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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by mb on April 25, 2002, at 23:28:27
So how much truth is there to the fact that Remeron, at higher doses, is less sedating? My doc wants me to try this next. I've tried it before but at 15mg. He wants me to start at 30mg and then go to 45mg. Says the Norepinephrine will counteract the antihistamine sedation. I'm wary as I am extremely sensitive to antihistamines (Zyrtec--the nondrowsey antihistamine) knocked me on my on my butt. I can take 1/2 a Benadryl, drink two pots of coffee and still be bedridden for days. I have bad feelings about this Remeron...even at high doses.
QUESTION: Is it *really* that much better at high doses, or am I going to still sleep all day and eat 10000 calories per meal?
MB
Posted by Optimistic on April 26, 2002, at 9:25:39
In reply to Remeron, H1 Blockade, posted by mb on April 25, 2002, at 23:28:27
Each individual reacts differently. I also am very sensitive to meds and antihistamines and when I took Remeron I found it sedating at all doses.
Posted by Adam on April 26, 2002, at 12:25:11
In reply to Remeron, H1 Blockade, posted by mb on April 25, 2002, at 23:28:27
Hi, MB,
I took Remeron a couple years back, and my experience mirrors what your doctor recommends. There is, in fact, an explanation that fits what your doctor has told you: Remeron blocks the histamine H1 receptor, but is also blocks the alpha 2 adrenergic receptor at higher doses. Blockade of the alpha 2 receptor on certain neurons in the brain leads to increased secretion of norepinephrine and serotonin by those cells. The increased norepinephrine tends to have an activating effect, which does seem to counteract the sedating effect of H1 blockade.
It's interesting to note that another drug, yohimbine, is also an alpha 2 blocker, and some people take it as an energy booster. Many people also take it because it reportedly improves sexual drive and performance. It at least has been shown to help with erectile dysfunction. Some doctors use yohimbine to treat sexual dysfunction caused by serotonergic drugs like Prozac. Remeron also blocks the 5-HT2 and 5-HT3 serotonin receptors, while leaving the 5-HT1A receptor open for business. It is thought that 5-HT2 and 5-HT3-mediated signaling is at the root of SSRI-related side-effects (like sexual dysfunction). Remeron is, not suprisingly, free of sexual side effects. I certainly never had any problems with it, though I don't recall feeling especially "enhanced" while taking it. The only reason I stopped taking Remeron was, alas, because it did not help me with depression. I never slept better, though.
Posted by Ritch on April 26, 2002, at 22:45:47
In reply to Remeron, H1 Blockade, posted by mb on April 25, 2002, at 23:28:27
> So how much truth is there to the fact that Remeron, at higher doses, is less sedating? My doc wants me to try this next. I've tried it before but at 15mg. He wants me to start at 30mg and then go to 45mg. Says the Norepinephrine will counteract the antihistamine sedation. I'm wary as I am extremely sensitive to antihistamines (Zyrtec--the nondrowsey antihistamine) knocked me on my on my butt. I can take 1/2 a Benadryl, drink two pots of coffee and still be bedridden for days. I have bad feelings about this Remeron...even at high doses.
>
> QUESTION: Is it *really* that much better at high doses, or am I going to still sleep all day and eat 10000 calories per meal?
>
> MB
MB,It never got any better for me at higher doses. All it did at the higher doses was make me more grouchy and make me dream so much I couldn't tell if I was awake or not at night. I started at 7.5 then went to 15. Then it got bumped to 30mg. That is when I got sleep disruption when I was supposed to sleep, and then the same unrelenting brain fog all day long the next day. It sucked big time. When I withdrew from it I had agitated dysphoria for several days before I calmed down. The only thing I found it was good for was 1) getting to sleep, 2) anxiety. That's it. Hey, you can try it-bump it and see what happens. There are many that report the fog lifts, but if it doesn't I would get rid of it and try something else.
Mitch
Posted by katekite on April 27, 2002, at 11:05:06
In reply to Remeron, H1 Blockade, posted by mb on April 25, 2002, at 23:28:27
My experience with one pill of the 45 mg (started there to avoid sedation) was that I slept for somewhere between 18-20 hrs straight. Then I was in a groggy haze until I had the bad judgement to go to work (they tell me) the next day and attempted to work while 'looking under the influence'. I was still looking a little weird the day after that but can at least remember it. I apparently had enough sense to tell everyone at work I had the flu. Soooo, bad experience for me.
Posted by TSA West on April 27, 2002, at 11:20:20
In reply to Remeron, H1 Blockade, posted by mb on April 25, 2002, at 23:28:27
My best friend started Remeron at 60 mg right away and had few side-effects. He had no weight gain or sedation during the day. Plenty of needed sedation at night though...
Why you, MB, should consider Remeron in significant doses and long-term:
--It can be used for all types of depression, anxiety, OCD, and insomnia.
--It is convienient because it is taken only once at bedtime.
--It may improve libido and sexual performance (its the only medication that improves mine). Dr. Bob Hsieung's fellow doctors recommend it for sexual dysfunction.
--You can take Remeron with most antidepressants except MAOIs.
--It has none of the anticholinergic effects of SSRIs.
--It has gained recognition as a very useful medication from psychiatrists in only four years of FDA approval.LINKS:
http://www.dr-bob.org/tips/split/Mirtazapine-for-SSRI-ADRs.html
www.remeron.com
http://www.rxlist.com/cgi/generic/mirtaz.htm--Continue to seek out and do God's great and wonderful will for your life: The Salvation Army USA West (New Frontier)
Posted by allisonm on April 27, 2002, at 19:07:04
In reply to Remeron, H1 Blockade, posted by mb on April 25, 2002, at 23:28:27
I found 45mg more sedating. No matter what the dose, I gained weight.
I would say that your mileage will vary.
Posted by BarbaraCat on April 28, 2002, at 12:25:37
In reply to Remeron, H1 Blockade, posted by mb on April 25, 2002, at 23:28:27
I found increasing Remeron from 30 to 45mg definitely kicked in the NE effect. I still have a major difficult time getting going in the morning, but have plenty of energy during the day, feel alert and content. Just for the record, I LOVE Remeron. It's the only AD that feels like home to me (I've taken 'em all), however, I also need to take Lithium in order to keep it from pooping out. This is a fairly typical occurence with Remeron but all ADs eventually run out of steam for me. If you find that Remeron works for you and it begins to not work after 2 or so months, augmenting it (Lithium in my case) seems to resurrect it. - Barbara
> So how much truth is there to the fact that Remeron, at higher doses, is less sedating? My doc wants me to try this next. I've tried it before but at 15mg. He wants me to start at 30mg and then go to 45mg. Says the Norepinephrine will counteract the antihistamine sedation. I'm wary as I am extremely sensitive to antihistamines (Zyrtec--the nondrowsey antihistamine) knocked me on my on my butt. I can take 1/2 a Benadryl, drink two pots of coffee and still be bedridden for days. I have bad feelings about this Remeron...even at high doses.
>
> QUESTION: Is it *really* that much better at high doses, or am I going to still sleep all day and eat 10000 calories per meal?
>
> MB
This is the end of the thread.
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