Posted by SLS on June 28, 2005, at 11:18:58
In reply to Re: To Mr Scott - More questions for you » Denise1966, posted by ed_uk on June 28, 2005, at 10:16:13
> Hi Denise,
>
> Now you're on mirtazapine, perhaps you could reduce the paroxetine..........maybe in a few weeks time. You might want to increase mirtazapine to 30mg and decrease the paroxetine to 10-20mg. Paroxetine is often very numbing - especially at high doses.
>
> ~EdI don't know how relevant this is, but Paxil greatly increases one of the active metabolites of Remeron (8-hydroxymirtazepine) because Paxil is a potent inhibitor of CYP450 2D6. I don't think this is much of a problem if one titrates Remeron clinically. It probably is a good idea to reduce the Paxil to 20mg unless it has already shown greater efficacy at the higher dosages. I wouldn't worry about the Remeron metabolite thing. You probably won't realize much benefit from Remeron for depression until you reach a dosage of 45mg. Just remember that you might feel odd upon the introduction of any new drug or upon dosage increases. This is not always such a bad thing. It might mean that things are "cooking".
Good luck.
- Scott
poster:SLS
thread:520455
URL: http://www.dr-bob.org/babble/20050627/msgs/520489.html