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Dr. Bob is Robert Hsiung, MD,
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Posted by Shawn. T. on July 25, 2002, at 23:28:43
In reply to Re: DHEA, et al » Shawn. T., posted by BarbaraCat on July 24, 2002, at 0:13:54
Cool ... neuroscience has really grabbed my interest because you never run out of more interesting topics to read about. A lot of other subjects have run into dead ends for me, take philosophy for example. I'm not crazy about all of the animal sacrificing going on either; I'd like to think that we can put the knowledge that we have gained to use in veterinary medicine. I've been sidetracked from fibromyalgia by my realization that receptors can directly interact via G proteins; I have had to reread several things to adjust my thinking patterns. I really wish that someone would have released all the possible interactions between receptors by now; I am having to figure most of these out on my own. Just as an example, I'll list a few possible candidate pairs. Don't look at these as facts, just some possibilities. Certainly don't base any drug decisions on this information. If anyone could point out some that are incorrect, that would be nice. I've got about thirty possible combinations to look up; it's going to take me forever to verify which ones are probable and which aren't.
Guesses:
D1 and 5-HT2a
D5 and 5-HT2c
alpha-1-NA and 5-HT2c
D2 and alpha-2-NA
5-HT1b and 5-HT1d
D1 and D3
D1 and dynorphin
D1 and 5-HT2a
mu and GABAb
5-HT3 and GABAbEven less certain guesses:
alpha2 and 5-HT1a
D2 and glutamate channels
D1 and a dynorphin receptor
D2 and a enkephalin receptor
D4 and 5-HT2b/d
D2 and GABAb
5-HT2a and GABA(a or b)
5-HT3 and NK2
kappa1 and alpha-2-NA
delta and alpha-2-NA
GABAa and D3
5-HT1a and alpha-2-NA
5-HT1a and D2 (presynaptically)
Posted by BarbaraCat on July 26, 2002, at 2:02:17
In reply to Re: DHEA, et al » Shawn. T., posted by Shawn. T. on July 25, 2002, at 23:28:43
My goodness, what a wealth of information! I don't even know where to start. Some neuro research project ought to snatch you up - no kidding! Your mention of G protein rang a bell for me. About a year ago I was hot on the trail of G protein and I don't remember why. I got sidetracked and forgot all about it until your post. Wish I kept notes about these brainstorms but I get so darn engrossed. It's like right brain has no patience for left brain.
When I got out of music school I thought 'uh oh, now what do I do to pay the rent?'. So I got into computers thinking that it would be a neat way to 'slip in the backway' into researching things I was interested in: the ocean floor, astronomy, the brain. Neural mapping, computer imaging and such. Little did I know that to do this kind of work required a Ph.D. anyway. So I ended up as a systems analyst in corporations - so nowhere near my passions or dreams.
What would make me so happy would be be use my computer experience and neuro research to find a way to use 3-D computer imaging for testing drug interactions in the brain. We already know alot about ligands and receptor structures. With all the work done with the human genome project, you'd think we'd be farther along using what we've learned instead of the very crude and barbaric sacrificing of our animal relations. Of course, I use these drugs and other products, so I'm not really walking my talk. Life can be such a puzzle. Oh well, I guess I would have these meaning of life questions since another path deeply studied but not yet taken is transpersonal psych. Sigh, so many intersts, so little time (or money). Sometimes I wish I had 200 years to live. - BarbaraCat
Posted by swingsnroundabouts on July 31, 2002, at 17:29:49
In reply to Re: Does anyone not gain weight on Remeron? » Nala, posted by Sleepy Lizard on July 18, 2002, at 9:08:33
> I have not used Remeron, but I've read that people gain about 5 pounds (in some documents 10 pounds). According to one study, the placebo group also gained the weight. The explanation was that when depression lifts, appitite increases. I suspect that it is more than that, perhaps metabolic, or due to the sedation. You can read some about remeron at:
>
> http://www.organon-conferences.com/rsem2001/I think this explanation is inadequate - I was not depressed when I started (I switched from efexor)and managing to stick to a healthy eating, steady weight loss program. This past week, since starting remeron / zispin I have stuffed my face with any and every food I could get hold of and stuff I wouldn't normally even consider eating and I still want more. My appetite is increased massively and I don;t seem to get the signal that says 'you're full now - you can stop stuffing your face'. I need to get a grip - hopefully this will wear off a bit and I will be able to.
Posted by BarbaraCat on August 1, 2002, at 0:49:34
In reply to Re: Does anyone not gain weight on Remeron? » Nala, posted by swingsnroundabouts on July 31, 2002, at 17:29:49
Despite Remeron being the best AD I've ever been on, I'm getting off it because no matter what, I've steadily gained and gained and am now heavier than I've ever been in my life. I'm small framed, medium height and very conscious of my diet, semi vegitarian, etc., moderate exercise, but can't lose the 25 lbs. I'm also a dancer, or used to be, before getting fibro. I'm trying to get back to dancing, but nothing budges this pudge! So Remeron goes adios. I'm really feeling the lowered dosage, oh yeah, but I WILL conquer this depression!!! If it doesn't kill me, the weight will.
> > I have not used Remeron, but I've read that people gain about 5 pounds (in some documents 10 pounds). According to one study, the placebo group also gained the weight. The explanation was that when depression lifts, appitite increases. I suspect that it is more than that, perhaps metabolic, or due to the sedation. You can read some about remeron at:
> >
> > http://www.organon-conferences.com/rsem2001/
>
> I think this explanation is inadequate - I was not depressed when I started (I switched from efexor)and managing to stick to a healthy eating, steady weight loss program. This past week, since starting remeron / zispin I have stuffed my face with any and every food I could get hold of and stuff I wouldn't normally even consider eating and I still want more. My appetite is increased massively and I don;t seem to get the signal that says 'you're full now - you can stop stuffing your face'. I need to get a grip - hopefully this will wear off a bit and I will be able to.
>
>
Posted by Nala on September 14, 2002, at 6:42:12
In reply to Re: General Remeron Questions, posted by BarbaraCat on March 12, 2002, at 11:54:55
> Barbaracat,
You've responded to me before re: "REmeron Alone". Since then, my pdoc has added lithium 450 mg (Eskalith CR)qd, to my regimen. I've been on this combo for 3 weeks. In addition, my pdoc believes I also have BP II. How are you currently doing on these meds? I haven't read anything recently from you. I think I feel better, but I'm not sure. I also take a low dose adderall 5mg bid (??) and klonopin 1mg qd. any thoughts?Nala
Posted by BarbaraCat on September 14, 2002, at 17:10:59
In reply to Re: General Remeron Questions, posted by Nala on September 14, 2002, at 6:42:12
Hi Nala,
I responded to you a few weeks back, guess it got lost in cyberspace. I'm reducing Remeron and eventually want to get off for good. I'm now at 22mg down from 75. Feeling pretty rocky, but everytime I start to go way down, I remind myself that it's normal, I'm reducing an AD, things are more touchy right now. It's amazing how this works. My goal and prayer is to be able to call on this mantra and have it work every time and to keep on using it when and if I'm off entirely (it's normal to feel like life sucks - it does, etc). For me it boils down to no AD has worked well enough to warrant the side effects. I'll probably stay on lithium or another mood stabiliser but I'm sick of being fat and/or numb. There has to be another way and by God I will beat the shit out of this depression bipolar whatever it is business.It sounds like your combo is a good one and that fact that you're feeling better after 3 weeks is a very good sign. Hang in there. Remeron is a good AD and many seem to have had great success with it.
> > Barbaracat,
> You've responded to me before re: "REmeron Alone". Since then, my pdoc has added lithium 450 mg (Eskalith CR)qd, to my regimen. I've been on this combo for 3 weeks. In addition, my pdoc believes I also have BP II. How are you currently doing on these meds? I haven't read anything recently from you. I think I feel better, but I'm not sure. I also take a low dose adderall 5mg bid (??) and klonopin 1mg qd. any thoughts?
>
> Nala
>
Posted by McPac on September 15, 2002, at 17:14:38
In reply to Re: General Remeron Questions » Nala, posted by BarbaraCat on September 14, 2002, at 17:10:59
BarbaraCat
Hi, Hope you are well.
Question for you re: your Remeron experience:Did Remeron at higher doses MAKE you feel MORE anxious/agitated/nervous?
It has for me (agitation/nerv./heart beating FASTER!
I hate Remeron at these higher doses (45 mg for me).
Perhaps if you did not feel these worsening symptoms it may be because you were on other meds (benzos) that counteracted these effects.
Hey, one more question:
Ever hear of the Pfeiffer Treatment Center (a nutritional care facility for biochemical imbalances)? I was thinking about going there; not sure yet. You can type its name and do a search to find it on the web.
Take Care!
Posted by McPac on September 15, 2002, at 17:18:04
In reply to Re: General Remeron Questions » Nala, posted by BarbaraCat on September 14, 2002, at 17:10:59
(See my other post Barb).
Posted by Jill on September 15, 2002, at 21:19:00
In reply to Re: General Remeron Questions, posted by McPac on September 15, 2002, at 17:14:38
Yes, I've heard from my pdoc that higher doses can cause more agitation. I take 45 mg, but every few months (with doctor's ok) I cut back for a few days because I start to have trouble sleeping. After a few days at a lower dose, I go back up to 45 mg with no more sleep probs.
I love this drug. I am planning on having children soon and am dreading going off of it after over 5 years of feeling fabulous with much reduced depression/OCD thoughts with it.
Anyone with any new info on Remeron and pregnancy?
Thanks.
Jill
Posted by McPac on September 15, 2002, at 21:46:23
In reply to Re: General Remeron Questions, posted by Jill on September 15, 2002, at 21:19:00
Jill, so Remeron doesn't cause YOU the increased agitation though?
Do you remember if it might have at first (and then perhaps it went away?)
Thanks!
Posted by Jill on September 15, 2002, at 22:24:45
In reply to Jill---Re: General Remeron Questions, posted by McPac on September 15, 2002, at 21:46:23
No, I don't have increased agitation...just feel normal. However, I'm kind of natural high energy (when I'm not depressed) person. My doctor said that many can feel anxious or wired at 45mg or above. I just feel good and happy.
For me, personally, I am falling asleep and crying if I only take 30 mg. However, that's just my body chemistry. As a nice side note, my pdoc said that weight gain tends to be less at 30mg and above.
Oh, I do grind my teeth at night with my current dose (and have no way of knowing if I would at lower doses...but I might), but I wear a mouth guard and it's no big deal. I was embarrassed at first, but taking another medication to reduce that effect (I forget the name) made me feel headachey and yucky. My boyfriend is really cool about reminding me to put it in at night...it's a small price to pay for feeling so great.
Good luck with Remeron. You may find that a lower dose works right for you. (My sister, coincidentally, takes 45 mg too and feels sleepy and not as good on 30 mg. Must be a family chemistry thing).
Take care.
Jill
Posted by LyndaK on September 15, 2002, at 22:53:06
In reply to Re: Jill---Re: General Remeron Questions, posted by Jill on September 15, 2002, at 22:24:45
I'm currently on 45mg of Remeron, but over the past couple months have been feeling my anxiety level increasing and having difficulty sleeping. I've been thinking that the Remeron has been "pooping out" a bit. Tried increasing the dose slightly by breaking another pill (difficult to do without completely pulverizing it). Seems to have helped some. I see my pdoc on Wednesday. Another thing that's been happening is my eye keeps twitching a lot -- drives me crazy!! Muscle twitches were a common side-effect of the SSRI drugs -- haven't had it happen with the Remeron until recently. I'm on no other drugs.
Any thoughts or similar experiences?
Lynda
Posted by BarbaraCat on September 16, 2002, at 1:51:35
In reply to Re: General Remeron Questions, posted by McPac on September 15, 2002, at 17:14:38
Hi Mc,
Let's see if I can remember just how I was feeling. I remember that at 45mg I was feeling lethargic and wanted more zip and I also wanted to just test the waters and see how a higher dose felt. I went from 45 to almost 90 in about 3 weeks and definitely felt speedier, but not in a bad way. I was concerned that I was getting a little hypomanic which is not a bad thing in and of itself, but I tend to really wear myself out and crash. So I went down to 75mg and was feeling pretty good for about 1 month. Had alot of energy, motivation, just felt good. About 1 month ago I started feeling the blahs return and a flare up of my fibromyalgia symptoms (aching muscles, tiredness). I increased my thyroid during this time and felt the fibro symptoms and tiredness abate. Lately I've been feeling increasingly anxious and teetering on the verge of depression, tendency to cry easily, worry, etc. I think the increased thyroid is contributing to the anxiety and so reduced it. I know the thyroid has messed up the controlled study parameters, so to speak, but I also know that the Rem pooped out well before this. I also continued to gain weight no matter what, so now I'm down to 15 mg Rem and riding the rollercoaster. Benzos have helped alot during this time, but when I miss a dose I really feel it and believe I'm developing tolerance.I'm pretty fed up with antidepressants and our mis-managed health care system where pdocs have just enough time to whip out their prescription pads. I'm seeing a naturopath for some intensive nutritional chemo treatments and am hoping that my poor fried nervous system can heal. I'm feeling definitely anti-med right now. Nothing has ever worked for very long which probably means I have not stumbled yet upon the magic brew, but I fear my brain is getting harmed in the process, so I say fooey to Remeron and all the rest of the bunch.
The clinic you mention sounds very interesting and I will check it out, although I have no idea how to pay for such care. I certainly wish I were wealthy and could devote my time and money to just getting well and not have to compound things by worrying about - ugh - money.
> BarbaraCat
>
> Hi, Hope you are well.
> Question for you re: your Remeron experience:
>
> Did Remeron at higher doses MAKE you feel MORE anxious/agitated/nervous?
>
> It has for me (agitation/nerv./heart beating FASTER!
> I hate Remeron at these higher doses (45 mg for me).
> Perhaps if you did not feel these worsening symptoms it may be because you were on other meds (benzos) that counteracted these effects.
> Hey, one more question:
> Ever hear of the Pfeiffer Treatment Center (a nutritional care facility for biochemical imbalances)? I was thinking about going there; not sure yet. You can type its name and do a search to find it on the web.
> Take Care!
Posted by Roo on September 16, 2002, at 9:24:23
In reply to Re: General Remeron Questions » McPac, posted by BarbaraCat on September 16, 2002, at 1:51:35
Have you gained weight on Remeron?
Posted by BarbaraCat on September 16, 2002, at 12:39:30
In reply to Re: General Remeron Questions, posted by McPac on September 15, 2002, at 17:14:38
Hi Mc,
I checked out the Pfeiffer Center and it looks very interesting. I think a relative of my husband's went there with her son, who was diagnosed with ADD and slight autism. They discovered high levels of copper in his blood and put him on a regimen of customized vitamins and anti-copper compounds. It helped him tremendously. I also noticed that their prices are very reasonable with a Hope fund for those who can't pay the full price.The naturopath I'm going to has had me take numerous tests such as standard blood tests, live blood cell analysis (VERY fascinating), pH values, and hair analysis for heavy metals. The results aren't all in yet, but what has come back is showing some definite metabolic and cellular dysfunction. He's also an expert in hormones and how a dysfunction in any of those systems can cause havoc with psychological health. So I'm gettting intravenous vitamin and mineral drips until he can sort the whole interrelated mess out. I'm devouring endocrinology and cellular biology textbooks in the meantime to shed some light on the incredible complexity of our mortal coils. So at any rate, I'm probably getting the equivalent of the Pfeiffer Center and encourage you to explore this path. It makes sense to look at the whole body instead of only the brain.
Posted by Roo on September 16, 2002, at 14:20:28
In reply to Re: General Remeron Questions » McPac, posted by BarbaraCat on September 16, 2002, at 12:39:30
Please keep posting about these alternative methods
and how you're doing. I read about the Pffeifer Institute
and others like it and became interested in orthomolecular medicine too.
I've been off meds for a month and I'm trying acupuncture and homeopathy...
I like to go to some sort of Naturopath like you, Barbara Cat, one that
does all that testing...I would find it fascinating as well.
I know that this isn't a popular opinion around here, but I just feel
sure there has GOT to be some other way to treat depression other than these
meds. There's just got to be. Please, both of you, keep me updated...
I'll do the same...
Posted by BarbaraCat on September 16, 2002, at 15:05:09
In reply to Re: General Remero--McPhat and Barbara Cat, posted by Roo on September 16, 2002, at 14:20:28
Roo,
Good luck to you - you've got my total support on this. I think it's helping alot. If nothing else, I'll be a very fit and healthy mentally ill person. I'll ask my naturopath whom I'll be seeing on Friday his ideas on your finding a good doc. I'm reading a fascinating book about hormones and their role in physical and mental health (can't really separate them) that might be of interest to you. It's called 'Screaming to be Heard: Hormone connections women suspect and doctors still ignore" by Elizabeth Vliet, MD (newest edition). It's not so much 'alternative medicine' as a very thorough and enlightening endocrine study. I suspect you're a women? This will be extremely relevant. If not, it's still info that applies to everyone in ways most of us (including docs) are relatively clueless about. It will arm you with needed info you can take to your holistic doc when you find one.
Posted by Jill on September 16, 2002, at 16:53:18
In reply to Re: Jill---Re: General Remeron Questions, posted by LyndaK on September 15, 2002, at 22:53:06
In my experience (I've taken this drug for over 5 years), increasing the Remeron may actually be increasing the anxiety/twitching. I don't think your increased anxiety is necessarily Remeron poop out. In fact, my pdoc mentioned Remeron has less poop out than the SSRIs.
Talk to your doctor about possibly taking LESS for a short time (I take about 1/2 of my dose for about 4 days or so every few months to improve my sleep...then I go back up...and then sleep great again and feel great).
As a side note, don't forgot you and your doctor can be creative with dosing. I was taking 37.5 mg for a while (30mg + 1/2 a 15mg). Another thing to consider is that this drug, although faster to kick in for many than the SSRIs also isn't "automatic"...meaning that if you take a lower dose for a short time it will take a little bit for the norepinephrine (spelling?) to lower a bit. For me it takes about 4-7 days to feel a difference. To save $...with doc's ok...[can you tell I have OCD :)] you can talk about taking a 1/2 dose or other reduced dose on whatever schedule you find works with your body (I hear the pill cutters work well).
At the higher dosages (e.g., 45+ or even 30 for some people), my doc said NE is more prevalent. At low doses (like 15mg) you get more of the histamine effect (more tired, sleepy). It's a funky drug that way. Serotonin is also in there somewhere :). Reducing your dose of Remeron actually makes you more tired...interesting.
This is nice to know, because with this knowledge, I've been able just to slightly tweak my dosage at times and avoid having to take sleeping meds and also have been able to avoid feeling overly anxious (beyond what seems to be normal job/family/life stress). For me, less is more when it comes to medication. Remeron is the only med I use to treat my depression/OCD. My body is very sensitive to change (as I've been told many people with mental health issues are), so I feel so blessed that this medication works so well for me (no headaches, nausea, sleep problems, or anorgasmia...plus I feel really good).
Talk to your doc to see if reducing for a short time to activate more of the histamine effect will help.
Another aside, I have gained some weight on Remeron (although some is due to no longer being 27!). I went from a size 8 to a 10. Not a big deal. I asked my doc if I should try taking 60 mg to reduce a bit of hunger. However, since that would increase my teeth grinding and make sleep more difficult, we decided not to do that. (In Europe, my pdoc said dosages can be as high as 90mg. Weight gain seems very minimal then, but I know that I would be way too wound up and sleepless at that dose.)
Hope this helps. Please talk to your pdoc. Every body is different.
Take care,
Jill
Posted by Jill on September 16, 2002, at 17:00:57
In reply to Re: General Remeron Questions--Jill, posted by Roo on September 16, 2002, at 9:24:23
Hi Roo,
Yes, I've gained some, but it's not a big deal (I went from a size 8 to size 10). Please see my other post today. My sister also went from a size 6 to a size 8, which she says she really doesn't mind because she feels so great.
My pdoc said young, skinny females tend to gain more than other people. However, he said average weight gain due to the drug (at 30+ mg) was 7 pounds.
I'm currently 15 pounds heavier than I was 5 years ago. However, I was pretty much a nervous wreck at that time who often couldn't eat due to nerves. Also, I get very depressed periodically and drop a lot of weight (about 20 pounds during one episode...was down to 119 which for my swimmer's build of 5' 5 1/2" was very thin). And, now I'm 33 and not 27 and can't eat whatever I want without gaining weight.
I weigh 150 lbs now, but I don't mind wearing a slightly larger size. This drug is a God-send for me, and I wish I could stay on it during pregnancy. However, since there isn't much info out there on this drug during pregnancy, I think I'll have to go back to SSRIs :(.
Take care, and talk to your pdoc too about your concerns.
Best wishes.
Jill
Posted by Jill on September 16, 2002, at 17:04:17
In reply to Re: General Remeron Questions--Jill, posted by Jill on September 16, 2002, at 17:00:57
Just a quick note...my last post was a bit confusing. I USED to get depressed periodically and lose a lot of weight, but since being on Remeron since 7/97, I haven't had any more episodes.
Hope this helps.
Jill
Posted by LyndaK on September 16, 2002, at 23:42:45
In reply to Re: Jill---Re: General Remeron Questions, posted by Jill on September 16, 2002, at 16:53:18
Posted by McPac on September 17, 2002, at 8:35:53
In reply to Re: Jill---Re: General Remeron Questions, posted by Jill on September 16, 2002, at 16:53:18
Jill,
I didn't know you had OCD as well---me too.
I'm trying to get established on Remeron for my OCD right now (trying to go off of Zoloft).
At what dose do you recall working for your ocd?
Was your ocd the 'obsessional thinking/thoughts' or the compulsions OR both?
I'm hoping that a lower dose of Remeron could work for me; who knows?
Gotta run now, but, we must talk some more!
Take care
Posted by Jill on September 17, 2002, at 12:23:24
In reply to JILL---Re: General Remeron Questions, posted by McPac on September 17, 2002, at 8:35:53
Mc Pac,
I'm just home quickly for lunch...just got engaged last night, so I'm in a bit of a fog :).I take 45mg for my OCD. My OCD is almost purely obsessive thinking. Was brought up Catholic and took the guilt stuff VERY seriously!
I feel great at 45mg. The histamine aspect of the drug has really calmed me too. My sister has a similar "worried" personality...and she takes 45mg of Remeron too and feels very good.
I used to become depressed because I was so obsessional...if you have OCD, I'm sure you understand.
I'll check in later...but I have to tell my sisters about my engagement before I run back to work!
Take good care :)
Jill
Posted by Roo on September 17, 2002, at 12:41:32
In reply to Re: JILL---Re: General Remeron Questions, posted by Jill on September 17, 2002, at 12:23:24
Posted by BarbaraCat on September 17, 2002, at 21:51:38
In reply to Re: JILL---Re: General Remeron Questions, posted by Jill on September 17, 2002, at 12:23:24
Hi Jill,
May you be wondrously happy. I hope your future hubby knows that he has a zillion babblers to answer to for treating you well! ;)BTW, I too am a recovering Catholic. I didn't associate my leftover guilt, worry, persnickediness to Catholism, but now that you mention it...
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Dr. Bob is Robert Hsiung, MD,
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