Posted by Astounder on October 31, 2007, at 3:02:07
In reply to Re: Mitazapine » froggy, posted by unfrgvn on October 28, 2007, at 9:51:16
> i was placed on mitazapine last week got in the mail fri.took 1 and was so wasted i could barely walk.why did they place me on such a powerfull drug?just lossed alot of weightt and only have some anxiety issues sleep and nervous problems.i usually take 2-4 mg of xanax,and then im fine.i am a gulf war vet and i am finding problems now that werent there before the mass innoculation in 89 and 91.my daughter has no defects.her mother and i divorced.i also have this mysterious rise in blood pressure,used to run 4 miles in around 16 minutes twice a week .it seems like my cardio should be perfect.bp averages 145/112.it lost me a job in charge of equipment repair all over east texas co truck everything so sad.i think the va thinks i have post tra stress!!!!!!!!!!
--You sound extremely distressed. You mention you've had weight loss, anxiety, and sleep problems. You also seem somewhat obsessive over the autonomic dysregulation (e.g., blood pressure) that is probably only the result of stress.
Mirtazapine (Remeron) is actually a good choice for you. It is sedating by nature of its sub-nanomolar affinity for the H1 histamine receptor. It also blocks the 5HT2a and 5HT2c serotoin receptors; this can relieve insomnia, excitability, obsessive symptoms, avoidance, and anorexia. It also blocks 5HT3 which reduces nausea and anxiety.
Remeron is extremely sedating at all doses, so don't bother reducing the dose (at any dose your histamine receptors will already be saturated). Therapeutic doses usually range between 40-90 mg, though you can go higher, as it's incredibly nontoxic. Start with 40 mg at night for your insomnia; go to bed early because there will be a long hangover. If needed, you can wake yourself up with stimulants (ephedrine, caffeine) by placing them next to your alarm clock. After a week or so you will develop tolerance and will be able to sleep your normal hours. Besides it being very sedating, mirtazapine is notorious for weight gain (this is a dual effect from H1 and 5HTc blocking). Once you get to the higher doses (around 90 mg), it starts to become more stimulating, by virtue of the alpha2 adrenoceptor blockade and the desensitization of the H1 receptors.
My advice to you is to increase the dose as quickly as possible, since the side effects max-out at the lower doses, and the actions at higher doses attenuates these side-effects and starts elevating your mood more.
Remeron is a good drug to start out with because it augments other antidepressants while attenuating their side-effects from its 5-HT2 blockade: SSRIs, SNRIs, DNRIs, NRIs, MAOIs, and tricyclics can all be combined with Remeron.
poster:Astounder
thread:65452
URL: http://www.dr-bob.org/babble/20071027/msgs/792468.html