (yuck and YUCK!!!!) before she would give me Ritalin, etc. I asked her about Klonopin today, no go, said it's too sedating. (Can you tell she's not a benzo fan???LOL!)
You're so funny! I had a pdoc once I thought was going to beat me to death with a hammer if I mentioned any new meds! :) You ARE very lucky to have someone that is that responsive. My current pdoc is VERY patient with my med whims. The main thing I have found is 1) Try to stick with what works, and 2) Dont' retry stuff that didn't work. When it comes to adverse events (like weight gain), you have to get creative I guess.....
Posted by Rainbowlight on March 1, 2003, at 22:12:54
In reply to Re: Ritch » Rainbowlight, posted by Ritch on March 1, 2003, at 10:02:51
Ahhhhhh, day one back on Remeron, I feel like a new person! Amazing stuff! No obsessing, stressing or sleepiness. I'm in heaven! And last night I slept like a log with just the Remeron, no sleep med. Geez, I hope this works! Still drinking tons of water, lol! Bought some chewing gum to try to kill the sugar craving the Remeron always brings late at night. Now I just have to remember not to eat the WHOLE pack of gum at one sitting. The other night I ate two WHOLE packs of lifesavers before bed. How sick is that? Makes me cringe! What was I thinking? I have a major sweet tooth. I will bump up 15 mgs every 3 days until I reach 45. Hopefully all will go well. How are you? Sleeping any better? I hope so!
Posted by Rainbowlight on March 1, 2003, at 22:21:11
In reply to Re: Ritch, posted by Rainbowlight on March 1, 2003, at 22:12:54
Ritch, please read the LAST post from "Patients" under the post "Remeron, please help I can't eat" (I tried to paste it here but it wouldn't work). I think this is what my doctor is talking about, about the higher dose, what do you think?
Posted by Ritch on March 2, 2003, at 9:48:42
In reply to Re: Ritch, posted by Rainbowlight on March 1, 2003, at 22:21:11
Ahhhhhh, day one back on Remeron, I feel like a new person! Amazing stuff! No obsessing, stressing or sleepiness. I'm in heaven! And last night I slept like a log with just the Remeron, no sleep med. Geez, I hope this works! Still drinking tons of water, lol! Bought some chewing gum to try to kill the sugar craving the Remeron always brings late at night. Now I just have to remember not to eat the WHOLE pack of gum at one sitting. The other night I ate two WHOLE packs of lifesavers before bed. How sick is that? Makes me cringe! What was I thinking? I have a major sweet tooth. I will bump up 15 mgs every 3 days until I reach 45. Hopefully all will go well. How are you? Sleeping any better? I hope so!
> Ritch, please read the LAST post from "Patients" under the post "Remeron, please help I can't eat" (I tried to paste it here but it wouldn't work). I think this is what my doctor is talking about, about the higher dose, what do you think?OH you mean this one:
As for Remeron, at lower doses it actually causes an increase in appetite as a result of blocking histamine receptors. This is also what causes the extreme sleepiness at lower doses. Remeron causes the serotonin system to get turned down and the norepinephrine system to be turned up, but this occurs at higher doses. You shouldn't have to worry about the norepinephrine system if you only take it at low doses. One reason doctors increase Remeron qucikly after starting a patient on it is to counteract the drowsiness and the increase in appetite that commonly occurs at the low dose end. Increasing the dose stimulates norepinephrine which counteracts these effects. The lower dose end is better for those that suffer from extreme anxiety or that need help with sleep. You are already at the high end for Remeron. The usual start up dose is 15 mg a day, and depending upon response, increased to 45 mg a day.
From what I understand Remeron "saturates" the histamine receptors at just about any dose. Dose increases kickin the noradrenergic effects as mentioned, which would likely begin to supress appetite. Obviously you have got a Remeron "circuit" readymade for your brain! I've got some major temper problems and it makes them really bad, so I can't take the stuff. I liked Remeron's regulation of my IBS symptoms better than anything else (and of course sleep). I would just like to take a selective serotonin antagonist that had a short half-life at bedtime to help sleep and cool my gut.
Posted by Rainbowlight on March 3, 2003, at 0:04:27
In reply to Re: Ritch » Rainbowlight, posted by Ritch on March 2, 2003, at 9:48:42
Day two - all is going well. I have noticed an appetite increase but I am trying to watch what (and how much!) I eat. I am going to bump up to the 30 mgs. tonight. I want to get up to the 45 pretty quickly to see if it will decrease the appetite. What is your opinion on being on these types of meds for the long haul? Is it going to fry our brains in the end? It does scare me a bit. ALso, had did you learn about all this "receptor, antagonist, etc." stuff anyway?
Posted by Ritch on March 3, 2003, at 9:41:09
In reply to Re: Ritch, posted by Rainbowlight on March 3, 2003, at 0:04:27
> Day two - all is going well. I have noticed an appetite increase but I am trying to watch what (and how much!) I eat. I am going to bump up to the 30 mgs. tonight. I want to get up to the 45 pretty quickly to see if it will decrease the appetite. What is your opinion on being on these types of meds for the long haul? Is it going to fry our brains in the end? It does scare me a bit. ALso, had did you learn about all this "receptor, antagonist, etc." stuff anyway?
All that receptor stuff? Reading here and elsewhere about the meds I take. As far as "frying our brains"-I look at being ill and experiencing symptoms as a brain frying experience itself! I think chronic SSRI use has had a deleterious effect on my esophagous (due to heartburn). However, that runs in my family and they are not *all* :) on SSRI's. Lithium may have been a little mean to my thyroid-but thyroid illness runs in my family, too. I think it isn't so much a brain-frying worry as much as the burden to the *body*. Liver, kidneys, thyroid, etc. OTOH, chronic untreated anxiety (i.e.) can be harsh on your body, too.
This is the end of the thread.
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