Posted by Mitch on September 23, 2001, at 16:05:00
In reply to Do Caffeine Ephedrine counteract Remeron?, posted by 3 Beer Effect on September 23, 2001, at 3:40:31
> I recently started taking Remeron 45 mg at bedtime for depression. I often have trouble getting up in the morning for class, so sometimes I take a No-Doz (200 mg) caffeine, & 50 mg of Ephedrine Sulfate (Bronkaid tablets)- (I do not have asthma but ephedrine is the only effective non-prescription stimulant besides caffeine, yes I know ephedrine is bad for you).
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> Anyways, do these two otc stimulants counteract the anti-depressant effect of Remeron, or do they actually improve the anti-depressant effect of Remeron since Ephedrine & Caffeine stimulate the release of Norepinephrine/(noradrenaline)?
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> CAFFEINE- "The medullary, respiratory, vasomotor and vagal centers are stimulated by caffeine". Adenosine blocking action, Inhibits phosphodiesterase (PDE), "Caffeine also stimulates releases of catecholamines from the adrenal medulla and norepinephrine is released from nerve endings in the isolatA heart"., "Caffeine's ability to potentiate cyclic AMP can explain its ability to potentiate ionotropic responses to B-adrenergic agonists and glucogon."
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> EPHEDRINE SULFATE- Releases norepinephrine from synaptic storage sites. Has direct effects on alpha, beta-1, and beta-2 receptors.
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> REMERON (Mirtzapine)- Enhances noradrenergic & serotonergic activity, perhaps by antagonism at central presynaptic alpha-2 adrenergic inhibitory autoreceptors & heteroreceptors. Also a potent antagonist of 5-HT 2, 5-HT 3, and histamine H 1 receptors. Moderate antagonist of peripheral alpha-1 adrenergic receptors & muscarinic receptors.
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>I take a little Remeron at nite for sleep and a little Zoloft in the daytime. Two cups of strong java are a must in the morning immediately after waking. My pdoc recommended taking a No-Doz tablet or two in the morning and midday to replace all of the coffee drinking and spare my stomach. Ephedrine didn't get brought up. Some people here have been prescribed firstline stimulants such as Adderall and Ritalin (and Wellbutrin) with Remeron to knock out the next day grogginess and improve antidepressant response with good success, so I doubt if stimulants are going to counteract or reverse the antidepressant effect of the Remeron.
Dr. Winston O'Boogie M.D. (manic-depressive) :-) sorry, couldn't resist!
poster:Mitch
thread:79364
URL: http://www.dr-bob.org/babble/20010917/msgs/79394.html