Posted by Cam W. on April 29, 2000, at 23:34:11
In reply to Re: WWIII Averted Q for Cam, posted by allisonm on April 29, 2000, at 23:06:32
Allison - I haven't any real life experience with Remeron (mirtazapine), but I have read a bit about it (not in Canada, yet). If you went from Zoloft to Effexor to, say, a TCA, I would say that the antidepressant effect might have travelled across drug classes (unless the TCA was like desipramine, with little SRI activity). All of these drugs have serotonin reuptake inhibition (SRI) activity.With the trial of Remeron after Zoloft and Effexor, I would have to say - maybe. Remeron (I think), in a round-about way, increases levels of both serotonin and norepinephrine in the synaptic gap. So, there is a possibility that the serotonin function kicked in with the third drug.
Another possibility is that your type of depression needed some norepinephrine increases to treat it. Then it would not be a cumulative effect of serotonergic drugs, but the different drug effect of Remeron.
As for if the drug had worked over the last few years; if your depression was lowered, it possibly was working. You would not expect placebo effect to last that long. You could as your doctor to try the SSRIs again or maybe even switch to reboxetine (if it is available where you are). Trials of each of these would determine if you depression was serotonin or norepinephrine based.
Wishy-washy answer, huh. - Cam W.
poster:Cam W.
thread:31659
URL: http://www.dr-bob.org/babble/20000429/msgs/31724.html