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Dr. Bob is Robert Hsiung, MD,
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Posted by Jack Smith on May 5, 2003, at 12:54:25
In reply to Re: Period for Remeron's benefits to kick-in?, posted by jrbecker on May 5, 2003, at 12:31:35
JR--
Are you on Remeron now? I am surprised to see that it worked for you because I would think it would be no good in atypical cases because of its sedative effects. I am really tired on effexor (150mg) but will move up to 225 to see if noradrenic (sp?) effect will start to wake me up.
By the way, Remeron is not a reuptake inhibitor correct? So, it is an agonist? What is the difference?
JACK
Posted by jack smith on May 5, 2003, at 16:46:19
In reply to Re: Period for Remeron's benefits to kick-in? » charlie12, posted by LyndaK on May 5, 2003, at 2:44:22
>Now, I realize not everyone has had this experience with this drug, but it has made a WORLD of difference for me . . . and I would've never found out if I had quit. I'm currently taking 60 mgs. per day (at bedtime) and have been on it nearly a year now.
Lynda,
What other drugs had you tried? What are your symptoms of depression like? Do you feel sedated on Remeron? Were you sedated on any prior AD's??
JACK
Posted by JrBecker on May 5, 2003, at 23:58:07
In reply to Remeron for Atypical Dep » jrbecker, posted by Jack Smith on May 5, 2003, at 12:54:25
Jack,
yes, the sedation certainly does not help my atypical symptoms, however, Remeron can be quite stimulating at higher doses. With every drug there are side effects, and the big sacrifice with remeron is the sedation and a slight propensity toward weight gain. But the more you get up there in dosage the more these two effects diminish to a very low level. Both side effects are matter of degrees subject to dosage levels as well as an individual's ability to tolerate as well as adapt to it. OK, with the bad side out of the way, it's a great antidepressant. I mean this drug works like no other modern class antidepressant I've been on. It's sort of a jack-all-trades med: it antagonizes 5HT2(a&c), 5HT3 and noradrenergic alpha-2 receptors. To answer your question, it is not a reuptake inhibitor but causes a cascade of increased activity at dopaminergic and noradrengic sites because of its antagonism at those receptors. Also, it indirectly decreases cortisol output from the HPA. And don't discount the possible role that the antihistamine effect probably has as an AD. So, it's one dirty drug! And it works well. Are the side effects manageable? Yes. Will I still try other drugs as they come out (e.g., Duloxetine) to see if it has a better efficacy to side effect ratio? Sure. But right now it's working and that's the best I can hope for before having to think about trying out an MAOI.
Should you try it? Only doing a trial yourself will let you know if you can tolerate it. But I would definitely give yourself a period of at least 1-2 weeks where you know you wont have too many responsibilities for a while b/c it will zonk you out at first.
Sorry to hear the Effexor is working so-so. It's a rough ride. Perhaps when duloxetine comes out this summer, you can find a better match with an SNRI.
JB
Posted by LyndaK on May 6, 2003, at 14:14:54
In reply to Re: Period for Remeron's benefits to kick-in? » LyndaK, posted by CharlieL on May 5, 2003, at 10:41:01
Hi Charlie,
Yes, you ask alot of questions, but that's GOOD.:-)
>
> Lynda, do you consider yourself to be a sensitive person to AD meds in general or not?I don't think that I am overly sensitive to medications in general, I usually take the typical dose. But I am very sensitive to changes in my body and how I feel -- I notice EVERY little difference. I realized early on that I wasn't going to find the perfect drug that treated my severe depression AND didn't have any side-effects. It's definitely a trade-off, and I (you) had to decide if it's a GOOD trade-off or not. The drug I was on before this was Zoloft -- it did a great job with my depression, but the trade-off is that it messed with my memory. During the time that I was suicidal, this was an acceptable trade-off, but once I wasn't suicidal anymore, it wasn't an acceptable trade-off, and that's when my Doc and I started searching for a different med. -- thus Remeron.
>
> Lynda, do I understand you correctly that your start-up experience with Remeron was at 30mg every night and you did NOT stop it or drop the dose down at all, but just toughed it out at 30mg/nite and then the worst of it diminished for you after 1 to 2 weeks?Yes.
>
> Also, were you using the Remeron mouth-dissolving SolTabs or just the regular swallow tabs? (I think that the SolTabs version of Remeron may deliver more net potency than the regular Tabs at the same rated mg dosage; I am using the SolTabs version.)I've always used the SolTabs.
>
> I do understand now that that is the general goal for Remeron users, to get to and then sustain the use of Remeron at those higher doses. Lynda, may I ask at what point in your Remeron usage did you raise from 30 to 45, and then from 45 to 60?I went up to 45 at about the 4 to 6 week point and then stayed there for roughly 4 to 6 months. My anxiety started to return so we bumped it up to 60 and I've been good there ever since.
>
> Lynda, I see that you mentioned anxiety; did you have any mild OCD-type anxiety as well? I do.No one's ever added OCD to my diagnosis, but I do sometimes obsessively worry. My anxiety is more of a social phobia type thing, though never severe enough to turn me into a hermit.
>
> Also, are you only using just the Remeron for your depression & anxiety?Yes. It's great to be on only one medication.
>
> Again, thanks so much!
>
You're very welcome.
I'll be looking to see how you're doing.Best Wishes,
Lynda
Posted by LyndaK on May 6, 2003, at 14:28:45
In reply to Remeron » LyndaK, posted by jack smith on May 5, 2003, at 16:46:19
> >Now, I realize not everyone has had this experience with this drug, but it has made a WORLD of difference for me . . . and I would've never found out if I had quit. I'm currently taking 60 mgs. per day (at bedtime) and have been on it nearly a year now.
>
> Lynda,
>
> What other drugs had you tried? What are your symptoms of depression like? Do you feel sedated on Remeron? Were you sedated on any prior AD's??I've tried most of the SSRI's and Wellbutrin. Never been on a tricyclic or MAOI. My SSRI-of-choice was Zoloft -- worked the best for the anxiety component of my depression. The bad thing about it is that it really messed with my memory; that's why I eventually went off. I have/had a typical unipolar depression with anxiety. Most of the AD's I've been on have sedated me which is why I take them at night before bed. Remeron is probably the most sedating, but it is less so at higher doses. It still helps me sleep at night yet I can get up in the morning without the aide of a bulldozer shoving me out of bed (which is how I felt when I was first on it)! Wellbutrin didn't sedate me, it made me TOO awake; I couldn't sleep at night. It also made me VERY irritable.
Hope this helps. Good luck with your search.
Lynda
Posted by earthmamma on May 8, 2003, at 15:57:21
In reply to Re: Remeron » jack smith, posted by LyndaK on May 6, 2003, at 14:28:45
Posted by earthmamma on May 8, 2003, at 16:26:08
In reply to New here, been on Remeron 2 weeks (nm), posted by earthmamma on May 8, 2003, at 15:57:21
Grrrr!! I didn't know what the "message" button was for and assumed it meant it wouldn't post the message above mine, but it errased my message instead!
I'm not typing all that out again, what a piss off!
Ok, short and sweet...
I'm concerned about weight gain on this drug. I've worked really hard to get back into shape after the birth of our 2nd daughter a year ago. I run every other day for 50 minutes, and lift weights 3-4 days a week. I'm worried that all the hard work I've done will be ruined. I make healthy food choices most of the time (we all need some junk here and there...) and make fat free jello and puddings instead of binging on cakes and cookies etc. But I've read that some of these meds can change the body's metabolism and so no matter what you do you gain weight. I didn't gain weight on Paxil, so I'm hoping this will be the same.
Also, (maybe this won't be short and sweet) I'm down to 2.5 MG Paxil, (my original dose was 20 MG for PPD with my main symptoms being panic attacks and constant anxiety) and will be on that for about 2 weeks, then off. I'm on 30 MG Remeron, and have been for about 2 weeks. Is this a dose that many people stay with, or will my doc most likely up it in a month or so? I noticed the sedation initially, and it was pretty severe, but it has decreased significantly, and almost doesn't effect me anymore.
Did anyone notice as a side effect that their hearing and eyesight was sensative? If so, how long did that last? I'm hoping that it will be better also once I'm off the Paxil. I was weaning off the Paxil for this reason (ears ringing, head tightness, loss of libido etc) when all my symptoms came back after I mistakenly missed one dose of 2.5 MG. I never levelled back out tho after going back up to 5 MG, then 10 MG, and so my doc put me on Remeron. What a change!! It only took for a few days before I noticed some relief from my anxiety.
Thanks for any advice, this seems like a great forum. I guess I DID end up typing almost all of it out again LOL!
Cheers,
Earthmamma
Posted by McPac on May 8, 2003, at 20:58:25
In reply to Re: Remeron » jack smith, posted by LyndaK on May 6, 2003, at 14:28:45
Want to try Remeron again. My first time on it, my doc raised my dose from 7.5mg to 45mg---in ONE jump!!! Wayyyyyy too much norepinephrine effect (adrenaline)---I got sooo jittery/nervous/ w/racing heartbeat...couldn't stand that effect. I want to try it again only raising the dose GRADUALLY in small increments...probably not even going as high as 45 mg. Anybody else get that jittery/nervous effect? If so, how did you deal w/ that? Thanks!!!
Posted by jrbecker on May 9, 2003, at 15:01:25
In reply to Re: Period for Remeron's benefits to kick-in? » jrbecker, posted by CharlieL on May 5, 2003, at 11:18:39
wasn't this the thread where duloxetine's availability was being discussed? The thread has been mysteriously altered.
anyways. I thought I'd add this link to a press release from Lilly, saying that Duloxetine is still on for fourth quarter approval (different from what I heard, which was August). At least it's still this year.
Posted by Dr. Bob on May 9, 2003, at 22:07:51
In reply to Re: Duloxetine availability » CharlieL, posted by jrbecker on May 9, 2003, at 15:01:25
> The thread has been mysteriously altered.
I don't remember if it was on this thread, but I deleted some posts from someone who was supposed to be blocked. And responses to those posts. Sorry for any confusion.
Bob
PS: Follow-ups to this should be redirected to Psycho-Babble Administration, thanks.
Posted by LyndaK on May 10, 2003, at 2:42:34
In reply to Remeron jitters/nervousness, posted by McPac on May 8, 2003, at 20:58:25
What you describe is totally opposite of what I experience on this med -- at any dose.
> Want to try Remeron again. My first time on it, my doc raised my dose from 7.5mg to 45mg---in ONE jump!!! Wayyyyyy too much norepinephrine effect (adrenaline)---I got sooo jittery/nervous/ w/racing heartbeat...couldn't stand that effect. I want to try it again only raising the dose GRADUALLY in small increments...probably not even going as high as 45 mg. Anybody else get that jittery/nervous effect? If so, how did you deal w/ that? Thanks!!!
Posted by Earthmamma on May 13, 2003, at 17:00:05
In reply to Period for Remeron's benefits to kick-in?, posted by charlie12 on May 1, 2003, at 14:39:58
I posted above, but no one answered. I have noticed an increase in my appetite, and it seems also, that my brain isn't telling me the same thing that my body is. We went for dinner on Mother's Day to a Thai food place, and they were having this fantastic buffet. Well I ate myself silly (Sunday is my "cheat day" for the week) and only stopped b/c my stomach literally HURT, but I still felt hungry!! I felt like I did when I was about 3 months pregnant, and had to put stretchy clothing on when we got home. It's like my brain isn't making the connection that I'm full, and I still feel hungry when I shouldn't be. I am concerned, since I am very active, and have worked really hard to get back into shape after having two children. The hunger really only hits me hard at night. In the day I seem to be ok. Is this an effect that eventually fades or do I have to deal with this the whole time I'm on remeron?? I've been on it almost a month. I make healthy food choices, and I don't eat white flour products, or much sugar. I rarely eat bread, but if I do it's always whole grain. But I've also read that some of these meds alter the body's metabolism. While I'd rather have a few extra pounds than have to deal with my severe anxiety and panic attacks (PPD related), I'm still worried about it. I have heard that some people gain 50+ lbs on this drug! I am only 5'1" and I can't "hide" extra weight.
Any advice on this??Cheers,
Kyah :)
Mamma to 2 ^Angelic^ girls
~Annika June~ June 30th, 1999
*Lorien Moss* April 15th, 2002"It is never too late to be what you might have been"
~George Eliot~
Posted by Earthmamma on May 13, 2003, at 18:17:07
In reply to Period for Remeron's benefits to kick-in?, posted by charlie12 on May 1, 2003, at 14:39:58
I posted above, but no one answered. I have noticed an increase in my appetite, and it seems also, that my brain isn't telling me the same thing that my body is. We went for dinner on Mother's Day to a Thai food place, and they were having this fantastic buffet. Well I ate myself silly (Sunday is my "cheat day" for the week) and only stopped b/c my stomach literally HURT, but I still felt hungry!! I felt like I did when I was about 3 months pregnant, and had to put stretchy clothing on when we got home. It's like my brain isn't making the connection that I'm full, and I still feel hungry when I shouldn't be. I am concerned, since I am very active, and have worked really hard to get back into shape after having two children. The hunger really only hits me hard at night. In the day I seem to be ok. Is this an effect that eventually fades or do I have to deal with this the whole time I'm on remeron?? I've been on it almost a month. I make healthy food choices, and I don't eat white flour products, or much sugar. I rarely eat bread, but if I do it's always whole grain. But I've also read that some of these meds alter the body's metabolism. While I'd rather have a few extra pounds than have to deal with my severe anxiety and panic attacks (PPD related), I'm still worried about it. I have heard that some people gain 50+ lbs on this drug! I am only 5'1" and I can't "hide" extra weight.
Any advice on this??Cheers,
Kyah :)
Mamma to 2 ^Angelic^ girls
~Annika June~ June 30th, 1999
*Lorien Moss* April 15th, 2002"It is never too late to be what you might have been"
~George Eliot~
Posted by LyndaK on May 14, 2003, at 1:19:20
In reply to Remeron and increased appetite?? HELP!, posted by Earthmamma on May 13, 2003, at 18:17:07
Actually, if you look at some of the other threads about Remeron, you'll see some of the information that you're looking for.
I've been on Remeron nearly a year now; up to 60 mgs. per day and holding -- doing quite well on it. BUT . . .increased hunger is definitely a side effect early on. Yes, you will feel like you are starving even though you just ate a banquet, I remember that. You're going to have to use your better judgement on food quantity instead of your sense of hunger for awhile. The increased hunger subsided with time and increase in dose.
That being said, I still gained 20 lbs. on this drug even though I don't overeat, I eat healthy most of the time, and I exercise. The 20 lbs. has remained stable -- no worse, no better. It is my opinion that my metabolism HAS changed. Not everyone on this message board agrees on that issue. Although I would prefer not to have the extra weight, this medication has helped me SO MUCH that I accept the trade-off. Being "well" for the first time in nearly 10 years is definitely worth 20 lbs.
Good luck to you.
Lynda
Posted by kashusha on May 14, 2003, at 9:06:39
In reply to Remeron and increased appetite?? HELP!, posted by Earthmamma on May 13, 2003, at 17:00:05
> But I've also read that some of these meds alter the body's metabolism. While I'd rather have a few extra pounds than have to deal with my severe anxiety and panic attacks (PPD related), I'm still worried about it. I have heard that some people gain 50+ lbs on this drug! I am only 5'1" and I can't "hide" extra weight.
> Any advice on this??
My husband was on Remeron for about a year. Up to that point, it was the only thing that helped his insomnia. HOWEVER, my alway-slim husband gained almost 30lbs. He went from a 32" waist to a 36. Exercise didn't help. the only thing that worked is going off Remeron. I hope you can find a comparable med that doesn't put a "rim-around" you. Good luck!
Kashusha
>
>
Posted by Earthmamma on May 14, 2003, at 23:14:42
In reply to Re: Remeron and increased appetite?? HELP! » Earthmamma, posted by kashusha on May 14, 2003, at 9:06:39
> > But I've also read that some of these meds alter the body's metabolism. While I'd rather have a few extra pounds than have to deal with my severe anxiety and panic attacks (PPD related), I'm still worried about it. I have heard that some people gain 50+ lbs on this drug! I am only 5'1" and I can't "hide" extra weight.
> > Any advice on this??
>
>
> My husband was on Remeron for about a year. Up to that point, it was the only thing that helped his insomnia. HOWEVER, my alway-slim husband gained almost 30lbs. He went from a 32" waist to a 36. Exercise didn't help. the only thing that worked is going off Remeron. I hope you can find a comparable med that doesn't put a "rim-around" you. Good luck!
> Kashusha
Did he eat more or the same? I've heard some people have this appetite problem, but that it goes away after a while (I know everyone is different so it's hard to compare). When did the weight gain occur? Was it initial, or something that was stretched out over the entire year he was on it? I'm hoping that I'll at least be able to mantain my weight. I run about 4-5 miles every other day, and lift weights 3-4. Hopefully everything will be ok. I've been on it now about a month and I haven't noticed and gain, just my hunger increased.
Thanks,
Cheers,
Kyah :)
Mamma to 2 ^Angelic^ girls
~Annika June~ June 30th, 1999
*Lorien Moss* April 15th, 2002"It is never too late to be what you might have been"
~George Eliot~
Posted by johnj on May 18, 2003, at 10:40:50
In reply to Re: Remeron for Atypical Dep, posted by JrBecker on May 5, 2003, at 23:58:07
Hi jrbecker,
I have followed your posts and you seem to have a great grasp of things. I have some questions for you and hope you have some time to answer.
I am unipolar with anxiety. I take TCA(nortryptline) 50 mg, lithium 600 mg for AD boost, and 15 to 18.5 mg of a benzo (tranzene). I have tried remeron over a year ago, but stopped since I was so spacey. However, the spaciness could have been due to excercise. I have had big problems with sleep disturbance when I excercise and think it has something to do with my meds(just a guess).Well, due to stresses at work and feelings that have popped up (meaning of life, purpose, etc.) I did not sleep much from last Tues, Wed, and Thurs. I took some bendryl (50 mg)on Thursday with little effect. I couldn't take it anymore so I popped 30 mg of remeron. Great sleep that night with some naseau, and of course sedation the next day. Last night I took 30 mg more and still have the sedation and weak feelings.
My question is this: Have you ever experienced a staring habit while on remeron? It is like my eyes can't focus or go out of focus. I don't have much brain fog and I have realized I need the sleep to function. I have found I recently need something to function as best I can, not something to get me closer to what I was before the depression/anxiety. I feel so dependent and powerless to get better at times. It is so hard accepting I have no control. If I could sleep well, I could handle things, but alas the very thing I need evades me.
Do you have any idea what receptor of remeron could be responsible for the staring? I hope this diminishes since I don't think I have any other choices right now. At least until cymbalta comes out. That is what I was waiting for, but I don't have the time.
Also, how do you think a TCA and remeron act? Do they cancel out portions if they both act on the same receptor? I would like to get off the TCA, but need to make sure I have something else lined up like cymbalta. Any help or hints would be appreciated. Thank you for your time.
johnj
Posted by McPac on May 18, 2003, at 12:42:55
In reply to Re: Remeron for Atypical Dep » JrBecker, posted by johnj on May 18, 2003, at 10:40:50
I'm taking 15 mg's of Remeron right now...jitters, increased heart beat....might this go away? how long? thanks!
Posted by johnj on May 18, 2003, at 13:12:28
In reply to How long will this last? Re: Remeron for Atypical , posted by McPac on May 18, 2003, at 12:42:55
I am curious as to why you started at 15 mg? That amount did not help my depression, but made me zoned out. I slept well but if felt as if someone was standing on my brain. I wonder if rasing the dose to 30 mg is better? I have some heart jitters but nothing like what you describe. Talk to your doc. take care
johnj
Posted by LyndaK on May 18, 2003, at 14:42:12
In reply to Re: Remeron for Atypical Dep » JrBecker, posted by johnj on May 18, 2003, at 10:40:50
I know you targeted your post to jrbecker, but I experienced something similar when I first started Remeron (the eyes-going-out-of-focus thing). I attributed it to the fact that Remeron acts like a muscle relaxant on me and I think it was relaxing my eye muscles a bit. I don't have that problem now.
I too have a unipolar depression with anxiety. Remeron has helped me more than anything else I've tried, in fact I am pretty much in a state of remission at this point. It has helped me so much with sleep that I RARELY take my Ativan anymore. Remeron is the only med. I'm on now.
Hope you find what works for you.
Lynda
Posted by johnj on May 18, 2003, at 18:32:26
In reply to Re: Remeron for Atypical Dep » johnj, posted by LyndaK on May 18, 2003, at 14:42:12
Hi Lynda,
Thank you very much for the reply. Today my wife and I went to the library and drove to a lake to read. Since I just ramped up I expect some unpleasant SE. It may very well act like you said since I do find my body a little limp now that you mention it. If I continue to walk I do pretty well, the motion thing I guess, and looking at things up close is not as bad either. Distance is the majority of the problem. But, reading can be tricky as I sometimes get lost where I am at. I don't feel in tune and sharp as usual, but right now this is better than where I was headed on Friday! I do wonder what I would feel like off my TCA, lowered lithium, and benzo though. But, that is a ways off.
Any other SE effects that you had that went away?
I don't feel the weight gain is a huge problem since I am on lithium and a TCA. take care and thank you
johnj
Posted by kashusha on May 19, 2003, at 17:58:34
In reply to Re: Remeron and increased appetite?? HELP!, posted by Earthmamma on May 14, 2003, at 23:14:42
> > Kashusha
> Did he eat more or the same? I've heard some people have this appetite problem, but that it goes away after a while (I know everyone is different so it's hard to compare). When did the weight gain occur? Was it initial, or something that was stretched out over the entire year he was on it? I'm hoping that I'll at least be able to mantain my weight. I run about 4-5 miles every other day, and lift weights 3-4. Hopefully everything will be ok. I've been on it now about a month and I haven't noticed and gain, just my hunger increased.
> Thanks,
> Cheers,
> Kyah :)
> Mamma to 2 ^Angelic^ girls
> ~Annika June~ June 30th, 1999
> *Lorien Moss* April 15th, 2002
>
> "It is never too late to be what you might have been"
> ~George Eliot~
>He gained the weight gradually. He went to the gym and exercised, but nothing helped until he went off Remeron. I think it increased his appetite, but I think his metabolism was more of a problem. He had never (really, never!) gained weight before in his life.
Posted by LyndaK on May 19, 2003, at 22:51:49
In reply to Re: Remeron for Atypical Dep, posted by johnj on May 18, 2003, at 18:32:26
Hi Johnj,
Glad you're feeling a little better. Sedation, dizziness (lowered blood pressure?), and feeling hungry all the time were the main side-effects I noticed starting up. All resolved with time and/or increased dose. I did gain 20 lbs. which hasn't budged, but I think that too is related to the muscle relaxant effect (i.e. if your muscles are less active in general - even at rest - your metabolism is lower), but others on this board differ on that opinion. From my experience, this drug seems to have a strong effect all by itself, so I don't know how it would interact with other drugs in combination.
Hang in there and good luck.
Lynda
Posted by johnj on May 20, 2003, at 9:09:13
In reply to Re: Remeron for Atypical Dep » johnj, posted by LyndaK on May 19, 2003, at 22:51:49
Hi Lynda,
Thanks for the response. I feel pretty good today and the heavy head feeling has subsided considerably. I actually lowered my benzo dose since I felt ok, probably not wise but I just didnt' feel any anxiety. Today I am much clearer, but do have the staring/focusing problem too. I am getting more accomplished at work. I have noticed a little shortness of breath when speaking. Last night I was able to look at my illness out and away from usual depressed me. It is odd how just a tweak of biochemistry and things seem better. I hope it lasts and I can get off some of my other meds, especially the TCA. I think that will help with sedation and fuzziness too. Thanks again and take care.
johnj
Posted by LyndaK on May 21, 2003, at 0:27:32
In reply to Re: Remeron for Atypical Dep, posted by johnj on May 20, 2003, at 9:09:13
< I actually lowered my benzo dose since I felt ok, probably not wise but I just didnt' feel any anxiety.
I think that's a perfectly reasonable thing to do (just my opinion). That's what I did. The Remeron started working for my anxiety/sleep so I didn't need the benzo any more. On rare occasions I take 1/2 mg. of Ativan just to help me get to sleep, so my doc still prescribes it so I have it when I need it, but I really don't need it very often.
Glad you're continuing to do better! ;-)
Take Care!
Lynda
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