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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by rainbowlight on January 30, 2003, at 19:15:43
Hi again Ritch. I have a question I thought you or 3Beers might be able to answer. When I was taking my Lamictal/Remeron/Zoloft combo I felt great, relaxed calm and happy. Now that I have taken the Remeron out of the equation and I have upped my Zoloft from 25 to 50 mgs. I don't feel good anymore, not calm and happy like before, just kind of "here". Was I experiencing what is called "hypomania" before or was I feeling like I am supposed to feel? Is there something I could change in my meds to get that happy feeling back or am I being unrealistic? I miss it!
Posted by dreamerz on January 30, 2003, at 19:37:44
In reply to Ritch and 3Beers: Question, posted by rainbowlight on January 30, 2003, at 19:15:43
Was I experiencing what is called "hypomania" before or was I feeling like I am supposed to feel? Is there something I could change in my meds to get that happy feeling back or am I being unrealistic? I miss it!
I know how you feel about missing that happy feeling but if you experienced really bad down periods after that happy feeling then that's hypomania..if not I'd reconsider the Remeron and be happy , why not : )
Posted by Ritch on January 31, 2003, at 0:21:52
In reply to Ritch and 3Beers: Question, posted by rainbowlight on January 30, 2003, at 19:15:43
> Hi again Ritch. I have a question I thought you or 3Beers might be able to answer. When I was taking my Lamictal/Remeron/Zoloft combo I felt great, relaxed calm and happy. Now that I have taken the Remeron out of the equation and I have upped my Zoloft from 25 to 50 mgs. I don't feel good anymore, not calm and happy like before, just kind of "here". Was I experiencing what is called "hypomania" before or was I feeling like I am supposed to feel? Is there something I could change in my meds to get that happy feeling back or am I being unrealistic? I miss it!
Hi, I think it might have something to do with Remeron's ability to ensure good solid sleeping. I don't think you were experiencing hypomania from the Remeron, probably just a kicked-back relaxed sort of feeling. You might consider adding some lithium to your Lamictal+Zoloft+Restoril combo to get that back to some degree. I never got much weight gain from lithium. When I was taking 900mg at bedtime I never missed a full night's sleep I assure you!
Posted by rainbowlight on January 31, 2003, at 20:20:59
In reply to Re: Ritch and 3Beers: Question » rainbowlight, posted by Ritch on January 31, 2003, at 0:21:52
Thanks Ritch. What exactly does hypomania feel like? Just curious. Unfortunately I can't do Lithium. I used to take it for years, now when I try it I get extreme 24 hour nausea. I'm glad to hear my Remeron reaction was normal and not hypomania. I am trudging through, still have nausea off and on and now I have a horrible cold. I tell ya, I can't win this month!
Posted by Ritch on January 31, 2003, at 21:39:51
In reply to Re: Ritch and 3Beers: Question, posted by rainbowlight on January 31, 2003, at 20:20:59
> Thanks Ritch. What exactly does hypomania feel like? Just curious. Unfortunately I can't do Lithium. I used to take it for years, now when I try it I get extreme 24 hour nausea. I'm glad to hear my Remeron reaction was normal and not hypomania. I am trudging through, still have nausea off and on and now I have a horrible cold. I tell ya, I can't win this month!
OH, what about 15mg of "kiddie" Topamax at bedtime? I forgot about your weight gain issues with the Remeron. Lithium will generally cause some weight gain, but it was much less than with Remeron or Depakote for me. TOP kicks so hard as a sleeper (for me it did for sure), you *might* be able to replace the Restoril with it. It seems like your pdoc was looking at trying to ditch your benzo it seems. If you want to try something that can replace a benzo they will bite like a hungry carp after a nightcrawler in the Mississipppi. OK :) I had to say that! Seriously, the topamax was incredible for sleep, and you didn't have any trouble with "that Remeron feeling". Well, that is similar IMO. Have you brought up the idea of topamax to your doc previously?
Posted by rainbowlight on February 1, 2003, at 0:02:57
In reply to Re: Topomax » rainbowlight, posted by Ritch on January 31, 2003, at 21:39:51
She has never suggested Topamax before. I will have to ask her about it. I was sleeping pretty good for a few day and then the last few nights have been awful again. The sleep deprivation really makes my moods awful. I'm so frustrated. The Zoloft nausea is not going away and I have tried everything else for anxiety. I don't know what to do. I keep hoping the nausea will go away, but it's not happening. UGH!!!
Posted by Maximus on February 1, 2003, at 0:06:32
In reply to Re: Ritch and 3Beers: Question » rainbowlight, posted by Ritch on January 31, 2003, at 0:21:52
>You might consider adding some lithium to your Lamictal+Zoloft+Restoril combo to get that back to some degree. I never got much weight gain from lithium. When I was taking 900mg at bedtime I never missed a full night's sleep I assure you!
As Mitch told you, a trial of lithium might bring you stability. If you do, try Eskalith or Duralith. They are the extended release form of Lithium. In the begining i didn't believe it. But i got/get no side effect from it. It's worth a try.
Max.
Posted by Ritch on February 1, 2003, at 9:56:29
In reply to Re: Topomax, posted by rainbowlight on February 1, 2003, at 0:02:57
> She has never suggested Topamax before. I will have to ask her about it. I was sleeping pretty good for a few day and then the last few nights have been awful again. The sleep deprivation really makes my moods awful. I'm so frustrated. The Zoloft nausea is not going away and I have tried everything else for anxiety. I don't know what to do. I keep hoping the nausea will go away, but it's not happening. UGH!!!
Zoloft nausea was really profound with me. Geez, maybe you could ask about reducing your dose from 37.5 back down to 25mg. Did the Atarax help any with that? From what I can recall I didn't experience any nausea from Topamax just a 'dah' feeling (like Remeron-hey there you go!), and a little paresthesia (skin feeling numby crawly in places). There has been some success using TOP for PTSD anxiety and I belive that Zoloft is the fav. SSRI for PTSD. Who knows, maybe she would go for a little top at bedtime and you could drop your Zoloft dose a click and not feel nauseaous, and your anxiety would be helped even more, AND you could lose a little weight to boot? Yes, I know it always looks best on paper......
Posted by rainbowlight on February 1, 2003, at 19:30:13
In reply to Re: Topomax » rainbowlight, posted by Ritch on February 1, 2003, at 9:56:29
I am going to try to see my pdoc this week to see what can be done. I can't do this nausea anymore. It's so strange that when I was on the Remeron with the Zoloft I didn't get this nausea, but without the Remeron I have the nausea. Doesn't make any sense to me. I can't figure it out, and it's driving me crazy. What really stinks is mentally I feel good, but physically I feel horrible. I can never seem to get both. It's one or the other. I am definately going to ask her about the Topamax. The atarax didn't help with the nausea. The nausea doesn't seem to change when I change the dosing time. It seems to come in waves. Worse some days, better on others. I don't get it!
Posted by Ritch on February 2, 2003, at 10:40:22
In reply to Re: Topomax, posted by rainbowlight on February 1, 2003, at 19:30:13
> I am going to try to see my pdoc this week to see what can be done. I can't do this nausea anymore. It's so strange that when I was on the Remeron with the Zoloft I didn't get this nausea, but without the Remeron I have the nausea. Doesn't make any sense to me. I can't figure it out, and it's driving me crazy. What really stinks is mentally I feel good, but physically I feel horrible. I can never seem to get both. It's one or the other. I am definately going to ask her about the Topamax. The atarax didn't help with the nausea. The nausea doesn't seem to change when I change the dosing time. It seems to come in waves. Worse some days, better on others. I don't get it!
Hi, Remeron is a serotonin antagonist and it tends to have an anti-nausea effect. I've got acid reflux and I never had any while I was on Remeron (no IBS stuff either). If it weren't for the weight gain you liked it OK, otherwise?
Posted by rainbowlight on February 2, 2003, at 14:39:45
In reply to Re: Topomax » rainbowlight, posted by Ritch on February 2, 2003, at 10:40:22
Unfortunately, I felt great on the Remeron. But the weight continued to climb and wasn't stopping. I was afraid I would just keep gaining and gaining. Are there any other meds that have that anti-nausea property you describe?
Posted by Ritch on February 2, 2003, at 15:07:28
In reply to Re: Topomax, posted by rainbowlight on February 2, 2003, at 14:39:45
> Unfortunately, I felt great on the Remeron. But the weight continued to climb and wasn't stopping. I was afraid I would just keep gaining and gaining. Are there any other meds that have that anti-nausea property you describe?
Well... there is Zofran, which is a drug used for post-op and chemotherapy induced nausea, but it is horribly expensive and short acting (It is a 5-HT3 antagonist like Remeron, but that is its only action-Remeron hits receptors all over the place). If you could afford it, it might be worth trying (it is also being studied for use in social anxity, BTW). You would probably need to take it 3-4x daily. Can you positively attribute your nausea to Zoloft rather than Lamictal? If so, you may end up having to reduce the dose, or take an AP like Seroquel at bedtime like your pdoc wants (from what I remember you said it resolved the nausea completely for you?). But, I know you want to avoid using AP's. I still would float the idea to your pdoc about seeing if Topamax could be used to help for sleep and anxiety, allowing you to reduce the Zoloft which is triggering the nausea.
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