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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by shakingoscar on March 1, 2003, at 6:48:09
i would be very grateful if someone can help.i have been on remeron about 12 days now, up to 60mg (last night), before that 45, and before that 30.
i am taking it for acute anxiety which 60mg celexa worked for but i got sick of the sexual sife effects - remeron is great for this - i feel like a man again woooo hooooo
however, i just can NOT eat anything. when i do i have about 5 mouthfuls and thats it...
i thought it should work the opposite way round.
i am also very angrey all the time but ive read about this side effect so its not worrying me (yet)
PLEASE PLEASE HELP!!!! i am coming off serzone at the moment (gradually, and stopped yesterday) - could this be the cause? i never ever get this side effects apart from with stimulants (which i dont want with anxiety).
i am a bit worried about the NE effect of remeron - hope it doesnt spoil the med for me, but so far, im a bit shaky but managing.
what do you think of this lack of hunger thing?
thanks
Posted by jflange on March 1, 2003, at 9:27:24
In reply to REMERON - PLEASE HELP - I CAN ***NOT*** EAT, posted by shakingoscar on March 1, 2003, at 6:48:09
shakingoscar:
This sounds like Serzone withdrawal to me. I have a hard time even >looking< at food during withdrawal. Remember, serotonin is present mostly in the gut, and any modulation will upset the balance. It SHOULD go away. Give yourself a few more days - maybe even a week- with just you, the Celexa, and the Remeron before you make any conclusions about this combo as the culprit.
feel better,
jflange
Posted by male34 on March 1, 2003, at 10:46:39
In reply to REMERON - PLEASE HELP - I CAN ***NOT*** EAT, posted by shakingoscar on March 1, 2003, at 6:48:09
what worked for anxiety celexa remeron or what?
Posted by Patient on March 1, 2003, at 16:39:02
In reply to REMERON - PLEASE HELP - I CAN ***NOT*** EAT, posted by shakingoscar on March 1, 2003, at 6:48:09
Hi,
When did you last discontinue Celexa and how long have you been taking it?
You were taking Celexa at the higher dosage end.
Remember that one can go from one antidepressant to another that has a slightly different mode of action, with the results of withdrawal symptoms from discontinuing the first drug.
Anger is one of the more common withdrawal effects of SSRI's as well as SNRI's like Effexor. I experienced extreme anger outbursts when I discontinued 20 mg of Celexa--this began to occur about day 5, but was especially worse going into week two. I ended up going back on Celexa.
This could occur with Serzone as well. What dose were you taking and for how long?
Nausea and a lack of appetite also occurs when disonctinuing these drugs.
As for Remeron, at lower doses it actually causes an increase in appetite as a result of blocking histamine receptors. This is also what causes the extreme sleepiness at lower doses. Remeron causes the serotonin system to get turned down and the norepinephrine system to be turned up, but this occurs at higher doses. You shouldn't have to worry about the norepinephrine system if you only take it at low doses. One reason doctors increase Remeron qucikly after starting a patient on it is to counteract the drowsiness and the increase in appetite that commonly occurs at the low dose end. Increasing the dose stimulates norepinephrine which counteracts these effects. The lower dose end is better for those that suffer from extreme anxiety or that need help with sleep. You are already at the high end for Remeron. The usual start up dose is 15 mg a day, and depending upon response, increased to 45 mg a day.
Posted by shakingoscar on March 2, 2003, at 9:35:35
In reply to Re: Remeron**I CAN**NOT**EAT-Withdrawal symptoms » shakingoscar, posted by Patient on March 1, 2003, at 16:39:02
> Hi,
>
> When did you last discontinue Celexa and how long have you been taking it?
>
> You were taking Celexa at the higher dosage end.
>
> Remember that one can go from one antidepressant to another that has a slightly different mode of action, with the results of withdrawal symptoms from discontinuing the first drug.
>
> Anger is one of the more common withdrawal effects of SSRI's as well as SNRI's like Effexor. I experienced extreme anger outbursts when I discontinued 20 mg of Celexa--this began to occur about day 5, but was especially worse going into week two. I ended up going back on Celexa.
>
> This could occur with Serzone as well. What dose were you taking and for how long?
>
> Nausea and a lack of appetite also occurs when disonctinuing these drugs.
>
> As for Remeron, at lower doses it actually causes an increase in appetite as a result of blocking histamine receptors. This is also what causes the extreme sleepiness at lower doses. Remeron causes the serotonin system to get turned down and the norepinephrine system to be turned up, but this occurs at higher doses. You shouldn't have to worry about the norepinephrine system if you only take it at low doses. One reason doctors increase Remeron qucikly after starting a patient on it is to counteract the drowsiness and the increase in appetite that commonly occurs at the low dose end. Increasing the dose stimulates norepinephrine which counteracts these effects. The lower dose end is better for those that suffer from extreme anxiety or that need help with sleep. You are already at the high end for Remeron. The usual start up dose is 15 mg a day, and depending upon response, increased to 45 mg a day.
>
>
>
>hi everyone and thanks for the replies.
i am taking 60mg of remeron with now only 10mg of celexa (for about 10 days). i have dropped over 5 weeks down from 60mg celexa to 10mg celexa because of the sexual side effects and have gone to 60mg remeron.
i am a little bit shaky still. hope this goes away. im frightened it might get worse. gotta go back to work tomorrow after being ill for 3 days last week.
sigh.
Posted by shakingoscar on March 2, 2003, at 9:40:06
In reply to Re: I CAN ***NOT*** EAT, posted by jflange on March 1, 2003, at 9:27:24
i should also add that whilst i was dropping the celexa, i was going to 600mg serzone (gradually over 4 weeks). anyway, it became obvious when i was on 600mg serzone and 20mg celexa that the serzone wasnt good enough to beat my anxiety.
i was up and down all day long like a yo-yo - as soon as my morning dose weared off, i was down and shaking - then took my next dose which made me ok until about bed time. then woke in the morning really anxious.
anyway, so after week 3.5 i knew i had to come down from 600mg serzone, which i have done in about 10 days, and am going to 60mg remeron which i have done in that 10 days.
i know this is a lot of changes in a short time, so its expected that im gonna feel a twinge or two.
its just the shakiness that bothers me. i dont think its anxiety-based, but i can not be 100% certain it isnt either.
need more time probably to settle to see how i am. just hope i can go to work tomorrow. :(
Posted by beardedlady on March 3, 2003, at 12:27:18
In reply to Re: I CAN ***NOT*** EAT, posted by shakingoscar on March 2, 2003, at 9:40:06
That is waaaaay too fast to come off Serzone. No wonder you have the shakes!
I went off Serzone once (just to take a meds break), and it took me about three months. I was only at 300 mg. to start! Every two weeks, I reduced by 50 mg. You could go faster, but I don't think you can taper 600 mg. in ten days.
If I were you, I'd talk to your doc and see about putting some serzone back and going more slowly.
Good luck.
beardy
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