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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Janelle on July 13, 2001, at 16:22:10
I figured I'd better start a new thread because the old one is moving up rapidly and it might be hard for you to find a sub-thread (?) there ... the second website link you gave me does have info on titration recommendations for SSRI's, but unfortunately, it doesn't seem to include EffexorXR!! However, I saw my doc and she said she did NOT think I went up on it too fast, but rather that 150mg may be too stimulating for me, which mystifies me because I thought EffexorXR would CALM anxiety, not intensify it?!
Posted by SalArmy4me on July 13, 2001, at 16:30:30
In reply to To SalArmy4Me: about those titration sites:, posted by Janelle on July 13, 2001, at 16:22:10
If you can't tolerate 150 mg of Effexor, I recommend you try something else. Perhaps something like Remeron or Serzone.
Posted by Janelle on July 13, 2001, at 16:45:36
In reply to Re: To SalArmy4Me: about those titration sites: » Janelle, posted by SalArmy4me on July 13, 2001, at 16:30:30
THanks - I've heard of both, and know that Serzone is known for being sedating. Is Remeron also sedating?
I had great success years ago with Elavil which I took at night and the first week or so it got me sleeping like a baby! Then that wore off but the a-d properties worked!
I think I need a sedating a-d, like those you mentioned, but I also have obsessions and compulsions and may try Luvox. I hear it can also be sedating, but works more for OCD than depression! Ack, this is trial and error till my doc and I find the right cocktail for me. I will most likely wind up with a mood stabilizer and an a-d that also works on obessions, compulsions and anxiety if there is such a thing!
Posted by SalArmy4me on July 13, 2001, at 16:58:37
In reply to To SalArmy4Me: about Serzone, Remeron: » SalArmy4me, posted by Janelle on July 13, 2001, at 16:45:36
Remeron or Serzone could be used for OCD. You see the only reason why Luvox got a special indication for only OCD was for marketing reasons. It really does not have any advantage over any other serotonergic medicine in treatment, and actually, Anafranil is the most serotonergic--thus the gold standard in OCD treatment.
I'll give you the shpiel for Remeron.
Here are the benefits of Remeron:
--It can be used for all types of depression, anxiety, OCD, and insomnia.
--It is convienient because it is taken only once at bedtime.
--It may improve libido and sexual performance (its the only medication that improves mine). Dr. Bob Hsieung's fellow doctors recommend it for sexual dysfunction.
--You can take Remeron with most antidepressants except MAOIs.
--It has none of the anticholinergic effects of SSRIs.
--It has gained recognition as a very useful medication from psychiatrists in only four years of FDA approval.I myself started Remeron at 60 mg right away and had no side-effects. I had no weight gain or sedation during the day.
http://www.dr-bob.org/tips/split/Mirtazapine-for-SSRI-ADRs.html
www.remeron.com
http://www.rxlist.com/cgi/generic/mirtaz.htm
Posted by Janelle on July 13, 2001, at 17:25:25
In reply to Re: To SalArmy4Me: about Serzone, Remeron:, posted by SalArmy4me on July 13, 2001, at 16:58:37
Interesting what you said about how the only reason why Luvox got a special indication for only OCD was for marketing reasons and that it really does not have any advantage over any other serotonergic medicine in treatment, because my pdoc told me the SAME thing about Effexor and general anxiety: she said that Effexor initially had trouble with its capsules (hard to swallow or something) and it was marketing reasons - to catch up with other newer SRI's, that got them the special indication for general anxiety.
As for Anafranil, I've heard it's the gold standard in OCD treatment, I tried it years ago and it zonked me out.
Thanks for the shpiel for Remeron. VERY helpful. Because my doc and I have to decide which a-d to put me on when I go off Effexor, and I will ask her about Remeron (and Serzone).
However, again, since I'm so hyper/agitated/anxious, and you said Remeron is NOT sedating (which for most people would be good!), I may need an a-d to take at NIGHT to help me sleep. (I have developed very bad insomnia and am on Zyprexa to hopefully get back the natural sleep pattern/rythmn). Thanks again for all your help and information - I really appreciate it. This board is WONDERFUL.
-Janelle
Posted by SalArmy4me on July 14, 2001, at 2:02:37
In reply to TSalArmy4Me: about marketing tactics:, posted by Janelle on July 13, 2001, at 17:25:25
Did I say that Remeron is not sedating? If I did, I must have misspoke. Its probably one of the most sedating antidepressants, comparable to a benzodiazapine. It could work for your sleep problems.
This is the end of the thread.
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