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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by geno on September 21, 2001, at 19:43:50
Hi, im currently on 30mg of remeron,25mg desipramine, and .5mg xanax in day as needed. I feel that i need more of a mood boost. im going to list 3 alernative med combos, and would like some advise on what combo would be the most effective for a good night sleep, improved libido, AND MOOD LIFT.
Combo #1: 15mg remeron at bed
50mg 5htp morning
desipramine 25mg bedCombo#2 30mg remeron at bed
25mg despirimine bed
25mg desiprimine am
combo#3 45mg remeron bed
25mg des am.combo#4 15mg remeron bed
50mg 5htp am
25mg des bed/25 amgeno
Posted by Mitch on September 22, 2001, at 0:02:56
In reply to Remeron, 5htp, desipramine, posted by geno on September 21, 2001, at 19:43:50
> Hi, im currently on 30mg of remeron,25mg desipramine, and .5mg xanax in day as needed. I feel that i need more of a mood boost. im going to list 3 alernative med combos, and would like some advise on what combo would be the most effective for a good night sleep, improved libido, AND MOOD LIFT.
>
> Combo #1: 15mg remeron at bed
> 50mg 5htp morning
> desipramine 25mg bed
>
> Combo#2 30mg remeron at bed
> 25mg despirimine bed
> 25mg desiprimine am
>
> combo#3 45mg remeron bed
> 25mg des am.
>
> combo#4 15mg remeron bed
> 50mg 5htp am
> 25mg des bed/25 am
>
> geno
Wow, this is like a pharmaco game show! I would vote for ...number two! Just double up on the TCA (desipramine)-at 25mg/day you may not be in the therapeutic range for it (TCA's don't have the "flatter" dose-response curve like newer meds do). Go with #2, doubling your present med then get a blood draw after a couple of weeks and see if you are "in the range"-you might feel a lot different.Mitch
Posted by SLS on September 22, 2001, at 2:08:46
In reply to Remeron, 5htp, desipramine, posted by geno on September 21, 2001, at 19:43:50
Hi Geno.
Are you sure the 5-HTP is helping?
Just a thought. This is a strategy that might be worth considering:
Step #1 - increase the dosage of desipramine up to between 100mg - 200mg.
Step #2 - after 2 weeks at the therapeutic dosage of desipramine, assess its efficacy and side-effects. Side-effects will most likely show a trend towards reduction. Don't be too quick to jump to conclusions based upon their initial magnitude. You can take it once a day or twice a day. Schedule your dosing according to how it affects you. Some people finding it activating. Others find it sedating. For me, it tends to be activating following a brief period of sedation when first beginning treatment.
Step #3 - adjust Remeron to optimize its antidepressant, sleep-improvement, and sexual enhancing effects. Take it all at night.
Step #4 - evaluate the importance of 5-HTP by reducing the dosage or discontinuing it.
Step #5 - have fun.
If you do nothing else, at least follow step #5.
- Scott
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