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Re: tappering

Posted by SLS on January 5, 2015, at 23:36:55

In reply to tappering » Guy, posted by jpa on January 5, 2015, at 21:32:36

> I'm just looking at my dog sleeping right now. Man, I would trade my brains for his zzzs anytime.

I totally get that.

I'm sorry that the CBT book didn't help. I'm not sure how much more a CBT therapist can do for you, but I would leave that as an option. Meditation? Hypnosis?

Since part of your problem might be a protracted "withdrawal" from Remeron, perhaps you can crossover to a drug that is easier to discontinue. I am not quick to shove drugs down your throat, but you say that losing sleep right now is not an option. In an emergency, you might think about using one of the sedating TCAs at a low dosage. The order of potency might look something like this: amitriptyline > doxepin > trimipramine > nortriptyline. Like Remeron, these drugs exert antihistaminic effects, which might help with sleep. Unlike Remeron, they leave other synaptic receptors alone. (Amitriptyline and nortriptyline do block 5-HT2a receptors, which might help buffer Remeron discontinuation induced rebound anxiety). For me, personally, I would try doxepin first, mainly because it is less anticholinergic than amitriptyline, and might help with anxiety more. Look at hydroxyzine, too.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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URL: http://www.dr-bob.org/babble/20150102/msgs/1074853.html