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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by dcm1 on August 19, 2002, at 18:06:18
My wife has had anxiety problems for years. She started having a real problem early this summer. The doctor put her on zyprexa and it seemed to help for about 3 months then she had a bad anxiety problem and the doctor put her on Wellbutrin. This started all the problems; she couldn't sleep at all after the second day. She never had sleep problems. After about a week of this I took her to a phyc. He prescribed Effexor and Klonopin. She slept a little at first then for six weeks she hardly slept and was so anxious she would just lie in the bed and cry for help. I finally figured out it was the Effexor giving her the anxious feeling. We weaned off of it in about 2 1/2 weeks. Switching over to Remeron she now went the other way she has bad depression, which she never had before. She was up to 30mg. Could the Remeron be causing the depression or could it be withdrawals from Effexor? She started on the Effexor 6-5-02 and quit8-18-02. She had started the Remeron on 8-11-02 The Remeron hasn't helped at all for the depression.
Posted by sleepy lizard on August 20, 2002, at 0:58:19
In reply to Effexor, posted by dcm1 on August 19, 2002, at 18:06:18
My doctor said that Remeron is not quite as effective as Effexor. I am taking Effexor XR and it has been working well for depression and anxiety, but it is more activating than Paxil or Celexa. I have not tried Remeron yet. There is also BuSpar which is for anxiety that you can use with Effexor, which also works to cut the sexual side effects. The higher doses of Effexor cause more activation (150 mg/day) than the usual 75 mg per day. I have even tried 225 mg/day, but it spaces me out. Watch out for Wellbutrin too, because it also is activating.
I think it is the withdrawal from the Effexor that is causing the side effects mainly, because it takes a few weeks for the Remeron to work and it is not a strong. If you take Remeron 15 mg it will cause more sedation (Histamine), but at 30 mg or 45 mg, it is more activating (norepinephrine).
Posted by Linkadge on August 20, 2002, at 9:32:56
In reply to Effexor, posted by dcm1 on August 19, 2002, at 18:06:18
I have tried all the drugs you have
mentioned, and am very confused with
your docs choice of meds. With typical
anxiety, the first line of meds should
be an SSRI like Celexa, or Zoloft.
I found drugs like Effexor, only made
the anxiety worse (these drugs are typically
perscribed for low energy / low motivation
type depression). Remeron was not strong
enough the Seritonin aspect, of its mechanizm.
I would hate to say that much of her suffering
has been unneccesary, but I would go to the
doctor and discuss an SSRI.
Email me if you have any questions:
Posted by John2222 on August 20, 2002, at 19:01:25
In reply to Re: Effexor, posted by sleepy lizard on August 20, 2002, at 0:58:19
What do you mean by "more activation"? I have been taking Effexor XR 112.5 mg per day, and my dr also mentioned that at higher doses there was more activation/benefit. But, I just get more sleepy every day the higher doses that I have tried. (At 150 mg/day I was getting 8 hrs sleep every night, but still had to have a nap if I could each day.)
John
> The higher doses of Effexor cause more activation (150 mg/day) than the usual 75 mg per day. I have even tried 225 mg/day, but it spaces me out. Watch out for Wellbutrin too, because it also is activating.
Posted by sleepy lizard on August 21, 2002, at 18:19:04
In reply to Re: Effexor ... more activation ?, posted by John2222 on August 20, 2002, at 19:01:25
Well, by activating I mean stimulating, for example some people have difficulty sleeping at night or experience anxiety on Wellbutrin, or on higher doses of antidepressants like Effexor that increase norepinephrine. I had the shakes from taking Effexor XR 150 mg/day with Wellbutrin SR 100 mg/day. When I reduced the Effexor XR to 75 mg/day that side effect was greatly reduced. But everyone responds a little differently, so maybe that is why it is not making you agitated.
Posted by dcm1 on August 21, 2002, at 18:37:49
In reply to Re: Effexor, posted by Linkadge on August 20, 2002, at 9:32:56
My wife tried Celexa, Zoloft and she felt like she was going to crawl out of her skin. When I say they agitate her I mean she can't sleep, she shakes and her muscles are rigid. She never had none of these symptoms until she started with Wellbutrin. She says she feels so bad on the Remeron that is why she is depressed. What do you think?
Posted by sleepy lizard on August 21, 2002, at 22:35:42
In reply to Re: Effexor, posted by dcm1 on August 21, 2002, at 18:37:49
Remeron can make you sleepy at 15 mg/day and begins to be more activating at 30 mg/day up to 45 mg/day. It is more sedating at a lower dose. Maybe she is feeling down because of the sedative effects. She might try upping the dose (under medical supervison, of course). Remeron does not always eleviate depression in everyone, although I've never heard of it causing it.
Posted by dcm1 on August 22, 2002, at 22:00:00
In reply to Re: Effexor » dcm1, posted by sleepy lizard on August 21, 2002, at 22:35:42
She tried 15mg Remeron at night and she took 15mg this morning. She felt a lot less of the side effects and less depression. I hope this works.
This is the end of the thread.
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