Posted by sowhysosad on May 4, 2009, at 18:08:35
In reply to Re: Mirtazapine and RLS » sowhysosad, posted by West on May 4, 2009, at 16:03:56
> I thought that was what it could be, but since it was just in the legs i think it's more likely to be rls. Akithisia is a whole body feeling and of not being able to control it.
I've read theories about region-specific akathisias - eg. some speculate SSRI-induced bruxism is a variety of it.
> Of interest on mirtazapine: ken gillman seems unconvinced it has any significant serotonergic action at all, claiming serotonin syndrome is almost impossible to induce even at uber overdoses; there is however at least one documented case of SS i know of in somebody taking it alone and with nothing else on board.
Yeah, I was initially with Ken Gillman on that one as I didn't think I was getting a serotonergic effect. That said, as I mentioned earlier, I now realise I probably had some mild serotonin-related side effects.
Maybe mirt just wasn't all that powerful for me when it came to serotonin, or my receptors were fried or something. Or perhaps the 5HT2A/C blockade made it feel different to SSRI's.
> How do you find it in comparison to the SSRIs in regards to your depression? I imagine there's less apathy involved since mirt increases noradrenergic and (in theory) dopaminergic tone. I'm pretty much resigned to taking an ssri for life since i rapidly decline without it.
It did next to nothing for my depression but, to be fair, I've since realised that noradrenergic meds just don't seem to work for me. However, it didn't seem to boost my noradrenaline as much as imipramine, the med I moved on to next. Imipramine made me very edgy and anxious at times.
As far as apathy is concerned, you may find the heavy sedation mirt induces might actually outweigh the noradrenergic benefits. For some it gets better the longer they're on it and the higher the dose, but others have a long-term issue with the sedation (15mg mirt = 10mg diazepam IIRC).
I don't think it had any effect on dopamine at all. Since quitting meds and switching to a dopamine-boosting supplement (helped along by some other dopaminergics like nicotine and codeine) my depression's got way better. There was no danger whatsoever of that happening with mirt, and I just couldn't "feel" any dopamine.
poster:sowhysosad
thread:894213
URL: http://www.dr-bob.org/babble/20090426/msgs/894260.html