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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Francesco on January 19, 2004, at 10:12:47
I've read on many posts that even if you experience sleepiness on 15 mg of Remeron you shouldn't experience it on 30 mg. Does anybody know why ? It seems very strange to me, so I think there must be a neurophysiological explaination.
Posted by SLS on January 19, 2004, at 12:59:52
In reply to a question about remeron dosage, posted by Francesco on January 19, 2004, at 10:12:47
> I've read on many posts that even if you experience sleepiness on 15 mg of Remeron you shouldn't experience it on 30 mg. Does anybody know why ? It seems very strange to me, so I think there must be a neurophysiological explaination.
The increase in norepinephrine stimulation does not become significant until one reaches 30-45mg. Below this, the antihistaminergic properties predominate, and one becomes somnolent. Remeron also blocks serotonin receptors, but I don't know how much that contributes to sleepiness.
- Scott
Posted by Francesco on January 19, 2004, at 14:06:45
In reply to Re: a question about remeron dosage, posted by SLS on January 19, 2004, at 12:59:52
It's the first day I'm taking 30mg. I'm wondering if I have to quit. I'm not only experiencing somnolence but also severe depression. I was not depressed before starting Remeron. Now my mood is incredibly low and I'm experiencing severe anhedonia. I can't understand why the doctor put me on it. I just complained about adhd-like syntoms saying that I had no anxiety and that I was not depressed. He allowed me to take desipramine but he suggested also Remeron. since I started Remeron I began at first to act in a strange way and finally got depressed. I can't understand. But I suppose I have to quit. many antidepressant meds depress me and I can't understand why.
Posted by SLS on January 19, 2004, at 14:22:42
In reply to depressed by remeron ? » SLS, posted by Francesco on January 19, 2004, at 14:06:45
> It's the first day I'm taking 30mg. I'm wondering if I have to quit. I'm not only experiencing somnolence but also severe depression. I was not depressed before starting Remeron.
Francesco, I don't know what to tell you. Remeron treated me unkindly also. It made my depression worse. However, I would have to say that your reaction might be transient and resolve in a few days. It is probably the antihistaminic properties of Remeron that are making you feel so crummy.
I have never heard of Remeron being used to treat ADHD. I only did a quick search on Medline, but I found ZERO abstracts regarding mirtazapine (Remeron) and either ADHD or attention deficit. I don't understand your doctor's choice if the only thing you are looking to treat is the ADHD. Did he give you any explanation behind his decision?
- Scott
Posted by Francesco on January 19, 2004, at 15:07:52
In reply to Re: depressed by remeron ? » Francesco, posted by SLS on January 19, 2004, at 14:22:42
Thanks for answering, it's very important for me at this moment. My doctor didn't tell me explicitly what his diagnosis was but I think he thinks I could be bipolar II because the first thing he wanted me to take was Trileptal. He expressed also some perplexity about my self-diagnosis of ADHD because I have managed to get to the last year of high school without meds.
In my opionion I cannot be bipolar II, given the DSM-IV criterions, because I have never had an hypomaniac episode lasting three or more days, with the exception of the last time I quit Anafranil cold turkey. But this, also according to him, doesn't mean anything.
What remains is bipolar II-rapid cycling and/or adhd (and several personality disturbs).
The reason why he put me on Remeron he's still a a mystery for me. I asked him in a mail what was it for and he replied me "for anxiety". I can remember that the last time I saw him he asked me: "Do you have anxiety ?" and I replied: "Nope". Do I have latent anxiety maybe ? ;-)
Sorry for ranting ... so, Remeron worsened your depression and this is interesting given my situation ... what are taking now and what is your disturb ?
Thanks, you have been helpful
Posted by Sad Panda on January 20, 2004, at 1:17:28
In reply to depressed by remeron ? » SLS, posted by Francesco on January 19, 2004, at 14:06:45
I would say Remeron's best usage is as agumentation to SSRI's & Efexor as it seems to reverse nausea, sex & sleep problems caused by Serotonin increase.
Cheers,
Panda.
Posted by PoohBear on January 20, 2004, at 16:40:38
In reply to Remeron reverses SSRI side effects., posted by Sad Panda on January 20, 2004, at 1:17:28
> I would say Remeron's best usage is as agumentation to SSRI's & Efexor as it seems to reverse nausea, sex & sleep problems caused by Serotonin increase.
>
> Cheers,
> Panda.
>
I would second this. My PDoc told me that Remeron was an antidepressant in the same class as Effexor. I use it for sleep and to counteract the sexual side effects of Effexor XR.I would say that it seems you (Francesco) havent't been on it long enough to really see any benefits, besides perhaps better sleep, and that's only if you're taking it at night.
As for getting through your senior year of High school without drugs for ADHD, I made it through high school with a 3.5 and college (five years) with a 3.0 and a BFA and didn't get diagnosed until 40. That's a lousy criterion to base a judgement. You probably have developed very good coping skills.
All that said, I haven't been able to turn up anything on using Remeron for ADHD except that I will say this:
From personal experience, getting the best sleep that I can remember and getting my depression lifted has helped tremendously with my focus and concentration, as my mind isn't tied in knots with other things...
TR
Posted by SandyWeb on January 20, 2004, at 17:15:36
In reply to Re: Remeron reverses SSRI side effects. » Sad Panda, posted by PoohBear on January 20, 2004, at 16:40:38
I have also found that Remeron reverses some side effects of SSRIs. I had chronic diarrhea (over two months, every single day!) from Celexa. The very first day that I took Remeron, the diarrhea stopped! What a relief! *wink*
Celexa also exacerbated my insomnia, and the Remeron helped a little in that department as well.
Posted by Francesco on January 20, 2004, at 17:28:11
In reply to Re: Remeron reverses SSRI side effects. » Sad Panda, posted by PoohBear on January 20, 2004, at 16:40:38
> I would second this. My PDoc told me that Remeron was an antidepressant in the same class as Effexor. I use it for sleep and to counteract the sexual side effects of Effexor XR.May I ask you how much Effexor are you taking ?
I'm thinking to go on it if my desipramine trials fails. Aren't you experiencing any sexual side-effects from the combo ? Do you have only Adhd or other diagnosis ? Sorry for all these questions, just trying to figure out what to do ... I must add that maybe Remeron was not the only culprit for my depression ... I'm taking also Tolep and I think it's contributing ...> I would say that it seems you (Francesco) havent't been on it long enough to really see any benefits, besides perhaps better sleep, and that's only if you're taking it at night.
You're probably right. I quit Remeron last night just because I found myself very depressed, and when I'm not on meds I am *never* that depressed. But maybe I made the wrong choice. Given your experience it seems that Remeron is not necessarily an unesuful med even for ADHD.
> From personal experience, getting the best sleep that I can remember and getting my depression lifted has helped tremendously with my focus and concentration, as my mind isn't tied in knots with other things...
How much did you have to wait for the depression-lifting ? And how much for the end of the over-sleeping ? For me it was a big problem ... I slept 11 hours per night and felt sleepy all over the day. But maybe Remeron is a good add on for Effexor and not for Desipramine.
Posted by PoohBear on January 20, 2004, at 17:48:53
In reply to thanks ... » PoohBear, posted by Francesco on January 20, 2004, at 17:28:11
Francesco:
I take 75mg of Effexor XR every morning for depression and 60mg of Remeron (generic) each night to counteract the sexual side effects of the Effexor plus for sleep.
I also have ADHD, but we have chosen to treat the depression first this time around and it seems to be working better. We *MAY* add a small dose of Adderal at some point in the future, but my PDoc wants to be certain that I'm stable on what I'm taking before we add anything new.
Please also note that Effexor, for the first time in my life has enabled me to get control of my thoughts, which would often run rampant, and this alone has helped my concentration tremendously.
I could tell that the Effexor was helping with the depression within a day or so of starting, definitely within the first week. It was amazing to me to not have to deal with a racing mind and suicidal thoughts. Absolutely amazing. I would have never carried anything out, mind you, but all of the extra thought was a terrific drag on my mental processes.
Does that help?
TR
Posted by Francesco on January 20, 2004, at 18:33:17
In reply to Re: thanks ... » Francesco, posted by PoohBear on January 20, 2004, at 17:48:53
> Does that help?
Yes, it helped a lot. I think Effexor will be the next. My p-doc wanted me to try it but I was scared 'cause I had read some post about the withdrawal that were not very encouraging. Since I will have no the possibility to try stimulants (I live in Italy) and since you said that it's helping also your concentration I think it's worth of a trial. Moreover Effexor seems to have a chimical structure very similar to Anafranil, a med that has helped me a lot in the past for concentration.
At that dosage (75 mg) it should act as an SSRIs, from what I've read. Have you tried some SSRIs in the past and what reaction did you have ?
Incidentally I'm very glad you're doing so fine ... there should be hope also for me out there, in the almost infinite med's world ;-)
Posted by PoohBear on January 20, 2004, at 19:13:31
In reply to why not ? : ) » PoohBear, posted by Francesco on January 20, 2004, at 18:33:17
Francesco:
Six years ago we tried all of the SSRI's: nothing worked for my ADHD, but then I don't believe that I really gave each med a decent trial. Every time I got the jitters I'd go back to my doctor and tell him it wasn't working... The difference this time is that I had some sort of idea at the start what might happen and was prepared for it.
It's too bad that the stimulants are not available in Italy, since ADHD people react differently to them and frequently have such good results. Even here they're not that easy to obtain, since they've been abused. Most are classified as Class II narcotics.
Look at this site:
They have some interesting material regarding ADHD, the types of ADHD and interaction with various drugs and diets.
Good luck and God Bless,
TR
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