Shown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by paxvox59 on December 1, 2008, at 18:03:15
Hey all, I know that Remeron must have been discussed at length before, but I was wondering how hard it is to come down from it if one has been on 30mg for over a year? I am a problem sleeper,and I fear the insomnia if I stop the Remeron. Thanks!
PAX
Posted by greywolf on December 1, 2008, at 18:26:57
In reply to remeron, posted by paxvox59 on December 1, 2008, at 18:03:15
I wonder if insomnia will be a problem for you. I have noticed that taking Remeron 30mg for a few months has gotten me to the point where the sedating effect of the Remeron is much reduced.
Of course, everyone experiences meds differently.
Greywolf
Posted by raisinb on December 1, 2008, at 19:21:02
In reply to remeron, posted by paxvox59 on December 1, 2008, at 18:03:15
Insomnia is easily dealt with with a hypnotic drug like Ambien or Lunesta. Maybe your dr can prescribe you something like that to help with the Remeron taper.
Posted by bleauberry on December 1, 2008, at 19:56:00
In reply to remeron, posted by paxvox59 on December 1, 2008, at 18:03:15
I was on remeron 15mg for over a year. To wean fairly comfortably I had to cut the dose down in tiny chunks, perhaps 2mg at a time, over a period of about 2 months. The last 7.5mg was the hard part. Something else to help you sleep when you get to the last stages would be an idea. Something with a different mechanism. My personal fav would be lunesta. Other things that are not known to be sleep meds can actually make awesome sleep meds. For example low dose Milnacipran (12.5mg-25mg) or LDN (low dose naltrexone 1.5mg bedtime).
Posted by Phillipa on December 1, 2008, at 21:08:23
In reply to Re: remeron, posted by bleauberry on December 1, 2008, at 19:56:00
Did the remeron poop out? Isn't 15mg supposed to help with sleep? Love Phillipa
Posted by desolationrower on December 1, 2008, at 21:47:25
In reply to Re: remeron, posted by Phillipa on December 1, 2008, at 21:08:23
hm i would think since cyproheptadine works the same mechanism for sleep, using that would let you taper the mirtazapine faster while still having enough histamine/serotonin antagonism to get to sleep when you need it.
-d/r
Posted by Tony P on December 1, 2008, at 22:19:43
In reply to Re: remeron, posted by desolationrower on December 1, 2008, at 21:47:25
If I've got the biochem. right, Remeron's sleep-inducing effect is mainly an H1 (histamine) one, so almost any old-fashioned anti-histamine should have a similar effect -- cyproheptadine or good old diphenhydramine (Benadryl), which has the great virtue of being cheap!
As others have said, there are many Rxs that are commonly used off-label for sleep, with less risk of tolerance & poop-out than Lunesta or related meds. Some that have worked for me are trazadone, serzone, seroquel, neurontin (gabapentin), trimipramine ....
Gabapentin didn't help me fall asleep but helped me stay asleep, so I'd combine it with something else if I were taking it again.
Trimipramine has some risks in adding a TCA to whatever other A/D you're taking, although my pdoc said it is the weakest of the TCA's in antidepressant effect, and it has a l-o-n-g halflife -- so set two alarms and the coffemaker on auto! But it gave me absolutely the most natural sleep of anything I have evr taken, not excepting the benzos & lunesta/Ambien etc.
Tony
Posted by desolationrower on December 2, 2008, at 4:27:48
In reply to Re: remeron, posted by Tony P on December 1, 2008, at 22:19:43
it also antagonises 5ht2a/c receptors, which while not causing drowsiness, do contribute to restful sleep: they increase slow-wave (deep) sleep, which is the most restorative. Antihistamines may somewhat, but probably more as an effect of increased sleep.
-d/r
Posted by theo on December 2, 2008, at 19:21:44
In reply to remeron, posted by paxvox59 on December 1, 2008, at 18:03:15
Why are you stopping Remeron?
Posted by 49er on December 6, 2008, at 8:00:48
In reply to remeron, posted by paxvox59 on December 1, 2008, at 18:03:15
> Hey all, I know that Remeron must have been discussed at length before, but I was wondering how hard it is to come down from it if one has been on 30mg for over a year? I am a problem sleeper,and I fear the insomnia if I stop the Remeron. Thanks!
>
> PAXPAX,
I have tapered very slowly (10% of current dose every 4 weeks) from 30mgs to around my current dose of 2mg. I generally didn't have any problems until I got below the 3 mg mark.
Since that time, I have had insomnia so bad that I can't sleep thoughout the night unless I take Benadryl. Unfortunately, it has slight ototoxic properties and due to suffering a hearing loss from Remeron and thus making me susceptible to drugs that cause hearing issues, I need to find something else to take. So far, I haven't found any natural remedies that work and I am not going to take drugs.
I fall asleep just find but wake up and can't back to sleep.
But if you haven't suffered hearing problems or similar issues such as tinnitus, you might find Benadryl helpful.
If you do decide to taper, please do it very slowly.
Good luck.
49er
Posted by desolationrower on December 6, 2008, at 14:44:08
In reply to Re: remeron, posted by 49er on December 6, 2008, at 8:00:48
> PAX,
>
> I have tapered very slowly (10% of current dose every 4 weeks) from 30mgs to around my current dose of 2mg. I generally didn't have any problems until I got below the 3 mg mark.
>
> Since that time, I have had insomnia so bad that I can't sleep thoughout the night unless I take Benadryl. Unfortunately, it has slight ototoxic properties and due to suffering a hearing loss from Remeron and thus making me susceptible to drugs that cause hearing issues, I need to find something else to take. So far, I haven't found any natural remedies that work and I am not going to take drugs.
>
> I fall asleep just find but wake up and can't back to sleep.
>
> But if you haven't suffered hearing problems or similar issues such as tinnitus, you might find Benadryl helpful.
>
> If you do decide to taper, please do it very slowly.
>
> Good luck.
>
> 49erI can't find any evidence diphenhydramine or antihistamines generally are ototoxic...do you have something about that? There are other antihistamiens that are better sleep drugs too, though not taking drugs makes it more difficult. Hope you can get back to normal.
-d/r
Posted by 49er on December 6, 2008, at 15:40:19
In reply to Re: remeron, posted by desolationrower on December 6, 2008, at 14:44:08
> I can't find any evidence diphenhydramine or antihistamines generally are ototoxic...do you have something about that? There are other antihistamiens that are better sleep drugs too, though not taking drugs makes it more difficult. Hope you can get back to normal.
>
> -d/rD/R,
Neil Bauman, who is not an MD, has done extensive research on the ototoxic meds. On the email list I belong to that he runs, he called it slightly ototoxic.
Also, here is this link:
http://www.berardaitwebsite.com/sait...s/saitt30.html
"Practitioners shared concerns about the use of ototoxic medications and their impact on AIT improvements. There were reported instances of individuals losing the benefits that had been gained following use of these medications. There are a variety of medications that can have ototoxic side effects, and it is difficult to obtain this information. The Physicians Desk Reference can be helpful, and pharmacists are often knowledgeable. Specific drugs that were mentioned on several occasions include IV drip Ceclor (often used for surgeries) that may cause sound sensitivity, and Benadryl, an antihistamine used for allergic reactions, which may cause tinnitus, vertigo and acute labyrinthitis."
As an FYI, AIT stands for auditory integration therapy.
Granted, this isn't much information to go on. But one day, when I took the Benadryl, I got the pulsating tinnitus I hadn't had since I was on my full complement of psych meds. It only happened that one time but that was enough to concern me greatly.
Otoxocicity is sadly an issue that is not very well recognized in the medical community. That is why there is not alot of research.
I was nodding my head on a board when people who suffered hearing loss from an antibiotic were told they had meneire's diease. That is what happened to me with the Remeron.
What are the other histamines that are better sleep drugs? Are they OTC or prescription as I don't have health insurance.
Thanks for your support.
49er
Posted by desolationrower on December 6, 2008, at 18:06:55
In reply to Re: remeron » desolationrower, posted by 49er on December 6, 2008, at 15:40:19
> What are the other histamines that are better sleep drugs? Are they OTC or prescription as I don't have health insurance.
>
> Thanks for your support.
>
> 49erCyproheptadine is the one i think is best; it has a short halflife so its not in your system all day (and less morning hangover) and it also has serotonin antagonism which improves sleep. It is old and cheap, it is prescription in the US but OTC is most other countries, so it depends on the jurisdiction of your pharmacy. Interesting about the diphenhydramine.
-d/r
Posted by 49er on December 7, 2008, at 5:46:35
In reply to Re: remeron, posted by desolationrower on December 6, 2008, at 18:06:55
> Cyproheptadine is the one i think is best; it has a short halflife so its not in your system all day (and less morning hangover) and it also has serotonin antagonism which improves sleep. It is old and cheap, it is prescription in the US but OTC is most other countries, so it depends on the jurisdiction of your pharmacy. Interesting about the diphenhydramine.
>
> -d/r
>
>Thanks. My natural remedy worked last night but I will keep this in mind in case it stops working.
49er
Posted by zenhussy on December 8, 2008, at 16:17:04
In reply to remeron, posted by paxvox59 on December 1, 2008, at 18:03:15
Posted by paxvox59 on December 10, 2008, at 17:53:52
In reply to Re: remeron--any changes, updates? (nm) » paxvox59, posted by zenhussy on December 8, 2008, at 16:17:04
Hey, thanks for all the feedback. I cut to 15mg, but the problem is that I don't have all that much more of it to do long-term taper-off. I'll try to go to 7.5 tonight to see how that works. Too bad I'm right in the middle of this anxiety crisis!
PAX
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