Posted by yxibow on March 17, 2008, at 2:48:19
In reply to Re: Experiences with Remeron? » yxibow, posted by Molybdenum on March 16, 2008, at 22:01:54
> Yes I;m a bit of a "horse" when it comes to certain meds. Other's I am quite sensitive to. And I also can't help having this stupid belief that "more is better". The theory has always worked with toys, chocolate, hifi amplifiers, money, sex.....right?????? :)
Oh toys of all kind, if you can afford it I suppose. Sex, safely -- its an important part of adult development and Freud wasn't all wrong. Chocolate, sure, if it is calorie free :)
> Apart from the 225mg mirtazapine, I take 600mg venlafaxine, 6mg melatonin, 500mcg clonazapine, 12.5mg Stilnox CR and 32mg of Atacand (for the hypertension we blame on the venlafaxine).The clonazapine is trivial -- Stilnox (Ambien) CR has the potential like all sleeping agents to eventially decline in use over time. I can imagine that much Effexor can cause severe sleep issues (at least I couldn't take it).
I had nightmares at 5mg of Melatonin, but that could have been a starting transient. I tried Ramelteon, but it wasn't particularly potent.
Atacand, that's pretty potent and a new ARB (successors or variants on ACE inhibitors).
> I'd really like to wean myself down to a more reasonable mirtazapine dose but I'm in a bit of a stressful situation at the moment - divorcing, custody battle, poor, no job - need I go on? And guns are impossible to get in my country (Aust) so there's no quick way out if I ever can't stand it anymore. And I can't just run down to Tijuana & pickup some Nembutal like US people can. The Northern Territory (aka state) gov't here was leading the world in "assisted suicide" legislation a few years back. Then the federal gov't chickened out & wound us back to the dark ages. I think you have to be a VET to get Nembutal here nowadays.
Oh please dear god -- you're lucky to live in a country that doesn't allow guns (including Canada and the UK, although they're starting to trickle in more unfortunately and from Northern Ireland to the present UK officers have no longer had the no-gun carrying appearance, they have standing orders now to have SWAT like squads.)
I won't even further this conversation with the Nembutal -- barbiturates are a an ancient medication and becoming a citizen of Oregon isn't going to change anything -- its for people who are truly incapacitated.
I've had suicidal ideations, I'm sure a number of people have here -- and one can't really stop someone determined but I would think many times about it and the people around you. I suffer from a number of things and can't see through the tunnel my disorder has gotten so complicated I feel like damaged goods sometimes, but I have to know that that is a constructed ideation, yes, there are neurological things that are going on but one can reinterpret the lines from Trainspotting and not go to the extreme on "Choose Life."
> Hence I'll just keep on the current combo & try to reduce it back when I'm settled in 6 months or so (unless I'm dead by then of course ;:)
>
> My p-doc is very senior in his field. Has been practicing for yrs & is a senior whatever at 2 Universities, blah, blah, blah. So I don't think he's a bad doc.No, that's fine... especially if he has university credentials -- doctors attached to teaching situations have seen more patients with unusual cases typically than others -- not always the case, but often true.
> I think his belief is that different people need different amounts and that there's a limit to how much effect the drug can have (at least over time gradually increasing it) on a given brain. He also believes that some ADs do poop out over time. And honestly, I'm not getting any new side effects at these doses.Definately would agree with that -- and yet there are new views on neuroplasticity -- there is a lag time also on how psychotropics affect the brain, and that's why its generally better to have the minimum effective dose to see how it progresses, because it may be up to a few months for progress to occur with certain medications, which is why some doctors are and probably rightly so in their practice, to immediately up dosage, because one can never appreciate the current amount.
> One bad thing happened the other night though - instead of taking 5 x 45mg, I just took 3. I was already sleepy & I thought maybe it wouldn't be so hard to bring down the dose rapidly.
>
> Well......I woke up at 3am in a state of DREAD bordering on physical PANIC - really WEIRD & BAD feeling. I've never felt so bad in my life. So I popped the other 2 x 45mg tabs plus 1mg of Xanax.
>
> When I woke up in the morning I felt "normal" again. But I'm sure not going to try such a drastic reduction ever again...!Yes, one can't try a drastic reduction of anything or one's ... ugh, medical terminology... "functionality" can go wild and decompensation occurs (the byproducts and worsening of a mental health state.)
> The p-doc says my combo is the most he's ever had anyone on & he won't be upping it any more. He says "there's no scientific evidence that supports increasing it further".
Thankfully... it is a lot, my doctor would fall out of his chair.
> Lastly, I recall when he agreed to the "California rocket fuel" (venlafaxine & mirtazapine combo) for me years ago, he used some medical service he subscribes to to send him the "latest medical data". I read what he got back. He got back two lots of articles from two different drug companies, as I believe they're each manufactured by different orgs. Neither company claimed there was any conclusive evidence that the 2 drugs worked well together. ie neither company has any interest in paying for or even promoting a study involving a competitor's product...!
As a denizen of this fair state I have never heard of our rocket fuel -- but if it works for you, then so much the better. I also tend to have what you describe -- its basically called being a "high metabolizer" (meaning you eat through medicine and out it goes), but I am also very sensitive to certain others.
> What a load of b*llsh*t.. ;)
>
> So all that aside, I know it's a common combo & it DOES seem to be still working for me. At least here it doesn't cost any more to be on higher doses. So as I'm currently unemployed, I get one month's worth of venlafaxine for $5. Same for mirtazapine $5/mth, etc - no matter how many actual mgs of tabs he says I need per day.
>
> All I know about the US (are you in the US?) health-care system is from watching that Michael Moore movie "Sicko". I sure hope it was fiction, 'cos if it's 1/2 true, then I think it's really time you need to either have another revolution or else move to Canada...!Oh, don't remind me about it. Canada took on a lot of the social revolution in the 60s, [while the US had a more dampened response as a whole except for important movements of race equality, Title IX and the 24th and 26th Amendment], creating a system of National universal health care (Federal -- some provinces grumble about it), eliminating the death penalty, first the Canadian Constitution of 1960 ultimately culminating in the Charter of Rights and Freedoms (after a supreme court ruling about the Quebecois in 1982) which it never had spelled out language, and now gay marriage which is Federal so it doesn't matter of any provincial objection.
Which is to say, there are definately conservative forces in Canada -- I wouldn't want to live in the prairies particularly although I've visited Canada many times, it's beautiful, relatively clean, and there's a general sense of civility. It's definately not however a socialist state whatever one's view might be.
I haven't seen Sicko yet, I imagine it will be like his other film at GM, investigative and provocative. Of course Canada suffers from triage, meaning that there can be a wait for crucial procedures for months on end. This ends up with some Canadians hocking money together to get special insurance or even paying for the entire procedure, just across in the US.
This is a problem too in the NHS in the UK -- its not perfect, it tends to use older medication....
(Canada generally has most but not all US medication, its oversight board has taken longer to let certain things in like Cymbalta and on the opposite has a few things not available in the US)
....and also has a triage problem, but then it has more than twice the population of Canada.
That creates a problem with how to build a system of fair health care (that includes a definite, non loopholed, aka Mental Health Parity Act, that provides true coverage for what is a biological illness) in a country 10 times the population of Canada and 5 times that of the UK.
Other countries carry it out to the extent that their monetary and sometimes caste systems create, such as Brazil, Mexico, and India, but it of course falls below acceptable standards often.
Anyhow, that's my soapbox.
> Thanks for caring :)
no problem
> Good Luck with your meds ;)Thanks
-- tidings
poster:yxibow
thread:806302
URL: http://www.dr-bob.org/babble/20080316/msgs/818402.html