Posted by 3 Beer Effect on May 1, 2002, at 0:17:36
In reply to 3 Beers: Question for you and others re: Zoloft, posted by rainbowlight on April 30, 2002, at 16:27:04
If you lower your Remeron dose you will be MORE, not less sedated. The only way to lessen Remeron sedation is to INCREASE the dose (45-60 mg), or stop taking it.
Upping the Zoloft to 75 mg or more will cause LESS to NO sedation & will likely be activating (which could induce hypomania/mania in bipolars).
You should probably quit the Remeron & take Klonopin instead (since Klonopin is a 2nd line anti-manic agent) & either stay at 50 mg of Zoloft or cautiously up the dose to 75 mg if the Zoloft sedation doesn't subside.
OR keep the Remeron atleast at 30 mg (or even increase it to 45 mg-60 mg for less sedation) & Up the Zoloft dose to 75 mg.
Keep in mind that the Zoloft sedation could really be Remeron sedation,
OR the Remeron could potentiate the Zoloft sedation,
OR since Remeron blocks the 5-ht2 & 5-ht3 serotonin receptors that Zoloft acts on, Remeron may cancel out the 'activating' effect people normally experience at Zoloft 75-100+ mgs.
[When you combine two different anti-depressants the pharmacology becomes much more complex & it is often difficult even for psychiatrists to predict the likely outcome of a combination or to predict the best (optimal) dose when dealing with two different anti-depressants which interact with each other & can potentiate or even antagonize each other's effects.]Keep in mind that each time you change the Zoloft dose it will take about 3-4 weeks to notice the full effect, it is not going to change in a few days.
As you have probably read before, the lower the dose of Remeron, the higher the sedation. This is because the higher the dose, the greater ability Remeron has to raise norepinephrine. At 45 to 60 mg the activating effects of norepinephrine cancel out/overpower the strong anti-histamine/drowsiness effect of Remeron.
15 mg is much more sedating than 30 mg while 45 mg is either not sedating or somewhat sedating, & for many 60 mg is activating. Keep in mind that women may be less sedated at a given dose since the elimination half life of Remeron is longer in females than males.3 Beers.........................
poster:3 Beer Effect
thread:104552
URL: http://www.dr-bob.org/babble/20020425/msgs/104596.html