![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Sad Panda on January 25, 2004, at 6:22:03
Over the last couple of weeks I've managed to increase my Efexor XR to 225mg & my Remeron to 30mg per day & I find myself in a truely good mood. I'm a little worried that my mood is too good as it feels a little un-natural & I am talking too much. Could this be a sign on BP2? I thought I just have atypical depression, I haven't been diagnosed yet as I still have to wait 2-3 months to see a pdoc.
Any & all replies appreciated,
Cheers,
Panda.
Posted by linkadge on January 25, 2004, at 6:28:40
In reply to Efexor+Remeron=I'm in a GREAT Mood!! :-)......BP2?, posted by Sad Panda on January 25, 2004, at 6:22:03
The name for this combination has been dubbed "california rocket fuel" I'm not sure which psychiatrist called it this.
IF you have been very depressed for a while, sometimes it is good to be a little "above normal" for a while. After you feel that you are in remission, then I would lower it down till you feel more natural.This is not necessarily bipolar disorder. Somebody called it "california rocket fuel" for a reason. It is obviously a very stimul;ating combination.
Linkadge
Posted by Rainee on January 25, 2004, at 7:13:16
In reply to Re: Efexor+Remeron=I'm in a GREAT Mood!! :-)......BP2?, posted by linkadge on January 25, 2004, at 6:28:40
Major Interaction -- Drug-Drug
venlafaxine and mirtazapineMONITOR CLOSELY: The combining of agents that can inhibit serotonin reuptake and/or other agents with serotonergic activity (including some medications for migraine therapy and certain opioids) may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A receptors. MANAGEMENT: In general, the concomitant use of multiple serotonergic agents should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Close monitoring is recommended for signs and symptoms of excessive serotonergic activity such as CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia. Particular caution is advised when increasing the dosages of these agents.
This scared me but what you said felt hopeful to get me up and moving...Rainee
Posted by linkadge on January 25, 2004, at 13:52:27
In reply to would any Dr prescribe the effex.rem mix?, posted by Rainee on January 25, 2004, at 7:13:16
Surprisingly, many people with treatment resistant depression, also seem somewhat more resistant to serotonin snydrome.
I would personally not wory about it if the drugs are working fine, as I have also red many reports of the combination working in difficult to treat patients with resistant depression.
The emergence of serotonin syndrome is likely to occur upon initiation of the drugs. But like is cautioned, just keep a watch for the warning signs.
Linkadge
Posted by Sad Panda on January 25, 2004, at 23:25:22
In reply to would any Dr prescribe the effex.rem mix?, posted by Rainee on January 25, 2004, at 7:13:16
> Major Interaction -- Drug-Drug
> venlafaxine and mirtazapine
>
> MONITOR CLOSELY: The combining of agents that can inhibit serotonin reuptake and/or other agents with serotonergic activity (including some medications for migraine therapy and certain opioids) may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A receptors. MANAGEMENT: In general, the concomitant use of multiple serotonergic agents should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Close monitoring is recommended for signs and symptoms of excessive serotonergic activity such as CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia. Particular caution is advised when increasing the dosages of these agents.
>
>
> This scared me but what you said felt hopeful to get me up and moving...RaineeThanks for the heads up :) I think the risk of serotonin syndrome with Remeron+Anything is largely theoretical. I like Remeron because it reverses all the SSRI side effects caused by Efexor + it gives the best sleep I've had in my whole life.
Cheers,
Panda.
Posted by PoohBear on January 26, 2004, at 13:15:55
In reply to Re: would any Dr prescribe the effex.rem mix? » Rainee, posted by Sad Panda on January 25, 2004, at 23:25:22
Sad Panda (Happy Panda???):
Glad to see the combo is working for you. It was working for me too, until I started to gain back all the weight I'd lost with the addition of the Remeron. D@mn that sleep was nice!
Take care,
Tony
Posted by Sad Panda on January 27, 2004, at 11:12:32
In reply to Re: would any Dr prescribe the effex.rem mix? » Sad Panda, posted by PoohBear on January 26, 2004, at 13:15:55
> Sad Panda (Happy Panda???):
>
> Glad to see the combo is working for you. It was working for me too, until I started to gain back all the weight I'd lost with the addition of the Remeron. D@mn that sleep was nice!
>
> Take care,
>
> TonyI dunno what my weight is doing, I don't care enough, I'll worry about it when I get better. Remeron has done a bunch of good things for me, strangely I sleep 8 hours now instead of 12. When I wake in the morning I just get out of bed! Previously I would wake, wish I was dead & go back to sleep again....
Cheers,
Panda.
Posted by PoohBear on January 27, 2004, at 11:24:01
In reply to Re: would any Dr prescribe the effex.rem mix? » PoohBear, posted by Sad Panda on January 27, 2004, at 11:12:32
Wide-Awake Panda:
That sounds like a wounderful improvement. Most sleep researchers say that we don't really need more than 7-8 hours of GOOD sleep. Sound like you were getting too much, I was getting too little.
You're right right about the weight: first things first...
Take care,
Tony
> I dunno what my weight is doing, I don't care enough, I'll worry about it when I get better. Remeron has done a bunch of good things for me, strangely I sleep 8 hours now instead of 12. When I wake in the morning I just get out of bed! Previously I would wake, wish I was dead & go back to sleep again....
>
> Cheers,
> Panda.
>
Posted by BettyM on January 19, 2005, at 8:04:04
In reply to Re: would any Dr prescribe the effex.rem mix? » PoohBear, posted by Sad Panda on January 27, 2004, at 11:12:32
I'm now on Efexor, but I can't sleep at all. So I can use Remeron at night for my insomnia? I still have 2 boxes of Remeron left from a previous treatment.
And how much Remeron do you take?> > Sad Panda (Happy Panda???):
> >
> > Glad to see the combo is working for you. It was working for me too, until I started to gain back all the weight I'd lost with the addition of the Remeron. D@mn that sleep was nice!
> >
> > Take care,
> >
> > Tony
>
> I dunno what my weight is doing, I don't care enough, I'll worry about it when I get better. Remeron has done a bunch of good things for me, strangely I sleep 8 hours now instead of 12. When I wake in the morning I just get out of bed! Previously I would wake, wish I was dead & go back to sleep again....
>
> Cheers,
> Panda.
>
Posted by PoohBear on January 19, 2005, at 10:24:41
In reply to Re: would any Dr prescribe the effex.rem mix? » Sad Panda, posted by BettyM on January 19, 2005, at 8:04:04
Betty:
You should have no problem getting Remeron prescribed for sleep. The combination of Effexor + Remeron is known as "California Rocket Fuel".
I had too much weight gain when I tried it, but the sleep was the best ever. If you take it, exercise and be VERY cognisant of what goes in your mouth and how much...
Good Luck!
Tony
> I'm now on Efexor, but I can't sleep at all. So I can use Remeron at night for my insomnia? I still have 2 boxes of Remeron left from a previous treatment.
> And how much Remeron do you take?
>
> > > Sad Panda (Happy Panda???):
> > >
> > > Glad to see the combo is working for you. It was working for me too, until I started to gain back all the weight I'd lost with the addition of the Remeron. D@mn that sleep was nice!
> > >
> > > Take care,
> > >
> > > Tony
> >
> > I dunno what my weight is doing, I don't care enough, I'll worry about it when I get better. Remeron has done a bunch of good things for me, strangely I sleep 8 hours now instead of 12. When I wake in the morning I just get out of bed! Previously I would wake, wish I was dead & go back to sleep again....
> >
> > Cheers,
> > Panda.
> >
>
>
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.