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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 Phillipa on January 28, 2005, at 18:53:00
Posted a Thread yesterday asking if anyone had taken these two meds together for anxiety and depression. I really would love some responses both good and bad. This is the end of the road in SSRI's . Please Thanks Phillipa
Posted by tensor on January 29, 2005, at 4:23:04
In reply to How do Like Zoloft Mirtazapine Together?, posted by Phillipa on January 28, 2005, at 18:53:00
Hi Phillipa,
When it worked, it was a truly wonderful combo, like i use to say, i've never felt that good in my entire life. Unfortunately it pooped out a couple of months ago and i'm desperately trying get back there, no success so far. Back then i took 15mg remeron and 50mg zoloft(+clonazepam).
/Mattias
Posted by SLS on January 29, 2005, at 6:42:31
In reply to Re: How do Like Zoloft Mirtazapine Together? » Phillipa, posted by tensor on January 29, 2005, at 4:23:04
> Hi Phillipa,
>
> When it worked, it was a truly wonderful combo, like i use to say, i've never felt that good in my entire life. Unfortunately it pooped out a couple of months ago and i'm desperately trying get back there, no success so far. Back then i took 15mg remeron and 50mg zoloft(+clonazepam).
>
> /MattiasHi.
Will you be increasing the dosages of the Remeron and Zoloft before adding or switching? You've got lots of room. I would think to bring the Zoloft up first.
I would really like for you to capture that magic again!
- Scott
>
Posted by tensor on January 29, 2005, at 7:02:11
In reply to Re: How do Like Zoloft Mirtazapine Together?, posted by SLS on January 29, 2005, at 6:42:31
Hi Scott!
> Will you be increasing the dosages of the Remeron and Zoloft before adding or switching? You've got lots of room. I would think to bring the Zoloft up first.Yes i've tried 45mg remeron and 150mg zoloft, i was forced to come down to 30mg remeron and 50mg zoloft because of horrible s/e. Currently trying to amplify the antidepressant effects with lithium, am now at 900mg, fourth week. No success so far, but my blood level has always been low 0.2-0.3. Next blood check monday morning.
> I would really like for you to capture that magic again!Thank you for your concern.
/Mattias
Posted by SLS on January 29, 2005, at 8:18:24
In reply to Re: How do Like Zoloft Mirtazapine Together? » SLS, posted by tensor on January 29, 2005, at 7:02:11
> Hi Scott!
>
> > Will you be increasing the dosages of the Remeron and Zoloft before adding or switching? You've got lots of room. I would think to bring the Zoloft up first.
>
> Yes i've tried 45mg remeron and 150mg zoloft, i was forced to come down to 30mg remeron and 50mg zoloft because of horrible s/e. Currently trying to amplify the antidepressant effects with lithium, am now at 900mg, fourth week. No success so far, but my blood level has always been low 0.2-0.3. Next blood check monday morning.
>
>
> > I would really like for you to capture that magic again!
>
> Thank you for your concern.
>
> /Mattias
If you don't mind my asking, what side effects are getting in the way?Are there any drugs that you have had a partial response to in the past?
I think it is smart to give the higher dosage of lithium a try. It might not work, but it would make sense not to overlook it while you are still on it. You might need something in the range of 0.4-0.6 mEQ/L. That should be enough of an exploration if you are not bipolar.
- Scott
Posted by tensor on January 29, 2005, at 9:44:57
In reply to Re: How do Like Zoloft Mirtazapine Together?, posted by SLS on January 29, 2005, at 8:18:24
Hi,
> If you don't mind my asking, what side effects are getting in the way?
Anxiety/anguish, akathisia and headache.
> Are there any drugs that you have had a partial response to in the past?Yes, reboxetine and clomipramine, which had their sexual s/e, reboxetine also gave me ache in my testicles, horrible! I've been thinking of ditching zoloft and remeron for a TCA like amitrip or nortrip, but this isn't the time to do it. I will let the lithium take its time it need before doing any switching. I'm wondering how i will notice the effect of lithium if it does work, will there be an 'omph'?
> I think it is smart to give the higher dosage of lithium a try. It might not work, but it would make sense not to overlook it while you are still on it. You might need something in the range of 0.4-0.6 mEQ/L. That should be enough of an exploration if you are not bipolar.
I think there's a high probability that i'll need at least 1200mg to reach blood levels of 0.4-0.6. Will be interesting to see where i am at monday.
/Mattias
Posted by SLS on January 29, 2005, at 18:58:59
In reply to Re: How do Like Zoloft Mirtazapine Together? » SLS, posted by tensor on January 29, 2005, at 9:44:57
> > If you don't mind my asking, what side effects are getting in the way?
>
> Anxiety/anguish, akathisia and headache.I'm surprised that reboxetine didn't produce anxiety.
If you are willing to go the TCA route, either of the two drugs you mentioned can certainly work, but given your response to reboxetine, I'm surprised you are not more focused on the selective NE drug desipramine. Of course, you can remain on lithium while you make the switch. Given how much positive data there is regarding the addition of lithium as an augmentor of a TCA, it probably makes sense. Lets see how you do with the increased dosage of lithium. 1200mg usually gets people to around 1.0 mEQ/L. You seem to need a bit more than most people.
> I will let the lithium take its time it need before doing any switching. I'm wondering how i will notice the effect of lithium if it does work, will there be an 'omph'?
The thing about lithium when it is used as an augmenter to antidepressants to treat unipolar depression, the response is usually immediate (2-7 days) and robust. Yes, it is likely there will be an oomph. I hope there is.
- Scott
Posted by ed_uk on January 29, 2005, at 19:40:57
In reply to Re: How do Like Zoloft Mirtazapine Together?, posted by SLS on January 29, 2005, at 18:58:59
Hi,
As far as we can tell, desipramine isn't available in Finland. Lofepramine isn't available in Finland either- but it is used in Sweden. Nortriptyline, on the other hand, is definately used in Finland.
Ed.
Posted by Phillipa on January 29, 2005, at 20:04:57
In reply to Re: How do Like Zoloft Mirtazapine Together? » SLS, posted by ed_uk on January 29, 2005, at 19:40:57
Is Tensor from Finland? Are you Tensor? Phillipa
Posted by ed_uk on January 29, 2005, at 20:55:13
In reply to Re: How do Like Zoloft Mirtazapine Together? » ed_uk, posted by Phillipa on January 29, 2005, at 20:04:57
Hi,
Yes, Mattias (tensor) lives in Finland.
>Are you Tensor?
That's a strange question! I'm Ed, not Mattias!
Ed.
Posted by Phillipa on January 29, 2005, at 22:05:43
In reply to Re: How do Like Zoloft Mirtazapine Together? » Phillipa, posted by ed_uk on January 29, 2005, at 20:55:13
Ed, I know who you are! I was just trying to ask you both a question in the same Post. Sorry if I didn't word it right. Fondly, Phillipa O
Posted by ed_uk on January 29, 2005, at 22:24:58
In reply to Re: How do Like Zoloft Mirtazapine Together?, posted by Phillipa on January 29, 2005, at 22:05:43
Wow, that was confusing!
Ed.
Posted by SLS on January 29, 2005, at 23:06:48
In reply to Re: How do Like Zoloft Mirtazapine Together? » SLS, posted by ed_uk on January 29, 2005, at 19:40:57
> Hi,
>
> As far as we can tell, desipramine isn't available in Finland.That's a real shame. What about imipramine? Nortriptyline is a more forgiving drug both cognitively and physically, but will often work when nortriptyline won't. Failure to respond to one TCA does not guarantee failure to them all.
So, what are the non-SSRI antidepressants that are currently available in Finland?
- Scott
Lofepramine isn't available in Finland either- but it is used in Sweden. Nortriptyline, on the other hand, is definately used in Finland.
>
> Ed.
Posted by tensor on January 30, 2005, at 5:45:49
In reply to Re: How do Like Zoloft Mirtazapine Together?, posted by SLS on January 29, 2005, at 23:06:48
Hi Scott,
> That's a real shame. What about imipramine? Nortriptyline is a more forgiving drug both cognitively and physically, but will often work when nortriptyline won't. Failure to respond to one TCA does not guarantee failure to them all.
Not imiprimamine either, but trimipramine is as well as amitriptyline.
> So, what are the non-SSRI antidepressants that are currently available in Finland?
There are lists with available AD's in Finland, but they are not complete, i don't know why.
/Mattias
Posted by CareBear04 on February 1, 2005, at 11:53:51
In reply to Re: How do Like Zoloft Mirtazapine Together? » Phillipa, posted by tensor on January 29, 2005, at 4:23:04
hi tensor,
i've been on 50mg of zoloft for about a year and a half, but it has pooped out on me. my pdoc added 10mg of prozac in the hope that if we can't go up on the zoloft, we can titrate up on something else. i can't take away the zoloft, either, because then i really crash. recently, my pdoc wrote me a script for 15mg of remeron to help with sleep. i was manic, and though i took huge cocktails of sleeping meds, i couldn't sleep more than 3-4 hours. i haven't taken the remeron. i've afraid i'll become a zombie, and i'm afraid because i hear that lower doses make you gain weight. what is your experience in this respect? does the drowsiness and the big appetite wear off? if i took remeron just once in awhile for sleep, would i still have the huge appetite in the morning? or is it more of a problem when you take remeron regularly?
thanks so much!
Posted by tensor on February 1, 2005, at 12:32:33
In reply to Re: How do Like Zoloft Mirtazapine Together? » tensor, posted by CareBear04 on February 1, 2005, at 11:53:51
Hi CareBear!
If you take 15mg remeron occasionaly for sleep aid you don't need to worry about weight gain. I don't gain weight at 15mg when taken regularly. I take 30mg daily now, and i hardly find any increase in my appetite. I eat wisely, low fat.
The drowsiness wears off in about 3-4h, so you won't feel anything in the morning.Sleep well!
/Mattias
Posted by Phillipa on February 1, 2005, at 15:47:54
In reply to Re: How do Like Zoloft Mirtazapine Together? » tensor, posted by CareBear04 on February 1, 2005, at 11:53:51
The remeron is not making me sleep, even with 5cc chloral hydrate, and .5mg of klonopin, and .5mg of xanax. I must be a "drug Addict". Now I'm concerned. Phillipa
Posted by tensor on February 1, 2005, at 16:49:40
In reply to Re: How do Like Zoloft Mirtazapine Together?, posted by Phillipa on February 1, 2005, at 15:47:54
What dose of remeron do you take for sleep?
Also, 0.5mg isn't much, try a higher dose?
/Mattias
Posted by Phillipa on February 1, 2005, at 17:37:24
In reply to Re: How do Like Zoloft Mirtazapine Together?, posted by Phillipa on February 1, 2005, at 15:47:54
I take l5mg of remeron at bedtime. Fondly, Phillipa
Posted by Phillipa on February 1, 2005, at 17:43:06
In reply to Re: How do Like Zoloft Mirtazapine Together? » Phillipa, posted by Phillipa on February 1, 2005, at 17:37:24
I forgot, I can't take more because the pdoc only Rx's the right amt of medication for 30 days, and I'm supposed to be cutting down on klonopin and CH, and substituting the .5xanax and then dcing the other two in a weeks time. I'm already taking an extra lmg of xanax in the middle of the night. I had extra from an old Rx. Fondly, Phillipa
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