![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Squiggles on June 4, 2007, at 19:33:17
I was looking at one of Dr. Nemeroff's books and his colleague's (a guide), and this drug Mirtazpine (a TCA) looks really good. It has very low anticholinergic effects, thus good for the heart, very little hypotension, and easy to tolerate all-around, with one adverse reaction which stops when the drug is stopped.
It looks like a drug that might be good for seniors too.
Has anyone taken it?
Squiggles
Posted by thatcertainedge on June 4, 2007, at 19:35:32
In reply to Mirtazapine, posted by Squiggles on June 4, 2007, at 19:33:17
isn't that remeron? people say it works quite well but you gain a lot of weight on it. i'm not sure if it is the kind of weight gain that can be stopped with diet. i didnt think remeron was a tca. isnt it a desinger drug????
Posted by linkadge on June 4, 2007, at 19:54:13
In reply to Mirtazapine, posted by Squiggles on June 4, 2007, at 19:33:17
>I was looking at one of Dr. Nemeroff's books and >his colleague's (a guide), and this drug >Mirtazpine (a TCA) looks really good.
Remeron isn't a TCA. Not sure of the structure, but it is not reltated to traditional TCA's.
>It has very low anticholinergic effects, thus >good for the heart,
I don't know if one can make this conclusion. The cardiac effects of TCA's are not due to their anticholinergic activity. Remeron can sometimes increase blood pressure and heart rate like other alpha-2 antagonists (yohimbine etc)
>very little hypotension, and easy to tolerate >all-around, with one adverse reaction which >stops when the drug is stopped.
Well, that does sound like a nice (drug book) summary. Remeron has different side effects, but not necessarily less burdonsome. It can be very sedating. It can cause irritability (REM rage) it can also increase the appetite significantly.
>It looks like a drug that might be good for >seniors too.
Well, I don't know.
Linkadge
Posted by Squiggles on June 4, 2007, at 20:20:09
In reply to Re: Mirtazapine, posted by linkadge on June 4, 2007, at 19:54:13
> >I was looking at one of Dr. Nemeroff's books and >his colleague's (a guide), and this drug >Mirtazpine (a TCA) looks really good.
>
> Remeron isn't a TCA. Not sure of the structure, but it is not reltated to traditional TCA's.
>
> >It has very low anticholinergic effects, thus >good for the heart,
>
> I don't know if one can make this conclusion. The cardiac effects of TCA's are not due to their anticholinergic activity. Remeron can sometimes increase blood pressure and heart rate like other alpha-2 antagonists (yohimbine etc)
>
> >very little hypotension, and easy to tolerate >all-around, with one adverse reaction which >stops when the drug is stopped.
>
> Well, that does sound like a nice (drug book) summary. Remeron has different side effects, but not necessarily less burdonsome. It can be very sedating. It can cause irritability (REM rage) it can also increase the appetite significantly.
>
> >It looks like a drug that might be good for >seniors too.
>
> Well, I don't know.
>
>
> Linkadge
>>
Right, it's a tetracyclic - the only one FDA approved. Actually, it is the *only* drug my
friend who has major depressive disorder took, that made her look alive and happy, EVER in the serial drugging of about 20 ADs. Unfortunately, it made her sleepy so it was terminated-- seems to me that with such a stellar performance this drug could have been adjuncted with a stimulant.As for the appetite, i wonder if it is not like lithium which makes you eat a lot and is sometimes used on anorexics. With a drug that has such unique "clean" attributes, you'd think clinicians would be knocking themselves out trying to clean up the edges.
Squiggles
http://www.sciencedaily.com/releases/2007/01/070101113033.htm
Posted by Racer on June 4, 2007, at 21:49:02
In reply to Re: Mirtazapine » linkadge, posted by Squiggles on June 4, 2007, at 20:20:09
I'm one of those who experienced the rage on Remeron. It may be a very good drug, and I know it's been great for a lot of people, but don't underestimate the side effects based on that article. I'm a very quiet person, rarely raise my voice, and have NEVER had any sort of a temper tantrum.
On Remeron, I told my husband to stay away from me, because I was afraid I'd hurt him. I avoided my cats for the same reason. I didn't drive, for the same reason.
It wasn't irritability, it was full on, out of control rage. And it was scary as all get out.
Otherwise, I know it's a very helpful drug for a lot of people. It's just that I worry when I see too much enthusiasm, just as I worry when I see too much skepticism...
I'll go shut up again now...
Posted by Phillipa on June 4, 2007, at 22:13:22
In reply to Re: Mirtazapine » Squiggles, posted by Racer on June 4, 2007, at 21:49:02
Gave me remeron l5mg supposedly for sleep along with benzos didn't do squat took for a month then just stopped it. no point in spending money on a med that did nothing for me. Love Phillipa
Posted by mnfarmboy77 on June 5, 2007, at 0:14:28
In reply to Mirtazapine, posted by Squiggles on June 4, 2007, at 19:33:17
I have been on remeron for 3 yrs now my experience with it has been mostly positive does well to controll anxiety and depression the only side effect is it gives me the munchies about 20 min after taking it, if I can go for about an hour without eating the munchies tend to go away, at least thats my experience
> I was looking at one of Dr. Nemeroff's books and his colleague's (a guide), and this drug Mirtazpine (a TCA) looks really good. It has very low anticholinergic effects, thus good for the heart, very little hypotension, and easy to tolerate all-around, with one adverse reaction which stops when the drug is stopped.
>
> It looks like a drug that might be good for seniors too.
>
> Has anyone taken it?
>
> Squiggles
Posted by Squiggles on June 5, 2007, at 0:26:26
In reply to Re: Mirtazapine » Squiggles, posted by Racer on June 4, 2007, at 21:49:02
Ouch! Thanks, i think.
Squiggles
Posted by Racer on June 5, 2007, at 1:46:22
In reply to Re: Mirtazapine, posted by Squiggles on June 5, 2007, at 0:26:26
I'm sorry if that sounded as though I was being harsh. Honestly, it's really just that the Remeron thing was so frightening for me, that's all.
And, again, I do know that it's great for a lot of people.
I hope you didn't think I was being harsh towards you. That wasn't at all my intent, and I'm very sorry if it came across that way.
Posted by Squiggles on June 5, 2007, at 7:15:20
In reply to Re: Mirtazapine » Squiggles, posted by Racer on June 5, 2007, at 1:46:22
Not at all, if it's the truth, it's best
to know the adverse reactions of as many
people as possible-- sounds like the SSRI
suicide reactions, which may be even more
numerous, but not for all people.Squiggles
Posted by Jesus is Savior on June 5, 2007, at 19:12:51
In reply to Mirtazapine, posted by Squiggles on June 4, 2007, at 19:33:17
> I was looking at one of Dr. Nemeroff's books and his colleague's (a guide), and this drug Mirtazpine (a TCA) looks really good. It has very low anticholinergic effects, thus good for the heart, very little hypotension, and easy to tolerate all-around, with one adverse reaction which stops when the drug is stopped.
>
> It looks like a drug that might be good for seniors too.
>
> Has anyone taken it?
>
> SquigglesYour talking about REMERON. It's an snri, kind of similar to Effexor. It's a selective alpha-2-adrenergic antagonist that inhances noredrenergic and serotenergic neurotransmission. Sedation is the most common side effect, also increase in appetite.
-MJ
Posted by Quintal on June 6, 2007, at 16:45:42
In reply to Mirtazapine, posted by Squiggles on June 4, 2007, at 19:33:17
I took mirtazapine (trade name Zispin here) a number of years ago and it just made me slow and heavy with a lot of fluid retention. If this is the only AD your friend has had a good response to maybe she could ask her pdoc to consider trying the 'California Rocket Fuel' combo? There are a number of variations to it, most simply mirtazapine (Remeron) + venlafaxine (Effexor), and sometimes bupropion (Wellbutrin) is added. In combination these drugs are said to offset some of the side effects of mirtazapine, like sedation, cognitive impairment and weight gain. Mirtazapine and bupropion are said to offset some of the sexual side effects of venlafaxine. There's a section in one of my psychopharmacology textbooks explaining the dynamics of it in more detail if you would like to know.
Q
Posted by psychobot5000 on June 6, 2007, at 20:55:15
In reply to Re: Mirtazapine » Squiggles, posted by Jesus is Savior on June 5, 2007, at 19:12:51
>
> Your talking about REMERON. It's an snri, kind of similar to Effexor. It's a selective alpha-2-adrenergic antagonist that inhances noredrenergic and serotenergic neurotransmission.
>
> -MJMirtazapine is Remeron, but it's not an SNRI. It has no clinically significant effect on serotonin and noradrenalin reuptake. It's noradrenergic effects are described above, but its known serotonergic action comes from action at 5ht-2a and 2c receptors. None of its mechanisms are substantially similar to Effexor's.
Posted by Jesus is Savior on June 6, 2007, at 22:47:34
In reply to Re: Mirtazapine » Jesus is Savior, posted by psychobot5000 on June 6, 2007, at 20:55:15
> >
> > Your talking about REMERON. It's an snri, kind of similar to Effexor. It's a selective alpha-2-adrenergic antagonist that inhances noredrenergic and serotenergic neurotransmission.
> >
> > -MJ
>
> Mirtazapine is Remeron, but it's not an SNRI. It has no clinically significant effect on serotonin and noradrenalin reuptake. It's noradrenergic effects are described above, but its known serotonergic action comes from action at 5ht-2a and 2c receptors. None of its mechanisms are substantially similar to Effexor's.
>Really? Learn something new every day! :)
-MJ
Posted by psychobot5000 on June 8, 2007, at 23:35:20
In reply to Re: Mirtazapine, posted by Jesus is Savior on June 6, 2007, at 22:47:34
Really? Learn something new every day! :)-MJ
__
Pretty sure I found that information out in roughly the same way - on this site. Confusing, all those serotonin/norepinephrine meds. I only wish I understood the difference between Remeron and the trazadone and nefazodone class of meds. ;)
Best,
Psychbot
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.