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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by jamesdean on October 1, 2002, at 23:52:06
I've been on Remeron for only 7 weeks and feel that I can't stand it a moment longer. I feel like it is making my anxiety worse. It's too late to call my doctor and I don't want to take my dose tonight. If you know anything about abruptly discontinuing Remeron, please let me know ASAP! I appreciate it. BTW, some background, I have suffered bouts of depression since I was 11, anxiety problems since I was around 20. Thankfully, I don't have any worse psychiatric problems. Oh, and I'm 24. Thanks!!!
Posted by BrittPark on October 2, 2002, at 1:35:19
In reply to stopping Remeron abruptly, posted by jamesdean on October 1, 2002, at 23:52:06
It is never wise to suddenly discontinue an AD. You may find that if you skip your dose tonight you'll feel even worse than you do now. I don't know what your dosage is but remeron is a somewhat funny AD. At doses up to 30mg it is sedating. At larger doses it is activating and could aggravate anxiety.
If you feel you have to stop taking remeron NOW, start by dropping say 25% of your dosage tonight. Then talk to your doctor about a schedule for discontinuing.
Since you are suffering from severe anxiety it might make sense for you to be taking a benzo of some sort (xanax and klonopin are currently fashionable). Benzos are front line treatment for anxiety and they are very safe.
Don't worry (easy to say isn't it) things will get better,
Britt
Posted by jamesdean on October 2, 2002, at 1:51:50
In reply to Re: stopping Remeron abruptly » jamesdean, posted by BrittPark on October 2, 2002, at 1:35:19
I have been taking one 2mg tablet of klonopin for a couple of weeks. It does help, but lately, I've been feeling so much worse. I also have suffered from severe migraines my entire life so I'm on methadone for that. The problem is my weight gain. I've been the same weight for like 8 years and I was tried on Elavil for migraine prevention and Effexor XR for anxiety/depression. Boom!! I began my rapid, now 35 pound gain. I loved the Effexor. It worked great for my anxiety. I hardly ever had breakthrough anxiety and when I did klonopin took it away. But I had no sex drive or ability to orgasm so I switched to Remeron and lost the Elavil. More weight gain. Less sexual side effects. I don't know what to do next. Klonopin at 2mg doesn't seem to be helping. Basically, at my last pdoc visit, we came up with 3 options if I was still wanted a change in meds. 1. Switch to Lexapro. 2. Add Wellbutrin to help with energy, weight loss, and sex drive. 3. Stop Remeron and see how I do with just the klonopin. Any suggestions?
Posted by wsj on October 2, 2002, at 3:04:57
In reply to stopping Remeron abruptly, posted by jamesdean on October 1, 2002, at 23:52:06
i think you will have trouble sleeping if you don't taper.
wsj
Posted by Ritch on October 2, 2002, at 9:09:20
In reply to Re: stopping Remeron abruptly, posted by jamesdean on October 2, 2002, at 1:51:50
> I have been taking one 2mg tablet of klonopin for a couple of weeks. It does help, but lately, I've been feeling so much worse. I also have suffered from severe migraines my entire life so I'm on methadone for that. The problem is my weight gain. I've been the same weight for like 8 years and I was tried on Elavil for migraine prevention and Effexor XR for anxiety/depression. Boom!! I began my rapid, now 35 pound gain. I loved the Effexor. It worked great for my anxiety. I hardly ever had breakthrough anxiety and when I did klonopin took it away. But I had no sex drive or ability to orgasm so I switched to Remeron and lost the Elavil. More weight gain. Less sexual side effects. I don't know what to do next. Klonopin at 2mg doesn't seem to be helping. Basically, at my last pdoc visit, we came up with 3 options if I was still wanted a change in meds. 1. Switch to Lexapro. 2. Add Wellbutrin to help with energy, weight loss, and sex drive. 3. Stop Remeron and see how I do with just the klonopin. Any suggestions?
I would go with (3), because if you feel a lot better *without* the Remeron (and Klon. alone works just fine), then you will know it wasn't a med for you and you won't have to revisit that one again for any reason. Remeron has about a 35 hour half-life. If your pdoc listed stopping it as an option, you might try taking the same dose every *other* night until you get a chance to see him. I would get a mild positive "rebound" effect when I stopped Remeron (that lasted a few days).
Posted by jamesdean on October 2, 2002, at 16:16:51
In reply to Re: stopping Remeron abruptly » jamesdean, posted by Ritch on October 2, 2002, at 9:09:20
Thanks so much for the responces. If anyone else has a thought, please let me know. BTW, some of the restlessness and anxiety went down slightly with a rough cut from 45mgs to 30/34mgs. However, I still didn't sleep a wink last night. I couldn't even relax enough to lie in bed. AND, my pdoc called and postponed my appt. !!! I still am not sure what to do. Another problem I have, complete and total inability to make decisions.
Posted by Ritch on October 2, 2002, at 22:06:48
In reply to Re: stopping Remeron abruptly, posted by jamesdean on October 2, 2002, at 16:16:51
> Thanks so much for the responces. If anyone else has a thought, please let me know. BTW, some of the restlessness and anxiety went down slightly with a rough cut from 45mgs to 30/34mgs. However, I still didn't sleep a wink last night. I couldn't even relax enough to lie in bed. AND, my pdoc called and postponed my appt. !!! I still am not sure what to do. Another problem I have, complete and total inability to make decisions.
Try dropping the dose to 15mg. I had some paradoxical insomnia with Remeron at 30mg the last time I tried it.
Posted by sleepy lizard on October 3, 2002, at 0:51:41
In reply to Re: stopping Remeron abruptly, posted by jamesdean on October 2, 2002, at 1:51:50
I was taking Effexor XR and added Wellbutrin SR to help the sexual side effects and it was disasterous for me. I got panicky, dry mouth, emotional instability, numb skin, body jerks, exagerated reflexes. I think it was too much norepinephrine. I have no idea how you will respond. But I just had to get off of it myself. After a month without either I finally am free of withdrawal shocks and my emotions have stabilized. Sex works again too. I'm just thinking that adding Wellbutrin to Remeron may not be a good idea because of my experience with combining with Effexor which also increases seretonin (and norepinephrine). Could you change the dose of Remeron? I heard 30-45 mg is more activating, and 15 mg is more sedating (because of histamine effects predominate at lower doses).
Posted by jamesdean on October 4, 2002, at 0:42:44
In reply to Re: stopping Remeron abruptly, posted by sleepy lizard on October 3, 2002, at 0:51:41
Thanks, I was started on 30mgs and was extremly sleepy all day and slept nightly about 12 hours. After 10 days, I upped it to 45mgs which seemed fine for a couple of weeks until I became worried about my weight issue. So, at my last appointment, I discussed this with the pdoc, and he said we could make a change if I still couldn't lose any weight in a month.
I've read that the weight gain is more likely at lower doses, but now since I've been so anxious and irritable even on 30mgs, I just want OFF. I've called the pdoc to ask if I can safely just stop, but he hasn't returned my phone call and my appt isn't until the 11th. I don't think Remeron is helping my anxiety and my therapist and family don't think I'm depressed anymore. I guess the only way to find out is to stop taking antidepressants and see if I am depressed.
I was thinking of the Effexor XR/Wellbutrin thing for the same reasons sleepylizard tried but now agree that wouldn't be a good idea. So, now the question is, lower the Rem. more until I see the pdoc or just stop cold turkey. I definately need something for the anxiety, 2mgs klonopin isn't working anymore. I would love to not be on anything right now. My emotions are all over the place, but more in the anxious and irritable way, not overly sad,... I'm thinking the Rem is making it worse?
Posted by sleepy lizard on October 9, 2002, at 1:48:14
In reply to Re: stopping Remeron abruptly, posted by jamesdean on October 4, 2002, at 0:42:44
Yes, the emotions were all over the place during the several months I was on Celexa, Effexor, Wellbutrin. I think that the whole time there was never a steady state of medications in my system, they were always changing. It has taken about a month of cold turkey from Effexor/Wellbutrin to get to a stable emotional state (without constant crying, despair, etc.) but now I am angry a lot more. It seems that the anxiety is harder to handle than sadness. (But probably not to the suisidal!) Maybe you are still having withdrawals that are destabilizing you. Withdrawal leave the seretonin levels low and causes many emotional symptoms.
This is the end of the thread.
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