![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Scars R. Stories on March 29, 2013, at 11:31:18
I have taken all of the drugs mentioned as an adult. My insomnia began at age 6. I am a medical researcher (ABD Ph.D.). I DO NOT SLEEP without help. This is what I have discovered after MUCH trial and error and cocktails... PLUS, I no longer spend $500/month on attempting to sleep.
Seroquel gives me the worst hangover. It makes sleep kind of useless, because I do not get the benefit of having a productive day after that sleep. Tolerance also develops rapidly. Ex/ if I take 100 mg one night and I pass right out, later in the week 400 mg is required to sleep at all (using Seroquel).
Haldol/Thorazine - excuse me, these cause a much worse hangover than Seroquel. Do you like standing up and being blind for two minutes (because of their effect on blood pressure)? Haldol also has many bizarre side-effects and is intended for EMERGENCY USE in PSYCHIATRIC FACILITIES/HOSPITALS. It is not a long-term answer for anything.
Zyprexa/Risperdal give me a less severe, but still unpleasant hangover. And Zyprexa makes me eat 4000 calories in 1/2 hour.
Remeron is DANGEROUS. My psychiatrists in 2 different countries agree. It makes one sleep for 14+ hours when taken long-term, and its long-term effect on weight, blood lipids, etc. are severe. I gained 50 lbs. over 4 years, and when I stopped Remeron not only was I hospitalized for melancholic depression after a suicide attempt, but I lost 50 lbs in a month, making me rather weak.
Ambien/Lunesta/Imovane/et. al (hypnotics and "sleeping pills" made for no other purpose) do not work for much longer than a month. Sometimes a dose increase will then make insomnia worse. The sleep-driving/eating/sex/other behaviors bit is also a serious concern. These medications also tend to cause other physical issues, acid-reflux being perhaps most common, that require additional medication.
Benzodiazepines simply do not make me sleep. 60 mg Klonopin wouldn't do it the other night. Benzos will put you to sleep if you have never taken them before, but are intended to treat anxiety. If you have any anxiety issues/disorders, they will calm you down, but they will not make you sleep.
Now, think about the neurotransmitters that these drugs affect. Do you really want to be REDUCING DOPAMINE (are you depressed? NOT a good idea, then)? Messing with GABA? And Remeron has recently been removed from the SNRI class and put into one entirely of its own that little is known about.
What about giving dopamine, serotonin (most sleep-related, why eating tryptophan foods like bananas or turkey makes some people sleepy), and norepinephrine a little boost overnight? TCAs, TRICYCLIC (the first) ANTIDEPRESSANTS ARE THE ANSWER. (they're VERY CHEAP BECAUSE they were released 50 years ago) But not just any TCA...
Amitriptyline causes just as much metabolism-slowing and appetite-increasing as any atypical antipsychotic (ex/ Zyprexa) or Remeron. Even, yes doc, in small doses.
TRAZODONE IS THE ANSWER. It does not have these effects, and you will sleep. Start with 50-150 mg at bedtime. I take 200 mg if I want 8 hours. The FIRST couple of times you take it, you may feel groggy the following day. THIS WILL STOP HAPPENING if you take it for a week or longer.
NEURONTIN, in COMBINATION with benzos taken at VERY SPECIFIC TIMES has also proven useful, and this is also a cheaper option because these are all older drugs.
BEST OF LUCK - I KNOW HOW MUCH INSOMNIA CAN BE TORTURE. It is used ("sleep deprivation") by the CIA to torture, er, interrogate with enhancement. Anyone starts going psychotic without any sleep for 2-3 nights. ANYONE. This does not mean you have a psychotic disorder, and there is no reason for anyone to take an antipsychotic for sleep.
*(Once a doctor prescribed me Zoloft for sleep. Zoloft is not a good drug to take for sleep (or in my research and experienced-based opinion, for anything). SSRIs (SNRIs DO work for depression, quite well) are not a solution for anything unless you want to become a suicidal zombie. I have taken Prozac, Paxil, Zoloft, and Celexa, and they have all had negative effects. Except for Celexa, which did nothing. Evidence now shows no difference between SSRIs and placebos.)
**I currently take 450mg Effexor XR, 90 mg Adderall, 8 mg Klonopin, 300 mg Neurontin.... and 200 mg Trazodone. It's the best sleep/day-functioning I've experienced in my life, or over the 10 years during which I tried everything/anything else.
Posted by Phillipa on March 29, 2013, at 11:52:35
In reply to Insomnia resolved after trying EVERYTHING..., posted by Scars R. Stories on March 29, 2013, at 11:31:18
Glad you found a combo that works for you. I'm finding for me less is best and have been cutting down meds I no longer need. Too many meds. Too many interactions. And it is working for me. I guess we all have different needs. Thanks for your post Phillipa
Posted by Tomatheus on March 29, 2013, at 12:41:38
In reply to Insomnia resolved after trying EVERYTHING..., posted by Scars R. Stories on March 29, 2013, at 11:31:18
Scars R. Stories,
Welcome to Psycho-Babble. I too am glad that you've found a combination of medications that seems to work well for you. I know that going through the trial-and-error process of finding an effective treatment for the health conditions that we have can be trying and doesn't always lead to a good outcome, but it's nice to hear from someone who has ultimately found a combo that seems to help. I wish you continued success with your treatment.
Tomatheus
Posted by linkadge on March 29, 2013, at 16:42:24
In reply to Insomnia resolved after trying EVERYTHING..., posted by Scars R. Stories on March 29, 2013, at 11:31:18
Trazodone has the potentially neurotoxic / cardiotoxic metabolite mcpp. Small doses of remeron and melatonin work for me. Never gained a pound.
Posted by linkadge on March 29, 2013, at 16:45:57
In reply to Insomnia resolved after trying EVERYTHING..., posted by Scars R. Stories on March 29, 2013, at 11:31:18
Benzodiazepines simply do not make me sleep. 60 mg Klonopin wouldn't do it the other night.
Doesn't sound like you've found the 'trazodone cure' for that long.
Linkadge
Posted by ChicagoKat on March 29, 2013, at 19:38:12
In reply to Insomnia resolved after trying EVERYTHING..., posted by Scars R. Stories on March 29, 2013, at 11:31:18
> Benzodiazepines simply do not make me sleep. 60 mg Klonopin wouldn't do it the other night.
60mg of Klonopin??????
> **I currently take 450mg Effexor XR, 90 mg Adderall, 8 mg Klonopin, 300 mg Neurontin.... and 200 mg Trazodone.
8mg Klonopin/day????? Have you considered rehab?
Posted by Scars R. Stories on March 30, 2013, at 12:45:04
In reply to Re: Insomnia resolved after trying EVERYTHING... » Scars R. Stories, posted by ChicagoKat on March 29, 2013, at 19:38:12
> > Benzodiazepines simply do not make me sleep. 60 mg Klonopin wouldn't do it the other night.
>
> 60mg of Klonopin??????
>
> > **I currently take 450mg Effexor XR, 90 mg Adderall, 8 mg Klonopin, 300 mg Neurontin.... and 200 mg Trazodone.
>
> 8mg Klonopin/day????? Have you considered rehab?LMAO... I've been on as little as 0.5 mg and as much as 12 mg over the past ten years. My psychiatrist is one of the few that prescribes benzos in large quantities because they are FAR LESS ADDICTIVE than many new, expensive, bonus-making drugs like Effexor (which I also take)... Paxil produces similar brain-zaps. SSRI Withdrawal Syndrome lasts for weeks to months and it's horrible...far worse than withdrawal I experienced from opiate painkillers post-surgery. Plus, 8 mg isn't that much, knew someone who took 25. Did you go to John's Hopkins or something?? LOL Everyone has a unique metabolism....
Posted by Scars R. Stories on March 30, 2013, at 12:49:00
In reply to Re: Insomnia resolved after trying EVERYTHING..., posted by linkadge on March 29, 2013, at 16:45:57
> Benzodiazepines simply do not make me sleep. 60 mg Klonopin wouldn't do it the other night.
>
> Doesn't sound like you've found the 'trazodone cure' for that long.
>
> LinkadgeActually, I tried it years ago and it worked well for several months, but I had this idea in my head that meds were bad and I stopped it and eventually everything else. Then I went into the worst depression of my life, did not shower or move for a month until I carried out my "plan"...long hospitalization followed, and life-changing realization that this stuff really is insulin for my illness. I had just forgotten about it/had some negative associations with it that prevented me from remembering - they were related to that summer, not the pill though.
Posted by Scars R. Stories on March 30, 2013, at 12:50:29
In reply to Re: Insomnia resolved after trying EVERYTHING... » Scars R. Stories, posted by Phillipa on March 29, 2013, at 11:52:35
> Glad you found a combo that works for you. I'm finding for me less is best and have been cutting down meds I no longer need. Too many meds. Too many interactions. And it is working for me. I guess we all have different needs. Thanks for your post Phillipa
Cheers! Absolutely... we all have metabolisms and enzymes as unique as our fingerprints... see below - I got off all my meds last fall... then I crashed, first time I realized why this condition is called an "illness"....
Posted by Scars R. Stories on March 30, 2013, at 12:55:21
In reply to Re: Insomnia resolved after trying EVERYTHING..., posted by linkadge on March 29, 2013, at 16:42:24
> Trazodone has the potentially neurotoxic / cardiotoxic metabolite mcpp. Small doses of remeron and melatonin work for me. Never gained a pound.
EVERY psychotropic drug is "potentially neurotoxic". We all have unique metabolisms, though everyone I know who has gone on Remeron has gained. I'd rather "potential neurotoxicity" (I breathe the air everyday, which is definitely neurotoxic lol) than *proven* increase in blood lipids and slowed metabolism... and thus a cause of Diabetes II. Glad it works for you. Smallest dose left me snowed... and Remeron is *supposed* to actually have a greater affect in lower doses, did you know that?
Posted by linkadge on March 30, 2013, at 13:09:20
In reply to Re: Insomnia resolved after trying EVERYTHING..., posted by Scars R. Stories on March 30, 2013, at 12:55:21
First of all, remeron is not "proven" to cause increased blood lipids, slowed metabolism etc.
As with all studies, an increased incidence of a particular side effect does not mean that every individual will have a particular side effect.
Some studies link trazodone to cardiac rhythm disturbances (risk factor for SCD), liver toxicity and blood sugar disturbances. Also, as mentioned the metabolite MCPP is potentially cardiotoxic (in the manner of other 5-ht2b agonists like cabergoline).
All in all, I get a little concerned when people put one medication on a pedistal at the exclusion of all others.
Trazodone never worked for me as a sleep aid. In fact it made my insomnia worse. Remeron does work (for me). The 5-ht2c antagonism might benefit certain mood disorders in which a supersentivity of inhibitory 5-ht2c receptors has been noted.
To each his own.
Linkadge
Posted by Scars R. Stories on March 31, 2013, at 8:02:43
In reply to Re: Insomnia resolved after trying EVERYTHING..., posted by linkadge on March 30, 2013, at 13:09:20
> First of all, remeron is not "proven" to cause increased blood lipids, slowed metabolism etc.
>
> As with all studies, an increased incidence of a particular side effect does not mean that every individual will have a particular side effect.
>
> Some studies link trazodone to cardiac rhythm disturbances (risk factor for SCD), liver toxicity and blood sugar disturbances. Also, as mentioned the metabolite MCPP is potentially cardiotoxic (in the manner of other 5-ht2b agonists like cabergoline).
>
> All in all, I get a little concerned when people put one medication on a pedistal at the exclusion of all others.
>
> Trazodone never worked for me as a sleep aid. In fact it made my insomnia worse. Remeron does work (for me). The 5-ht2c antagonism might benefit certain mood disorders in which a supersentivity of inhibitory 5-ht2c receptors has been noted.
>
> To each his own.
>
> Linkadge
>
>
Thanks for the info on Trazodone, I will look into it. But, I must give you the info for Remeron.First, MEDICAL RESEARCH does PROVE that Remeron causes weight gain in many, and EVEN IF IT DOESN'T affects the body of those that do not in a couple of ways that lead to Diabetes. For one, cortisol suppression = higher insulin. I found a good summary of some medical papers on the web - to quote:
"Not surprisingly, the research on Remeron talks alot about the weight gain, but, specfically, about the change in body composition. On Remeron, people tend to gain this layer of fat, or that's how I describe it. I call it the immovable layer of lard. It comes out of nowhere and is very stubborn about leaving. Walk all you want, hit that eliptical all you want....it won't move. It makes you want to give up on the drug. To hate it. To return to insomnia, if that's what will make the weight go away.
But then I happened upon some like that lead me another link. And, that's when I put together the cortisol + insulin connection.
This is how it goes: Remeron supresses the stress hormone cortisol. This is one of the reasons it helps people sleep. It basically 'powers down' your brain and slows your metabolism a bit. But, more interestingly is the relationship between cortisol and insulin. Apparently, cortisol counteracts insulin. Insulin basically grabs sugar from your bloodstream and stores it as fat. Your body needs cortisol to counteract and balance this effect of insulin, in addition to helping processing lipids (fats) and proteins.
So, as Remeron is supressing your cortisol it is also contributing to some of the effects of high insulin, specifically hypoglycemia or low blood sugar. When people say that can't stop eating carbs on Remeron, this may be why. Unabated, the insulin is grabbing sugar out of your blood, which leads you to think that you are carb depleted. So, you eat more carbs.
That's problem number one.
Problem number two comes from simply supressing cortisol. Because optimal levels of cortisol are neccessary for processing all macronutrients, having too little of it a night could drastically effect your body's conversion of these nutrients into energy. This could cause weight gain and would explain why people gain weight on Remeron so quickly.
That's problem number two."
Now, it is true, like I said, everyone has a different metabolism, but more importantly, different amounts of the TEN or so enzymes that process food/medication. One's body and the way we respond to medication is as unique as their fingerprints.
Pharmaceutical companies COULD but HAVEN'T developed technology to test for these, because they make more money if many drugs in higher dosages are tried.
So we are subject to this trial/error method. I have a very fast metabolism. VERY fast. I do not respond well to drugs that slow my metabolism down. I was on Clozaril for 2 years and the effects of Remeron were almost exactly the same. Massive weight gain, sleeping for 15+ hours, cravings for sweets.
Can I ask how much Remeron you take, for how long you've taken it, and what your diet is like? Body type? I'm interested in figuring out the puzzle, that's all. I'm a psychotropic drug researcher and journalist, and I would love to collect my own information about Remeron's effect according to these factors.
Best,
scars
Posted by linkadge on March 31, 2013, at 18:59:50
In reply to Re: Insomnia resolved after trying EVERYTHING... » linkadge, posted by Scars R. Stories on March 31, 2013, at 8:02:43
>Thanks for the info on Trazodone, I will look >into it. But, I must give you the info for >Remeron.
First of all, your "info" is anecdotal. It does not prove anything conclusively.
>First, MEDICAL RESEARCH does PROVE that Remeron >causes weight gain in many, and EVEN IF IT >DOESN'T affects the body of those that do not in >a couple of ways that lead to Diabetes.
Weight gain is a possible side effect. What does that "prove"?
>For one, cortisol suppression = higher insulin. >I found a good summary of some medical papers on >the web - to quote:
Most effective antidepressants will normalize the HPA axis. Trazodone (as a 5-ht2a antagonist) will lower cortisol. Melatonin (the natural sleep hormone) will significantly lower cortisol. Does that mean melatonin is dangerous? Melatonin extends the lifespan of rodents. Elevated cortisol is linked to depression, PDSD, heart disease, weight gain (hence the 'relacore' adds) as well as insulin resistance. Normal cortisol levels are connected with normal insulin levels. However, elevated cortisol is characteristic of certain forms of depression. Mirtazapine might just help normalize that. Do you have any (actual) studies that suggest that remeron leads to prolonged, unnaturally low levels of cortisol? (probably not).
>On Remeron, people tend to gain this layer of >fat, or that's how I describe it. I call it the >immovable layer of lard. It comes out of nowhere >and is very stubborn about leaving. Walk all you >want, hit that eliptical all you want....it >won't move.
Dude, I'm 135 pounds, I've got washboard abs. I havn't gained a pound in over a year of using mirtazpaine. Give me your email if you want pics!
>But then I happened upon some like that lead me >another link. And, that's when I put together >the cortisol + insulin connection.
Many antidepressants (TCA's imipramine, amitriptyline, doxapin, fluoxetine, paroxetine etc. etc. have been linked to blood sugar abnormalities). Effexor has been linked to cholesterol issues as well as hypertension. Effexor at >75 mg put my heart rate above 120bpm! It also blocks sodium channels which can cause abnormal rhythm. Desvenlafaxine the metabolite of effexor has been linked to elevated rates of stroke and heart attack. Wellbutrin has been linked to neurotoxicity, liver damage, seizures, cardiovascular issues etc. So pick your debilitating side effect and live with it!
>This is how it goes: Remeron supresses the >stress hormone cortisol. This is one of the >reasons it helps people sleep. It >basically 'powers down' your brain and slows >your metabolism a bit. But, more interestingly >is the relationship between cortisol and >insulin. Apparently, cortisol counteracts >insulin.
In the short term yes. However, elevated levels of cortisol eventually lead to cortisol insensitivity which will screw up the whole metabolic system. Chronic insomnia alone more than doubles the risk of metabolic disorders!
Deficiency of rem sleep (as strongly induced by effexor) is a risk factor of Alzheimer's and Parkinson's. So again, pick your debilitating side effect.
>Insulin basically grabs sugar from your >bloodstream and stores it as fat. Your body >needs cortisol to counteract and balance this >effect of insulin, in addition to helping >processing lipids (fats) and proteins.This is way too over simplistic and not really accurate. According to wikipedia:
[cortisol...] "Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat, protein and carbohydrate metabolism.[2] It also decreases bone formation. Various synthetic forms of cortisol are used to treat a variety of diseases."
"When people say that can't stop eating carbs on Remeron, this may be why. Unabated, the insulin is grabbing sugar out of your blood, which leads you to think that you are carb depleted. So, you eat more carbs."Many antidepressants are linked to carbohydrate craving. Remeron like most 5-ht2c and/or histamine 1 antagonists increases appetite. Patients with certain forms of depression exhibit a super sensitivity of 5-ht2c receptors. Certain patients should not be prescribed mirtazapine. For atypical depression, mirtazapine is clearly the *wrong* choice!
>Can I ask how much Remeron you take, for how >long you've taken it, and what your diet is >like? Body type? I'm interested in figuring out >the puzzle, that's all. I'm a psychotropic drug >researcher and journalist, and I would love to >collect my own information about Remeron's >effect according to these factors.
I have had about 3 major depressive episodes. I am 30, am 6 foot 2 135 pounds. My depression is characterized by high anxiety, weight loss, apathy, concentration problems, suicidality (related to insomnia).
I first took citalopram with helped a little with anxiety. I experienced remission when mirtazapine was added to the citalopram. My main issues were that the citalopram (or any SSRI / SNRI) caused wicked insomnia and constant nighttime awakenings. I have taken amitriptyline, trazodone and remeron as adjunctive. The remeron produced deeper sleep than amitriptyline or trazodone. Also, the mirtazapine helped restore my abnormally low appetite and aversion (literally fear) of food. I currently take 7.5 mg I occasionally go up to 15mg.
I don't recommend mirtazapine as a sole antidepressant because (as you say, side effects often outweigh the antidepressant benefits. However in conjunction with say effexor, remeron basically eliminates the major side effects of effexor for me (nausea, restorative sleep, emotional numbness, loss of appetite etc).
Linkadge
Posted by Scars R. Stories on April 1, 2013, at 2:21:55
In reply to Re: Insomnia resolved after trying EVERYTHING..., posted by linkadge on March 31, 2013, at 18:59:50
> >Thanks for the info on Trazodone, I will look >into it. But, I must give you the info for >Remeron.
>
> First of all, your "info" is anecdotal. It does not prove anything conclusively.
>
> >First, MEDICAL RESEARCH does PROVE that Remeron >causes weight gain in many, and EVEN IF IT >DOESN'T affects the body of those that do not in >a couple of ways that lead to Diabetes.
>
> Weight gain is a possible side effect. What does that "prove"?
>
> >For one, cortisol suppression = higher insulin. >I found a good summary of some medical papers on >the web - to quote:
>
> Most effective antidepressants will normalize the HPA axis. Trazodone (as a 5-ht2a antagonist) will lower cortisol. Melatonin (the natural sleep hormone) will significantly lower cortisol. Does that mean melatonin is dangerous? Melatonin extends the lifespan of rodents. Elevated cortisol is linked to depression, PDSD, heart disease, weight gain (hence the 'relacore' adds) as well as insulin resistance. Normal cortisol levels are connected with normal insulin levels. However, elevated cortisol is characteristic of certain forms of depression. Mirtazapine might just help normalize that. Do you have any (actual) studies that suggest that remeron leads to prolonged, unnaturally low levels of cortisol? (probably not).
>
> >On Remeron, people tend to gain this layer of >fat, or that's how I describe it. I call it the >immovable layer of lard. It comes out of nowhere >and is very stubborn about leaving. Walk all you >want, hit that eliptical all you want....it >won't move.
>
> Dude, I'm 135 pounds, I've got washboard abs. I havn't gained a pound in over a year of using mirtazpaine. Give me your email if you want pics!
>
> >But then I happened upon some like that lead me >another link. And, that's when I put together >the cortisol + insulin connection.
>
> Many antidepressants (TCA's imipramine, amitriptyline, doxapin, fluoxetine, paroxetine etc. etc. have been linked to blood sugar abnormalities). Effexor has been linked to cholesterol issues as well as hypertension. Effexor at >75 mg put my heart rate above 120bpm! It also blocks sodium channels which can cause abnormal rhythm. Desvenlafaxine the metabolite of effexor has been linked to elevated rates of stroke and heart attack. Wellbutrin has been linked to neurotoxicity, liver damage, seizures, cardiovascular issues etc. So pick your debilitating side effect and live with it!
>
> >This is how it goes: Remeron supresses the >stress hormone cortisol. This is one of the >reasons it helps people sleep. It >basically 'powers down' your brain and slows >your metabolism a bit. But, more interestingly >is the relationship between cortisol and >insulin. Apparently, cortisol counteracts >insulin.
>
> In the short term yes. However, elevated levels of cortisol eventually lead to cortisol insensitivity which will screw up the whole metabolic system. Chronic insomnia alone more than doubles the risk of metabolic disorders!
> Deficiency of rem sleep (as strongly induced by effexor) is a risk factor of Alzheimer's and Parkinson's. So again, pick your debilitating side effect.
>
> >Insulin basically grabs sugar from your >bloodstream and stores it as fat. Your body >needs cortisol to counteract and balance this >effect of insulin, in addition to helping >processing lipids (fats) and proteins.
>
> This is way too over simplistic and not really accurate. According to wikipedia:
>
> [cortisol...] "Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat, protein and carbohydrate metabolism.[2] It also decreases bone formation. Various synthetic forms of cortisol are used to treat a variety of diseases."
>
>
> "When people say that can't stop eating carbs on Remeron, this may be why. Unabated, the insulin is grabbing sugar out of your blood, which leads you to think that you are carb depleted. So, you eat more carbs."
>
> Many antidepressants are linked to carbohydrate craving. Remeron like most 5-ht2c and/or histamine 1 antagonists increases appetite. Patients with certain forms of depression exhibit a super sensitivity of 5-ht2c receptors. Certain patients should not be prescribed mirtazapine. For atypical depression, mirtazapine is clearly the *wrong* choice!
>
> >Can I ask how much Remeron you take, for how >long you've taken it, and what your diet is >like? Body type? I'm interested in figuring out >the puzzle, that's all. I'm a psychotropic drug >researcher and journalist, and I would love to >collect my own information about Remeron's >effect according to these factors.
>
> I have had about 3 major depressive episodes. I am 30, am 6 foot 2 135 pounds. My depression is characterized by high anxiety, weight loss, apathy, concentration problems, suicidality (related to insomnia).
>
> I first took citalopram with helped a little with anxiety. I experienced remission when mirtazapine was added to the citalopram. My main issues were that the citalopram (or any SSRI / SNRI) caused wicked insomnia and constant nighttime awakenings. I have taken amitriptyline, trazodone and remeron as adjunctive. The remeron produced deeper sleep than amitriptyline or trazodone. Also, the mirtazapine helped restore my abnormally low appetite and aversion (literally fear) of food. I currently take 7.5 mg I occasionally go up to 15mg.
>
> I don't recommend mirtazapine as a sole antidepressant because (as you say, side effects often outweigh the antidepressant benefits. However in conjunction with say effexor, remeron basically eliminates the major side effects of effexor for me (nausea, restorative sleep, emotional numbness, loss of appetite etc).
>
> Linkadge
>
>
>
I didn't even think to compare what we're treating aside from insomnia. I'm bipolar. It's when I'm revved up that I don't sleep, which is luckily more often and not at all a separation from reality..."hypomania" I would call it, though I know some psychiatrists/psychologists that would find another way to argue that I'm "fully bipolar". LOL...they can fight amongst themselves.When I get depressed I sleep for weeks at a time. I just do not get out of bed, give up on life for some reason or another silly reason (so it seems when I'm on the other side).
I've always been skinny as hell, fast fast metabolism, 5'7" 120 lbs. 29. So when I gain...actually almost 60 lbs it's pretty extreme - it's an entire half of what I'm accustomed to weighing! I lose it once off the med that was causing the weight gain so fast I get weak. On 15 Remeron AND 450 mg Effexor XR I was still in a coma for 16 h and then groggy and couldn't concentrate for 3. I tried for 2 months. Then I took Imovane (zopiclone, not eszopiclone or Lunesta but similar) with limited success for a month, then I rediscovered Trazodone.
I'll be thinking about this when I have some spare time... I'm glad you're getting sleep above all else!
scars
Posted by vanvog on April 5, 2013, at 4:13:24
In reply to Re: Insomnia resolved after trying EVERYTHING..., posted by Scars R. Stories on April 1, 2013, at 2:21:55
http://www.cnsspectrums.com/UserDocs/ArticleImages/176/1009CNS_Stahl.pdf
Off-label = not approved for insomnia. Please keep in mind that prescribing Trazodone for insomnia is essentially exploiting the side effect of the medication. Technically Trazodone is a mild antidepressant and is therefore not suitable for everyone. Just sayin'.
But here's the good news for MAOI people:
"Trazodone/nefazodone are, contrary to what is often said, not serotonergic antidepressants. Indeed they are 5-HT2A antagonists, which means they actually reduce serotonergic side-effects and symptoms of serotonin toxicity. Exactly the same applies to the anti-depressant efficacy-challenged twins, mirtazapine/mianserin (great sedatives), which have in fact been used to prevent symptoms of serotonin toxicity successfully in animal models of ST."
Posted by brynb on April 6, 2013, at 17:27:07
In reply to Insomnia resolved after trying EVERYTHING..., posted by Scars R. Stories on March 29, 2013, at 11:31:18
Hi Scars-
Just wanted to say I tend to agree with you on this thread. I'm naturally thin (5'4, 100-105 lbs, 38 yo F) and certain meds (APs, Remeron, Neurontin, etc.) not only don't help me sleep, but make me gain 10-20% of my body weight within weeks.
I'm also like you with benzos, though years of use have given me a high tolerance. I was in a bad place recently, and literally laughed at the hospital pdocs who couldn't understand why IV Ativan (starting at 4mg) wouldn't put me out.
Anyway, I can't sleep either, but here and there, Trazadone has worked better than the others mentioned for me as well.
Good to hear you're sleeping. My next step is an elephant tranquilizer.
-b
Posted by Scars R. Stories on April 6, 2013, at 22:53:38
In reply to Re: Insomnia resolved after trying EVERYTHING... » Scars R. Stories, posted by brynb on April 6, 2013, at 17:27:07
> Hi Scars-
>
> Just wanted to say I tend to agree with you on this thread. I'm naturally thin (5'4, 100-105 lbs, 38 yo F) and certain meds (APs, Remeron, Neurontin, etc.) not only don't help me sleep, but make me gain 10-20% of my body weight within weeks.
>
> I'm also like you with benzos, though years of use have given me a high tolerance. I was in a bad place recently, and literally laughed at the hospital pdocs who couldn't understand why IV Ativan (starting at 4mg) wouldn't put me out.
>
> Anyway, I can't sleep either, but here and there, Trazadone has worked better than the others mentioned for me as well.
>
> Good to hear you're sleeping. My next step is an elephant tranquilizer.
>
> -bThanks for the support! LOL Ativan doesn't touch me. It took me a long time to convince my doctor to prescribe Xanax PRN instead, already being on a lot of Klonopin. And it's interesting about body types and meds...gender, too, I'm sure.
I'm trying to take the Trazodone every couple of nights so I don't build up a tolerance... I start hallucinating because I don't sleep enough without even noticing sometimes. I slept all day today out of exhaustion after taking 8 mg Klonopin and 3 mg Xanax - rare achievement!
The person that suggested I go to rehab for being on benzos.... so ridiculous. We all need different tools. I just posted this to provide info about my experiences.
My next step is chloral hydrate LOL....
Sleep Well :)
scars
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