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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Zana on April 18, 2009, at 10:20:05
I have a new pdoc, as some of you may know already. She has put me on Pristiq which, oddly, seems to be helping my depression. Odd because Effexor didn't work and I've been through all the other ADs.
So, I am also on Remeron 45mgs and 300mgs of Seroquel. Two previous pdocs, the old one who dumped me and a consult, have recommended that I taper off the Remeron, suspecting that it is exacerbating my anxiety and increase the Seroquel.
My new pdoc doesn't like Seroquel and wants to start by tapering me off it at 25mgs a week.
I did get some modest anti-depressant effect from the Seroquel but also think it makes me shakey, wakes me early (i know it's supposed to be a knock-out drug.)I can't quite put my finger on it but I feel like I would at least like to try reducing the dose.
Here's the question: which would you start with?
Don't want to lose the sleep which Remeron is great for. But I understand it is even more sedating a lower doses. Is that what other people have found? What dose works for sleep for other people.
Seroquel is a big question mark. Don't know what it's doing good, bad or indifferent.
I'm inclined to start by lowering the Remeron but I don't want to lose sleep. I really need 8 hours and I can tell the Pristiq is interfering with my sleep and I also take Provigil. I have tried every benzo in the book for sleep with no luck. Remeron is the first med that has really knocked me out and kept me asleep.
So. Advice? Suggestions?
I am taking Remeron 45mg;Seroquel 300mgs;Pristiq 50mg;Provigil 150mgs;klonopin 3mgs.Thanks for your thoughts.
Zana
Posted by Relapse on April 18, 2009, at 10:38:10
In reply to New Med Regime, posted by Zana on April 18, 2009, at 10:20:05
Zana,
I am on 600mg lithium, 150mg Zoloft and 200mg of Seroquel for anxiety/depression. I have been on Zoloft several times prior and it seems pretty weight and sleep neutral to me. I also don't think the lithium has much to do with my sleep. The Seroquel really knocked me out when I first started taking it. After a few weeks the heavy sedation started to ware off. But the drug still seems to help me get to sleep and stay asleep. Like you probably, I have read many posts concerning sleep benefits of Seroquel, so I wouldn't completely discount it in your mix. I hope you find the right combo. Be well,
david
Posted by Phillipa on April 18, 2009, at 11:12:08
In reply to Re: New Med Regime, posted by Relapse on April 18, 2009, at 10:38:10
Zana I think in a way you answered your own question if remeron works well for your sleep start with the seroquel as it does have many side effects even though for some antidepressant effects. Of course I'm not qualified to give med info. Love Phillipa
Posted by sowhysosad on April 18, 2009, at 16:46:53
In reply to New Med Regime, posted by Zana on April 18, 2009, at 10:20:05
> She has put me on Pristiq which, oddly, seems to be helping my depression. Odd because Effexor didn't work and I've been through all the other ADs.
It's weird isn't it? Some would have you believe that Pristiq (which is just Effexor's active metabolite) is merely a patent-extender with identical effects to Effexor, but many people's experience says otherwise.
Same deal with Celexa and Lexapro/Cipralex (Lex just being a "purer" version of Celexa with the inactive bit removed). The UK health service discouraged docs from prescribing Cipralex because they claimed no convincing advantage over Celexa in the research.
Celexa costs the government way less to subsidise because it's available as generic citalopram whereas Cipralex is under patent, so no wonder they'd say that! But when a penny-pinching GP switched my wife from Cipralex to generic Citalopram she relapsed within a few days, so clearly there's a difference!
> Don't want to lose the sleep which Remeron is great for. But I understand it is even more sedating a lower doses. Is that what other people have found? What dose works for sleep for other people.
I think that's a bit of marketing bull from the drug company to mitigate criticism of its ridiculous level of sedation. They originally claimed that the norepinephrine boost at higher doses made you less sedated. I didn't find that, and neither have friends who've taken it.
Posted by Sigismund on April 18, 2009, at 17:47:21
In reply to New Med Regime, posted by Zana on April 18, 2009, at 10:20:05
>What dose works for sleep for other people.
Certainly way lower than 45.
However things may be different for you since you've become accustomed to 45.
Posted by Zana on April 19, 2009, at 11:03:23
In reply to Re: New Med Regime, posted by Sigismund on April 18, 2009, at 17:47:21
I have also heard that it is less sedating at lower doses. I'm going to ask my pdoc if we can go down to 30 and if that works out OK try 15.
ThanksZana
Posted by Amelia_in_StPaul on April 19, 2009, at 22:12:32
In reply to Re: New Med Regime, posted by Zana on April 19, 2009, at 11:03:23
Boy, Zana, you are on quite a mix. I am glad your new doc wants to take you off something. It sounds like you are on too many meds.
My understanding is that Remeron is more sedating at lower doses. At 7.5 mg Remeron was great for me as a sleep agent. I would still be on it, but I would sometimes wake up and feel agitated and, more importantly to me, I felt compelled to eat and eat and eat. Junk food, that is.
> I have also heard that it is less sedating at lower doses. I'm going to ask my pdoc if we can go down to 30 and if that works out OK try 15.
> Thanks
>
> Zana
Posted by desolationrower on April 24, 2009, at 15:25:28
In reply to Re: New Med Regime, posted by Zana on April 19, 2009, at 11:03:23
not sure if it was you or someone else but i think i recently posted on a similar combination
-d/r
This is the end of the thread.
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