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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by dragonblack on September 27, 2011, at 5:20:58
Hi All,
Dx: BP II / GAD/PD
Rx's: Wellbutrin 300 mg, Abilify 5 mg, Ativan .5 mg, Klonopin .5-1 mg prn. And Remeron - 30 mg.So, as the thread title suggested, my Remeron trial is proving to be a pain. I was hungry all the time on 15 mg and saw no positive movement; I moved to 30 about 2 weeks ago and every day I debate going off of it, only to convince myself to try to stick with it and give it a fair trial. I will often wake up an hour after falling alseep to voraciously eat (carbs, mainly), sometimes it's in the middle of the night or early morning. I then stumble back to bed. It's like that 20/20 special on Ambien sleep binge eating. I've gained 10-12 pounds in 5 weeks. I was fit, before...I'm on my way to being unfit, plus at this rate, this kind of weight gain is not sustainable. Maybe it will level out, I can't help but suspect not.
I don't know what to do! I figure I either push to 45 and give it another month or just call it quits. I really just don't know what to do. I hate to pull the plug before giving a med a fair trial, but I also hate wasting time on a med that gives me no benefit and deal-breaker side effects. I can't keep throwing months/years away on these stupid med trials, I have to get back to work. Next in line for me is probably Cymbalta or a TCA.
Any advice, experiences, etc. regarding Remeron would be appreciated.
Posted by floatingbridge on September 27, 2011, at 9:08:18
In reply to Waking up just to eat on Remeron. Not fun : (, posted by dragonblack on September 27, 2011, at 5:20:58
Hi!
The remeron, what do you get out of it? Sleep or a better mood?
What you describe doesn't sound good. It does sound like what happens on a malfunctioning sleep aid.
I hear you about wasting time on trials. It's maddening. The sx's you report sound to me like a no-go. That's just me. I don't know why it's in your cocktail, meaning I can't guess what your doc has in mind,
Last I recall, were you trying parnate.
Sorry this seems to be such a drawn out process.
Posted by FrustratedMama on September 27, 2011, at 9:11:25
In reply to Re: Waking up just to eat on Remeron. Not fun : ( » dragonblack, posted by floatingbridge on September 27, 2011, at 9:08:18
I do the same thing on AMBIEN but cant remember doing it....My evidence (empty wrappers) is the only way I know it happened!
Posted by Phillipa on September 27, 2011, at 10:28:46
In reply to Re: Waking up just to eat on AMBIEN Not fun : (, posted by FrustratedMama on September 27, 2011, at 9:11:25
I got no benefit at all out of l5mg of remeron. So after a month stopped taking it. Yes ambien give the sleep amnesia. Frustrating. Phillipa
Posted by Christ_empowered on September 27, 2011, at 12:16:32
In reply to Re: Waking up just to eat on AMBIEN Not fun : (, posted by Phillipa on September 27, 2011, at 10:28:46
You might want to try something else. I personally wouldn't take a TCA ever again--1 round with Tofranil-PM was more that enough for me--but thats something you and your doc will have to decide.
I think with Remeron you can go up to 60. I wouldn't stay on something that wasn't life-saving and was making me fat, personally; right now it might just be vanity that makes you want to drop weight (which is a good enough reason), but if it continues you could run into serious health problems. Trust me; I gained lots of weight on an absolutely necessary medication, and I still hate it. I wouldn't do this for a medication that could easily be dropped or replaced.
Good luck.
Posted by dragonblack on September 27, 2011, at 14:41:04
In reply to Re: Waking up just to eat on Remeron. Not fun : ( » dragonblack, posted by floatingbridge on September 27, 2011, at 9:08:18
> Hi!
>
> The remeron, what do you get out of it? Sleep or a better mood?
>
> What you describe doesn't sound good. It does sound like what happens on a malfunctioning sleep aid.
>
> I hear you about wasting time on trials. It's maddening. The sx's you report sound to me like a no-go. That's just me. I don't know why it's in your cocktail, meaning I can't guess what your doc has in mind,
>
> Last I recall, were you trying parnate.
>
> Sorry this seems to be such a drawn out process.
>Hi FB!
I gave up on Parnate a while back and went through a horrible washout, only to go back on Wellbutrin, which I took for years before it pooped out (and likely contributed to migraines when taken alongside anticonvulsants).
The Remeron is my idea, I'm trying to find something to augment the Wellbutrin for depression, anhedonia, etc. Wellbutrin blunts my appetite a fair amount, I thought that would quell the weight gain aspect of Remeron (which maybe it is!!! :0) Don't even want to know what Remeron would be like without the Wellbutrin. I know that the sedation is supposed to ebb over time, as you become desensitized to the antihistamine effect, as well as at higher doses, so part of me thinks that it is worth going higher to find out if the same is true for appetite/weight gain. I really can't stand the weight gain, it makes me feel horrible about myself, I have some body issues I guess.
Wellbutrin is such a mixed bag but I seem to need it, so the plan right now is to find something that pairs well with it. Remeron looks to not be it, so far.
Hope you are doing well - thanks for your response!
db
Posted by dragonblack on September 27, 2011, at 14:43:11
In reply to Re: Waking up just to eat on AMBIEN Not fun : (, posted by FrustratedMama on September 27, 2011, at 9:11:25
> I do the same thing on AMBIEN but cant remember doing it....My evidence (empty wrappers) is the only way I know it happened!
It's like that only I know it is happening and feel too drugged to act otherwise. Then again, my eating is terrible during the day, now too.
Posted by dragonblack on September 27, 2011, at 14:46:45
In reply to Re: Waking up just to eat on AMBIEN Not fun : (, posted by Christ_empowered on September 27, 2011, at 12:16:32
> You might want to try something else. I personally wouldn't take a TCA ever again--1 round with Tofranil-PM was more that enough for me--but thats something you and your doc will have to decide.
>
> I think with Remeron you can go up to 60. I wouldn't stay on something that wasn't life-saving and was making me fat, personally; right now it might just be vanity that makes you want to drop weight (which is a good enough reason), but if it continues you could run into serious health problems. Trust me; I gained lots of weight on an absolutely necessary medication, and I still hate it. I wouldn't do this for a medication that could easily be dropped or replaced.
>
> Good luck.Yeah, the Remeron was my idea in the first place, so I'm sure I'll be allowed to drop it. The TCA idea is mainly just because I've never tried it and I feel like I need to make the rounds before I ask for ECT, which I've been thinking about for some time. I just get so frustrated with the med-go-round, I can't keep doing it forever. BTW, I read (in a Stahl book) that some people go up to 90 on Remeron! That I don't plan on doing, plus my nurse practitioner seemed to think that 45 was the ceiling and that 45 didn't really work any better than 30 anyway. Who knows.
Posted by Christ_empowered on September 27, 2011, at 14:59:16
In reply to Re: Waking up just to eat on AMBIEN Not fun : (, posted by dragonblack on September 27, 2011, at 14:46:45
Hey. TCA drugs are good melancholic+severe depression and psychotic depression. I don't know about treatment-resistant depression. I mean, I know they're used for that, but I don't know that they're actually all that great for the treatment-resistant among us.
45 might make you less hungry. The wiki article I read said some side-effects diminish as the dose is increased. Whether that applies to hunger and subsequent weight gain, I have no idea.
Have you tried amoxapine? I think you'd have to drop the Abilify, and its more for psychotic depression, but apparently some people have a rapid and rather robust response to it.
Posted by floatingbridge on September 27, 2011, at 15:14:04
In reply to Re: Waking up just to eat on AMBIEN Not fun : (, posted by Christ_empowered on September 27, 2011, at 14:59:16
Yes, CE has some ideas here.
And why not try 45mg if you're in this deep?
I am sorry that parnate was a bust. And here I thought you had been off board because it was working :-/
Posted by dragonblack on September 27, 2011, at 16:06:34
In reply to Re: Waking up just to eat on AMBIEN Not fun : (, posted by Christ_empowered on September 27, 2011, at 14:59:16
> Hey. TCA drugs are good melancholic+severe depression and psychotic depression. I don't know about treatment-resistant depression. I mean, I know they're used for that, but I don't know that they're actually all that great for the treatment-resistant among us.
>
> 45 might make you less hungry. The wiki article I read said some side-effects diminish as the dose is increased. Whether that applies to hunger and subsequent weight gain, I have no idea.
>
> Have you tried amoxapine? I think you'd have to drop the Abilify, and its more for psychotic depression, but apparently some people have a rapid and rather robust response to it.I haven't tried amoxapine, nor do I know anything about it. I'll look into it, though, thanks for the tip.
Posted by dragonblack on September 27, 2011, at 16:15:42
In reply to Re: Waking up just to eat on AMBIEN Not fun : ( » Christ_empowered, posted by floatingbridge on September 27, 2011, at 15:14:04
> Yes, CE has some ideas here.
>
> And why not try 45mg if you're in this deep?
>
> I am sorry that parnate was a bust. And here I thought you had been off board because it was working :-/Yeah, I've been torn over whether to put another month into it at 45. It seems the debate is over, though, I put my concerns into an email just a little while ago and immediately heard back from my nurse practitioner: taper off remeron, come into the office and pick up samples of cymbalta tomorrow. So, it looks like a decision has been made, and naturally I am ambivalent about it. Oh well, I'm glad to get off it, losing the chance to find out what 45 would do isn't that big of a deal compared to getting to try something new. With something new comes a glimmer of hope.
[Unneeded rant: what's so vexing is, I wouldn't care so much about the weight gain if it was WORKING, because then I could exercise. But when it doesn't even work, and I'm stuck in my room, then it's just adding insult to injury. But I feel guilty for not sticking with it for 8 more weeks or whatever the apologists would admonish]
Not off board due to remission : )
That gave me an ironic chuckle.
Posted by floatingbridge on September 27, 2011, at 16:30:44
In reply to Re: Waking up just to eat on AMBIEN Not fun : (, posted by dragonblack on September 27, 2011, at 16:15:42
>that gave me an ironic chuckle.
Glad you got that much out of it.
Sorry it's been rough, DB
Nixing the remeron sounds fine to me. Another eight weeks seems excessively long.
Posted by dragonblack on September 27, 2011, at 20:00:56
In reply to Re: Waking up just to eat on AMBIEN Not fun : ( » dragonblack, posted by floatingbridge on September 27, 2011, at 16:30:44
> >that gave me an ironic chuckle.
>
> Glad you got that much out of it.
>
> Sorry it's been rough, DB
>
> Nixing the remeron sounds fine to me. Another eight weeks seems excessively long.Thanks : )
I feel the same, it's too long to wait, I'm supposed to be working by the end of the year and that seems like an awful joke to me at this point. ("supposed" to be as in, bad things will happen if I'm not earning by January. All the while I'm trying to decide if I am going to appeal my SSI denial) Oh well.
Posted by zatar on September 30, 2011, at 12:26:30
In reply to Waking up just to eat on Remeron. Not fun : (, posted by dragonblack on September 27, 2011, at 5:20:58
Boy, can I relate. I started on mirtazapine three weeks ago. 7.5mg totally zombified me and I was sleeping all day. I cut it down to 3.75 which still made me tired, but I'm sticking with it and it seems to be a little better after two weeks.
My hunger comes in the evening. I'm fine all day (which I tended toward even before starting mirtazapine), but once dinner rolls around, padlock the pantry and refrigerator doors, folks.
I bought some Crystal Lite and BeneFiber to see if I can fill myself up on that. Because I don't eat that much during the day, my weight gain has been minimal (2-4 pounds), but I'm already overweight and can't afford even that.
I'm going to give it the old college try for maybe two months, then we'll see. I may be back on 10mg doxepin for my sleep.
I was hoping that mirtazapine would help with atypical depression as I'm exquisitely sensitive to side effects with SSRIs and get mild serotonin syndrome on them, but if I can't get up to a decent therapeutic dose on mirtazapine, it may be a bust.
Sometimes I wonder if I'd be a good candidate for transcranial magnetic stimulation. Though I'm technically not treatment resistent (b/c it's due to side effects of med that I can't take them), maybe that would reboot me. Just a thought.
-Zatar
Posted by Phillipa on September 30, 2011, at 20:10:37
In reply to Re: Waking up just to eat on Remeron. Not fun : (, posted by zatar on September 30, 2011, at 12:26:30
Zatar what are the symptoms of mild serotonin syndrome? Phillipa
Posted by dragonblack on October 1, 2011, at 15:17:46
In reply to Re: Waking up just to eat on Remeron. Not fun : (, posted by zatar on September 30, 2011, at 12:26:30
Hi,
Good luck with your Remeron trial. Just wanted to offer a word of advice. If you are trying to combat sedation I would go up, not down, in dosage. Remeron is generally considered less sedating as you get into the higher (and for MDD, therapeutic) range, like 30-45 mg. This is because you get more of a norepinephrine boost, which counteracts the antihistamine sedation. At the lower doses (15 mg and under) I consider it basically an antihistamine. I found 7.5 to be very sedating, 15 mg to be fairly sedating, and 30 mg to be mildly sedating, and really I just felt drugged, it didn't help me fall asleep at all at 30 mg. Just a thought.
db
Posted by Maria3667 on October 3, 2011, at 6:46:07
In reply to Waking up just to eat on Remeron. Not fun : (, posted by dragonblack on September 27, 2011, at 5:20:58
Hi Dragon,
I know where you're coming from - I had similar problems being on Remeron. My weight shot up - until my P-doc told me there is a way to curb the appetite on Remeron. She heard it at a convention.
She told me to combine the use of Remeron with an anti-acid med (OTC) containing Ranitidine. I tried it and it did stop the weight gain.
Maybe Google a little on the subject?
BTW: I found Remeron to be 1 of the best anti-depressants around. I felt very sociable on it, my depression cleared, I slept like a log & it was excellent for sex drive.
Hope this info helps!
> Hi All,
>
> Dx: BP II / GAD/PD
> Rx's: Wellbutrin 300 mg, Abilify 5 mg, Ativan .5 mg, Klonopin .5-1 mg prn. And Remeron - 30 mg.
>
> So, as the thread title suggested, my Remeron trial is proving to be a pain. I was hungry all the time on 15 mg and saw no positive movement; I moved to 30 about 2 weeks ago and every day I debate going off of it, only to convince myself to try to stick with it and give it a fair trial. I will often wake up an hour after falling alseep to voraciously eat (carbs, mainly), sometimes it's in the middle of the night or early morning. I then stumble back to bed. It's like that 20/20 special on Ambien sleep binge eating. I've gained 10-12 pounds in 5 weeks. I was fit, before...I'm on my way to being unfit, plus at this rate, this kind of weight gain is not sustainable. Maybe it will level out, I can't help but suspect not.
>
> I don't know what to do! I figure I either push to 45 and give it another month or just call it quits. I really just don't know what to do. I hate to pull the plug before giving a med a fair trial, but I also hate wasting time on a med that gives me no benefit and deal-breaker side effects. I can't keep throwing months/years away on these stupid med trials, I have to get back to work. Next in line for me is probably Cymbalta or a TCA.
>
> Any advice, experiences, etc. regarding Remeron would be appreciated.
Posted by EERR11CC on October 9, 2011, at 20:44:14
In reply to Re: Waking up just to eat on Remeron. Not fun : (, posted by zatar on September 30, 2011, at 12:26:30
Remeron is the secular God of sexy delicious gluttony.
This is the end of the thread.
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