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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by denise1966 on May 24, 2006, at 7:15:54
Hi,
Again just wondering if anyone here had tried high dose Effexor with Remeron and what results they Get.
I've tried adding 30mg to my 40mg Seroxat now and again and it seems to help a bit, more so on the days I don't take it. So I was wondering if anyone else here had tried this combination.
Denise
Posted by cubic_me on May 25, 2006, at 7:11:42
In reply to High Dose Effexor plus Remeron, posted by denise1966 on May 24, 2006, at 7:15:54
I tried this, but unfortunately after 2 weeks of treatment I'd put on about 15 pounds in weight despite eating healthily and exercising more than normal so I decided to stop. It was the only combination I've found to totally get rid of my suicidal ideation, if I could have tollerated the wieght gain it would have been very helpful for me.
Posted by denise1966 on May 27, 2006, at 15:49:03
In reply to Re: High Dose Effexor plus Remeron » denise1966, posted by cubic_me on May 25, 2006, at 7:11:42
Hi,
Thanks maybe I'll try this one as I could do with putting on some weight. What doses did you take, how long did they take to kick in and did you have to titrate up slowly.
Thanks....Denise
Posted by cubic_me on May 27, 2006, at 18:09:41
In reply to Re: High Dose Effexor plus Remeron cubic_me, posted by denise1966 on May 27, 2006, at 15:49:03
I was already on 225mg of Effexor XR (the highest I could tolerate) and 15mg of mirtazipine was added in. It was due to be titrated up to 30mg after 3-4 weeks but I didn't get that far before coming off it.
I'm sorry I can't be of more help.
Posted by pulse on May 28, 2006, at 18:27:32
In reply to High Dose Effexor plus Remeron, posted by denise1966 on May 24, 2006, at 7:15:54
Only when 15 mg. Remeron was added to my very high Effexor dose several years ago, did I get severe edema in my feet and ankles, that then broke open, and developed into a rash - that was between my toes and already up to my knees - before an antibiotic shot stopped it cold.
I seem to recall reading at the PB Yahoo Group, that Remeron on it's own can cause edema, but no rash was mentioned. I may be wrong.
Note: this had never happened to me before on any other med or combo.
Don't want to scare you off, though, because Effexor + Remeron is considered by many p-docs to be the biggest gun going for SEVERE Major Depressive Disorder.
Perhaps it was just yet another quirk reaction for me...
pulse
Posted by corafree on June 12, 2006, at 16:58:10
In reply to Re: High Dose Effexor plus Remeron, posted by pulse on May 28, 2006, at 18:27:32
Hi All
I'm suffering from pretty severe major depression and am 'med resistant'(?) to a lot of ADs. I've only ever been treated w/ monotherapy though.
I saw my P last week and he thinks this Effexor-XR and Remeron combination is something I should try. He called it 'The C*lifornia C*cktail' and said some doc over there thought it was great. I googled it and found there are many C*lifornia C*cktails!
I haven't started it yet. I left the scrips at the pharmacy, but have not yet picked up.
I saw in my googling that Remeron stimulates appetite. Way not good for me! From hip to hip, I 'almost' measure 12 inches. I pretty much have no hips! I have the body of a runner. (I was a runner, but cannot run anymore due to a back injury :( ) There is no place for weight to deposit itself except smackdab in my stomach.
I suffer from IBS, lactose intolerance, chronic constipation, and have surgery pending for delapidated internal organs in that area. So, putting on/in any weight is again, way not good for me.
It's disappointing, because I am searching for something beyond monotherapy.
Denise1966, RU still on it? If so, how are you feeling?
bestwishes, cf
Posted by pulse on June 13, 2006, at 17:43:30
In reply to Re: High Dose Effexor plus Remeron » pulse, posted by corafree on June 12, 2006, at 16:58:10
me too re: ibs-c +/or chronic ideopathis constipation. also, i'm lactose intolerant - sometimes i CAN cheat a little on that, but avoiding all dairy is certainly best. i know that having to stop drinking the gallon of skim milk every 3 days, that i so loved, has helped most. boy, do i miss that one - far more than cheese. i do have the occasional egg with no problem.
i understand the weight gain all too well re: remeron, but it sure helps ibs for many. ..even can for us c's. it's abit constipating, but i managed it, and that's saying alot.
sorry you must have the surgery!
pulse
Posted by corafree on June 16, 2006, at 15:14:25
In reply to Re: High Dose Effexor plus Remeron, posted by pulse on June 13, 2006, at 17:43:30
Pulse:
RU still on Eff-XR and Remeron then?
I have started the Effexor-XR and am miserable ... can barely stand to sit here.
Awaiting call from P ... need get offline. You may babble me if you'd like.
TksSoMuch, cf
Posted by pulse on June 17, 2006, at 5:53:07
In reply to Re: High Dose Effexor plus Remeron » pulse, posted by corafree on June 16, 2006, at 15:14:25
oh heavens no. that was around 5 years ago.
adding the remeron near the tail end of my ultra high fxr dosage 2 yr. 'trial' (LOL) caused severe edema to my ankles, which then broke out allover feet and up to knees.
it's said that remeron alone can cause edema.
thanks so much for your offer! nothing personal, please be most assured, but i don't do babblemail at all.
sure hope you find out what is going on for you and soon!
if you meant by 'hardly able to sit here' the inability to sit still, that's VERY common for what i believe is the larger portion of fxr users. very stimulating, if NOT on a benzo. if on one, instead, would likely be quite fatiguing.
i had that extreme stimulation (i liked it) upon every single increase of my far too many, then, as i said before, fxr reached a plateau each & every time - at exactly 2 wks. after these - (in this case, instead, plateau meaning no feeling of stability or good-feeling leveling off whatsoever) - it didn't do a thing....i felt like i was on nothing for depression help.
*i've never seen anyone else here having this last part happen. wish someone would reply, if so.*
OR did you mean sick at stomach/ other?
all my best,
pulse
Posted by corafree on June 17, 2006, at 16:56:07
In reply to Re: High Dose Effexor plus Remeron » corafree, posted by pulse on June 17, 2006, at 5:53:07
I supposed w/ the edema and all, that you weren't on it any longer, but couldn't see clearly that you weren't. Thanks.
You said,
<i had that extreme stimulation (i liked it) upon every single increase of my far too many, then, as i said before, fxr reached a plateau each & every time - at exactly 2 wks. after these - (in this case, instead, plateau meaning no feeling of stability or good-feeling leveling off whatsoever) - it didn't do a thing....i felt like i was on nothing for depression help.
*i've never seen anyone else here having this last part happen. wish someone would reply, if so.*
OR did you mean sick at stomach/ other?>
I did have the manic stimulation on one of my times (4-5) on Effexor-XR. I was a cat on a hot tin roof and couldn't keep up with myself! I discontinued it. Then I tried it again and I did not have the manic stimulation.
The fact that I always discontinued it (But I believe it was usually longer than two weeks, well except for this time.) is evidence that I too plateaued out on it and lost any anti-depressant benefit.
My P called me back. (I have a hard time staying online long as don't have a separate phone line.)
He wanted to double the Eff-XR to 150 right away. I was scared to feel 'doubly' depressed (This time it was depressing, NOT stimulating.), and told him that I couldn't be 'doubly depressed'. Tho' ... maybe he was right.(?)
I made mention of Wellbutrin and he jumped on that. He said d.c. Eff-XR and start Wellbutrin 120mg Mon.
I tried Wellbutrin once in the past and it was very 'downing' ... I mean ... I felt heavy, slow in thought and movement. He said this is opposite to how most react.
Like Effexor-XR though ... maybe it will work differently in me at this time. Wonder.
Yep, I can say w/ certainty, for some reason, at different times in my life, the very same drug and dosage, reaps different results. Not a clue why.
Re: Stomach pain.
No, the Eff-XR had no physical side effects.
But yes, I do have to be very careful not to take an appetite stimulating med ... which rules out SO many psych meds.
I have an article about adenosine monophosphate in a sublingual form called Myoden. I am wondering if it is the conqueror of the evil appetite stimulating properties of so many psych meds. There is a pretty current thread re: nortryptiline that someone alluded to 'something expensive being out there to block that side effect', but could not recall the name of it. Just a thought.
Maybe post on alternatives.
Not sure have time enough to stay online and google Wellbutrin, but I fear that it alone is not a sufficient AD. I can't say why I feel that way tho'.
thankssomuch, cf
Posted by elanor roosevelt on June 18, 2006, at 7:58:06
In reply to Re: High Dose Effexor plus Remeron » pulse, posted by corafree on June 17, 2006, at 16:56:07
I will spare you the list of drugs that have fizzled out on me.
the periods of effectiveness got shorter and shorter.
Often the depression crept in so i was too detached to get a grip and make some changes.
i have just started parnate (2 weeks ago)
people who do not do well on the srris sometimes are fine on the maois.
good luck
watch the effexor sr.
does the remeron give you strange dreams?
good luck
Posted by corafree on June 18, 2006, at 10:34:53
In reply to Re: High Dose Effexor plus Remeron, posted by elanor roosevelt on June 18, 2006, at 7:58:06
Me too re: fizzled out drugs!
Hmmm ... an MAOI ... something to think about.
I only have 15m to see P once a month. We talked about the MAOI patch. I guess your diet isn't as restricted as apparently 'used to be' when taking an MAOI?
Oh re: the Remeron ... once heard it had side effect of weight gain, trashed whole idea, never started it. The plan was to wait 3mos after beginning Eff-XR to even add in the Remeron. I thought that was strange.
I did start Eff-XR again and d.c.'d it (again) in about four days ... felt awful. P wanted to double it, but I didn't. I get so depressed that at times I can't decide what is right for me either ... and that 'pro-activity' is so important when contact w/ P so ltd. I don't know if I was right or he was right.
I take it you've been down Effexor-XR road?
love, cf
Posted by elanor roosevelt on June 18, 2006, at 20:54:21
In reply to Re: High Dose Effexor plus Remeron » elanor roosevelt, posted by corafree on June 18, 2006, at 10:34:53
eight years of anti-depressants. more than a dozen of them and many of them tried multiple times. i was absolutely exhausted by the process.
my doctor recently attended a conference during which there was a lot of talk of the use of MAOI's for people who can not be treated sucessfully with srri's.lots of people do find srri's that work long-term.
celaxa was my dream come true until it fizzled out.effexor is an odd one.
it lets in more fear than many of the others do.
I had to work with detailed lists in order to get anything done.such a lousy cycle.
i wish you all the best.
Posted by pulse on June 18, 2006, at 21:52:59
In reply to Re: High Dose Effexor plus Remeron » pulse, posted by corafree on June 17, 2006, at 16:56:07
i'm the one who mentioned that expensive drug, but, again, that may have been, not for lower gi - only for nausea, following chemo.
no stomach probs with fxr ?!! - you and i having these same lower gi deals. AMAZING.
wellbutrin - my experiences - always - of my 3 - 4 very brief times (being ever hopeful and/ or desperate + apparently in extreme denial):
it caused me to burp up gas - it maufactured said gas - every waking minute. as i also mentioned on another thread, it's the only med where a pdoc called me back in 2 minutes - saying discontinue right away. that was likely more to do with the ultra-high anxiety level that wb engendered. she feared a med-induced mania for me - would have been my only one.
oddly, i lasted slightly longer - a few days - on the ir (immedate release). i know that's unheard of, supposed to be opposite/ worse than sr or xl. the urping/ burping was less, but still there. anxiety WAS less. my compounding pharmacist does not, as i did, think it would be something in the binders/ inactive ingredients that causes this urping bit. he is sure it it's wellbutrin itself, so another hoped for solution down tubes.
unlike you, i've not once had a different reaction to the same med the 2nd time.. or multiple times. the only reason i've ever had 'fatigue' (actually it's, instead, depression & always at exactly 4 months) is when i've had to go back on some klonopin, and even then, that was just re: this past year, the only time i've taken close to the max recommended dosage - 4mg. this was due to 2 out-of-nowhere very traumatic events, causing my ptsd to come back full force, and my ocd to sky-rocket.
my life had been without trauma for many years now, as i make sure to avoid the type of people that i well know could easily cause it's return. there are so very few things we can't control/ make stable in our own lives, if we're committed to doing so - other than these inadequate or sickening meds. (accidents, serious physical illnesses, or natural disasters being the other exceptions, of course).
you're most welcome,
pulse
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