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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by katekite on July 20, 2002, at 12:18:02
I took remeron once before, years ago, at a dose of 45 mg, for depression. I took one dose and fell asleep with a piece of pizza in my mouth. Woke up 18 hrs later and was in a foggy daze for 2 days. Swore I would never try it again.
But the years have passed and my pdoc did not want to give me trimipramine, so I said why not. Well now I know why not. I took 7.5 mg last night and went to sleep only to wake at 1:30am with hot flashes (which had been better since Monday on BC pills). I slept fitfully (about the same as benadryl). Got up at 10 (later than normal) and am in a mild foggy haze and my temperature sensation is still off. My eyes and mouth are sticky dry from the antihistamine effect. So I have answered the question: is there a remeron dose that induces a hypnotic daze but does not improve sleep?
Yes -- it is possible to take a dose of remeron that does not help sleep but does screw everything else up.
Posted by fachad on July 20, 2002, at 17:27:35
In reply to slept badly on remeron, posted by katekite on July 20, 2002, at 12:18:02
katekite,
I answered your trimipramine post, below, before seeing this one.
Why won't you dr rx trimipramine? Was it something with hormone levels?
Anyway, a couple observations. First, as I said below, theoretically, Remeron should not be drying because that is usually caused by anti-cholinergic effects, not anti-histamine effects. But in reality, you woke up dry - so it must have that effect on you.
Also, I've found that most sleep meds take a few days to really start working well. Somehow, my body needs to get used to them and get used to the idea of sleeping well. This was even true for benzos in my case. So you may need a few days to adjust to the Remeron.
Finally, if trimipramine is out, what about doxepin? It is a little more potent that trimipramine, but does not have the D2 activity of trimipramine and the associated hormonal consequences. It's also generic, where trimipramine is Surmontil brand only.
Doxepin comes in 10 mg capsules. I used to open those up, stir vigorously in a tall glass of water, then drink half the glass for an approximate dose of 5 mg.
The smallest Remeron tablet is 15 mg, scored. So 7.5 mg is easy, just snap it in half. But to get a lower does than 7.5 will be clumsy. You could try to use a tablet splitter to cut the 7.5 mg halves into 3.75 mg slivers, and that might be the perfect dose for you.
Let us know what you end up doing.
> I took remeron once before, years ago, at a dose of 45 mg, for depression. I took one dose and fell asleep with a piece of pizza in my mouth. Woke up 18 hrs later and was in a foggy daze for 2 days. Swore I would never try it again.
>
> But the years have passed and my pdoc did not want to give me trimipramine, so I said why not. Well now I know why not. I took 7.5 mg last night and went to sleep only to wake at 1:30am with hot flashes (which had been better since Monday on BC pills). I slept fitfully (about the same as benadryl). Got up at 10 (later than normal) and am in a mild foggy haze and my temperature sensation is still off. My eyes and mouth are sticky dry from the antihistamine effect. So I have answered the question: is there a remeron dose that induces a hypnotic daze but does not improve sleep?
>
> Yes -- it is possible to take a dose of remeron that does not help sleep but does screw everything else up.
Posted by katekite on July 20, 2002, at 18:07:06
In reply to Re: slept badly on remeron » katekite, posted by fachad on July 20, 2002, at 17:27:35
Yeah the doc didn't want to mess up hormone tests. But I think this is dumb reasoning because I just started the BC pill which messes up hormones, I will have to wash out of everything before tests resume anyhow. But I am less interested in trying trimip. now that I've heard that it has significant anti-cholinergic effects.
Since Remeron worsens my hot flashes I will not take it again. Especially since the 7.5 mg dose was not enough to make me sleep better than without it but my eyes still don't quite focus. I would have been better off with Vistoril or Benadryl.
What are some alternatives that have no anti-cholinergic activity? Clonidine maybe? Any other ideas?
thanks -- kate
Posted by fachad on July 20, 2002, at 19:03:58
In reply to what do you think about clonidine, posted by katekite on July 20, 2002, at 18:07:06
>But I am less interested in trying trimip. now that I've heard that it has significant anti-cholinergic effects.
I don't get any anti-cholinergic side effects from trimipramine as long as I keep the dose low. Even at 12.5 mg I did not get any drying.
Chole was being tortured by anti-cholinergic effects from Amitriptyline and they were much less when she switched to doxepin.
Keeping the dose low enough is the key.
As for clonidine, I considered that myself, but I don't think it's a good idea because you are messing with blood pressure regulation, and that could precipitate problems later on.
I still think very low dose TCAs are the best sleep meds, but other alternatives with little to no anti-cholinergic activity include trazodone, Ambien, Sonata and of course the benzodiazepines.
Popular benzos for sleep include Lorazepam, Temazepam, and Klonopin.
> Yeah the doc didn't want to mess up hormone tests. But I think this is dumb reasoning because I just started the BC pill which messes up hormones, I will have to wash out of everything before tests resume anyhow. But I am less interested in trying trimip. now that I've heard that it has significant anti-cholinergic effects.
>
> Since Remeron worsens my hot flashes I will not take it again. Especially since the 7.5 mg dose was not enough to make me sleep better than without it but my eyes still don't quite focus. I would have been better off with Vistoril or Benadryl.
>
> What are some alternatives that have no anti-cholinergic activity? Clonidine maybe? Any other ideas?
>
> thanks -- kate
Posted by jaby on July 21, 2002, at 12:37:42
In reply to slept badly on remeron, posted by katekite on July 20, 2002, at 12:18:02
There are some strange dose dependent effects for remeron. I know when I took it my dr. said it would make me super sleepy at the lower doses, so I was to ramp it up quickly. You would think that more of a sedating med would equal more sedation, but apparently that's not the case. It worked well for my anxiety, but made it si hard to wake up in the morning. I also gained 40 on it and I don't gain much weight. In comparison to what others say, however, I was able to lose it pretty quickly. Good luck with whatever you're using it for.
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