Posted by joebob on July 17, 2003, at 17:38:47
In reply to Re: Remeron Question, posted by jrbecker on April 12, 2003, at 12:09:09
jrbecker........you are one of the best posters i have seen on this site
here is one of my early posts that you may have missed....> my doc gave me depakote for 2 weeks prior to starting lexapro next week..........
> i am wondering how much dep i might need and will i need to keep taking it after the lex kicks in?by the way my neurologist has a great rep, but doens't do any diagnosis per se, just agrees with what i ask her for and writes it.....scary
i got the pre-dosing suggestion from a npsych who attended a seminar by daniel amen
i did have some mania a few days after trying lexapro the first time and quit
i need to gain weight, my appetite is zero for some time now, i mostly smoke cigs and drink beer
please keep up the good work, it is a help to me and i am sure many others
> Mary Helen:
>
> good luck with the switch. In terms of suggestions for augmentation for weight loss, well it's really too early to consider it your first priority when your mood is not stable yet. I would only suggest that you explore the following options only after being stabilized on the remeron for at least a month. I'm assuming your BP II since you take the lithium? If that's the case, are you going to stick with it when you switch or was is just an adjunct to the MAOI? If you are sticking with a mood stabilizer, maybe consider something that might not cause as much water retention (e.g., Lamictal). Also, have you ever tried Wellbutrin, and if so, how did you react? It can be a great adjunct for weight loss for some people. Along the same lines, Strattera at low doses might be an option. However, these drugs can induce mania/hypomania/irritability in most BPs so be advised. You might also try a low dose (e.g., 5 mg) of Lexapro at night to counterbalance the weightgain. It acts completely opposite to Remeron at the 5HT2c site, which is part of the culprit for the weight gain. On the bad side, it might also dampen the antidepressant effect of the remeron a little. Supplements to try chromium piconlinate, NADH, fish oil, b-vitamins/zinc. You might try DHEA but this comes with a very big caution since it can interact with the aplha-2 adrenergic effect and make you very overstimulated, so start very small (e.g., 2 mg per day). Maybe try a little tyrosine in the morning and/or at lunch. You might want to consider buying Mind Boosters by Ray Sahelian for other tips. Biggest tip, which is the most obvious of course, exercise, preferably in the late afternoon. This will help keep your food cravings down in the evening and keep your body's metabolism up through the rest of the day. Eat smaller meals throughout the day. Try to eat more protein, but don't skimp entirely on carbs (Atkins spells evil for depressives) it is the worst thing people like us can do to our bodies.
> Try to stick to a meditteranean diet...fish, light meats, olive oil, lots of vegetables, less refined grains (but don't cut it out completely), low dairy, low re meat, etc.
>
> I am traveling to Alaska on business for a week, so I'll be out of touch with the board, but let me know how you're doing once you've made the switch. Good luck.
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> JB
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poster:joebob
thread:217889
URL: http://www.dr-bob.org/babble/20030714/msgs/242949.html