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Dr. Bob is Robert Hsiung, MD,
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Posted by BarbaraCat on March 7, 2002, at 12:33:11
In reply to Re: Lithium; thyroid site » BarbaraCat, posted by Ritch on March 7, 2002, at 11:37:21
Mitch,
Be wary of getting TSH too low. Hyper symptoms are no fun, and can set off hypomania, agitation, insomnia, headaches. Supplementing with thyroid hormone can also suppress your natural production. Your TSH of 1.4 seems to be in an ideal spot and I'd certainly hesitate to mess with that.If you have doubts about the accuracy of your TSH readings, you might try the basal thermometer test. It's efficacy is somewhat anecdotal, but remains a time honored method of testing. Shake down mercury thermometer before going to bed at night. On waking, before moving around or going to the bathroom, place thermometer in the armpit for 10 minutes. If readout is less than 97.4, chances are you're hypothyroid. - Barbara
Posted by Ritch on March 7, 2002, at 13:51:04
In reply to Thyroid » Ritch, posted by BarbaraCat on March 7, 2002, at 12:33:11
Posted by JackD on March 7, 2002, at 14:05:05
In reply to Re: Lithium » capricorn, posted by BarbaraCat on March 3, 2002, at 14:08:30
> Not on it's own, but it's the spark plug that makes my Remeron work. It's made all the difference, since any antidepressant pooped out on any dose. - Barbara
>Barbara, any helpful feedback you could give me regarding your experience with Remeron in addition to a mood stabilizer would be greatly appreciated. JohnX2 has suggested I may be Bipolar II, and from further research I've done I realize it is more than likely I am. Oh, and I LOVE Remeron... the trick now is for me to "lock onto", as John said, to Remeron's positive effects.
P.S. Sorry to pirate this thread.
Posted by Dave1 on March 7, 2002, at 17:31:32
In reply to Re: Lithium » Denise528, posted by BarbaraCat on March 6, 2002, at 13:11:04
Hi,
I'm taking anafranil - 250mg/day. And lithium - 1200mg/day. It started to help my depression about a week ago.
Bye,
Dave
Posted by BarbaraCat on March 7, 2002, at 18:53:14
In reply to Remeron and Lithium -Barbara, posted by JackD on March 7, 2002, at 14:05:05
Hi Jack,
Glad to offer any help I can. I've had depressions and panic like symptoms periodically since my teens. Was on most of the old antidepressants and finally the SSRI's when Prozac became available. Zoloft was the one I was on for the longest, about 6 years. After 3 years of successful treatment, the depression started breaking through, as well as the panic attacks, so my doc kept upping the dose. This actually made me feel worse and so I tried going off ADs. Four attempts at quitting, some as long as 1 year and I felt OK, but the cycling of depression/panic would start up again and I'd have to go back on. Tried everything, celexa, effexor, paxil, wellbutrin, serzone. They'd all work for a short time then poop out and any increase would leave me feeling agitated and depressed, not to mention sexually and emotionally numb.Remeron was a different feeling altogether from the start and for two months at 30mg I have never felt better. Motivated, happy, calm, wonderful. Then at month 3 it pooped totally and I went into a bleak, dark and scary depression, feeling the rug had been pulled out yet again. This was back in late November.
My pdoc had been suggesting lithium as an augmentor all along, but I resisted, mainly because of the health cautions. Lithium requires monthly blood and urine tests since it has to fall within a window of blood level or can be toxic and cause renal failure. I'm very health conscious and this scared me, but figured the emotional stress I was under was probably killing me so what the heck. I'm also *so far* only taking 300 mg a day instead of the usual much higher doses for bipolar disorders.
While in the midst of a crushing depression, I started feeling better within 3 days of the lithium and could feel the same earlier effects from Remeron kicking in. The two act synergistically. The extra mood elevation has allowed me to get back to exercising which for me is the most effective antidepressant, but totally impossible when my brain in miswired.
I suspect I'm bipolar II as well from my past history of occassional hypomania (never long enough, alas), followed by horrible depression, as well as my non-response to AD's. So to make a very long story come to the point, I once again LOVE Remeron, but without the Lithium (and klonopin and thyroid as well which are crucial for me), it would be worthless. Hopefully I can remain at the low end of 300 mg and avoid the health stuff. Feel free to converse anytime. BTW, what makes you suspect BP-II for yourself? - Barbara
Posted by JackD on March 7, 2002, at 20:50:53
In reply to Re: Remeron and Lithium -Barbara » JackD, posted by BarbaraCat on March 7, 2002, at 18:53:14
Ah, a medicine love story; lithium and remeron. I hope I have as much success... I suspect bipolar since I have had very strong and rapid responses to meds, especially the more activating ones. However, after short while the meds soon stop working and make me even worse off than I was to begin with. I also have ADD, which is often comorbid with Bipolar. From the literature I've read symptoms of Bipolar II seem much more fitting than Bipolar I. Also, in retrospect, I have always been SO inconsistent with almost every aspect of my life. Even as far back as elemtary school through now (college), my teachers have said I'm very unpredictable and inconsistent. I'm sure there are a few more reasons for my prognosis, but I can't think of any off hand. Well, anyway, thanks for your input.
Posted by jane d on March 7, 2002, at 23:29:40
In reply to Hypopthyroidism in people wioth mood disorders., posted by Psydoc on March 7, 2002, at 5:05:55
I hadn't realized until now that the NEJM was allowing free access to some (most?) articles over 6 months old including the one recommended by Ivan Goldberg (many thanks!) below. You do need to register for it but that's easy enough. Just wanted to spread the word in case anyone else out there didn't know this.
Jane
> It has long been my impression that most endocrinologists tend to undertreat hypothyroidism in people with mood disorders. The best indicators of the adequacy of the treatment are the feeling of well-being of the person beingh treated and the level of TSH. It usually requires that sufficient thyroid hormones (optimally T-4 + T-3) be administered to cause the TSH to fall to the lowest quarter of the normal range.
>
> If your doctor is reluctant to use the combination of T-4 plus T-3, pringt out the paper from the New England Journal of Medicine at:
> http://content.nejm.org/cgi/content/abstract/340/6/424 and bring it to your next visit.
>
> Best regards . . .
>
> Ivan Goldberg
> psydoc@psycom.net
> %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Posted by Thrud on March 7, 2002, at 23:52:35
In reply to Hypopthyroidism in people wioth mood disorders., posted by Psydoc on March 7, 2002, at 5:05:55
Hi Psydoc,
Maybe you can help me with a little puzzle that has vexed me for a couple of years.
A couple of years ago I tried l-tyrosine as a monotherapy for depression/panic/crushing fatigue because I was so sick of SSRIs. After about 2 weeks it really kicked in and I excitedly told my family that I felt well for the first time in 10 years. There was one major problem though...it made me completely impotent, more than any SSRI. In the end it pooped out after a couple of months and I had to move on to other meds.
I did a lot of research on l-tyrosine to see where it is used in the body and see if I could pinpoint some biological basis for my problems: I simply shouldn't have felt that good (or that impotent) on a simple amino acid. I was using the standard dose of 1500mg per day.
It seems to be involved in the endocrine system a lot, including the thyroid. I also believe that the thyroid is connected to sexual function (through some hormone I guess) but I could find nothing linking higher levels of l-tyrosine to impotence. In fact the opposite always seems to be reported: the increase in brain dopamine is supposed to increase sex drive. My TSH levels are tested periodically and have always been normal.
I have celiac disease and know that there is some comorbitity with thyroid autoimmune problems. Could there be a thyroid problem which is not reflected in TSH levels? If it helps, I have just been found to be low in testosterone and LH.
I have discussed this all this with my pdoc and he is referring me to an endocrinologist. In the meantime, if you have any insights to offer I would be very, very appreciative.
Thrud
Posted by BarbaraCat on March 8, 2002, at 0:09:45
In reply to Re: Remeron and Lithium -Barbara, posted by JackD on March 7, 2002, at 20:50:53
Yep, your story sounds very similar to mine. I think we may be one of the few folks on this board who are on the lithium/remeron combo so I'll be interested to hear how your faring. Keep in touch. - Barbara
> Ah, a medicine love story; lithium and remeron. I hope I have as much success... I suspect bipolar since I have had very strong and rapid responses to meds, especially the more activating ones. However, after short while the meds soon stop working and make me even worse off than I was to begin with. I also have ADD, which is often comorbid with Bipolar. From the literature I've read symptoms of Bipolar II seem much more fitting than Bipolar I. Also, in retrospect, I have always been SO inconsistent with almost every aspect of my life. Even as far back as elemtary school through now (college), my teachers have said I'm very unpredictable and inconsistent. I'm sure there are a few more reasons for my prognosis, but I can't think of any off hand. Well, anyway, thanks for your input.
Posted by JohnX2 on March 9, 2002, at 1:14:44
In reply to Re: Hypopthyroidism in people wioth mood disorders. » Psydoc, posted by Thrud on March 7, 2002, at 23:52:35
Thrud,I've looked into and also tried l-tyrosine and
also l-phenylalanine suplemenatation with short lived poop out
results. My understanding of the biological pathway is that the
amino acid in the vast majority of neurons already saturates
the bottlneck enzyme called "tyrosine hydroxylase".
phenylalanine (via phenylalanine hydroxylase)-> tyrosine (via tyrosine hyrdroxylase)-> l-dopa -> dopamine -> norepineprine
The phenylalanine is converted to tyrosine through
a phenylalnine hydroxylase enzyme. Subsequently tyrosine
gets converted to l-dopa via a "tyrosine hydroxylase" enzyme.
And then l-dopa can get converted to dopamine and then
potentially norepinephrine.In the vast majority of cells the diet swamps the enzyme
tyrosine hydroxylyse. So for most people taking tyrosine
precursor provides no benefit. However, you can bypass by
taking l-dopa as in parkinson's.Now for impotence, its interesting that we usually see this
a lot in medicines that are norepinephrine reuptake inhibitors.
A lot of people complained of this in Reboxetine. People found
relief for this with medicines that blocked the noradrenaline
"alpha-1" receptor like "Flomax". Also medicines with side effects
like priapism (permanent erection) such as Trazodone, block the
noradrenaline "alpha-1" receptor. So I wonder if your effect had
more to do with norepinephrine than dopamine.-John
> Hi Psydoc,
>
> Maybe you can help me with a little puzzle that has vexed me for a couple of years.
>
> A couple of years ago I tried l-tyrosine as a monotherapy for depression/panic/crushing fatigue because I was so sick of SSRIs. After about 2 weeks it really kicked in and I excitedly told my family that I felt well for the first time in 10 years. There was one major problem though...it made me completely impotent, more than any SSRI. In the end it pooped out after a couple of months and I had to move on to other meds.
>
> I did a lot of research on l-tyrosine to see where it is used in the body and see if I could pinpoint some biological basis for my problems: I simply shouldn't have felt that good (or that impotent) on a simple amino acid. I was using the standard dose of 1500mg per day.
>
> It seems to be involved in the endocrine system a lot, including the thyroid. I also believe that the thyroid is connected to sexual function (through some hormone I guess) but I could find nothing linking higher levels of l-tyrosine to impotence. In fact the opposite always seems to be reported: the increase in brain dopamine is supposed to increase sex drive. My TSH levels are tested periodically and have always been normal.
>
> I have celiac disease and know that there is some comorbitity with thyroid autoimmune problems. Could there be a thyroid problem which is not reflected in TSH levels? If it helps, I have just been found to be low in testosterone and LH.
>
> I have discussed this all this with my pdoc and he is referring me to an endocrinologist. In the meantime, if you have any insights to offer I would be very, very appreciative.
>
> Thrud
Posted by Psydoc on March 9, 2002, at 6:10:39
In reply to Re: Hypopthyroidism in people wioth mood disorders. » Psydoc, posted by Thrud on March 7, 2002, at 23:52:35
Hi . . .
In the 8/16/80 issue of The Lancet I puiblished some brief case reports regarding people who had a good response to l-tyrosine. Symptoms of AD(H)D and depression were controlled. The only problem was that in soime people the results were not long-lasting and in other people l-tyrosine seemed to have no effect on thinking, mood or behavior.
Unfortunately I am unable explain the effectiveness or loss of effectiveness of l-tyrosine.
Best regards . . .
Ivan Goldberg
psydoc@psycom.net
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Posted by Zo on March 12, 2002, at 2:25:51
In reply to Hypopthyroidism in people wioth mood disorders., posted by Psydoc on March 7, 2002, at 5:05:55
Posted by Thrud on March 12, 2002, at 4:47:45
In reply to Re: Hypopthyroidism in people wioth mood disorders. » Thrud, posted by JohnX2 on March 9, 2002, at 1:14:44
Hi John,
> I've looked into and also tried l-tyrosine and
> also l-phenylalanine suplemenatation with short lived poop out
> results.I get the feeling that the body has "thermostat" levels set for just about every chemical in the body, and if it is a natural substance like tyrosine, it quickly figures out how to counter-act elevated levels (extra liver metabolism etc?).
It seems to take a fair time longer to figure out how to counteract (unnatural-to-the-body) psychmeds but does seem to eventually succeed in most people.>My understanding of the biological pathway is that the
> amino acid in the vast majority of neurons already saturates
> the bottlneck enzyme called "tyrosine hydroxylase".
>
> phenylalanine (via phenylalanine hydroxylase)-> tyrosine (via tyrosine hyrdroxylase)-> l-dopa -> dopamine -> norepineprine
>Yeah, I had a look at the metabolic pathways one day as well and noticed a possible bottleneck in tyrosine hydroxylase. I then bought some NADH which supposedly helps depression by increasing the production of tyrosine hydroxylase. It didn't really do much for the depression and also made me somewhat impotent. I don't really recommend it to anybody.
>So I wonder if your effect had
> more to do with norepinephrine than dopamine.
>
> -JohnI can't say. L-tyrosine is also used in the thyroid, thalamus, hypothalamus and adrenal glands. Any one of these could be screwy too. My low testosterone and LH levels has now given me an excuse to see an endocrinologist, so I will ask for a full work up.
I can't stand enforced celibacy for much longer................
Thrud
Posted by Thrud on March 12, 2002, at 4:52:49
In reply to Re: Hypopthyroidism in people wioth mood disorders. » Thrud, posted by Psydoc on March 9, 2002, at 6:10:39
Hi Psydoc,
Are there thyroid problems that might not be reflected in abnormal TSH levels, yet still affect mood and/or sexual function?
I've read that low thyroid hormone levels can cause impotency (although I don't know the mechanism) but then TSH levels should not be normal (mine always have been).
Thanks,
Thrud
Posted by BarbaraCat on March 12, 2002, at 11:42:05
In reply to Hypopthyroidism in people wioth mood disorders., posted by Psydoc on March 7, 2002, at 5:05:55
Dr. G.
Have a question for you. What is your opinion of taking T3 in the form of Armour or another dessicated thyroid hormone vs. synthetic T4 + Cytomel (synthetic T3) for hypothyroid with depression? Have you heard any positives about time release T3? (I haven't - felt like it dumped it's load all at once causing jitters). Thanks for feedback.
Posted by BarbaraCat on March 12, 2002, at 11:45:59
In reply to Love that Cytomel ! (nm) » Psydoc, posted by Zo on March 12, 2002, at 2:25:51
So speak to us, Zo. Why are you taking Cytomel? Hypothyroid? Depressed? Both? How much are you taking and how many times a day? Do you take it with levothyroxine or alone? Why do you love it?
I'm on 2 grains Armour thyroid. My TSH level is good, but I'm still dragging. Thinking of making the switch to synthetic T4 + Cytomel, but have not heard any 'real' stories praising Cytomel. - Barbara
Posted by noa on March 12, 2002, at 17:07:08
In reply to Re: Lithium; thyroid site » noa, posted by Ritch on March 6, 2002, at 23:48:34
I think one problem is that with the ease of TSH tests, testing is done more widely but the guidelines of "normal" being in the range of about 1 to 5 have been relied on too rigidly at the expense of listening to how the patient feels. Also, many doctors rely too heavily on just the one test--TSH--when other data may be needed. TSH is a good *screening* tool in my opinion, but not the be-all and end-all of diagnosing thyroid problems. But I think that manged care being what it is, unfortunately, SOP for many doctors is to rely on such screening tools as well as quick and easy numbers guidelines which were really intended to be statistical norms and not the definition of what is normal functioning for any one individual.
The 2.0 that you are referring to, I believe comes from an article in a British medical journal (please see the thyroid and depression folder --it is linked there) which suggests that anything 2.0 or above has a high correlation with subsequently emerging signs and symptoms of hypothyroidism, and therefore TSH results in the lower 1/4 of the so-called "normal" range should be considered not normal and treatment should be considered.
For me, I had a TSH at around 4.5-5. My pdoc prescribed cytomel and later, synthroid. My TSH then hovered around 2.5 for a while and I felt better than before, but not great. On lithium, the TSH went up to 3.8. I saw an endo who raised my doses gradually based on how it affected how I felt. He anticipated that my TSH target would be below 1, and subsequently wrote a letter to my Primary Care doctor saying that in his experience, patients with hypothyroidism and depression do best when thyroid is treated to the point of getting TSH below 1. My improvement leveled off at around .3, although even after that, I continued to feel increasingly better at that level of treatment.
I think the endocrinology *establishment* (ie organizations) should be distinguished from endocrinologists. You should go to an endo that you have recs about from other people--one who is up on the latest research about hypothyroid undertreatment, etc. and who does not rely solely on blood tests, but combines this data with listening to the patient about how they feel--but don't write off the whole profession, either. My endo has been fantastic--and my life drastically improved because I went to see him.
Posted by noa on March 12, 2002, at 17:11:24
In reply to Re: Love that Cytomel ! » Zo, posted by BarbaraCat on March 12, 2002, at 11:45:59
I take Synthroid and Cytomel and they work well for me. If I were starting out now, I would opt for a different brand of T4, though--ie, one of the ones that went through approval process with FDA, but since I have been on synthroid for so long without problems, I am staying with it.
I personally wouldn't want to take the Armour because its source doesn't jive with my dietary choices (ie, it's from Pigs)--unless of course there were no alternative for me.
Posted by BarbaraCat on March 12, 2002, at 18:16:51
In reply to Re: Lithium; thyroid site » Ritch, posted by noa on March 12, 2002, at 17:07:08
Amen, Amen I say to that, Noa. I like your endo. Below 1 seems like a healthy level to shoot for, but so many docs leave it at 3-4 and call it normal. Just out of curiosity, how long did it take your thyroid to get affected after starting lithium? And what are you taking and how much now vs. before the lithium? I realize we're all different, but it's of interest to me. - Barbara
Posted by Ritch on March 12, 2002, at 18:17:55
In reply to Re: Lithium; thyroid site » Ritch, posted by noa on March 12, 2002, at 17:07:08
> I think one problem is that with the ease of TSH tests, testing is done more widely but the guidelines of "normal" being in the range of about 1 to 5 have been relied on too rigidly at the expense of listening to how the patient feels. Also, many doctors rely too heavily on just the one test--TSH--when other data may be needed. TSH is a good *screening* tool in my opinion, but not the be-all and end-all of diagnosing thyroid problems. But I think that manged care being what it is, unfortunately, SOP for many doctors is to rely on such screening tools as well as quick and easy numbers guidelines which were really intended to be statistical norms and not the definition of what is normal functioning for any one individual.
>
> The 2.0 that you are referring to, I believe comes from an article in a British medical journal (please see the thyroid and depression folder --it is linked there) which suggests that anything 2.0 or above has a high correlation with subsequently emerging signs and symptoms of hypothyroidism, and therefore TSH results in the lower 1/4 of the so-called "normal" range should be considered not normal and treatment should be considered.
>
> For me, I had a TSH at around 4.5-5. My pdoc prescribed cytomel and later, synthroid. My TSH then hovered around 2.5 for a while and I felt better than before, but not great. On lithium, the TSH went up to 3.8. I saw an endo who raised my doses gradually based on how it affected how I felt. He anticipated that my TSH target would be below 1, and subsequently wrote a letter to my Primary Care doctor saying that in his experience, patients with hypothyroidism and depression do best when thyroid is treated to the point of getting TSH below 1. My improvement leveled off at around .3, although even after that, I continued to feel increasingly better at that level of treatment.
>
> I think the endocrinology *establishment* (ie organizations) should be distinguished from endocrinologists. You should go to an endo that you have recs about from other people--one who is up on the latest research about hypothyroid undertreatment, etc. and who does not rely solely on blood tests, but combines this data with listening to the patient about how they feel--but don't write off the whole profession, either. My endo has been fantastic--and my life drastically improved because I went to see him.Thanks Noa, for that information. Got a couple of questions though. Did you ever get adverse reactions from the supplementation? If so, what were they and at what TSH level seemed to be the most troublesome (you mentioned mood improvement leveling off at .3). I have just half a thyroid and my latest TSH was 1.4. I have a stable calcification in the side that is left (my right). I don't want to get another tumor. The thyroid augmentation is used to supress tumor growth isn't it?
thanks in advance,
Mitch
Posted by Nala on August 29, 2002, at 5:48:28
In reply to Re: Remeron and Lithium -Barbara, posted by JackD on March 7, 2002, at 20:50:53
Barbara,
You've responded to me in the past re: Remeron as monotherapy. However, since then my pdoc has diagnosed me with BP II as well as started me on Lithium. I've been on it about 1 week. Is this combo still working well for you? I also practice a healthy lifestyle like you including: exercise, healthy eating, water drinking, etc. I have felt no change "yet" since beginning Lithium. But, everyone tells me "watch out, you'll gain weight!" I may have put on 2 nEEDED pounds on Remeron, alone, but I've already noticed I'm not hungry like I used to be on Remeron. Any input would be appreciated. Thanks a bunch,
Nala!
Posted by BarbaraCat on August 29, 2002, at 23:13:23
In reply to Re: Remeron and Lithium -Barbara, posted by Nala on August 29, 2002, at 5:48:28
Hi Nala,
Good to hear from you again. I've been reducing the Remeron slowly due to the weight gain and the fact that I wasn't getting as good an antidepressant response as I felt I should at 75mg, a high dose. I think the lithium has helped very much in keeping the crazier part of my condition at bay and to act as a stabilizer. However, I've been under extra stress lately and am acutely feeling the lessened dose of Rem (at 45mg and will stay here til life settles down more). I've found a very good naturopath who has pinpointed some considerable health issues that may be very influential in my fibromyalgia and neuro-inflammatory symptoms, and general feeling of fatigue, pain and anxiety. So, hopefully, I'll be able to manage things better with correct metabolic and nutritional support instead of only targeting it from the antidepressants. I guess what I'm saying in a nutshell is that I think Remeron and lithium are a very good combo. I don't think Remeron has as good a track record on it's own and seems to need the lithium kick - but that may be due to my own BP-II idiosyncracies. There is the real problem of weight increase, but many folks on this board seem to manage it through exercise. I could not, especially since my fibromyalgia makes strenuous exercise out of the question. I eat well and definitely not in excess, but any seems to be too much.It's difficult to separate what's emotional and what's physical stress, however, I know that my condition requires much more than head meds (and probably needs prayer more than anthing) so I'm probably not the best person to ask on the efficacy of any AD - they just don't work after a bit.
Question: why does your doc think you have BP-II? It's become the catch-all dx du-jour, and sometimes I wonder about my own diagnosis.
> Barbara,
> You've responded to me in the past re: Remeron as monotherapy. However, since then my pdoc has diagnosed me with BP II as well as started me on Lithium. I've been on it about 1 week. Is this combo still working well for you? I also practice a healthy lifestyle like you including: exercise, healthy eating, water drinking, etc. I have felt no change "yet" since beginning Lithium. But, everyone tells me "watch out, you'll gain weight!" I may have put on 2 nEEDED pounds on Remeron, alone, but I've already noticed I'm not hungry like I used to be on Remeron. Any input would be appreciated. Thanks a bunch,
> Nala
>
> !
Posted by wcfrench on September 4, 2002, at 12:56:03
In reply to Re: Remeron and Lithium -Barbara » Nala, posted by BarbaraCat on August 29, 2002, at 23:13:23
I've been on Remeron and Lithium for 5 weeks now with no real antidepressant response. When did the Remeron kick in for good for you guys?
-Charlie
Posted by BarbaraCat on September 4, 2002, at 13:20:05
In reply to Re: Remeron and Lithium -Barbara, posted by wcfrench on September 4, 2002, at 12:56:03
You don't say what dosage you're on? I had a response after about 3 weeks. By then I was up to 30mg. I felt fabulous, wonderful, the best I ever felt on an AD for about 2 months and then it pooped totally and I was in pretty bad shape. I increased it up to 60mg with no alleviation in symptoms - it was like whipping a dead horse. It was at this point (about 4 months after starting) that I began lithium. I felt a lifting of symptoms after 3 days, peaking at 3 weeks. I felt pretty darn good for a few months, but then the little demons of melancholy and anxiety starting slinking back in, and increasing dosages was like abusing the poor horse again. I'm now looking for another drug. I'll probably keep lithium and perhaps talk my pdoc into putting me on a trial of Lexapro. But I don't think Remeron has what it takes, at least for me. I've never found that initial wonderful feeling, and I've gone up to 80mg. Also, it sure would be nice to loose the pudge I've gained on it. I think it's a fairly benign drug and potentially a great drug, but at this point, it needs tweaking.
I've been on Remeron and Lithium for 5 weeks now with no real antidepressant response. When did the Remeron kick in for good for you guys?
>
> -Charlie
Posted by wcfrench on September 4, 2002, at 15:05:09
In reply to Re: Remeron and Lithium -Barbara » wcfrench, posted by BarbaraCat on September 4, 2002, at 13:20:05
Thanks.
I have had a similar poop-out experience. I first started Lithium with Effexor and it made me super energetic.. but I felt like I was lacking feeling, sadness, love, I was working out a lot and felt like a machine without emotion. I was at least feeling decent though, and then for some ungodly reason my doc decided to stop the Effexor and go with just lithium, 600mg a day, thinking that was all I needed.. well.. I don't know why he did it, but then I got really depressed, crying all the time, and I started Paxil. With the Paxil, it peaked at about 6 days and I felt good, and then it gave out completely... after that, I'm on Remeron and I'm scared because of this lack of response, I'm thinking it just won't do anything. Tomorrow makes 5 weeks and I really haven't had any good feelings with it like I had for the short time on Paxil. I started on 30mg and am still on 30mg, but I'm not sure that I could say I've even had partial response. People say 6 to 8 weeks, but I'm pretty skeptical that it will magically kick in during the next couple of weeks if it has already been this long. All ADs are supposedly 6 to 8 weeks, but with Effexor and Paxil, I felt changes during the first week. I guess I'll wait and see what happens.. if it fails, on to something else. Uhhhg. It's a bummer too because I did a lot of reading about it and it seems to be a good medicine, but nothing's good if it doesn't work. Here's to hope.
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