![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 25 of 40. This is the beginning of the thread.
Posted by Barb on August 19, 1999, at 22:19:52
Has anyone had any experience with mirtazapine (Remeron)?
Posted by Adam on August 20, 1999, at 11:47:29
In reply to Mirtazapine (Remeron), posted by Barb on August 19, 1999, at 22:19:52
I had somewhat positive results out of a 45mg/day regimen
of Remeron. My basic problem with it was that while it seemed
to attenuate my depression to a degree, it still left me rather
flat and anhedonic. I gained a little weight on it and never
slept better.As I remember, the first couple of days I took it I felt so
sedated I didn't feel safe driving and actually had to call
in sick for work. But sticking it out through this initial
phase seems to work, and I did adjust to the point that I
didn't really notice it any more, except that it made me kind
of sleepy throughout the day. Absolutely no sexual side
effects which was nice, to say the least.I think it's worth trying, but I personally found that it
didn't do all that I hoped it would.> Has anyone had any experience with mirtazapine (Remeron)?
Posted by JohnB on August 20, 1999, at 23:14:50
In reply to Mirtazapine (Remeron), posted by Barb on August 19, 1999, at 22:19:52
Barb:
I was on Mirtazepine for about 5 weeks. I never felt so sedated, so "out of it," in my life. It sparked the most obscene binges of overeating and hunger cravings I've ever experienced. I gained over 20 pounds in just 3 weeks because I literally felt helpless to control my appetite. It was very scary for me, since I've always battled with my weight and my relationship with food. I guess you could say that it was the wrong medication for me.
You, however, might not react the same way. My depression is more "atypical" and anergic, so the more stimulating meds have been better for me. Remeron would probably work well for you if your depression involves a loss of appetite, high levels of anxiety, and pronounced insomnia.
I hope your trial goes well.John B.
Posted by mila on August 22, 1999, at 20:39:47
In reply to Re: Mirtazapine (Remeron), posted by JohnB on August 20, 1999, at 23:14:50
I've been on remeron for a few months. It is the first anti-depressant which has made a substantial difference in my life. It does increase appetite. Though they say appetite increase and sedation reduces with higher doses.
I have had no negative effects aside from the weigth gain. I have also never slept better.
If your sleep patterns are out of whack, and contributing to your depression, remeron would be the med to try. Also, it may work well in combination with another AD.
Posted by Mauro on January 27, 2000, at 16:10:05
In reply to Re: Mirtazapine (Remeron), posted by Adam on August 20, 1999, at 11:47:29
After several trials on SSRI's, which were abandoned due to the side effects of sexual dysfunction that I experienced my GP suggested that I try Zispin (Mirtazapine). I started immediately on 30mg daily, and after only two days the hunger pangs started! Appetite increase was not a problem for me as I ate little when depressed. My mood started to lift after the second week...I have been on it for two months now and I feel much more focused and motivated.
Posted by Sem on April 27, 2000, at 11:10:17
In reply to Re: Mirtazapine (Remeron), posted by mila on August 22, 1999, at 20:39:47
I initially was prescribed Zispin(Remeron) when citalopram was found to be ineffective over a year ago for me. This led to a lift from the depression I had felt and I was soon reduced until I stopped taking it. Things were better for a time but recently the depression came back which has resulted in me being returned to the medication. I found that second time around that mirtazipine increased my appetite unbelieveably but was not as effective as it first had been. I also found that I was more anxious and reacted worse to stress, but by and large it has made a considerable overall difference.
Posted by Marsha on March 13, 2001, at 15:09:18
In reply to Mirtazapine (Remeron), posted by Barb on August 19, 1999, at 22:19:52
Yes, I had a bad experience with Remeron. I had nightmares, difficulty disguishing reality from dreams, being in a constant fog, tired, feeling unsafe driving, outbursts of anger, my eyes began to jerk and still do 10 days after stopping the med. I am having trouble with short term memory still. It was a terrible experience and I never want to take anti-depressents again. I feel so much better now that I am off them. My family says they are glad to have me "back again". If it were not for a concerned psychiatrist that learned I was put on these drugs, I would probably still be on them and going downhill. He invited me to his house to talk about what my doctor had put me on and talked some sense into my head about them. He continues to check on me regularly at church and we communicate via email during the week sometimes. I am convinced I have done the right thing to quit taking them and he is too. Now I have to face my doctor next week.....I know he will not be happy I quit and I have the job of convincing him I am better without them.
Posted by IanS on July 15, 2001, at 11:06:08
In reply to Re: Mirtazapine (Remeron), posted by Marsha on March 13, 2001, at 15:09:18
I have tried Zispin for about 4 weeks. Though it has lifted mood, I have cravings for chocolate (not something I have at all usually) and ice-cream specifically, and you are the first person that has mentioned anger outbursts like I have. What struck a chord is people commenting how 'unlike' myself I am. Also, I have whole days and strings of days, like now, where I feel very lethargic, but then a string of days when I am very active. I like the 'up' days which I was not having without Zispin, but the anger is a big problem - also, I am having problems feeling cold all the time, which no one else has mentioned.
> Yes, I had a bad experience with Remeron. I had nightmares, difficulty disguishing reality from dreams, being in a constant fog, tired, feeling unsafe driving, outbursts of anger, my eyes began to jerk and still do 10 days after stopping the med. I am having trouble with short term memory still. It was a terrible experience and I never want to take anti-depressents again. I feel so much better now that I am off them. My family says they are glad to have me "back again". If it were not for a concerned psychiatrist that learned I was put on these drugs, I would probably still be on them and going downhill. He invited me to his house to talk about what my doctor had put me on and talked some sense into my head about them. He continues to check on me regularly at church and we communicate via email during the week sometimes. I am convinced I have done the right thing to quit taking them and he is too. Now I have to face my doctor next week.....I know he will not be happy I quit and I have the job of convincing him I am better without them.
Posted by Elizabeth on July 15, 2001, at 12:24:06
In reply to Mirtazapine (Remeron), posted by Barb on August 19, 1999, at 22:19:52
> Has anyone had any experience with mirtazapine (Remeron)?
It didn't do anything noticeable for me, although I may not have given it enough of a chance (about 30 days -- marginal). I do know people who've found it very effective. Some people gain weight as a side effect. I didn't have this problem.
Remeron tends to be more sedating at low doses (7.5-15 mg), and my pdoc says that he generally starts people at 30 mg in order to avoid this side effect. It's possible that the weight gain becomes less of a problem at higher doses, although that's not as clear.
-elizabeth
Posted by thrasher on July 18, 2001, at 6:55:21
In reply to Re: Mirtazapine (Remeron), posted by Marsha on March 13, 2001, at 15:09:18
> Yes, I had a bad experience with Remeron. I had nightmares, difficulty disguishing reality from dreams, being in a constant fog, tired, feeling unsafe driving, outbursts of anger, my eyes began to jerk and still do 10 days after stopping the med. I am having trouble with short term memory still. It was a terrible experience and I never want to take anti-depressents again. I feel so much better now that I am off them. My family says they are glad to have me "back again". If it were not for a concerned psychiatrist that learned I was put on these drugs, I would probably still be on them and going downhill. He invited me to his house to talk about what my doctor had put me on and talked some sense into my head about them. He continues to check on me regularly at church and we communicate via email during the week sometimes. I am convinced I have done the right thing to quit taking them and he is too. Now I have to face my doctor next week.....I know he will not be happy I quit and I have the job of convincing him I am better without them.
yeh same, mirtazapine was undergoing test release here in .au
doc got some for me because I'd tried nearly everything else and was nearly dead..
talk about tripping! remeron for 3 days was the worst continuous bad trip I have ever had, waking up from one nightmare/dream/terror into another one...
so yeh I am happy someone else has had this experience, because it's the only drug of this type to affect me negatively (200mg fluoxetine per day all week is fine,
30mg mirtazapine was the very definition of ph33r :(
Posted by JohnL on July 18, 2001, at 17:48:55
In reply to Re: Mirtazapine (Remeron) » Marsha, posted by IanS on July 15, 2001, at 11:06:08
> I have tried Zispin for about 4 weeks. Though it has lifted mood, I have cravings for chocolate (not something I have at all usually) and ice-cream specifically, and you are the first person that has mentioned anger outbursts like I have. What struck a chord is people commenting how 'unlike' myself I am. Also, I have whole days and strings of days, like now, where I feel very lethargic, but then a string of days when I am very active. I like the 'up' days which I was not having without Zispin, but the anger is a big problem - also, I am having problems feeling cold all the time, which no one else has mentioned.
>
> > Yes, I had a bad experience with Remeron. I had nightmares, difficulty disguishing reality from dreams, being in a constant fog, tired, feeling unsafe driving, outbursts of anger, my eyes began to jerk and still do 10 days after stopping the med. I am having trouble with short term memory still. It was a terrible experience and I never want to take anti-depressents again. I feel so much better now that I am off them. My family says they are glad to have me "back again". If it were not for a concerned psychiatrist that learned I was put on these drugs, I would probably still be on them and going downhill. He invited me to his house to talk about what my doctor had put me on and talked some sense into my head about them. He continues to check on me regularly at church and we communicate via email during the week sometimes. I am convinced I have done the right thing to quit taking them and he is too. Now I have to face my doctor next week.....I know he will not be happy I quit and I have the job of convincing him I am better without them.This is exactly why I do not subscribe to the popular practice of "giving it more time". In my experience, if there isn't some kind of hint of a good reaction in the first week or two, at least a hint, then I am quite willing to trash it and move on. There is a perfect drug for everyone, but we'll never find it if we're forced to stay with something that isn't working out, or stay with something hoping it will work a month or two later. That's the way doctors are trained though. I totally disagree with it. When a medicine is right, you'll know it without a doubt in a short amount of time. Lots of people clobber me for saying that. But all I can say is that by dumping drugs that were either bad or neutral in the first two weeks was how I discovered in an abbreviated amount of time the drugs that were obviously good within two weeks. My experiences do not jive with popular theory. But I don't care about popular theory. All I care about is what actually works. Someone else can wait 6 weeks or longer if they wwant to, but not me. I would rather find that drug that will work well in a short amount of time. The right one always does.
John
Posted by MB on July 18, 2001, at 20:59:02
In reply to Re: Mirtazapine (Remeron), posted by JohnL on July 18, 2001, at 17:48:55
< snip >> There is a perfect drug for everyone...
< snip >
I'm curious as to why you believe this. I don't necessarily disagree, but I'm not sure why it should be taken for granted as being true...
Posted by Cecilia on July 19, 2001, at 4:26:09
In reply to Re: Mirtazapine (Remeron) » JohnL, posted by MB on July 18, 2001, at 20:59:02
>
> < snip >
>
> > There is a perfect drug for everyone...
>
> < snip >
>
> I'm curious as to why you believe this. I don't necessarily disagree, but I'm not sure why it should be taken for granted as being true...Maybe someday, with research based on the human genome, there will be a perfect drug for everyone, but there sure isn`t now. At least I haven`t found one and I`ve tried the following: Desipramine, Trazodone, Doxepin, Prozac, Nardil, Zoloft, Paxil, Wellbutin, Effexor, Imipramine, Amitriptyline, Serzone, Buspar, Atenolol, Anafranil, St. John`s Wort, Remeron, thyroid supplement, lithium, Nortriptyline, Celexa, Neurontin, SAM-e, Ritalin, Dexedrine, Zyprexa, Parnate, Xanax, Clonazepam, Amisulpride, Reboxetine, Luvox, and Adrafinil.
Posted by Elizabeth on July 19, 2001, at 10:57:16
In reply to Re: Mirtazapine (Remeron), posted by JohnL on July 18, 2001, at 17:48:55
> This is exactly why I do not subscribe to the popular practice of "giving it more time". In my experience, if there isn't some kind of hint of a good reaction in the first week or two, at least a hint, then I am quite willing to trash it and move on.
I generally like that technique, at least for most drugs (more on that in a minute). One thing I'd add is that for antidepressants in general, you should give them two weeks at a dose that could reasonably be expected to work.
> There is a perfect drug for everyone, but we'll never find it if we're forced to stay with something that isn't working out, or stay with something hoping it will work a month or two later.
This theory (that there's a "perfect drug for everyone") I don't buy so much!
> When a medicine is right, you'll know it without a doubt in a short amount of time.
This technique does produce false positives at times, though perhaps not false negatives so much. (I'm thinking of when I started taking Nardil and it seemed to work miracles but stopped working after less than a year and made things *worse* in the long run.)
I think that Buspar, for example (the subject of a couple of current threads), is a drug that takes longer to work even than most other antidepressants, and for which the recommended therapeutic dose range is too low. It has a reputation for being ineffective, but I wonder if that might not change if people started taking higher doses and giving it a longer time to work. That's an exceptional case, though; most of the time, I think you're right that
One other exception I can think of is Effexor. I say this because it has such a wide range of possibly effective doses; some people will notice improvement after 2 weeks on 75 mg, but others need 400 mg.
I'll be interested to find out whether the "JohnL Method" proves successful in my current trial (desipramine, which I've been taking for about 2 1/2 weeks -- though only about 7-10 days within the normal therapeutic dose range -- and which seems to be doing something already). Having tried so many exotic things, I would find it terribly ironic if the "right drug" for me proved to be a tricyclic!
-elizabeth
Posted by Elizabeth on July 19, 2001, at 10:58:51
In reply to Re: Perfect Drug for Everyone?, posted by Cecilia on July 19, 2001, at 4:26:09
> Maybe someday, with research based on the human genome, there will be a perfect drug for everyone, but there sure isn`t now. At least I haven`t found one and I`ve tried the following: Desipramine, Trazodone, Doxepin, Prozac, Nardil, Zoloft, Paxil, Wellbutin, Effexor, Imipramine, Amitriptyline, Serzone, Buspar, Atenolol, Anafranil, St. John`s Wort, Remeron, thyroid supplement, lithium, Nortriptyline, Celexa, Neurontin, SAM-e, Ritalin, Dexedrine, Zyprexa, Parnate, Xanax, Clonazepam, Amisulpride, Reboxetine, Luvox, and Adrafinil.
Hi...have you found any of those drugs at least somewhat helpful (though not perfect)? If so, what were the disadvantages of the ones that helped you?
-elizabeth
Posted by SalArmy4me on July 19, 2001, at 14:12:33
In reply to Re: Perfect Drug for Everyone? » Cecilia, posted by Elizabeth on July 19, 2001, at 10:58:51
> Hi...have you found any of those drugs at least somewhat helpful (though not perfect)? If so, what were the disadvantages of the ones that helped you?
>
> -elizabethI'd like to know that too. Is doxepin any good?
Posted by JohnL on July 19, 2001, at 15:47:04
In reply to Re: Perfect Drug for Everyone?, posted by Cecilia on July 19, 2001, at 4:26:09
I'm curious as to why you believe this. I don't necessarily disagree, but I'm not sure why it should be taken for granted as being true...
>
> Maybe someday, with research based on the human genome, there will be a perfect drug for everyone, but there sure isn`t now. At least I haven`t found one and I`ve tried the following: Desipramine, Trazodone, Doxepin, Prozac, Nardil, Zoloft, Paxil, Wellbutin, Effexor, Imipramine, Amitriptyline, Serzone, Buspar, Atenolol, Anafranil, St. John`s Wort, Remeron, thyroid supplement, lithium, Nortriptyline, Celexa, Neurontin, SAM-e, Ritalin, Dexedrine, Zyprexa, Parnate, Xanax, Clonazepam, Amisulpride, Reboxetine, Luvox, and Adrafinil.I'm sorry folks, I didn't mean to stir things up. I believe there is a great drug for everyone because I have seen it happen over and over, that's all, both here and at my pdoc's office. Granted, at this board we have especially tough cases, so a perfect drug seems like a pipedream. And sometimes it takes years to find that drug. Perhaps my choice of the word 'perfect' was a bit much, and I apologize for that.
In my own opinion the most critical thing to give anyone who is suffering is hope. Without hope, there is nothing. I lost count a long time ago of the desperate cases that eventually found their perfect, well, great, drug. And as I read the long list of drugs that we have all tried, the best ones are continually absent from those lists. All too often we spend years trying one antidepressant or mood stabilizer after another and accidentally ignore the wonderful drugs available in other psychiatric categories.
Anyway, again, I am sorry for stirring things up. Didn't mean to do that. I meant to give hope, based on real life experiences I have witnessed.
John
Posted by MB on July 19, 2001, at 18:02:26
In reply to Re: Perfect Drug for Everyone?, posted by JohnL on July 19, 2001, at 15:47:04
> I'm curious as to why you believe this. I don't necessarily disagree, but I'm not sure why it should be taken for granted as being true...
> >
> > Maybe someday, with research based on the human genome, there will be a perfect drug for everyone, but there sure isn`t now. At least I haven`t found one and I`ve tried the following: Desipramine, Trazodone, Doxepin, Prozac, Nardil, Zoloft, Paxil, Wellbutin, Effexor, Imipramine, Amitriptyline, Serzone, Buspar, Atenolol, Anafranil, St. John`s Wort, Remeron, thyroid supplement, lithium, Nortriptyline, Celexa, Neurontin, SAM-e, Ritalin, Dexedrine, Zyprexa, Parnate, Xanax, Clonazepam, Amisulpride, Reboxetine, Luvox, and Adrafinil.
>
> I'm sorry folks, I didn't mean to stir things up. I believe there is a great drug for everyone because I have seen it happen over and over, that's all, both here and at my pdoc's office. Granted, at this board we have especially tough cases, so a perfect drug seems like a pipedream. And sometimes it takes years to find that drug. Perhaps my choice of the word 'perfect' was a bit much, and I apologize for that.
Hey man, don't apologise on my account. I wasn't trying to imply that you were wrong for your belief, I just wanted to discuss it :-) I used to say the same thing about there being a perfect drug out there waiting for me...and then I thought, "what if it's *not* out there, what if it hasn't been developed yet..." So I decided that maybe there *is* a "cure" out there, maybe not (for me, I mean).
> In my own opinion the most critical thing to give anyone who is suffering is hope. Without hope, there is nothing. I lost count a long time ago of the desperate cases that eventually found their perfect, well, great, drug. And as I read the long list of drugs that we have all tried, the best ones are continually absent from those lists. All too often we spend years trying one antidepressant or mood stabilizer after another and accidentally ignore the wonderful drugs available in other psychiatric categories.
>
> Anyway, again, I am sorry for stirring things up. Didn't mean to do that. I meant to give hope, based on real life experiences I have witnessed.
> John
John, I think your optomism is refreshing. Again, please don't apologize on my account. I am a chronic pessimist; that's part of my, well, "neurosis" if you want to call it that. I could probably use any hope you throw my way. Thanks. Peace
Posted by Elizabeth on July 19, 2001, at 22:37:42
In reply to Re: Perfect Drug for Everyone?, posted by SalArmy4me on July 19, 2001, at 14:12:33
> I'd like to know that too. Is doxepin any good?
I tried it once (for insomnia, not depression). It's *very* sedating. Its middle ring is kind of interesting because it has an oxygen in it (IIRC). But it's pretty much Just Another Tricyclic.
-elizabeth
Posted by Cecilia on July 20, 2001, at 3:39:17
In reply to Re: Perfect Drug for Everyone?, posted by JohnL on July 19, 2001, at 15:47:04
> I'm curious as to why you believe this. I don't necessarily disagree, but I'm not sure why it should be taken for granted as being true...
> >
> > Maybe someday, with research based on the human genome, there will be a perfect drug for everyone, but there sure isn`t now. At least I haven`t found one and I`ve tried the following: Desipramine, Trazodone, Doxepin, Prozac, Nardil, Zoloft, Paxil, Wellbutin, Effexor, Imipramine, Amitriptyline, Serzone, Buspar, Atenolol, Anafranil, St. John`s Wort, Remeron, thyroid supplement, lithium, Nortriptyline, Celexa, Neurontin, SAM-e, Ritalin, Dexedrine, Zyprexa, Parnate, Xanax, Clonazepam, Amisulpride, Reboxetine, Luvox, and Adrafinil.
>
> I'm sorry folks, I didn't mean to stir things up. I believe there is a great drug for everyone because I have seen it happen over and over, that's all, both here and at my pdoc's office. Granted, at this board we have especially tough cases, so a perfect drug seems like a pipedream. And sometimes it takes years to find that drug. Perhaps my choice of the word 'perfect' was a bit much, and I apologize for that.
>
> In my own opinion the most critical thing to give anyone who is suffering is hope. Without hope, there is nothing. I lost count a long time ago of the desperate cases that eventually found their perfect, well, great, drug. And as I read the long list of drugs that we have all tried, the best ones are continually absent from those lists. All too often we spend years trying one antidepressant or mood stabilizer after another and accidentally ignore the wonderful drugs available in other psychiatric categories.
>
> Anyway, again, I am sorry for stirring things up. Didn't mean to do that. I meant to give hope, based on real life experiences I have witnessed.
> JohnSorry if I sounded critical, John. Hope IS incredibly important. It`s just so frustrating-it took me a long time to get brave enough to try overseas meds, but I finally ordered Amisulpride and Adrafinil because of your frequent praise of them and was disappointed when hope was again shot down-just 2 more meds with unpleasant side effects and no benefit.
Posted by Cecilia on July 20, 2001, at 4:39:17
In reply to Re: Perfect Drug for Everyone? » Cecilia, posted by Elizabeth on July 19, 2001, at 10:58:51
> > Maybe someday, with research based on the human genome, there will be a perfect drug for everyone, but there sure isn`t now. At least I haven`t found one and I`ve tried the following: Desipramine, Trazodone, Doxepin, Prozac, Nardil, Zoloft, Paxil, Wellbutin, Effexor, Imipramine, Amitriptyline, Serzone, Buspar, Atenolol, Anafranil, St. John`s Wort, Remeron, thyroid supplement, lithium, Nortriptyline, Celexa, Neurontin, SAM-e, Ritalin, Dexedrine, Zyprexa, Parnate, Xanax, Clonazepam, Amisulpride, Reboxetine, Luvox, and Adrafinil.
>
> Hi...have you found any of those drugs at least somewhat helpful (though not perfect)? If so, what were the disadvantages of the ones that helped you?
>
> -elizabethRight now I`m taking 300 mg/day of Trazodone, 20 mg/day of Celexa, 1 mg/day of clonazepam and 100 mg/day of Atenolol(prescribed for blood pressure but maybe helps a little with anxiety). Also temazepam or Ambien "prn" for sleep (trazodone doesn`t make me sleepy at all). I really don`t know if anything (except the sleeping pills) really does anyhing or not. Until a year ago I wasn`t on anything regularly except the Atenolol, I just kept trying each new med and giving it up because it didn`t help, or because the side effects were too bad for an adequate trial-the case with most of the tricyclics. Then my doctor told me there wasn`t anything left to try except ECT, which put me into the worst panicky depression of my life and I`ve probably been depressed since childhood-also anxious- I think I was born anxious. For 3 monts I felt like I was trapped beside a steep cliff with a wild fire roaring beside me-which was I more afraid of? ECT (and people at work finding out about it) or suicide. I got my doctor to prescribe Xanax(later changed to clonazepam) which was the 1st psychiatric drug(other than sleeping pills) that I ever felt had done anything for me at all. Then I decided to add Trazodone which I`d tried ten years ago but only at a low dose, ( because the doctor who prescribed it at the time was such a jerk that I wasn`t willing to go back to have the prescription increased). With the trazodone I gradually got over that horrible panic, but I really don`t know if it WAS the trazodone or simply giving up the ECT idea. Later, I added Celexa, which I`d previously tried by itself, with buspar, with wellbutrin,and
with Neurontin, without ever feeeling it was doing anything, but I did feel more anxious when I went off it so I decided maybe it WAS doing something. So, I`m back to my baseline chronic depression but now on several drugs which I`m afraid to go off of in case they ARE helping.
Posted by Sherry on July 20, 2001, at 8:28:36
In reply to Re: Mirtazapine (Remeron) » JohnL, posted by Elizabeth on July 19, 2001, at 10:57:16
Hi Elizabeth,
I had the exact same experience with Parnate,(poop out within 6 months and a worsened imbalance). I'm getting ready to try Nardil after 2 years of not taking anything becuase of the fear of making things worse as with Parnate. I would love to hear of your experience with Nardil, and in what ways it made things worse for you.
When Parnate pooped out for me,(BTW, it's the only thing that's ever even worked partially for me.) it took a toll on my cognitive abilities worse than anything. Since I have so little of my intelligence left( I used to consider myself slightly above average in certain aspects of my intelligence) and a short term memory that is horrible, I'm reluctant to try anything else.
I feel like Parnate messed up my carbohydrate metabolism because I feel differently after every meal. I also feel differently depending on the level of carbos in my diet. Within 2.5 hours of eating, I can actually feel insulin levels go down because I lose the ability to thing clearly. For example, it's difficult to think about how to solve a math problem. I have difficulty finding words, etc., etc. On the other hand, after eating meals, I have difficulty concentrating. I can think clearly as long as I keep a fairly high level of carbs in my diet. I have Parnate to thank for this.
Anyway, if you would share your experience with me I would really apreciate it.
Sherry
> > This is exactly why I do not subscribe to the popular practice of "giving it more time". In my experience, if there isn't some kind of hint of a good reaction in the first week or two, at least a hint, then I am quite willing to trash it and move on.
>
> I generally like that technique, at least for most drugs (more on that in a minute). One thing I'd add is that for antidepressants in general, you should give them two weeks at a dose that could reasonably be expected to work.
>
> > There is a perfect drug for everyone, but we'll never find it if we're forced to stay with something that isn't working out, or stay with something hoping it will work a month or two later.
>
> This theory (that there's a "perfect drug for everyone") I don't buy so much!
>
> > When a medicine is right, you'll know it without a doubt in a short amount of time.
>
> This technique does produce false positives at times, though perhaps not false negatives so much. (I'm thinking of when I started taking Nardil and it seemed to work miracles but stopped working after less than a year and made things *worse* in the long run.)
>
> I think that Buspar, for example (the subject of a couple of current threads), is a drug that takes longer to work even than most other antidepressants, and for which the recommended therapeutic dose range is too low. It has a reputation for being ineffective, but I wonder if that might not change if people started taking higher doses and giving it a longer time to work. That's an exceptional case, though; most of the time, I think you're right that
>
> One other exception I can think of is Effexor. I say this because it has such a wide range of possibly effective doses; some people will notice improvement after 2 weeks on 75 mg, but others need 400 mg.
>
> I'll be interested to find out whether the "JohnL Method" proves successful in my current trial (desipramine, which I've been taking for about 2 1/2 weeks -- though only about 7-10 days within the normal therapeutic dose range -- and which seems to be doing something already). Having tried so many exotic things, I would find it terribly ironic if the "right drug" for me proved to be a tricyclic!
>
> -elizabeth
Posted by Sherry on July 20, 2001, at 8:36:07
In reply to Re: Mirtazapine (Remeron), posted by Sherry on July 20, 2001, at 8:28:36
Hi All,
I'm sorry, but as you have all discovered by now the previous post was for Elizabeth and any one else who has had a similar experience with an antidepressant.Sherry
> Hi Elizabeth,
>
> I had the exact same experience with Parnate,(poop out within 6 months and a worsened imbalance). I'm getting ready to try Nardil after 2 years of not taking anything becuase of the fear of making things worse as with Parnate. I would love to hear of your experience with Nardil, and in what ways it made things worse for you.
>
> When Parnate pooped out for me,(BTW, it's the only thing that's ever even worked partially for me.) it took a toll on my cognitive abilities worse than anything. Since I have so little of my intelligence left( I used to consider myself slightly above average in certain aspects of my intelligence) and a short term memory that is horrible, I'm reluctant to try anything else.
>
> I feel like Parnate messed up my carbohydrate metabolism because I feel differently after every meal. I also feel differently depending on the level of carbos in my diet. Within 2.5 hours of eating, I can actually feel insulin levels go down because I lose the ability to thing clearly. For example, it's difficult to think about how to solve a math problem. I have difficulty finding words, etc., etc. On the other hand, after eating meals, I have difficulty concentrating. I can think clearly as long as I keep a fairly high level of carbs in my diet. I have Parnate to thank for this.
>
> Anyway, if you would share your experience with me I would really apreciate it.
>
> Sherry
>
>
>
> > > This is exactly why I do not subscribe to the popular practice of "giving it more time". In my experience, if there isn't some kind of hint of a good reaction in the first week or two, at least a hint, then I am quite willing to trash it and move on.
> >
> > I generally like that technique, at least for most drugs (more on that in a minute). One thing I'd add is that for antidepressants in general, you should give them two weeks at a dose that could reasonably be expected to work.
> >
> > > There is a perfect drug for everyone, but we'll never find it if we're forced to stay with something that isn't working out, or stay with something hoping it will work a month or two later.
> >
> > This theory (that there's a "perfect drug for everyone") I don't buy so much!
> >
> > > When a medicine is right, you'll know it without a doubt in a short amount of time.
> >
> > This technique does produce false positives at times, though perhaps not false negatives so much. (I'm thinking of when I started taking Nardil and it seemed to work miracles but stopped working after less than a year and made things *worse* in the long run.)
> >
> > I think that Buspar, for example (the subject of a couple of current threads), is a drug that takes longer to work even than most other antidepressants, and for which the recommended therapeutic dose range is too low. It has a reputation for being ineffective, but I wonder if that might not change if people started taking higher doses and giving it a longer time to work. That's an exceptional case, though; most of the time, I think you're right that
> >
> > One other exception I can think of is Effexor. I say this because it has such a wide range of possibly effective doses; some people will notice improvement after 2 weeks on 75 mg, but others need 400 mg.
> >
> > I'll be interested to find out whether the "JohnL Method" proves successful in my current trial (desipramine, which I've been taking for about 2 1/2 weeks -- though only about 7-10 days within the normal therapeutic dose range -- and which seems to be doing something already). Having tried so many exotic things, I would find it terribly ironic if the "right drug" for me proved to be a tricyclic!
> >
> > -elizabeth
Posted by Lorraine on July 20, 2001, at 9:53:26
In reply to Re: Mirtazapine (Remeron), posted by Sherry on July 20, 2001, at 8:28:36
> > > I feel like Parnate messed up my carbohydrate metabolism because I feel differently after every meal. I also feel differently depending on the level of carbos in my diet. Within 2.5 hours of eating, I can actually feel insulin levels go down because I lose the ability to thing clearly. For example, it's difficult to think about how to solve a math problem. I have difficulty finding words, etc., etc. On the other hand, after eating meals, I have difficulty concentrating. I can think clearly as long as I keep a fairly high level of carbs in my diet. I have Parnate to thank for this.
Sherry:Just jumping in with my 2c. The type of sugar swings you are talking about look to me like they would respond to a low carb approach. This gets you off the carb cycle stuff--feeling spacey after eating etc. What you would want to do is to try to keep your blood sugar fairly constant by eating the same amount of carbs per meal. I am low carb and I would guess I eat between 10-20 gms of carbs a meal (I am not dieting.) My FIL is diabetic and they recently put him on a steady state mod. carb diet--he is to eat 60 carbs per meal no more, no less. Anyway, might be worth a try...
Posted by Elizabeth on July 20, 2001, at 13:47:36
In reply to Re: Perfect Drug for Everyone?-Elizabeth, posted by Cecilia on July 20, 2001, at 4:39:17
> Right now I`m taking 300 mg/day of Trazodone, 20 mg/day of Celexa, 1 mg/day of clonazepam and 100 mg/day of Atenolol(prescribed for blood pressure but maybe helps a little with anxiety).
Interesting mix. One doesn't see trazodone used as an AD that often anymore.
Atenolol can help with jittery feelings, palpitations, etc., but it's not so good for the ruminative, "can't-stop-thinking" sort of anxiety.
> Also temazepam or Ambien "prn" for sleep (trazodone doesn`t make me sleepy at all).
I can't imagine trazodone being a good long-term sleeping pill. When I tried to use it that way, I just kept developing tolerance and having to increase the dose.
> I really don`t know if anything (except the sleeping pills) really does anyhing or not.
Uh-oh!
> Until a year ago I wasn`t on anything regularly except the Atenolol, I just kept trying each new med and giving it up because it didn`t help, or because the side effects were too bad for an adequate trial-the case with most of the tricyclics.
That was my problem with the tricyclics too. But desipramine seems to be doing me some good without any significant side effects. For various reasons, I'd been down on the tricyclics and I didn't really expect desipramine to work, so this comes as a pleasant surprise. Did you manage to stick it out with desipramine?
> Then my doctor told me there wasn`t anything left to try except ECT, which put me into the worst panicky depression of my life and I`ve probably been depressed since childhood-also anxious- I think I was born anxious.
Me too. :-( I didn't have phobias or anything, but I was always very nervous and had (still have) very bad performance anxiety.
Can you say more about your depression and anxiety? Like, what sort of symptoms do you have, and have any of your symptoms been alleviated or worsened by any of the drugs on your list?
I don't think there's *ever* a point where you've tried so many medications that ECT is the only thing left. There are always weird, off-label things you can use. It's not surprising to see that you haven't tried an opioid, but given the large number of things that haven't worked for you, though, it might be worthwhile to look into the possibility, if you think there's a chance that your doctor would be willing. (I'd recommend doing some research before bringing it up, though.)
> ECT (and people at work finding out about it) or suicide.
Suicide isn't scary, but whenever I think about it I feel guilty. You know?
> I got my doctor to prescribe Xanax(later changed to clonazepam) which was the 1st psychiatric drug(other than sleeping pills) that I ever felt had done anything for me at all.
Some depressed people respond to Xanax, especially in high doses, and it's a great anxiolytic. In a situation like yours, where the depression might be secondary to anxiety, a benzodiazepine would seem like a logical thing to try. Do you find Klonopin equally helpful?
> Then I decided to add Trazodone which I`d tried ten years ago but only at a low dose, ( because the doctor who prescribed it at the time was such a jerk that I wasn`t willing to go back to have the prescription increased).
*ouch* :-)
> With the trazodone I gradually got over that horrible panic, but I really don`t know if it WAS the trazodone or simply giving up the ECT idea.
Probably a little of both, I'd think.
> Later, I added Celexa, which I`d previously tried by itself, with buspar, with wellbutrin,and
> with Neurontin, without ever feeeling it was doing anything, but I did feel more anxious when I went off it so I decided maybe it WAS doing something.SSRIs can be subtle (to put it mildly). How does Celexa compare to the other ones, since you've tried *all* of them? (I only ever tried Prozac, Zoloft, and Paxil.)
> So, I`m back to my baseline chronic depression but now on several drugs which I`m afraid to go off of in case they ARE helping.
Oh dear. Looking over your list, I see that Nardil is on it. Did that do anything for you? IMO, it's the best AD for anxiety, although it does have some annoying side effects. And what about Neurontin? I tried it briefly once, and it reminded me of Xanax. I got scared and stopped taking it because it was giving me the munchies, though. (I gained 50 lbs on Nardil and only was able to lose the weight because I was so depressed when I stopped taking it; I'm not interested in going through that again!) I also notice that you've tried stimulants. What happened with those?
Also, 1 mg/day of clonazepam really isn't all that much. You could probably increase it safely if your doctor says it's okay to.
Maybe there isn't a perfect drug for you, but I bet that there's a combination that will make things better.
-elizabeth
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.