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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by rainbowlight on April 29, 2002, at 17:51:02
My Zoloft is working well for the OCD/anxiety. But I cannot figure out why this "activating" SSRI makes me sedated and sleepy? Could it be because I am also taking Remeron with it? The Remeron never made me sleepy on it's own.
Posted by jay on April 29, 2002, at 17:54:42
In reply to Why do I feel sedated from an activating SSRI?, posted by rainbowlight on April 29, 2002, at 17:51:02
Zoloft, like Prozac, has sedating properties along with some 'energizing' ones. It also may be your Remeron, but I would suspect it is both. I eventually took to taking Zoloft at bedtime, but even late afternoon, around supper, might be wise.Hope that helps!
Jay
Posted by 3 Beer Effect on April 29, 2002, at 22:23:03
In reply to Re: Why do I feel sedated from an activating SSRI? » rainbowlight, posted by jay on April 29, 2002, at 17:54:42
For starlight: The dose of Zoloft you are on (37.5-50 mg) is sedating, but i'm not sure why. When you get to 75mg or more it seems to become activating. Zoloft does not equal the potency of the starting dose of Prozac (20 mg) until about 80 mg. You could switch to Prozac which I think is supposed to be more activating than Zoloft (although i've never tried Prozac) or up your Zoloft dose but watch out for the possibility of a manic switch since you have bipolar.
Stuff about Remeron/SSRI interactions & general Remeron stuff:
The Remeron & Zoloft (or any SSRI) do interact depending on the dosages. I think Remeron actually blocks the "bad" 5-HT2 & 5-HT3 serotonin receptors which cause insomnia, sexual dysfunction, & gastointestinal distress while selectively potentiating the "good" serotonin receptor 5-HT1A & Norepinephrine at the higher doses. If you get the dosages right, Remeron can effectively cancel out the insomnia & some of the other side effects common to Prozac & Zoloft.
If you want to read about how SSRIs & the newer anti-depressants work, a great book to read is "Essential Psychopharmacology of Depression & Bipolar Disorder" by Stahl, Stephen M ($32 at amazon.com).
If Remeron did not have the wicked anti-histamine/sedation & weight gain properties it would be the greatest anti-depressant out there, & would probably be a "blockbuster drug" for the company that makes it like Prozac is for Eli-Lily and Zoloft is for Pfizer, & Paxil is for whoever makes that. Besides the very stong anti-histamine effect & sedation/weight gain that comes with it, it has virtually no side effects & no sexual side effects which is one of the primary reasons people quit SSRIs.
I was on Remeron for a long time but it never seemed to improve my mood probably because of the sedation. Some people do well on it though, especially at higher doses like 45 or 60mg, which are the doses where the norepinephrine effect kicks in and basically "cancels out" or diminishes the anti-histamine effect (although I personally found 45 mg still sedating, 60 mg wasn't sedating at all). In Europe they normally use higher doses than in the USA & I think it is a more popular anti-depressant there. My personal opinion is that Organon screwed up by recommending 15 mg as the starting dose (it should probably be 30mg). 15 mg is ridiculously sedating & only appropriate for extremely agitated patients.
But it is very important to keep in mind that for some reason (I don't know why) the half life in females is much longer than males so a lower dose will not be as sedating to a female than it is to a male. I don't remember the difference is male/female half-lives but it says in the Remeron Prescribing Information, but I think it is quite a surprising difference.
3 Beers
Posted by rainbowlight on April 30, 2002, at 1:24:09
In reply to Remeron/SSRI inter; Remeron 1/2 life hi in women, posted by 3 Beer Effect on April 29, 2002, at 22:23:03
Thanks for the info!
Posted by noa on May 1, 2002, at 15:11:06
In reply to Thanks for replying, you guys are great!, posted by rainbowlight on April 30, 2002, at 1:24:09
Also, it seems from posts here at PB that there are folks who get activated by the SSRIs and folks who get sedated.
This is the end of the thread.
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