Posted by yxibow on January 7, 2006, at 3:56:53
In reply to Remeron dosing and weight gain, posted by med_empowered on January 6, 2006, at 1:57:45
> hi! So, I've been thinking about possibly trying to Remeron to help with sleep and to take care of some anxiety/OCD/depression (basically generalized neurotic stuff) I still have going on. Anyway, I do **not** want to gain weight--I'm actually trying to lose weight. I just need to be less anxious right now. So, if I quickly titrated up to 30mgs or 45mgs, would I still gain weight? I understand the sedative effects tend to lessen at higher doses...what about the weight gain?
I never recommend "quick titrations", you could have some idosyncractic reaction. In my experience, neither the sedative effect nor the weight gain changed at a lower dose or a higher dose, it just compounded it. I never got to 60, so I wouldn't know -- that would be an awfully high dose and I don't know if any psychiatrist would prescribe it.
> Here's my problem, btw--I have this weird obsession that I'm balding (I'm not--and my friends are getting exasperated by this particular obsession) and that people are staring at me, talking about me, etc. Its really irritating, and I think I can work through it but...I'm starting school again soon, so I need to minimize the anxiety and OCD at least for a while so I can focus on more important things. What should I do?No form of OCD is "wierd", trust me. I've heard of the strangest form of OCD and my personal worst OCD, while not out of the ordinary, had a YBOCS (test measurement) of 39, I believe. That's one less than off the scale. I can sympathise with the feeling of baldness though if there is any actual real component to it -- it is a male pride, and I do have what sounds similar, slightly thinning, with just a small patch of loss. Who knew? There's no baldness history in my family but I suppose you could trace back generations.
It sounds like you have OCD mixed with some paranoia. But you seem to be managing the paranoia by rationalization. Otherwise I would suggest a low dose Seroquel addition, it would make an SSRI more powerful. I would suggest any of the SSRIs that are tolerable to you -- I dont know if I would mix Anafranil and Seroquel although I'm sure it has been done, its just more risk of side effects I think because its an older medication. But the TCA Anafranil, for severe OCD, is extremely effective, even though it is 26 years old give or take, although it wasn't approved until more recently. I might also add a pinch of Klonopin, Xanax, or Valium while titrating up an SSRI to reduce anxiety effects.
Hope you feel better.
poster:yxibow
thread:595712
URL: http://www.dr-bob.org/babble/20051231/msgs/596141.html