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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by John on October 11, 1999, at 15:38:36
Is it true Remeron is more sedating at lower doses?? Please let me know.
Posted by allison on October 11, 1999, at 17:43:18
In reply to Remeron dose, posted by John on October 11, 1999, at 15:38:36
> Is it true Remeron is more sedating at lower doses?? Please let me know.
I don't think so. I started at 15mg, which knocked me out at first. Luckily, I started taking it on a weekend.
Pdoc upped it to 30, then the maximum of 45. Half an hour after taking 45mg, I was not only sleepy, I was unsteady on my feet. I had no choice but to go to bed.
I'm down to 30mg now. I get sleepy, which is good, but I don't have to worry about falling down. And if I'm reading, I can fight the effect enough now to finish what I'm reading. I couldn't do that before, nor could I drive. Also, I've found less weight gain with the lower dose.
Posted by JohnL on October 11, 1999, at 17:56:51
In reply to Re: Remeron dose, posted by allison on October 11, 1999, at 17:43:18
> > Is it true Remeron is more sedating at lower doses?? Please let me know.
In theory that is true. In reality not. At least my experience. I agree with Allison. Actually any dose knocks me out in an hour or less, but at higher doses (above 15mg) I find it carries into the next day. I was in the 45mg to 60mg range for a while and felt very drugged. My personal experience is that Remeron is best as an adjunct with another AD, not as stand alone monotherapy. Several very promising clinical trials though had much better results than my own. Only a personal trial will tell...
Posted by John on October 12, 1999, at 11:40:09
In reply to Re: Remeron dose, posted by allison on October 11, 1999, at 17:43:18
> >
I took 7.5 mgs last night around 8 pm for sleep. I was sedated to ABOUT NOON THE NEXT DAY. Will this sedation eventally decrease over time???
Is it true Remeron is more sedating at lower doses?? Please let me know.
>
> I don't think so. I started at 15mg, which knocked me out at first. Luckily, I started taking it on a weekend.
>
> Pdoc upped it to 30, then the maximum of 45. Half an hour after taking 45mg, I was not only sleepy, I was unsteady on my feet. I had no choice but to go to bed.
>
> I'm down to 30mg now. I get sleepy, which is good, but I don't have to worry about falling down. And if I'm reading, I can fight the effect enough now to finish what I'm reading. I couldn't do that before, nor could I drive. Also, I've found less weight gain with the lower dose.
Posted by JohnL on October 12, 1999, at 17:47:05
In reply to Re: Remeron dose, posted by John on October 12, 1999, at 11:40:09
>
>
> I took 7.5 mgs last night around 8 pm for sleep. I was sedated to ABOUT NOON THE NEXT DAY. Will this sedation eventally decrease over time???Yes! It will diminish in a week or two. One hint though, the earlier in the evening you take it the less it will affect you the next day. My sedation is usually gone by the time I reach for my second coffee and is absent all day. If I take it too late though, I drag all day. Not to worry. It's get much easier.
Posted by John on October 12, 1999, at 18:42:48
In reply to Re: Remeron dose, posted by JohnL on October 12, 1999, at 17:47:05
> >
> >
> > I took 7.5 mgs last night around 8 pm for sleep. I was sedated to ABOUT NOON THE NEXT DAY. Will this sedation eventally decrease over time???
>
> Yes! It will diminish in a week or two. One hint though, the earlier in the evening you take it the less it will affect you the next day. My sedation is usually gone by the time I reach for my second coffee and is absent all day. If I take it too late though, I drag all day. Not to worry. It's get much easier.Thanks for the advice and encouragement John L!
Posted by allison on October 13, 1999, at 11:25:44
In reply to Re: Remeron dose, posted by John on October 12, 1999, at 18:42:48
I agree with JohnL. Sedation does decrease over time.
I found when taking Remeron alone I had to watch not to take it too late (past 9) or I'd have trouble getting up in the morning (alarm at 6, sometimes can't wake up till 7 or 7:30). I used to use coffee in the morning to help clear the cobwebs. However, my pdoc has added 100mg of Wellbutrin in the morning, which also helps clear the Remeron cobwebs, but I find if I drink coffee too, I get the shakes and my mind zooms all morning with little accomplished.
So I do decaf or half n' half, or nothing. I can only do real coffee in the morning if the cobwebs are really thick (ie, I've taken the remeron too late or I'm run down besides, like right now).
Posted by allison on October 13, 1999, at 11:34:37
In reply to Re: Remeron dose, posted by allison on October 13, 1999, at 11:25:44
Or maybe I can drink real coffee now because I'm getting accustomed to the Wellbutrin. Hard to say.
I only started on it in the summer.
Posted by John on October 14, 1999, at 11:47:27
In reply to Re: Remeron dose, posted by allison on October 13, 1999, at 11:25:44
> I agree with JohnL. Sedation does decrease over time.
>
> I found when taking Remeron alone I had to watch not to take it too late (past 9) or I'd have trouble getting up in the morning (alarm at 6, sometimes can't wake up till 7 or 7:30). I used to use coffee in the morning to help clear the cobwebs. However, my pdoc has added 100mg of Wellbutrin in the morning, which also helps clear the Remeron cobwebs, but I find if I drink coffee too, I get the shakes and my mind zooms all morning with little accomplished.
>
> So I do decaf or half n' half, or nothing. I can only do real coffee in the morning if the cobwebs are really thick (ie, I've taken the remeron too late or I'm run down besides, like right now).
Do you have any other side effects besides sedation??John
Posted by JohnL on October 14, 1999, at 17:23:01
In reply to Re: Remeron dose, posted by John on October 14, 1999, at 11:47:27
> Do you have any other side effects besides sedation??
>
> JohnNope. Not me. I think 7.5mg to 15mg is really too low to cause any real side effects.
Posted by allison on October 15, 1999, at 9:21:57
In reply to Re: Remeron dose, posted by John on October 14, 1999, at 11:47:27
> Do you have any other side effects besides sedation??
Weight gain has been the only other side effect, but it was more of a problem when I was at 45mg. I would swim 3X/week and watched what I ate and STILL gained weight.
But I also was on lithium during part of that time, which may have added to the problem.
Now at 30mg Remeron, paired with 100mg Wellbutrin, which can cause weight loss, gaining weight doesn't seem to be as much of a problem. In fact, I think I'm losing weight and I haven't had time to exercise regularly in the last month.
Posted by JOHN on October 15, 1999, at 16:06:03
In reply to Re: Remeron dose, posted by allison on October 15, 1999, at 9:21:57
> > Do you have any other side effects besides sedation??
>
> Weight gain has been the only other side effect, but it was more of a problem when I was at 45mg. I would swim 3X/week and watched what I ate and STILL gained weight.
>
> But I also was on lithium during part of that time, which may have added to the problem.
>
> Now at 30mg Remeron, paired with 100mg Wellbutrin, which can cause weight loss, gaining weight doesn't seem to be as much of a problem. In fact, I think I'm losing weight and I haven't had time to exercise regularly in the last month.How is remeron's antidepressant effect?. Was Wellbutrin added because of sedation or because remeron alone wasn't cuttin the mustard?
Posted by allison on October 16, 1999, at 14:02:52
In reply to Re: Remeron dose, posted by JOHN on October 15, 1999, at 16:06:03
> How is remeron's antidepressant effect?. Was Wellbutrin added because of sedation or because remeron alone wasn't cuttin the mustard?Lithium and Wellbutrin were added because the Remeron wasn't cuttin' the mustard, as you say. I think each helped some. I was on lithium (300mg 2X/day) from last October until March/April-ish when my pdoc thought I didn't need it anymore. I was soooooo happy to get off of it. In addition to the weight gain, I had almost daily doses of diarrhea.
Went along all spring with just the Remeron (45mg), but started sliding again in June/July. It got to the point where even my boss and co-workers started getting concerned, so I knew I had to do something. Got on the Wellbutrin (100 mg), which seemed to help. After a time, he reduced the Remeron to 30mg, which I'm still glad about because it's less sedating, as I mentioned.
I am not convinced that this is the perfect cocktail, and I'm worried about poop-out. But I'm having trouble telling what's poop-out and what's just life.
The last 2 years has been really hard (depression diagnosed, husband left and alcoholic mother died in July 98). The last couple of months have not been easy (work is hard, divorce nearly final, cleaned out and am selling my mother's house -- my childhood home. I'm an only child... My dad's a jerk.). I still live with thoughts of suicide, but at least they're not daily. Just kinda weekly or in spells. I actually find them kind of a comfort, like some solution I keep in my back pocket if things get worse again. So it's hard to say. Hope this helps.
Posted by allison on October 16, 1999, at 15:29:16
In reply to Re: Remeron dose, posted by allison on October 16, 1999, at 14:02:52
I also should add here that I was having major problems with sleep.
My pdoc put me on Zoloft first. Too jittery. I couldn't stand it. I don't do much caffeine, but I stopped all caffeine. It didn't matter.
So then I started Effexor XR, which was even worse. I felt as though I was zooming. Pdoc suggested balancing my meals (having little snacks in between meals and cutting all caffeine)to try to counteract, but to no effect.
Finally got of that and onto the Remeron, which was the only thing that helped me sleep and didn't make me shaky, jittery, with a zooming, unproductive mind. I've been on Remeron for a year and a half.
Posted by saint james on October 16, 1999, at 22:29:05
In reply to Re: Remeron dose, posted by JOHN on October 15, 1999, at 16:06:03
> How is remeron's antidepressant effect?. Was Wellbutrin added because of sedation or because remeron alone wasn't cuttin the mustard?
James here....
Remeron + Effexor is considered a big gun because
Effexor works with 3 NT's and Remeron works with specific 5HT sites that have not been targeted b4.j
Posted by allison on October 19, 1999, at 9:12:38
In reply to Re: Remeron dose, posted by saint james on October 16, 1999, at 22:29:05
> Remeron + Effexor is considered a big gun because
> Effexor works with 3 NT's and Remeron works with specific 5HT sites that have not been targeted b4.OK, but I couldn't handle Effexor even by itself (see previous post). What to do? Try it again?
Posted by LG on October 24, 1999, at 9:40:37
In reply to Remeron dose, posted by John on October 11, 1999, at 15:38:36
> Is it true Remeron is more sedating at lower doses?? Please let me know.
Not for me. However, it is not helping sleep
like I had hoped(45mgs). Started helping than quit
helping.
The PDR says that lower doses are more likely to
cause weight gain.I'm reading here that higher
doses cause gain. Does it vary widely?
I may have to go over the maximum for sleep
and don't want to gain weight. Depression is
better on it.LG
especiallly when I sleep well.
Also on neurontin and effexorXR.(insomnia before I
started any of these, also).LG
Posted by LG on October 24, 1999, at 9:59:32
In reply to Re: Remeron dose, posted by saint james on October 16, 1999, at 22:29:05
> > How is remeron's antidepressant effect?. Was Wellbutrin added because of sedation or because remeron alone wasn't cuttin the mustard?
>
> James here....
>
> Remeron + Effexor is considered a big gun because
> Effexor works with 3 NT's and Remeron works with specific 5HT sites that have not been targeted b4.
>
> jHi! Addendum to my previous note.
I'm on effexorXR and Remeron. Good AD effect
except insomnia.I wonder if I could decrease
or stop pm dose of effexor?Also on neurontin,
clonapin.
Will ask doc. about changing dose. Also
concerned with wt. gain. Now I read Effexor
can cause gain. Go figure. :]
LG
This is the end of the thread.
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