Posted by Mitch on June 15, 2001, at 23:33:51
In reply to Re: Questions About Adrafinil?, posted by PaulB on June 15, 2001, at 12:32:57
> > > Given that Remeron enhances noradrenaline at the alpha-1 post-synaptic receptors I shouldnt think Adrafinil would help with Remeron histamine induced sedation. It was my impression that Remeron sedation decreased after the antidepressant started working.
> >
> > I mentioned that because I have noted that Remeron (and atypical and conventional antipsychotics) have *antagonist* properties (which are secondary to their intended receptors) at alpha-1 noradrenergic receptors which *causes* orthostatic hypotension and dizziness (not necessarily drowsiness-H1 receptor activity). I was thinking that if the dizziness component and *possibly* reduced alertness due to the a1 blockade was reversed with an a1 *agonist*, then meds such as Remeron might be more *tolerable* and more *effective*. Allowing the Remeron to function primarily from the 5-HT2 and 5HT-3 antagonism and wouldn't require as large a dose of Remeron to *overcome* the antihistamine sedation.
> >
> >
> > Mitch
>
> I guess an alpha-1 agonist such as Adrafinil or Modafinil could help. I dont know. Ive heard of antagonists to block agonists but not agonists to block antagonists before. I guess you have to take into account the effaciousness of Remeron, the degree of sedation and whether or not such a combination could be helpful. I think the augmentor Pinodol has a similar action to Remeron, blocking the 5-HT autoreceptors stimulating the release of 5-HT and increasing 5-HT at the 5-HT1a receptors only.
>
> From what I have heard Remeron is the most sedating of all antidepressants alongside Trazadone. It is a potent anti-histamine even at low doses. Thats its first effect.
>PaulB,
I *liked* the positive effects of taking Remeron and the lack of some negative ones. BUT the antihistamine and orthostatic hypotension (dizziness) was just too much to bear for me to take. I tried up to 30mg/bedtime. Yes, the higher doses helped reduce some drowsiness, but the *dizziness* worsened with increased dosage. It felt like my body was following me around a foot or two behind me all the time-it really sucked. And it didn't get better with three months administration either-also gaining 30 lbs didn't help. If they could somehow *redesign* this med and get RID of the antihistamine and orthostatic hypotensive effects it could be a really BIG winner.
Mitch
poster:Mitch
thread:66351
URL: http://www.dr-bob.org/babble/20010612/msgs/66640.html