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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by saturn on January 6, 2007, at 22:04:07
Does anyone know the *primary* mechanism responsible for Remeron's anxiolytic properties? Thanks...Peace...Saturn.
Posted by mattye on January 6, 2007, at 22:30:16
In reply to Remeron, anxiolysis, posted by saturn on January 6, 2007, at 22:04:07
Didn't do anything for my anxiety . . . just puts me to sleep. It is the kind of groggy sleepiness characteristic of antihistamines like those found in cough syrups.
Posted by saturn on January 6, 2007, at 22:53:15
In reply to Re: Remeron, anxiolysis, posted by mattye on January 6, 2007, at 22:30:16
> Didn't do anything for my anxiety . . . just puts me to sleep. It is the kind of groggy sleepiness characteristic of antihistamines like those found in cough syrups.
It made me feel very calm. Sedated also, but a distinct calmness as well. I do not know if this is the antihistamine action or 5-HT2/3 antagonism or what.
Posted by yxibow on January 6, 2007, at 23:23:51
In reply to Re: Remeron, anxiolysis, posted by saturn on January 6, 2007, at 22:53:15
> > Didn't do anything for my anxiety . . . just puts me to sleep. It is the kind of groggy sleepiness characteristic of antihistamines like those found in cough syrups.
>
> It made me feel very calm. Sedated also, but a distinct calmness as well. I do not know if this is the antihistamine action or 5-HT2/3 antagonism or what.
>I personally believe when I took it, not my doctor's belief necessarily, that at a high enough dose the 5HT blockade is similar to an atypical neuroleptic without the D2 action. The alpha adrenergic may be a primary action of the drug but the other blockade does play a role.
The sedation though also probably provides some of the anxiolytic action as all heavily sedating agents. In fact if I look at the list of my medications, there is one thing in common with a lot of them -- they are sedating. Sure, one gets used to it -- but only in part.
-- tidings.
Posted by cgd092 on January 6, 2007, at 23:37:54
In reply to Remeron, anxiolysis, posted by saturn on January 6, 2007, at 22:04:07
I read one time (i.e., I don't have any documentation) that it was a strong antihistamine. But that at higher, antidepressant doses, this antihistamine effect is over-run by the stimulating (serotonin-enhancing) effects. For me, it was good for sleep and appetite. Too good. I couldn't get it up to the therapeutic dose. I just got really tired and near hyperphagia. I have a little left in a bottle from four years ago. I sometimes chip it as a sleep aid. It was only anxiolytic for me in that it made me stop pacing around and lie down.
-Katy
Posted by cache-monkey on January 7, 2007, at 12:53:09
In reply to Re: Remeron, anxiolysis, posted by cgd092 on January 6, 2007, at 23:37:54
Remeron's most selective as an antagonist of the H-1 receptor, followed by the 5-HT2A/2C receptors. And then at higher doses, it blocks the alpha-2 receptor. See: http://www.preskorn.com/columns/0003.html
I believe that it's a combination of the anti-histamine and 5-HT2 blockade that's responsible for Remeron's anxiolytic properties.
The alpha-2 antagonism is supposedly energizing at higher dose because this leads to a higher NE release. But this can cause anxiety for some people, similar to the herbal yohimbine. But if you're like me and have a super-sensitive NE system (based on how I respond to other meds), you might get increased anxiety even at lower doses.
Good luck,
cache-monkey
Posted by dbc on January 8, 2007, at 5:59:18
In reply to Re: Remeron, anxiolysis, posted by cache-monkey on January 7, 2007, at 12:53:09
Yep, its like taking 5000mg hit of benadryl. The stuff certainly knocks you out and is calming. Im one of the few people that made it passed the first month or so of near catatonic constant sleep. Of course i was combining it with effexor so that may have helped.
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