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Re: Why does lower dose of Remeron cause more sedation

Posted by linkadge on March 12, 2012, at 22:00:41

In reply to Re: Why does lower dose of Remeron cause more sedation » linkadge, posted by mogger on March 12, 2012, at 16:51:26

>Thanks Linkadge. Would that translate into at a >lower dose Remeron works on more Serotonin than >at a higher dose working on NE?

Roughly speaking yes. The rate at which receptors are occupied by a drug is not directly proportional to the dose. Suppose that for every doubling of dose, half of the remaining receptors are occupied.

So say:

2mg --> 20% h1 and 5% NE-alpha
4mg --> 60$ h1 and 53% NE-alpha
8mg --> 80% h1 and 77% NE-alpha
16mg --> 90% h1 and 89% NE-alpha

This data is made up, but the trend would likely be the same. You can see that as you increase the dose, the NE effect catches up to the h1 blocking effect. Despite the higher affinity for histamine, it becomes easier for the drug to find NE-alpha receptors (as fewer of them are occupied at lower doses). This makes the drug relatively more activating at higher doses.

As far as effectiveness goes, I'm not sure. I've heard of people having sucess on 45 or 60mg when 30 did not work.

It may be worth a try, if you are tolerating 30mg ok.

Linkadge


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