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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by tecknohed on September 30, 2007, at 14:19:15
I'm getting a bit impatient with this drug. I know 2 weeks is not very long, but I seem to be getting worse (by the day) not better.
I've been on 30mg/day since day 1 and, apart from the first few days (there was an almost immediate lift in energy levels, which has now gone) I just feel 'flat'.
Question to users of mirtazapine: should I have noticed 'something' positive by now, especially at my dose?
I'm thinking of trying fluvoxamine for the next 2 weeks, before I see my pdoc. Its the only SSRI I haven't tried (I suffer Social Phobia, OCD, depression & various other anxieties).
Posted by Phillipa on September 30, 2007, at 14:38:02
In reply to Mirtazapine - how long to wait???, posted by tecknohed on September 30, 2007, at 14:19:15
Oh that's what I'm on fluvoximine(luvox) right? get that and prozac mixed. If you babblemail King of Nothing he's doing well on remeron. I think he's at the top of the page still or last week. I'll also send him a quick e-mail and ask him to look at your thread Phillipa
Posted by tecknohed on September 30, 2007, at 16:31:16
In reply to Mirtazapine - how long to wait???, posted by tecknohed on September 30, 2007, at 14:19:15
I take my mirtazapine twice daily - 15mg morning & eve. I wonder if the drug's antihistamine effects have been/are dulling my mood during the day? I know that sedating antihistamines (ie. diphenhydramine) make me feel pretty numb/dull-headed during the daytime.
So what I'm gonna try, for the next 2 days at least, is taking the whole 30mg at night. After all, dosing this way (with this drug) is the 'norm'.
Posted by tecknohed on September 30, 2007, at 16:34:12
In reply to Re: Just had a thought..., posted by tecknohed on September 30, 2007, at 16:31:16
And at what sort of doses? Full doses? What about danger of Serotonin Syndrome?
Posted by Viking on September 30, 2007, at 17:29:17
In reply to Mirtazapine - how long to wait???, posted by tecknohed on September 30, 2007, at 14:19:15
> I'm getting a bit impatient with this drug. I know 2 weeks is not very long, but I seem to be getting worse (by the day) not better.
>
> I've been on 30mg/day since day 1 and, apart from the first few days (there was an almost immediate lift in energy levels, which has now gone) I just feel 'flat'.
>
> Question to users of mirtazapine: should I have noticed 'something' positive by now, especially at my dose?
>
> I'm thinking of trying fluvoxamine for the next 2 weeks, before I see my pdoc. Its the only SSRI I haven't tried (I suffer Social Phobia, OCD, depression & various other anxieties).
I have taken Mirtazapine (Remeron) on several occasions, mostly with good results. Here is what I have learned through my personal experience with it:It takes 4-8 weeks before it starts working. Until then it will be sedating.
A dose of 30 mgs is a minimum start dose. I need 45-60 mgs before it really works.
I had to take it in the evening. Anyway else I simply could not stay awake during the day. 1-2 hours before bedtime is the best for me.
I have taken Remeron together with Cipramil and with Effexor without any problems.
Remeron is not known for causing serotonin syndrome.
I hope this helps you.
Viking
Posted by tecknohed on October 1, 2007, at 7:15:13
In reply to Mirtazapine - how long to wait???, posted by tecknohed on September 30, 2007, at 14:19:15
Right! I'm gonna stick with this for a while longer. Augment if need be (& I probably will need to): http://www.dr-bob.org/babble/20070929/msgs/786202.html
Last night I took all 30mg & this morning just stuck with my usual clon. And guess what? I DO feel (a bit) better for it. Whether its biochemical or all in the mind I dont really know. I see my GP tomorrow - see if I can get her to up the mirt to 45mg.
To be honest, what drove me into thinking of giving up the mirtazapine in the first place is 'cause I'm going for a short holiday for a week, starting this Sat. The thought of feeling miserable & socially anxious the whole time (thus ruining it for both myself & my girlfriend) was crushing me! Though I might ask my GP for a week course of chlordiazepoxide (as if she'd agree! lol) so I'll have the best chance of enjoying myself.
Posted by tecknohed on October 1, 2007, at 7:23:50
In reply to Re: Mirtazapine - how long to wait??? » tecknohed, posted by Viking on September 30, 2007, at 17:29:17
Did you get any startup anxiety with it, particularly anticipatory anxiety? Thats what I'm getting at the mo, especially in the mornings & whenever I need to go out.
Posted by Viking on October 1, 2007, at 11:32:11
In reply to Re: Mirtazapine - how long to wait??? » Viking, posted by tecknohed on October 1, 2007, at 7:23:50
> Did you get any startup anxiety with it, particularly anticipatory anxiety? Thats what I'm getting at the mo, especially in the mornings & whenever I need to go out.
No I never got any anxiety from remeron. It should be said that I usually dont suffer from anxiety. My major problems are anhedonia and lack of energy and motivation.
I did find Remeron very activating once it kicked in. Maybe some people will see this as anxiety, I dont know.
Posted by tecknohed on October 1, 2007, at 12:05:10
In reply to Re: Mirtazapine - how long to wait??? » tecknohed, posted by Viking on October 1, 2007, at 11:32:11
I guess maybe the anxiety I'm experiencing at the moment is just the same anxiety I'm trying to treat. Possibly made a bit worse by the mirt, but only a bit. All noradrenergic meds that I've taken (ie. lofepramine, bupropion, reboxetine) have helped anticipatory anxiety, whereas serotonergic meds tend to increase the problem. As mirtazapine increases both its hard to tell whats really going on. Perhapse when I increase the dose its noradrenalin actions will come into effect (more than they are now) & this particular anxiety will dissappear.
Actually, today has been ralatively productive. I've done a few simple things (which I've been too lazy/lethargic to do lately) like check various bill payments & balances so as not to go into the red (again!), and I've been browsing & typing away on my PC all day so, maybe the drugs effects are slowly becoming apparent. I'm even talking with my girlfriend again (sort of, a bit)! I'm certain that not taking it in the morning has helped a lot. Even the clonazepam hasn't made my mood low today. I hope this is the start of something good!!!
Posted by Emme on October 1, 2007, at 13:53:04
In reply to Mirtazapine - how long to wait???, posted by tecknohed on September 30, 2007, at 14:19:15
It took 8 weeks for it to kick in for me. We were about to ditch it when it turned on like a light bulb. I took it at night. I did have some anxiety with it, but that was helped by clonazepam. Good luck with it.
emme
Posted by ClearSkies on October 8, 2007, at 9:47:52
In reply to Re: Mirtazapine - how long to wait??? » Viking, posted by tecknohed on October 1, 2007, at 12:05:10
How are you doing now on the Mirtazapine?
I've been on 30mg for several months now and am surprised at how "normal" I feel. I actually have moods now (!), not just being flattened out. It's quite nice to be able to feel, finally. I'm really pleased with this medication.
ClearSkies
Posted by Phillipa on October 8, 2007, at 19:59:51
In reply to Re: Mirtazapine - how long to wait??? » tecknohed, posted by ClearSkies on October 8, 2007, at 9:47:52
Think he's on vacation. Phillipa
Posted by ClearSkies on October 9, 2007, at 8:10:46
In reply to Re: Mirtazapine - how long to wait??? » ClearSkies, posted by Phillipa on October 8, 2007, at 19:59:51
> Think he's on vacation. Phillipa
Gotcha - thanks.
CS
Posted by tecknohed on October 13, 2007, at 6:55:50
In reply to Re: Mirtazapine - how long to wait??? » tecknohed, posted by ClearSkies on October 8, 2007, at 9:47:52
> How are you doing now on the Mirtazapine?
>
> I've been on 30mg for several months now and am surprised at how "normal" I feel. I actually have moods now (!), not just being flattened out. It's quite nice to be able to feel, finally. I'm really pleased with this medication.
>
> ClearSkiesThanx for asking!
Been a bit rocky for the last week but things are improving. I have plenty of energy but am having trouble getting out of bed - seem to need 10-12hrs per night!
My mood is getting better too though I'm hoping that there is more to come!
As for social anxiety, its a tiny bit better but not much. Still, I didn't expect it to cure my social phobia - its not really a drug good for doing that. Today I'm increasing my mirtazapine to 45mg/day & clonazepam to 3mg/day. See if that does something better!
I see my pdoc in just over a week & I'm keen to discuss various addons. I'm thinking perhapse adding an SSRI (escitalopram or fluvoxamine) AND a dopamine agonist (ropinirol). A mood stabilizer is another thought I want to discuss with him. We shall see!
This is the end of the thread.
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