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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 Molybdenum on January 27, 2008, at 23:50:14
Hi,
My Dr has me on 225mg mirtazapine & 600mg venlafaxine. I can't find any references on the inet re such large doses. It does seem to be helping the depression though.
I've been on the venlafaxine at this dose for 6 months but we've been upping the mirtazapine every few months when it seems to lose it's ability to help me sleep.
Does anyone have any experience with these levels? The main thing I am concerned with is how I would ever be able to come of this brew as I imagine tapering down could take forever.
Thanks.
Posted by torachan on January 28, 2008, at 7:38:59
In reply to Any limits to venlafaxine + mirtazapine dosages???, posted by Molybdenum on January 27, 2008, at 23:50:14
225 mg of mirtazapine??? I'm currently on 30 mg of remeron but am considering dropping it after a month or so of usage since it seems to give me this constant foggy headed feeling and blurry vision. Anyone else have this experience? I read somewhere the max dose for rem was 90 mg.
I've also used Effexor in the past at around 150 mg a day, but I've heard doses can go as high as about 400-500 mg's.
I'd say try another drug in the case of remeron if it doesn't help you sleep. Perhaps that high dose is giving you too powerful a norepinephrine kick.
Posted by Molybdenum on January 28, 2008, at 19:59:20
In reply to Re: Any limits to venlafaxine + mirtazapine dosage, posted by torachan on January 28, 2008, at 7:38:59
I understand that the soporific effects of Remeron (mirtazapine) are supposed to be more pronounced at the lower end of the dosage spectrum (15mg?) but with me, it has always really helped me to get a good 8 hrs sleep. Trouble is that the effect seems to wear off every few months. When I up the mirtazapine, I get the good sleep again. The Dr said it isn't supposed to work that way. "So sue me", I said..... Although he acknowledges he has no evidence to support such high doses as being "more effective", he also told me that they are relatively no-toxic, so there's little danger of my head exploding, etc. ;)
I take the venlafaxine at 6pm & the mirtazapine at 8pm and I'm generally asleep by 9:30pm.
I used to be quite open to trying different anti-depressants but now that this combo is working & also 'cos the dose is so high, I'm scared that changing now could push me back down & over the edge. :(
I've never had the blurred vision but I did feel a bit sedated on it to start with. Maybe if you stick it out a few more weeks, take it earlier in the evening or even up the dose, the foggyheadedness might go away. ;)
> 225 mg of mirtazapine??? I'm currently on 30 mg of remeron but am considering dropping it after a month or so of usage since it seems to give me this constant foggy headed feeling and blurry vision. Anyone else have this experience? I read somewhere the max dose for rem was 90 mg.
>
> I've also used Effexor in the past at around 150 mg a day, but I've heard doses can go as high as about 400-500 mg's.
>
> I'd say try another drug in the case of remeron if it doesn't help you sleep. Perhaps that high dose is giving you too powerful a norepinephrine kick.
>
>
Posted by tensor on January 29, 2008, at 0:53:08
In reply to Any limits to venlafaxine + mirtazapine dosages???, posted by Molybdenum on January 27, 2008, at 23:50:14
Are you sure you have your figures right?
Posted by Molybdenum on January 30, 2008, at 4:28:54
In reply to Re: Any limits to venlafaxine + mirtazapine dosage » Molybdenum, posted by tensor on January 29, 2008, at 0:53:08
Well, let's see:
6pm: 4x150mg Effexor XR, 1x40mg Somac, 2x3mg melatonin SR, 1x16mg Atacand (the Dr and I like to blame the Effexor for the high blood pressure).
8pm: 5x45mg Avanza (or 7&1/2 of the 30mg tabs if I have any of them left), 1x12.5mg Stilnox CR, 1x500mcg clonazepam (I have bad central sleep apnoea and the little bit of clonazepam is supposed to suppress my hyperventilation that disturbs my sleep).
9pm: hopefully I am feeling sleepy by now, else take another Stilnox or if I'm bored, 2xDigesic and/or 500mcg Xanax. I used to add a very tall mix of vodka & orange juice to that, but hey - you shouldn't drink acid going to bed if you're taking Somac anyway. Plus of course alcohol is not good for you :)
During the day I used to take up to 8x10mg Ritalin spread nicely from 7am to 2pm (I always wanted a big jeweled ring that I could flip open to expose the little white tabs, but I know it would have freaked out the office). *sigh* Actually, the modafinil were a lot better but they're too expensive for me now. A lot smoother than Ritalin. And I don't take either these days 'cos they make me optimistic for a few hours, which as it turns out is unrealistic for me these days - and we can't have that. I mean, that'll make you sad for sure.
It's true that I sometimes look at the 6pm pile & wonder if I've forgotten something. On rare occasions I have had to use both the 45mg & 30mg mirtazapine to make up the 225mg, 'cos I'd run out of the 45s. I admit to getting out the calculator then. :)
Worst is waking up at 3am, taking a couple of Digesic & a Xanax & STILL not getting back to sleep. Hey - that was last night.... ;)
Anybody want my liver?
So there's my profile for the world to see. I'm curious if anyone else is having such high doses of the ADs. My Dr doesn't think it's a problem. My real concern is the thought of ever coming off them. Eck...~!
The ADs have really been working for me. I used to be on 80mg Celexa but it lost it's effectiveness & I tapered & went off all ADs - only to discover that I was better on SOMETHING. Hence the venlafaxine & mirtazapine mix.
This is the end of the thread.
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