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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by g_g_g_unit on June 17, 2010, at 6:22:59
people often complain of discontinuation effects from SSRI's and whatnot, but i was wondering whether anyone had taken Mirtazapine for a reasonable period of time and a) were still on it without complication, or b) had withdrawn from it without complication?
Posted by Phillipa on June 17, 2010, at 11:06:17
In reply to is mirtazapine safe in the long-term?, posted by g_g_g_unit on June 17, 2010, at 6:22:59
I took 15mg once for a month noticed nothing just stopped it. Was still on other meds. No withdrawal though but not primary med. Just an add on for sleep which didn't help me. Phillipa
Posted by linkadge on June 17, 2010, at 16:22:11
In reply to is mirtazapine safe in the long-term?, posted by g_g_g_unit on June 17, 2010, at 6:22:59
Mirtazapine (and its withdrawl) left me much less messed up that with SSRIs.
Linkadge
Posted by Conundrum on June 18, 2010, at 0:47:56
In reply to Re: is mirtazapine safe in the long-term?, posted by linkadge on June 17, 2010, at 16:22:11
Did it help at all? If it did, with what symptoms?
Posted by Brain_Damage on June 18, 2010, at 7:20:46
In reply to Re: is mirtazapine safe in the long-term? » linkadge, posted by Conundrum on June 18, 2010, at 0:47:56
Mirtazapine withdrawal was brutal for me.....
It was far worse than Effexor withdrawal
I don't know about safety
Posted by Viking on June 18, 2010, at 9:10:51
In reply to is mirtazapine safe in the long-term?, posted by g_g_g_unit on June 17, 2010, at 6:22:59
I have tried to take both Mirtazapine and its predecessor Mianserin for longer periods.
I gave up on both of them because of sedation and weight gain (I tend to oversleep and overeat even without meds).
I dont remember any discontinuation symptoms even though I stopped without tapering.
Posted by linkadge on June 18, 2010, at 12:48:25
In reply to Re: is mirtazapine safe in the long-term? » linkadge, posted by Conundrum on June 18, 2010, at 0:47:56
Mirtazapine is a funny medication for me. It intially can really help depression (especially if stress induced), but the effect seems to fade after about 2 weeks of continual use. For me, it worked really well with an SSRI (citalopram).
Linkadge
Posted by 49er on June 18, 2010, at 17:28:22
In reply to is mirtazapine safe in the long-term?, posted by g_g_g_unit on June 17, 2010, at 6:22:59
> people often complain of discontinuation effects from SSRI's and whatnot, but i was wondering whether anyone had taken Mirtazapine for a reasonable period of time and a) were still on it without complication, or b) had withdrawn from it without complication?
It caused a hearing loss and withdrawal was tough even though I tapered slowly.
49er
Posted by g_g_g_unit on June 18, 2010, at 21:36:18
In reply to Re: is mirtazapine safe in the long-term?, posted by linkadge on June 18, 2010, at 12:48:25
> Mirtazapine is a funny medication for me. It intially can really help depression (especially if stress induced),
do you think it would be less beneficial in atypical depression?
For me, it worked really well with an SSRI (citalopram).
>yes precisely, i was hoping to take it alongside an SSRI; i have read it can be useful in ameliorating certain cognitive difficulties in depression
Posted by g_g_g_unit on June 18, 2010, at 21:37:43
In reply to Re: is mirtazapine safe in the long-term? » g_g_g_unit, posted by 49er on June 18, 2010, at 17:28:22
>
> It caused a hearing lossi think that's why i was questioning its safety. i recall reading of several instances where it's been linked to hearing problems
Posted by 49er on June 19, 2010, at 1:32:44
In reply to Re: is mirtazapine safe in the long-term? » 49er, posted by g_g_g_unit on June 18, 2010, at 21:37:43
>
> >
> > It caused a hearing loss
>
> i think that's why i was questioning its safety. i recall reading of several instances where it's been linked to hearing problems
>Wow, can you tell me where you recall reading this? It is listed as a rare side effect but I am curious about what you have read.
My psychiatrist claimed Remeron doesn't cause hearing problems. Not a surprise since many physicians, not just psychiatrists, have no idea that drugs can be ototoxic.
There was no doubt in my mind it caused it. And I received further confirmation when I was tapering it.
One day, I made a mistake in my dosage and took too much. My hearing worsened.
49er
Posted by g_g_g_unit on June 19, 2010, at 10:13:01
In reply to Re: is mirtazapine safe in the long-term?, posted by 49er on June 19, 2010, at 1:32:44
>
> Wow, can you tell me where you recall reading this? It is listed as a rare side effect but I am curious about what you have read.
>
sorry, i can't recall anything specific. maybe it was just through browsing dr-bob's archives - i think i recall reading about it worsening tinnitus, maybe as opposed to causing hearing loss per se?
Posted by Conundrum on June 19, 2010, at 10:47:53
In reply to Re: is mirtazapine safe in the long-term?, posted by 49er on June 19, 2010, at 1:32:44
Didn't you take Wellbutrin as well? That has more of reputation of causing tinnitus. I remember you once posted a link to a page of otoxic drugs and it actually recommended mirtazapine but then there was the link to that list and Wellbutrin was on it.
http://stason.org/TULARC/health/body/tinnitus-ringing-ears/6-What-are-some-ototoxic-drugs.htmlhttp://www.tinnitusformula.com/infocenter/articles/conditions/ototox.aspx
"Antidepressants
It should also be noted that, while not strictly ototoxic, prescription antidepressants can cause or worsen tinnitus for some people. Both the older, tricyclic, and the newer, SSRI, antidepressants have this capability. Among the tricyclics, Clomipramine and Amitriptyline are among the most frequent offenders. The SSRI antidepressants include Prozac, Zoloft, Paxil, Celexa and Luvox. These are listed in the Physicians Desk Reference as frequently causing tinnitus. One good choice for many people with both tinnitus and depression is the older medication Remeron, which has not been reported to cause tinnitus."
Posted by 49er on June 19, 2010, at 13:40:41
In reply to Re: is mirtazapine safe in the long-term? » 49er, posted by g_g_g_unit on June 19, 2010, at 10:13:01
Posted by 49er on June 19, 2010, at 13:46:45
In reply to Re: is mirtazapine safe in the long-term? » 49er, posted by Conundrum on June 19, 2010, at 10:47:53
> Didn't you take Wellbutrin as well? That has more of reputation of causing tinnitus. I remember you once posted a link to a page of otoxic drugs and it actually recommended mirtazapine but then there was the link to that list and Wellbutrin was on it.
>
>
> http://stason.org/TULARC/health/body/tinnitus-ringing-ears/6-What-are-some-ototoxic-drugs.html
>
> http://www.tinnitusformula.com/infocenter/articles/conditions/ototox.aspx
>
> "Antidepressants
> It should also be noted that, while not strictly ototoxic, prescription antidepressants can cause or worsen tinnitus for some people. Both the older, tricyclic, and the newer, SSRI, antidepressants have this capability. Among the tricyclics, Clomipramine and Amitriptyline are among the most frequent offenders. The SSRI antidepressants include Prozac, Zoloft, Paxil, Celexa and Luvox. These are listed in the Physicians Desk Reference as frequently causing tinnitus. One good choice for many people with both tinnitus and depression is the older medication Remeron, which has not been reported to cause tinnitus."Unfortunately, I did and I definitely think it cause my tinnitus which Doxepin also contributed to.
Personally, I wouldn't pick Remeron for tinnitus if you have it. That means you are very susceptible to any ototoxic drug and Remeron qualifies since it causes hearing loss.
Yes, the risk is small although my guess is that due to risks being underreported, it is greater than that. But when you already have developed ototoxic side effects which tinnitus qualifies as, that makes you alot more susceptible to any drug that has ototoxic properties be it hearing loss or tinnitus.
I didn't stand a bleeping chance with these 3 meds. I am so glad I am off everything.
49er
Posted by Hombre on June 27, 2010, at 22:32:48
In reply to Re: is mirtazapine safe in the long-term?, posted by 49er on June 19, 2010, at 13:46:45
Chinese medicine has several treatments for tinnitus.
http://www.itmonline.org/arts/tinmen.htm
In my experience (I've taken Remeron for 7+ months), antidepressants have a tendency to affect the Kidney system as described by Chinese medicine. This includes endocrine/adrenal function. Insomnia, agitation, anxiety, and night sweats are common symptoms of kidney yin deficiency, which, while recognized as "adrenal fatigue" according to Western medicine terms, does not seem to engender a consensus as to how to treat it. (awkward sentence. sorry)
Rest, going to be early (9:30pm), proper diet, gentle exercise, and herbal supplements (e.g. Liu Wei Di Huang Wan/Rhemannia Six Pills) can address this issue. The article goes into much more depth as to the various causes and treatments for tinnitus. Consult a pro, but know that there are reasons for these kinds of things and there are treatments to consider.
I also take Effexor, which works with Remeron to produce a robust antidepressant response. There are side effects, however, including trouble initiating urination, agitation, anxiety, an unstable "hollow" type of energy that makes it hard to concentrate, sexual dysfunction. I am currently using herbs to address some of these issues with satisfactory results. Diet, exercise, meditation and the right attitude are just as important helping me to manage my energy reserves.
You can think of it this way:
* diet and herbs provide the raw materials for a healthy nervous/endocrine system. the herbs also help stimulate certain helpful reactions.
* exercise provides the stimulus for regrowing nerve cells, blood vessels to support such growth, by regulating hormones such as insulin and HGH and growth factors such as IGF and BDNF
* meditation helps one to gain control over the parasympathetic/sympathetic nervous system so that you do not go into fight or flight mode as easily and can recover more quickly if you do
* attitude - basically CBT
For what it's worth.
Salud,
Hombre
This is the end of the thread.
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