![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Linkadge on July 1, 2014, at 16:14:35
Way too tired on remeron + fluvoxamine.
Posted by rjlockhart37 on July 1, 2014, at 18:31:43
In reply to New strategy needed, posted by Linkadge on July 1, 2014, at 16:14:35
that is alot of serotonin reptake in the synapse.....those both are serotonin meds, serotonin syndrome......but maybe .. reduce the remeron because that is the main one that causes sedation....luvox does but not as much as the remeron....googled it
maybe increase luvox and lower remeron? add a stimulant or increase methylphenidate
maybe prozac? reason im saying is it's the same as luvox reuptakeinhibitor but it's more stimulating and causes better mood with some energy, even though it's not a stimulant....
you could replace the remeron with buspar....that may work
Posted by Phillipa on July 1, 2014, at 22:29:20
In reply to Re: New strategy needed, posted by rjlockhart37 on July 1, 2014, at 18:31:43
Luvox is a good med. Remeron in my opinion did nothing for me. Phillipa
Posted by Christ_empowered on July 2, 2014, at 6:55:44
In reply to Re: New strategy needed, posted by Phillipa on July 1, 2014, at 22:29:20
maybe remeron plus wellbutrin, Cymbalta, or Effexor xr?
Posted by SLS on July 2, 2014, at 10:08:44
In reply to New strategy needed, posted by Linkadge on July 1, 2014, at 16:14:35
> Way too tired on remeron + fluvoxamine.
What are you trying to accomplish?
- Scott
Posted by Louisiana Sportsman on July 5, 2014, at 15:03:06
In reply to New strategy needed, posted by Linkadge on July 1, 2014, at 16:14:35
You're very smart. Linkadge. I notice this from your posts around here.
Are these the only two medications you take? I myself take a NaSSA + SSRI: Remeron 45mg., Zoloft 50mg. along with other medications.
I imagine you chose Luvox because it is a SSRI and sigma-1 receptor agonist. I imagine Remeron was chosen due to its novel mechanism of action. In theory, it is an expert combo. But in real life, I can see how it could be sedating.
Mirtazapine is potent. I imagine it is the culprit. See how you feel on Luvox monotherapy for a second. It is probably causing some sedation too. If it is manageable without mirtazapine:
"fluvoxamine + nortriptyline: safe, but not recommended, because the only CYP450 isoform fluvoxamine does not inhibit is 2D6."
On paper, try nortriptyline. It would compliment Luvox well based on theory.
In reality, bupropion and Luvox would be your best bet. Mirtazapine and bupropion sounds good too. The NDRI is here for the obvious stimulatory effect.
Beyond this point, you are asking me to pick two medicines out of the blue with no information. Umm, Latuda and Lyrica. Try that for real if you're only gonna take two medicines and they are going to be brand new, those I suggest.
Good luck with everything, man.
Posted by phidippus on July 6, 2014, at 18:33:27
In reply to New strategy needed, posted by Linkadge on July 1, 2014, at 16:14:35
what are yoou trying to treat?
Eric
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.