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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by saturn on February 8, 2007, at 0:07:13
My understanding is that Remeron's sedation/sleep-inducing properties are due to Histamine blockade. Is this the primary mechanism of it's hypnotic effects?
I'd always thought that antihistamines such as benadryl adversely affected sleep architecture and have significant tolerance and rebound problems.
Can anyone expound on this? Thanks...Peace...Saturn.
Posted by linkadge on February 8, 2007, at 9:06:44
In reply to Remeron's hypnotic qualities/mechanism(s), posted by saturn on February 8, 2007, at 0:07:13
Remeron is a strong antihistamine, but it is also a 5-ht2a antagonist. 5-ht2a antagonists enhance the excretion of melatonin (at least when taken in the evening).
Linkadge
Posted by ronaldo on February 8, 2007, at 9:32:56
In reply to Re: Remeron's hypnotic qualities/mechanism(s), posted by linkadge on February 8, 2007, at 9:06:44
> Remeron is a strong antihistamine, but it is also a 5-ht2a antagonist. 5-ht2a antagonists enhance the excretion of melatonin (at least when taken in the evening).
>
> LinkadgeHello Linkadge,
What dosages of Remeron are we talking about here? I've read on this board that only a small dosage is required, in the order of 15 mg. What dosage would you recommend for sleep?
Regards
ronaldo
Posted by psychobot5000 on February 8, 2007, at 10:24:02
In reply to Re: Remeron's hypnotic qualities/mechanism(s) » linkadge, posted by ronaldo on February 8, 2007, at 9:32:56
>
> What dosages of Remeron are we talking about here? I've read on this board that only a small dosage is required, in the order of 15 mg. What dosage would you recommend for sleep?
>I know this wasn't directed to me, but I thought I'd chime in and let you know that 25-30mg, one hour or so before bed, was the most powerful hypnotic dose for me. My body weight was about 140 pounds at the time.
Posted by Phillipa on February 8, 2007, at 11:00:57
In reply to Re: Remeron's hypnotic dose » ronaldo, posted by psychobot5000 on February 8, 2007, at 10:24:02
I heard l5mg which I once tried with xanax chloral hydrate and it didn't make me tired. Wonder why? Love Phillipa
Posted by ronaldo on February 8, 2007, at 11:29:27
In reply to Re: Remeron's hypnotic dose » ronaldo, posted by psychobot5000 on February 8, 2007, at 10:24:02
Posted by kaleidoscope on February 8, 2007, at 13:16:22
In reply to Remeron's hypnotic qualities/mechanism(s), posted by saturn on February 8, 2007, at 0:07:13
Hi Sat
>I'd always thought that antihistamines such as benadryl adversely affected sleep architecture
They do, mainly because of their anticholinergic properties, which Remeron lacks.
K
Posted by linkadge on February 8, 2007, at 13:27:17
In reply to Re: Remeron's hypnotic qualities/mechanism(s) » linkadge, posted by ronaldo on February 8, 2007, at 9:32:56
To be honest, I found that 7.5 was the most sedating. At higher doses, I find it somewhat stimulating, perhaps the noradrenergic effects surpass the antihistamine effects.
Linkadge
Posted by rovers95 on February 8, 2007, at 13:56:46
In reply to Re: Remeron's hypnotic qualities/mechanism(s), posted by linkadge on February 8, 2007, at 13:27:17
I always thought it was the HPA axis downregulation that caused the sleep quality?! I wonder if you took a lower dose e.g. 7.5mg, or even 3.75mg - would you get the hpa axis downregulation without the noradrenaline properties???!! I stil have some in my drawer from a prescription ages ago - it was too stimulating at 30 or 15mg for me!!
mark
Posted by saturn on February 8, 2007, at 14:04:21
In reply to Re: Remeron's hypnotic qualities/mechanism(s) » saturn, posted by kaleidoscope on February 8, 2007, at 13:16:22
Posted by saturn on February 8, 2007, at 22:47:18
In reply to Remeron's hypnotic qualities/mechanism(s), posted by saturn on February 8, 2007, at 0:07:13
I'd be interested to know more (for sleep, depression, how long taken?) Thanks...Peace....Saturn.
Posted by linkadge on February 9, 2007, at 17:19:31
In reply to Anyone take just 7.5 mg Remeron regularly?, posted by saturn on February 8, 2007, at 22:47:18
I took a low dose of remeron <=7.5mg regularly with celexa for a while. It was decent combination.
Linkadge
Posted by psychobot5000 on February 10, 2007, at 12:09:42
In reply to Re: Anyone take just 7.5 mg Remeron regularly?, posted by linkadge on February 9, 2007, at 17:19:31
> I took a low dose of remeron <=7.5mg regularly with celexa for a while. It was decent combination.
>
>
> LinkadgeMy impression is that people tend not to take low doses of Remeron consistently, because you get (relatively) more sedation with compared to antidepressant benefit. I read once that the blood-levels needed to block 5HT2 and H1 receptors are lower than levels needed to stimulate noradrenaline and serotonin release.
But I'm sure it'd be good for some.
Posted by cb_psy on February 11, 2007, at 5:53:26
In reply to Remeron's hypnotic qualities/mechanism(s), posted by saturn on February 8, 2007, at 0:07:13
according to preskorn, mirtazapine first blocks histamine. So 7,5 mg should just produce grogginess.
http://preskorn.com/images/columns/0007_fig1.gifFor me higher dosage is more sedating. Ive heard people state otherwise but that is probably due to histamine tolerance you get as time goes by and you raise the dose.
Posted by randermin on February 12, 2007, at 23:20:42
In reply to Re: Remeron's hypnotic qualities/mechanism(s), posted by cb_psy on February 11, 2007, at 5:53:26
is 30mg close to where it's still sedating, but also high enough to be less groggy in the morning?
where is the threshold betwean high-dose nockout (~30mg?) and higher dose activation, and non-drowsieness, while still being safe? (maybe 40?)
any experiences with this?
Posted by Cathb on February 13, 2007, at 0:10:09
In reply to Anyone take just 7.5 mg Remeron regularly?, posted by saturn on February 8, 2007, at 22:47:18
I've been taking Remeron 7.5mg qhs for almost two years. My primary antidepressant is Wellbutrin & I take 150mg bid of the SR w/ and additional 75mg of the IR in the morning. Other meds now include Adderall 30mg qam and 25mg Synthroid qam. The low-dose Remeron was the only thing that did anything for my severe insomnia. I used to "toss and turn" for several hrs before getting any sleep and the sleep that I did get was light (i.e., would wake up every hour for several more hours thereafter.) Eventually I'd be able to get into a deep sleep, but would require 12 hrs+ to feel rested.) Before the Remeron I tried Ambien (up to 20mg) as well as several benzos at high doses. When I strarted Remeron I experienced some very weird and "trippy" side effects (probably due to the unique was in which it works on the serotonin system.) I'd walk around feeling very dazed and spaced-out, but at the same time I was very aware of this & more insightful re: my depression symptoms. One cool effect was that my vision was sharper, colors were enhanced & images on TV really seemed to pop out. These SEs went away entirely after about 2-weeks. The other SEs included difficulty urinating (which improved somewhat) & increased appetite (which is thankfully offset by my Adderall.) Overall, I'm very pleased w/ the effects of my low-dose Remeron It works, it doesn't leave me w/ the hung-over feeling I get w/ benzos and -because you're splitting the lowest dose available- it's cheap (provided you're also getting the generic version.)
Posted by saturn on February 13, 2007, at 21:29:50
In reply to Re: Remeron's hypnotic qualities/mechanism(s), posted by cb_psy on February 11, 2007, at 5:53:26
> according to preskorn, mirtazapine first blocks histamine. So 7,5 mg should just produce grogginess.
> http://preskorn.com/images/columns/0007_fig1.gif
>
> For me higher dosage is more sedating. Ive heard people state otherwise but that is probably due to histamine tolerance you get as time goes by and you raise the dose.That's a really cool graph and site---thanks for the link.
I'm intersted in learning what dose would hit Histamine and 5-HT, but before significant NE effects. I'm guessing around 15(?).
Posted by psychobot5000 on February 14, 2007, at 21:27:24
In reply to Re: Remeron's hypnotic qualities/mechanism(s), posted by randermin on February 12, 2007, at 23:20:42
> is 30mg close to where it's still sedating, but also high enough to be less groggy in the morning?
> where is the threshold betwean high-dose nockout (~30mg?) and higher dose activation, and non-drowsieness, while still being safe? (maybe 40?)
> any experiences with this?The impression I get is that experiences vary a good bit, but for me I will say that anything from 10-30 was the significantly sedating--through the night, and sedating during the day, too. Doses of 45mg/day definitely did prove more activating and less sedating. Sleep also seemed poorer.
The sedation also seemed strongest during the first week or so after starting the med or raising the dose.
Such was my experience--best,
P-bot
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