Shown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by sweetmarie on April 5, 2001, at 6:24:30
I`ve posted before (I initialised the `treatment resistant` thread).
This is a direct thread concerning Venlafaxine and Mirtazapine (Remeron).
Has anyone had experience of this combination?
Any successes?
It`d be good to hear from anyone.
Anna.
Posted by SalArmy4me on April 5, 2001, at 12:52:37
In reply to Remeron and Venlafaxine, posted by sweetmarie on April 5, 2001, at 6:24:30
I was on that combination for a month, with megadoses of each. I took 450 of Effexor XR HS; 60 mg of Remeron HS. My depression is resistant enough even to that, but I have heard that that combination is effective for a lot of people.
Oh, the Remeron itself combats the sexual side-effects of the Effexor; higher doses of Remeron produce less sedation and weight gain than the 15-30 mg doses.
Posted by sweetmarie on April 5, 2001, at 15:48:21
In reply to Re: Remeron and Venlafaxine, posted by SalArmy4me on April 5, 2001, at 12:52:37
> I was on that combination for a month, with megadoses of each. I took 450 of Effexor XR HS; 60 mg of Remeron HS. My depression is resistant enough even to that, but I have heard that that combination is effective for a lot of people.
>
> Oh, the Remeron itself combats the sexual side-effects of the Effexor; higher doses of Remeron produce less sedation and weight gain than the 15-30 mg doses.SalArmy4me
Thanks for the reply.
Just to be sure - are you saying that it was not effective at all for you (i.e. no relief from
depression)?You say that you are resistant to treatment; which meds have you tried, and for how long? Have any been effective?
I`m resistant to treatment too (10 years of purseverance, on a total of 13 different meds, and permutations of these, plus an unsuccessful course of 20 ECT sessions, which has cost me my memory of the entirety of 1998).
I feel that I`m fast approaching the end of the line. I`ll be going into a unit in Newcastle (the North of England if you live outside the UK) that deals entirely with `difficult to treat depression`. There I will be under a Professor who is a specialist in this area, and it`s he that gave me my diagnosis (chronic severe double depression - basically Dysthymia, with an added episode of major severe deoression, in my case, lasting for approx 6 years). He`s decided to try me on Venlafaxine, Mirtazapine and Lamotragine (all at high doses). I`m afraid that I don`t hold out very much hope for this forthcoming hospitalisation - I`ve been in hospital 3 times already (although the first psychiatrist I was under was a complete berk, and didn`t have a clue what he was doing - he classed all cases of depression that he couldn`t treat as `atypical`, and washed his hands of all further treatment after 2 attempts at treatment. Anyway, this is irrelevant).
So that`s the story - no hope at all for the upcoming work with the specialist. I daren`t, because I`ve had too many disappointments.
That`s me.
Anyway, thanks again for answering my post.
Cheers,
Anna.
Posted by MSM on April 5, 2001, at 15:53:53
In reply to Remeron and Venlafaxine, posted by sweetmarie on April 5, 2001, at 6:24:30
I've been taking remeron for 8 weeks and am now up to 45mg's a day. I believe that the remeron has begun to break through the depression. My doc has given me some effexor xr samples. I am considering augmenting the remeron, but I do not want to take large doses of effexor (there are just too many posts here about effexor side effects). Would 75mg or 100mg doses of effexor be sufficent as an augmentor to remeron? This is my first experience with AD's and I hope to quit using them 8 to 10 months after I have broken the depression. Would I be better off sticking to a single med. ? Would a 3 or 4 month run of the combination, then tapering back to just the remeron be of benefit?
thanks,
Mark
Posted by JohnL on April 5, 2001, at 16:22:20
In reply to Remeron and Venlafaxine, posted by sweetmarie on April 5, 2001, at 6:24:30
Hi Anna,
In Dr Bob's Tips the combination of Remeron+Effexor is described as being 'big guns'. I've tried them both and didn't get well with either. Effexor actually made me worse, while Remeron was neutral but had the advantage of knocking me out at bedtime. At least it could take me away from my pain quickly and put me to sleep.I have a lot more faith in drug combinations that involve antipsychotics or stimulants or both instead of a second antidepressant. Over time I've just seen more success stories with those types of combinations. For example, I found Prozac+Zyprexa to be a million times better than Remeron+Effexor, and with far fewer side effects. I know it's different with everyone, but I just think success is reached quicker when other drugs are combined with an antidepressant, instead of adding in a second antidepressant. For example in your case I would favor Effexor+Zyprexa instead of Effexor+Remeron.
Just some random thought.
John
Posted by SalArmy4me on April 6, 2001, at 2:52:19
In reply to Re: Remeron and Venlafaxine - long » SalArmy4me, posted by sweetmarie on April 5, 2001, at 15:48:21
I like the idea of Venlafaxine, Mirtazapine and Lamotrigine as your next combination. Your side-effects will be minimal, and I guarantee you will benefit from one of those medications.
> > I was on that combination for a month, with megadoses of each. I took 450 of Effexor XR HS; 60 mg of Remeron HS. My depression is resistant enough even to that, but I have heard that that combination is effective for a lot of people.
> >
> > Oh, the Remeron itself combats the sexual side-effects of the Effexor; higher doses of Remeron produce less sedation and weight gain than the 15-30 mg doses.
>
> SalArmy4me
>
> Thanks for the reply.
>
> Just to be sure - are you saying that it was not effective at all for you (i.e. no relief from
> depression)?
>
> You say that you are resistant to treatment; which meds have you tried, and for how long? Have any been effective?
>
> I`m resistant to treatment too (10 years of purseverance, on a total of 13 different meds, and permutations of these, plus an unsuccessful course of 20 ECT sessions, which has cost me my memory of the entirety of 1998).
>
> I feel that I`m fast approaching the end of the line. I`ll be going into a unit in Newcastle (the North of England if you live outside the UK) that deals entirely with `difficult to treat depression`. There I will be under a Professor who is a specialist in this area, and it`s he that gave me my diagnosis (chronic severe double depression - basically Dysthymia, with an added episode of major severe deoression, in my case, lasting for approx 6 years). He`s decided to try me on Venlafaxine, Mirtazapine and Lamotragine (all at high doses). I`m afraid that I don`t hold out very much hope for this forthcoming hospitalisation - I`ve been in hospital 3 times already (although the first psychiatrist I was under was a complete berk, and didn`t have a clue what he was doing - he classed all cases of depression that he couldn`t treat as `atypical`, and washed his hands of all further treatment after 2 attempts at treatment. Anyway, this is irrelevant).
>
> So that`s the story - no hope at all for the upcoming work with the specialist. I daren`t, because I`ve had too many disappointments.
>
> That`s me.
>
> Anyway, thanks again for answering my post.
>
> Cheers,
>
> Anna.
Posted by sweetmarie on April 6, 2001, at 4:09:43
In reply to Re: Remeron and Venlafaxine, posted by JohnL on April 5, 2001, at 16:22:20
>
> Hi Anna,
> In Dr Bob's Tips the combination of Remeron+Effexor is described as being 'big guns'. I've tried them both and didn't get well with either. Effexor actually made me worse, while Remeron was neutral but had the advantage of knocking me out at bedtime. At least it could take me away from my pain quickly and put me to sleep.
>
> I have a lot more faith in drug combinations that involve antipsychotics or stimulants or both instead of a second antidepressant. Over time I've just seen more success stories with those types of combinations. For example, I found Prozac+Zyprexa to be a million times better than Remeron+Effexor, and with far fewer side effects. I know it's different with everyone, but I just think success is reached quicker when other drugs are combined with an antidepressant, instead of adding in a second antidepressant. For example in your case I would favor Effexor+Zyprexa instead of Effexor+Remeron.
>
> Just some random thought.
> JohnJohn,
The combination is actually going to be Remeron, Effexor and Lamictal (Lamotragine), which as you probably know is a mood stabiliser.
This (the Lamictal) has been part of my current med `cocktail` for the past 8 months or so (Phenelzine/Trimipramine/Valproate/Lamotragine), but only at a small dosage (25 mg). This new combo has the Lamictal up to 250 mg.
Anyway, we`ll see. I HOPE it will have some effect - I`ve been so ill for so long now.
Anna.
Posted by sweetmarie on April 7, 2001, at 13:16:25
In reply to Re: Remeron and Venlafaxine - long, posted by SalArmy4me on April 6, 2001, at 2:52:19
>
> > > I was on that combination for a month, with megadoses of each. I took 450 of Effexor XR HS; 60 mg of Remeron HS. My depression is resistant enough even to that, but I have heard that that combination is effective for a lot of people.I would say that a month would not be long enough to expect any result, especially when you`ve been resistant to treatment in the past. For a start, I don`t expect that you were on optimal doses of both to start with. I`ve always been led to believe that time-scale starts when optimal dosage has been reached. I could be totally wrong here, and I also know that it is virtually impossible to exercise any kind of patience when you`re feeling lousy. Presumably, this period of a month was recommended by the doctor treating you? I`m probably just sticking my nose in here, and I apologise if that`s the way it sounds. It just struck me, that`s all. > >
> > > Oh, the Remeron itself combats the sexual side-effects of the Effexor;
What are the sexual side-effects of Efexor?
> >Anna.
Posted by SalArmy4me on April 10, 2001, at 0:35:26
In reply to Re: Remeron and Venlafaxine - long, posted by sweetmarie on April 7, 2001, at 13:16:25
The sexual side-effects of Effexor are or can be lack of sex drive and anorgasmia. But most people don't realize that trials of not only buproprion, but buspirone, methylphenidate, and mirtazapine can remedy the sexual problems. This requires a great deal of patience, though, because the sexual side-effects go away in 2-4 weeks on average--if they do at all.
Posted by SLS on April 10, 2001, at 10:46:36
In reply to Re: Remeron and Venlafaxine - long, posted by SalArmy4me on April 6, 2001, at 2:52:19
> I like the idea of Venlafaxine, Mirtazapine and Lamotrigine as your next combination. Your side-effects will be minimal, and I guarantee you will benefit from one of those medications.
Personally, I try to refrain from giving guarantees (I may not always succeed). I’m not smart enough yet. Although there are times when I have a good “feeling” about a particular treatment for any one individual, I try not to convey a sense of confidence that it will work. I also have to discipline myself to not make the mistake of generalizing my own experiences with drugs to others. Where does one go next when the “guaranteed” treatment doesn’t work? Perhaps this is a ticket to unwarranted despair. Sometimes, a treatment that is guaranteed not to work does. It doesn’t matter how “big” the “gun” is if it is pointed at the wrong target.> > > I was on that combination for a month, with megadoses of each. I took 450 oaf Effexor XR HS; 60 mg of Remeron HS. My depression is resistant enough even to that, but I have heard that that combination is effective for a lot of people.
- Scott
Posted by sweetmarie on April 10, 2001, at 14:43:48
In reply to Re: Remeron and Venlafaxine - long, posted by SLS on April 10, 2001, at 10:46:36
> > I like the idea of Venlafaxine, Mirtazapine and Lamotrigine as your next combination. Your side-effects will be minimal, and I guarantee you will benefit from one of those medications.
>
>
> Personally, I try to refrain from giving guarantees (I may not always succeed). I’m not smart enough yet. Although there are times when I have a good “feeling” about a particular treatment for any one individual, I try not to convey a sense of confidence that it will work. I also have to discipline myself to not make the mistake of generalizing my own experiences with drugs to others. Where does one go next when the “guaranteed” treatment doesn’t work? Perhaps this is a ticket to unwarranted despair.Sometimes, a treatment that is guaranteed not to work does. It doesn’t matter how “big” the “gun” is if it is pointed at the wrong target.
>
> > > > I was on that combination for a month, with megadoses of each. I took 450 oaf Effexor XR HS; 60 mg of Remeron HS. My depression is resistant enough even to that, but I have heard that that combination is effective for a lot of people.
>
>
> - ScottScott,
I hear what you`re saying, and totally know why you`re saying it.
But, sometimes false hope is better than absolutely no hope at all (if you see what I mean).
Anna.
This is the end of the thread.
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