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Re: To DL: Still on Remeron?

Posted by JohnL on October 24, 1999, at 9:20:22

In reply to Re: To DL: Still on Remeron?, posted by LG on October 24, 1999, at 8:49:38

>I just upped to 45 mgs
> and still can't sleep,also on 500neurontin at bed
> time.
> LG

Hi LG. Theoretically Remeron is less sedating at high doses like 45mg or 60mg. I found it pretty sedating at 45mg but also very drugged during the day. I find it much more sedating at 7.5mg or 15mg without the daytime drugged feeling. But if it's helping with your depression, going down that low wouldn't be a good move.

This might sound strange, but it would probably work nicely. Ask your doc about one of the TCAs with a short half-life. All are sedating, but some more than others. I'm not sure which one that would be, but either you or the doc could research that stuff pretty easily on the web. The shortest half-life would avoid daytime sedation as much as possible.

I've never heard of a TCA being combined with Remeron. There's certainly nothing wrong with combining them. Especially if the TCA is added at a small dose just for sleep. It would potentiate the Remeron as well. And they're cheap. While the Remeron stimulates neurotransmitter synthesis, the TCA would provide some reuptake inhibition to boot. This probably is a rare combination because most people are already too sedated on Remeron to begin with. But if it's not doing that to do, adding the right TCA would make sense, even though for nearly all the rest of us Remeron alone is plenty sedating. I admit it sounds like a bizarre combination. But for you, and probably hardly anyone else, it could work well. You seem to have strong tolerance to antidepressant induced sedation. Just something to consider.


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URL: http://www.dr-bob.org/babble/19991016/msgs/13753.html