Posted by bleauberry on February 7, 2010, at 14:41:08
In reply to Re: mirtazapine side effects.. clue? » bleauberry, posted by viper1431 on February 6, 2010, at 10:11:44
Well, I'm so sorry you've had so much trouble. You've obviously put a valiant effort into trying some worthwhile things.
It does look confusing. I can't quite put my finger on it. My general impression is there is something else going on...thyroid, sub-clinical insulin resistance, cortisol imbalance. Something's going on. Whatever it is, it probably won't be easy to pinpoint.
To conclude that your body doesn't like norepinephrine I think might be an oversimplified generalization. It's a lot more complicated than that.
Children with ADD calm down and relax when given stimulants. A clue? I think so.
Reboxetine makes a lot of people tired. Not a clue.
Prozac has rage as a common side effect. Not a clue.
Parnate is usually stimulatory, but put you to sleep. A clue? I think so.
Nortriptyline...well, it did the same to me as to you, so I'm not sure that's a clue or not...it's doing so many other things it's hard to say.
When you've experimented with Remeron doses between 1mg and 30mg, you'll have more clues. Hopefully at a 30mg dose you'll have a surprising benefit, if you can weather the obvious expected sedation for a week or two. No matter, win or lose, you'll get some clues.
Xanax...a definite clue. In a pubmed study, one group of researchers used 3mg xanax to treat depression and had a high response rate...small study, probably not well structured, but still worth considering...their theory was that GABA is involved in various disorders. Xanax also has some indirect poorly studied impact on enhancing both serotonin and dopamine function. One negative is that when it wears off, it causes a cortisol spike from rebound. That pattern itself can cause a viscious cycle of problems similar to what you describe.
What all these clues mean, well, that's another story. I guess we could armchair quarterback that all day. But they do mean something. All those medication failures were not losses. There are pieces of the puzzle there to try to figure out.
In the meantime, the most significant clues I see are the positive paradoxical response to Xanax and the negative paradoxical response to stimulants and Parnate. I wish I could tell you what all that means. From my brief explorations into ADD, it probably has something to do with dopamine receptors.
As I see the whole conglomerate of things in your case, two things that would make sense to try, in my mind, would be...
1. Low dose (1mg-5mg) abilify.
2. Benadryl (to test the histamine sensitivity you mentioned)
3. I can't really back this up with anything more than a hunch, but I would also put a mention in for Milnacipran. Strong on NE, but forget that...it's a lot different than the other NE drugs you've taken.> I havn't tried the stimulants due to them being so restricted in australia however ones on there you did mention i have tried all made me worse, they actually made me more tired and weak and inthe case of parnate puts me right out to sleep, i have tried the wellbutrin but only in SR version as it's all we have, prozac made me want to go on a rampage, nortriptyline made me tired and weak and bad tempered and reboxetine feels like a sedative. So that's why i kept the mirtazapine at the low dose as my body doesn't seem to like noradrenaline but i wanted to be knocked out for a while to really get some sleep. I used to use 25mg of seroquel for 7 hours sleep but i still feel wierd when i wake up so i was hoping the mirtazapine wouldn't do the same.
>
> Was wondering if it's possible to be ultra sensative to anti-histamines or even have a low amount to begin with and that can cause trouble ?
>
> On an interesting note, thanks to the way my body is so silly, benzos make me feel more awake rather than sedating or helping with sleep, so i take 3mg alprazolam a day to help keep me up and about.
poster:bleauberry
thread:936087
URL: http://www.dr-bob.org/babble/20100204/msgs/936277.html