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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 3 Beer Effect on January 21, 2003, at 20:18:38
I currently take Paxil CR 50 mg + Wellbutrin SR 300 mg. I haven't had any real side effects but the Paxil CR doesn't seem to improve my mood. I am always lethargic, anhedonic, melancholic etc.
The best AD I ever took was Zoloft but after a month at 100 mg I started to get ridiculous insomnia which turned into my first 'manic' episode= ended up with a DUI from Xanax + Benadryl (no alcohol) that I took in order to go to sleep.
I don't know if i'm Bipolar II or not- ADD kids often have odd, impulsive, hyper & manic-like reactions to Zoloft & Prozac. But I guess since both Paxil CR, Celexa didn't work for my depression that the only ADs that are going to help me are the "stimulating" SSRIs Prozac & Zoloft. (Wellbutrin & Effexor XR don't seem to help).
Anyways my main question is will taking the combination of 20 mg of Prozac in the morning, & either 45 or 60 mg of Remeron at bedtime cause the dreaded Serotonin Syndrome?
Thanks,
3 Beers....
Posted by Ame Sans Vie on January 21, 2003, at 20:45:06
In reply to Does Prozac 20mg + Remeron 45mg= 5-HT Syndrome? , posted by 3 Beer Effect on January 21, 2003, at 20:18:38
Though I admittedly lack scientific knowledge on the subject, FWIW, I know two people who are on that same combo-- 20 Prozac/45 Remeron, as well as one who takes 40 Prozac/75 Remeron. They've been on these regimens for years to no ill effect.
--Michael
Posted by rainbowlight on January 21, 2003, at 21:03:22
In reply to Does Prozac 20mg + Remeron 45mg= 5-HT Syndrome? , posted by 3 Beer Effect on January 21, 2003, at 20:18:38
Don't know if this helps, but I took Remeron 30 mgs. and Zoloft for quite awhile and didn't have any problem (except the Remeron weight gain - watch out for that!)
Posted by JohnL on January 22, 2003, at 5:16:37
In reply to Does Prozac 20mg + Remeron 45mg= 5-HT Syndrome? , posted by 3 Beer Effect on January 21, 2003, at 20:18:38
Any combination of meds can have the potential to cause serotonin syndrome. But Prozac plus Remeron is a relatively safe combination. You shouldn't have any problems. Just titrate up on dosage slowly and carefully.
To be quite honest, I must comment that I believe Zyprexa would be a far better choice than Remeron.
I was on Remeron for a year. It did little for me except make me tired all the time and give me a morning hangover every day. Searching the archives here you will find few people that have been happy with Remeron. In contrast, you will find lots of positive comments about Zyprexa, except for the weight gain potential.
Even though Remeron is called an antidepressant, and Zyprexa is called an antipsychotic, forget the names. Both are drugs that have mutliple actions at various receptors in the brain. It just happens that Zyprexa's multiple actions seem anecdotally much better for depression. They should have called Zyprexa an antidepressant, because it is a great one.
Scientific evidence shows that Zyprexa plus Prozac is a great combination with few side effects and profound antidepressant action, much better than either alone.
Another thing too...if Remeron is going to work, you will most likely have to wait 2 to 4 weeks to find out. If Zyprexa is going to work, you should know inside one week, sometimes even by day 2.
John
Posted by Ilene on January 22, 2003, at 9:56:11
In reply to Does Prozac 20mg + Remeron 45mg= 5-HT Syndrome? , posted by 3 Beer Effect on January 21, 2003, at 20:18:38
> I currently take Paxil CR 50 mg + Wellbutrin SR 300 mg. I haven't had any real side effects but the Paxil CR doesn't seem to improve my mood. I am always lethargic, anhedonic, melancholic etc.
>
> The best AD I ever took was Zoloft but after a month at 100 mg I started to get ridiculous insomnia which turned into my first 'manic' episode= ended up with a DUI from Xanax + Benadryl (no alcohol) that I took in order to go to sleep.
>
> I don't know if i'm Bipolar II or not- ADD kids often have odd, impulsive, hyper & manic-like reactions to Zoloft & Prozac. But I guess since both Paxil CR, Celexa didn't work for my depression that the only ADs that are going to help me are the "stimulating" SSRIs Prozac & Zoloft. (Wellbutrin & Effexor XR don't seem to help).
>
> Anyways my main question is will taking the combination of 20 mg of Prozac in the morning, & either 45 or 60 mg of Remeron at bedtime cause the dreaded Serotonin Syndrome?
>
> Thanks,
> 3 Beers....I think it depends on your particular sensitivities. I had symptoms resembling serotonin syndrome on Wellbutrin & Effexor XR. I felt better once I started tapering off the Effexor. (I still got hit with massive withdrawal about 36 hours after the last dose.)
I think if you titrate up the Remeron very slowly you may be able to stop if or when you start feeling strange. I can't really recall all my symptoms. I think they were dizziness, palpitations, headache. Uncomfortable but not emergency room awful.
On the other hand Prozac has such a long half-life that it stays in your system for something like 9 days. Maybe you can find out how long it takes to metabolize Remeron before you make your decision.
BTW, prozac was the 2nd AD I took. It worked--for a while. It triggered psychosis in someone I know thru the internet. I don't have warm and fuzzy feelings toward it anymore. YMMD
Posted by linkadge on January 23, 2003, at 17:40:14
In reply to Does Prozac 20mg + Remeron 45mg= 5-HT Syndrome? , posted by 3 Beer Effect on January 21, 2003, at 20:18:38
I heard somewhere that Remeron can actually alleviate the symptoms of serotonin syndrome.
Does anyone know if this is true.
Linkadge
Posted by rainbowlight on January 23, 2003, at 18:57:46
In reply to Does Prozac 20mg + Remeron 45mg= 5-HT Syndrome? , posted by 3 Beer Effect on January 21, 2003, at 20:18:38
Wanted to add this too, I am currently going through Remeron withdrawel. Psychologically it is not too bad at all, but physically it is not fun. Headaches, bad nausea, lethargic, the usual. I think Remeron is great for severe depression, but it does not treat anxiety the way say "Zoloft" would and definately does not give you (or at least "me") that warm fuzzy, happy feeling that I know you (and I) get from Zoloft.
Posted by oracle on January 23, 2003, at 21:15:33
In reply to Re: Does Prozac 20mg + Remeron 45mg= 5-HT Syndrome? , posted by JohnL on January 22, 2003, at 5:16:37
> Even though Remeron is called an antidepressant, and Zyprexa is called an antipsychotic, forget the names.
But don't forget the movement disorders and EPS
Zyprexa can cause.
This is the end of the thread.
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