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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Heide on November 9, 2002, at 8:22:58
I took my first dose of Remeron yesterday, (15mg)and I still feel so stunned I can barely type. Its almost like being drunk. How long is this going to last? Will it ease up when I raise my dose? (I've read that higher doses have fewer side effects.)
I'm doing an "overlap"--reducing my Effexor and starting up Remeron. Could that be relevant?
If this is what Remeron is like, I don't want it. I miss my Effexor already. I'm weaning off it though, because its not helping anymore. I've develpoed PTSD because I'm going through a rough patch in my therepy (I also have GAD, panic attacks and depression.)
I also take Risperdal, Trazadone, and Clonazepam. I'm going to cut out the Clonazepam until I'm not so stunned, I can live without that stuff.
I must say, too, that this seems to be the nicest board I've found dealing with mental health (lurked yesterday) others I've tried are outright depressing and sometimes kind of frightening.
Any advice or experiences people have had that may relate would be really helpful.
Thanks.
Posted by Larry Hoover on November 9, 2002, at 9:36:35
In reply to Remeron, posted by Heide on November 9, 2002, at 8:22:58
Remeron at 15 mg is far more sedating than at 30 mg. In my local area, pdocs don't even use the 15 mg dose. You start right in at 30.
Posted by Heide on November 10, 2002, at 7:42:47
In reply to Re: Remeron, posted by Larry Hoover on November 9, 2002, at 9:36:35
> Remeron at 15 mg is far more sedating than at 30 mg. In my local area, pdocs don't even use the 15 mg dose. You start right in at 30.
Thanks for the reassurance, Larry. My pdoc started me at 15, because I'm still taking Effexor. She wants me to gradually reduce the one (Effexor) while increasing the other (Remeron) because I can't be without a primary antidepressant. We tried that once, and I just go back to being nuts. Almost all my drug changes (and there have been a lot) are "overlaps."
The dose of Remeron she wants me on is 30mg, or maybe more, depending. The 15 mg dose is temprorary, but I haven't felt this dopey since my experience with Lithium.
Remeron must be a weird drug to have less side effects the more you take. That just doesn't seem logical.
>
>
Posted by Larry Hoover on November 10, 2002, at 9:14:37
In reply to Re: Remeron, posted by Heide on November 10, 2002, at 7:42:47
> Thanks for the reassurance, Larry.
You're welcome.
>My pdoc started me at 15, because I'm still taking Effexor.
I hope the Remeron helps with the Effexor withdrawal. Some people get some weird shit happening.....electrical zap feelings.
> The dose of Remeron she wants me on is 30mg, or maybe more, depending. The 15 mg dose is temprorary, but I haven't felt this dopey since my experience with Lithium.
Lithium made me so stupid I literally couldn't remember what I was talking about. Half way through a sentence, I'd forget what I'd already said.
> Remeron must be a weird drug to have less side effects the more you take. That just doesn't seem logical.
Actually, that effect is very common. It's called an inverted-U dose/response curve. It might be useful if you picture something more like the bell-curve of the normal distribution.
On the left half of the U, the drug has escalating effect with increasing dose. Then you reach a plateau, where dose doesn't do much to change the effect. Then, with further increase in dose, the effect drops off.
The sedating effect of Remeron is generally attributed to the effect at histamine receptors. The antidepressant effect is attributed to binding to others altogether. The inverted-U picture applies to the histamine receptors at a lower dose than it does at the other receptors (whether it's an inverted-U at those other receptors or a more linear dose/response doesn't matter, if you're still to the left of the plateau). So, the antidepressant effect is increasing with dose, while the sedative effect is decreasing with dose.
Posted by Heide on November 11, 2002, at 6:49:58
In reply to Re: Remeron, posted by Larry Hoover on November 10, 2002, at 9:14:37
> >My pdoc started me at 15, because I'm still taking Effexor.
>
> I hope the Remeron helps with the Effexor withdrawal. Some people get some weird shit happening.....electrical zap feelings.I've been lucky that way. The last time I tried Effexor (on its own) and was taken off it, I experienced no ill effects whatsoever. I'm also glad to be getting rid of the nightmares.
> Lithium made me so stupid I literally couldn't remember what I was talking about. Half way through a sentence, I'd forget what I'd already said.
I felt like that. I had to go off because I "went toxic" although I didn't feel sick. The dose wasn't high enough to have any beneficial effects, but it was enough for me to balloon up 30 lbs, that I am still dragging around.
I understand Remeron causes weight gain, too. I'm going to be huge.
Thanks for all your help. The "bell curve" image helped make sense of that dosage thing.
Posted by Larry Hoover on November 11, 2002, at 7:08:23
In reply to Re: Remeron, posted by Heide on November 11, 2002, at 6:49:58
> I understand Remeron causes weight gain, too. I'm going to be huge.
My personal experience is that my sense of satiety, of being full, doesn't come after a reasonably sized meal. I want to snack, or top up, without any real need. I'm just hungry all the time. I did an experiment, wher I stuffed myself quite literally, and I didn't stop feeling hungry. So, I just have to watch the amounts, and feel hungry most of the time.
> Thanks for all your help. The "bell curve" image helped make sense of that dosage thing.
I'm glad that helped.
Lar
Posted by LyndaK on November 12, 2002, at 22:12:01
In reply to Remeron, posted by Heide on November 9, 2002, at 8:22:58
I almost quit Remeron before giving it a chance because of that groggi/dizzy feeling. It has turned out to be the best drug I've tried. I'm up to 60 mgs per day (hopefully I won't need to go higher) and the grogginess and constant hunger have gone away. I used to take Ativan to help me sleep, but I haven't needed the Ativan when the Remeron is working well. I gained about 20 lbs., but it's holding at that. I gladly accept the 20 lbs. if it means I get to join the "world of the living" instead of being in the "world of the walking dead".
Other posters have had different experiences with this drug. You can always do a search to bring up a list of posts about this drug.
Good luck to you.
Lynda
Posted by sleepy lizard on November 13, 2002, at 21:50:58
In reply to Re: Remeron » Heide, posted by LyndaK on November 12, 2002, at 22:12:01
I had a difficult time quiting Effexor. Starting Remeron at 15mg made me very sleepy and 30 mg is much better. However it is not so stimulating as the Effexor (so far). I think if you are overlapping Effexor withdrawal with Remeron startup effects, you will get mostly the Effexor withdrawal symptoms with some drowsiness. After about a month off of the Effexor you should see just the Remeron effects. I hope you have an easy transition.
Posted by Heide on November 14, 2002, at 7:39:57
In reply to Re: Remeron » Heide, posted by LyndaK on November 12, 2002, at 22:12:01
> I almost quit Remeron before giving it a chance because of that groggi/dizzy feeling. It has turned out to be the best drug I've tried.
Hi Lynda,
I hope I have the same luck with Remeron as you did. The withdrawl of the Effexor isn't really all that noticable, actually. I had my wisdom teeth out yesterday, and the pain is providing ample distraction from anything else I might be feeling!
I'm up to 60 mgs per day (hopefully I won't need to go higher) and the grogginess and constant hunger have gone away.
I'm *really* glad to hear that, as I gained 30 lbs on Lithium that I just can't seem to shake. Groggy I can deal but eating and never getting sated is a problem (although not so much at the moment. All I can eat so far it yoghurt.)
I used to take Ativan to help me sleep, but I haven't needed the Ativan when the Remeron is working well. I gained about 20 lbs., but it's holding at that. I gladly accept the 20 lbs. if it means I get to join the "world of the living" instead of being in the "world of the walking dead".
It would be nice to feel like me again. I feel so encourgaed by your experience with Remeron.
Thanks. : )
Posted by Heide on November 14, 2002, at 7:43:34
In reply to Re: Remeron, posted by sleepy lizard on November 13, 2002, at 21:50:58
> I had a difficult time quiting Effexor. Starting Remeron at 15mg made me very sleepy and 30 mg is much better. However it is not so stimulating as the Effexor (so far). I think if you are overlapping Effexor withdrawal with Remeron startup effects, you will get mostly the Effexor withdrawal symptoms with some drowsiness. After about a month off of the Effexor you should see just the Remeron effects. I hope you have an easy transition.
Thank you, Sleepy Lizard. I hope I do too. Things are going okay, so far. My biggest concern is the weight gain.
I also read that Remeron can lower your white blood cells and make you more open to infections. Although this is rare, it worries me a bit--has anyone ever had to stop Remeron because of this?
This is the end of the thread.
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