Posted by JohnL on February 13, 2000, at 4:18:43
In reply to Remeron Treatment, posted by Bruce Pehrson on February 12, 2000, at 12:04:01
Bruce,
Remeron is similar to other antidepressants in the wait of 4 to 6 weeks for benefit. However, in clinical trials Remeron did show rapid onset, often within the first week. It is normally a good choice when the depression has an anxiety component. Clinical trials indicated it is 'stronger and faster acting' than SSRIs in the early weeks of treatment, and similar to SSRIs in later weeks. Since you haven't noticed much benefit yet, it may need more time. But I woulnd't be surprised at the possibility that all of the treatments you've tried so far (including Remeron) have addressed the wrong underlying problem.
Have you tried a low dose antipsychotic? Zyprexa for example? An often overlooked cause of anxiety and depression is excess dopamine, which is easily corrected by a low dose AP. If that's the situation, there isn't a serotonin, norepinephrine, or GABA drug in the world that will do the job with you. I know two people who had anxiety and depression unresponsive to just about everything for a decade. In one woman a low dose AP completely normalized her. In the other, Ritalin did the trick. I know it sounds strange to consider a stimulant for anxiety, but it calms down a lot of hyperactive children, right? In the old days stimulants were used to treat depression. And still today they are used to enhance the effectiveness of antidepressants.
Especially after multiple failures on the more straight forward approaches to anxiety, it makes sense to me to consider that we are assuming the wrong cause. And thus taking all the wrong drugs. It might be worth trying short trials of an antipsychotic and/or stimulants. Things are not always as they appear. And these two approaches have indeed worked in others with similar stories as yours. At this point, there's not much to lose in trying, right? Just some ideas to think about. JohnL
poster:JohnL
thread:21284
URL: http://www.dr-bob.org/babble/20000209/msgs/21319.html