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Re: Remeron how to work

Posted by PaulB on August 18, 2001, at 19:00:56

In reply to Re: Remeron how to work, posted by JohnL on August 18, 2001, at 16:27:54

> > Hi: I have been on remeron for one week am now sleeping at night but still have anxiety thoroughout the day. Does any one know how long it takes to help this.
>
>Remeron is a antidepressant with a very complex mechanism of action. It may have a faster onset of action than other antidepressants because of one of its antidepressant effects-the antagonism of the 5-HT1a autoreceptors which controls the firing rate of serotonin. Antagonising these receptors increases the firing rate of serotonin. When the beta-blocker Pinodol is added to an SSRI the increase in antidepressant response can be seen in one week because it increases the firing rate of serotonin, via the same mechanism as Remeron.

You are probably sleeping better because Remeron antagonises the 5-HT2a receptors and is a very potent antagonist of histamine receptors, which also causes sedation. Remeron exerts its most potent effect at the histamine receptors. The question of whether anxiety will reduce is a difficult one with Remeron. With the SSRI's anxiety is often a common problem in the beginning and often reduces significantly in two to three weeks with the onset of antidepresant effect.

There is somewhat limited evidence for Remerons effectiveness for anxiety disorders such as panic disorder and social phobia but impressive evidence for its effectiveness for reducing generalised anxiety. I dont know what type of anxiety you have. Bear in mind that it increases norepinephrine which can increase anxiety. The increase in norepinephrine however also contributes to its its antidperesant effect.

I hope this information is of some use.
PaulB


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poster:PaulB thread:75514
URL: http://www.dr-bob.org/babble/20010814/msgs/75528.html