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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by kid_A on June 20, 2001, at 12:54:14
I was given some remeron samples as well as a small script of ambien for insomnia... I've also been taking effexor xr 37.5 for a little over a week and a half now (I'm going out of the country so I'm staying on 37.5 per day until I get back)...
Anyone have any advice as to which might help me sleep more? I've been told that the ambien should put me right out, but I've heard similar claims about the remeron, and plus the remeron has additional ad effects.
Posted by pellmell on June 20, 2001, at 14:34:27
In reply to Remeron vs Ambien ...i have both, try which first?, posted by kid_A on June 20, 2001, at 12:54:14
I've never tried Ambien, but Remeron put me right out (and a bit into the next day as well). Remeron may also counter the anorgasmia you might be experiencing on Effexor.
In the end I didn't like Remeron as an antidepressant because it left me sedated in the daytime, and...well, I just didn't respond to it very well. As always, YMMV. For some people the daytime grogginess goes away after a week or so on the drug.
-pm
P.S. - Also, watch your appetite on that stuff.. :)> I was given some remeron samples as well as a small script of ambien for insomnia... I've also been taking effexor xr 37.5 for a little over a week and a half now (I'm going out of the country so I'm staying on 37.5 per day until I get back)...
>
> Anyone have any advice as to which might help me sleep more? I've been told that the ambien should put me right out, but I've heard similar claims about the remeron, and plus the remeron has additional ad effects.
Posted by kid_A on June 20, 2001, at 15:30:34
In reply to Re: Remeron vs Ambien ...i have both, try which first?, posted by pellmell on June 20, 2001, at 14:34:27
> -pm
> P.S. - Also, watch your appetite on that stuff.. :)That was one of the effects that I was actually looking forward to! I'm skinny and I've been trying hard to put on some pounds! :)
Posted by Daveman on June 21, 2001, at 22:03:53
In reply to Re: Remeron vs Ambien ...i have both, try which first?, posted by kid_A on June 20, 2001, at 15:30:34
Hey Kid A:
I've taken both. Ambien knocked me out like a light but I woke up a few hours later- it is a potent hypnotic but has a short half-life. I've been on Remeron 15 mg. at bedtime since February. At first, it knocked me out immediately and kept me asleep for 10 hours or more- it was so sedating I was able to taper off of Klonopin, which I had been taking for sleep. After a month or so, this began to ease, and for the last several months I have found Remeron to be a subtle but effective sleep aid- it takes about an hour, but I always get to sleep, and the daytime sedation is minimal.
As always, Your Milaege May Vary, but I would always choose a non-addictive med like Remeron over a potentially addictive med like Ambien. While Ambien is not as addictive as the benzo sleeping meds (i.e., Halcion, Dalmane), it does react with the some of the same receptors and eventually can be addictive. So, if you're looking for something to take occasionally as needed, a med like Ambien works just fine (I even keep some on hand, tho I've had the same four pills left since February); but if you're looking for something to take regularly, Remeron would be my choice.
Dave
Posted by Elizabeth on June 25, 2001, at 6:11:27
In reply to Remeron vs Ambien ...i have both, try which first?, posted by kid_A on June 20, 2001, at 12:54:14
Ambien is less likely to have unpleasant side effects. It won't last as long, but on the other hand, you might find it doesn't last all night and you wake up early (a common problem for me).
-elizabeth
Posted by Neal on June 25, 2001, at 17:58:40
In reply to Re: Remeron vs Ambien ...i have both, try which first?, posted by kid_A on June 20, 2001, at 15:30:34
Low dose Remeron is the way to go, it worked for me. I don't like sleeping pills
Posted by joema on June 25, 2001, at 20:29:16
In reply to Re: Remeron vs Ambien ...i have both, try which first? » kid_A, posted by Daveman on June 21, 2001, at 22:03:53
Daveman said: "At first, it knocked me out immediately and kept me asleep for 10 hours ...After a month or so, this began to ease, and for the last several months...subtle but effective sleep aid- it takes about an hour, but I always get to sleep, and the daytime sedation is minimal."
I took Remeron for several months at varying dosages. My results were similar to Daveman. At low dosages (7.5 - 15mg), it was a very good sleep aid, and I didn't develop a real tolerance even after 3 months. Initially I was a little groggy in the AM, but after a cup of coffee I felt OK.
However when I increased to 30mg/day, the sedative effect was less. This inverse dose/response relationship is often reported.
I also took Klonapin, which is a great drug but there's a problem with tolerance. I strongly recommend low-dose Remeron over benzodiazepines. However Remeron can cause some weight gain. I gained about 5 lbs over 3 months, and I was watching my diet and exercising regularly.
-- joema
Posted by Ted on June 26, 2001, at 10:13:13
In reply to Re: Remeron vs Ambien ...i have both, try which first?, posted by pellmell on June 20, 2001, at 14:34:27
I asked my pdoc and he refused remeron *unless I really wanted to try it*. He said *every* patient he has had on it gained *lots* of weight. He continues to write scripts for ambien, which I take nightly at low dose (3-5 mg; I break the tablets).
I really like the ambien -- practically no side effects. It is supposedly non-addictive, but I agree with another poster -- being related to the benzodiazepines, it is probably at least weakly addictive. Just keep the dose as low as possible and skip taking it on an occasional night.
Ted
> P.S. - Also, watch your appetite on that stuff.. :)
Posted by Elizabeth on June 27, 2001, at 11:42:19
In reply to Re: Remeron vs Ambien » kid_A, posted by Neal on June 25, 2001, at 17:58:40
> Low dose Remeron is the way to go, it worked for me. I don't like sleeping pills
When used in low doses, Remeron *is* a sleeping pill...
Posted by Elizabeth on June 27, 2001, at 11:49:34
In reply to Re: Remeron vs Ambien ...i have both, try which first?, posted by Ted on June 26, 2001, at 10:13:13
> I asked my pdoc and he refused remeron *unless I really wanted to try it*. He said *every* patient he has had on it gained *lots* of weight.
I didn't gain any weight on Remeron. I started at 30 mg; my pdoc says the sedation definitely goes away at higher doses, and the weight gain may also.
> He continues to write scripts for ambien, which I take nightly at low dose (3-5 mg; I break the tablets).
It comes in 5 mg tabs, you know. (I've taken 20 mg nightly for long periods of time -- the longest stretch was something like 18 months -- with no loss of effect and no rebound insomnia on discontinuing it.)
> I really like the ambien -- practically no side effects. It is supposedly non-addictive, but I agree with another poster -- being related to the benzodiazepines, it is probably at least weakly addictive. Just keep the dose as low as possible and skip taking it on an occasional night.
I find it works better if I take it every night, actually.
There have been a few cases of dependence, and it certainly has potential for abuse (I've heard a lot of people say it is a better high than the benzos, although I think that its memory-impairing effects make it really impractical as a recreational drug), but dependence is the exception, not the rule.
Ambien is a more specific-acting benzo receptor agonist (but not chemically a benzodiazepine), but surprisingly, it seems to work a lot better than the benzos. Now if only there were a longer-acting drug of the same class -- then I'd be guaranteed a lifetime of good sleep every night! < g >
-elizabeth
Posted by Amy Blue on June 29, 2001, at 21:59:20
In reply to Re: Remeron vs Ambien » Neal, posted by Elizabeth on June 27, 2001, at 11:42:19
Elizabeth - question regarding your comment here. I was prescribed Remeron for insomnia ONLY. Not depression or anything else. Does this make sense to you? Also, my doc said the lower the dose, the more sleepy you are. This true? In other words, she told me to take 30 mgs and if I have too much daytime grogginess, to try 45 mgs. HELP. I am desperate for some sleep.
Thanks,
Amy Blue> When used in low doses, Remeron *is* a sleeping pill...
Posted by Elizabeth on June 30, 2001, at 1:35:06
In reply to Re: Remeron vs Ambien - to Elizabeth, posted by Amy Blue on June 29, 2001, at 21:59:20
> I was prescribed Remeron for insomnia ONLY. Not depression or anything else. Does this make sense to you?
Yeah, it's a great sleep drug, but at sedating doses it tends to cause appetite increase.
> Also, my doc said the lower the dose, the more sleepy you are. This true?
Yup! Remeron is a strong antihistamine, which is what causes the weight gain and sedation. The adrenergic effects kick in at higher doses and soon overwhelm the antihistaminic effects.
-elizabeth
Posted by Betts on August 14, 2001, at 9:13:41
In reply to Re: Remeron vs Ambien » Amy Blue, posted by Elizabeth on June 30, 2001, at 1:35:06
I've been taking amitriptylene so I can sleep at night. I have fibromyalgia, and lately the pain has been waking me up several times during the night. My doctor switched me to Remeron last night, and I was awake most of the night. I feel sluggish this morning, and definitely not refreshed. Is this drug all he says it is?
Betts
Posted by Betts on August 14, 2001, at 9:13:52
In reply to Re: Remeron vs Ambien » Amy Blue, posted by Elizabeth on June 30, 2001, at 1:35:06
I've been taking amitriptylene so I can sleep at night. I have fibromyalgia, and lately the pain has been waking me up several times during the night. My doctor switched me to Remeron last night, and I was awake most of the night. I feel sluggish this morning, and definitely not refreshed. Is this drug all he says it is?
Betts
Posted by stjames on August 15, 2001, at 1:21:09
In reply to Re: Remeron vs Ambien, posted by Betts on August 14, 2001, at 9:13:41
> I've been taking amitriptylene so I can sleep at night. I have fibromyalgia, and lately the pain has been waking me up several times during the night. My doctor switched me to Remeron last night, and I was awake most of the night. I feel sluggish this morning, and definitely not refreshed. Is this drug all he says it is?
>
> Bettsjames here....
Give yourself a week to adjust.
Posted by JohnL on August 15, 2001, at 18:00:29
In reply to Re: Remeron vs Ambien, posted by Betts on August 14, 2001, at 9:13:41
> I've been taking amitriptylene so I can sleep at night. I have fibromyalgia, and lately the pain has been waking me up several times during the night. My doctor switched me to Remeron last night, and I was awake most of the night. I feel sluggish this morning, and definitely not refreshed. Is this drug all he says it is?
>
> BettsI think St James is correct, in that it will take a little time to adjust.
Remeron is kind of weird because it can be more sedating at low doses and less sedating at regular doses. I used to take as little as 2.5mg to 7.5mg for sleep. Any more than that would actually wake me up and make me sleep lousy. Even the minimum dose of 15mg was way too much. I would cut or break the pills into smaller chunks. Those tiny chunks are amazingly sedating.
That being said, I like the tricyclics much better for pain and sleep than Remeron. I don't think Remeron has any action at all on pain. With me it actually created some joint pain which went away after I stopped taking it.
Also, no matter what dose size you take, the grogginess you feel during the day will go away. It takes a week or two. But that hangover feeling when you first wake doesn't go away. At least not for me. It would go away after my first coffee, but it was there every morning for over a year.
The best med I've tried for sleep is Zyprexa. It doesn't knock me out fast like other drugs did, but when I do fall asleep I sleep excellent. The early morning hangover is child's play compared to Remeron or the tricyclics. Very mild. After a week there is not daytime grogginess at all. I also have had weird minor pains for a long time, and they have all disappeared completely with Zyprexa. I don't think there is any clinical evidence for Zyprexa being used for pain, but I thought I would share my positive experience with it in case it might be helpful to you. It's been one of the best meds ever for my treatment resistent depression, pain, sleep, and it has also nearly completely eliminated the long time ringing in my ears.
John
Posted by stjames on August 18, 2001, at 0:51:07
In reply to Re: Remeron vs Ambien, posted by Betts on August 14, 2001, at 9:13:41
> I've been taking amitriptylene so I can sleep at night. I have fibromyalgia, and lately the pain has been waking me up several times during the night. My doctor switched me to Remeron last night, and I was awake most of the night. I feel sluggish this morning, and definitely not refreshed. Is this drug all he says it is?
>
> BettsThe TCA's are used in FM for sleep and pain control. Remeron could act as a TCA (in this respect) without some of the common TCA side effects.
james
Posted by AMenz on August 18, 2001, at 22:34:51
In reply to Re: Remeron vs Ambien, posted by stjames on August 18, 2001, at 0:51:07
Are Remeron and Ambien anxiolytics or anti-depressant and which of the two makes you gain weight?
> > I've been taking amitriptylene so I can sleep at night. I have fibromyalgia, and lately the pain has been waking me up several times during the night. My doctor switched me to Remeron last night, and I was awake most of the night. I feel sluggish this morning, and definitely not refreshed. Is this drug all he says it is?
> >
> > Betts
>
> The TCA's are used in FM for sleep and pain control. Remeron could act as a TCA (in this respect) without some of the common TCA side effects.
>
> james
Posted by Daveman on August 20, 2001, at 10:52:18
In reply to Re: Remeron vs Ambien, posted by AMenz on August 18, 2001, at 22:34:51
> Are Remeron and Ambien anxiolytics or anti-depressant and which of the two makes you gain weight?
>Ambien is a hypnotic with little or no anxiolytic or antidepressant qualities. Remeron is an antidepressant with some anxiolytic qualities which is quite sedating in lower doses. Remeron makes you gain weight, Ambien does not.
Dave
Posted by Elizabeth on August 22, 2001, at 12:54:15
In reply to Re: Remeron vs Ambien, posted by Daveman on August 20, 2001, at 10:52:18
> Ambien is a hypnotic with little or no anxiolytic or antidepressant qualities.
It's marketed as a sedative-hypnotic, and it is effective for insomnia (especially initial insomnia), but I have to disagree about the rest. I've been able to use a low dose of Ambien (half the hypnotic dose) in emergencies for anxiety and depression.
-elizabeth
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