Psycho-Babble Medication | about biological treatments | Framed
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Re: To: Adam

Posted by Adam on November 4, 1999, at 11:40:28

In reply to To: Adam, posted by JohnB on November 3, 1999, at 22:17:20

Well, as I said, I've never heard of Remeron being used for social phobia, so maybe it's not effective for that indication. It's a pretty new drug
on the scene, though, so it's not always possible to know just based on the literature if it might work or not.

I don't suffer from social phobia, but I have had issues with OCD, and, hence, anxiety. My pdoc recommended Remeron to me b/c it was "dual-acting"
(effects on both 5-HT and NE) and so, he reasoned, it might be good for both depression and OCD. It seems venlafaxene might be a good choice for treating
comorbid anxiety disorders (dual acting), but, again, you run into weight gain and sexual problems. I'm not sure about selegiline. I'm having quite a lot
of success using it; it's been a great antidepressant, I've lost weight (and keep losing it!), I'm experiencing no sexual side effects at all, and I'm
not being bothered too much by OCD. But, like tranylcypromine, it might be a dubious choice for social phobia (or any anxiety disorder-can't figure
out why I'm doing so well) since what little historical information exists on its use for depression seems to indicate people with anxiety problems don't
respond as well to it, as either a treatment for depression or comorbid anxiety, as, say, phenelzine.

It's too bad Remeron didn't work for you. As for dosing, I got up to 45mg/day without a lot of response, and, as I said, it put me in a stupor. If
it's well tolerated, though, I bet you could go up to 60mg/day.

Also, I have read in places (and this seems mechanistically sound, if what they theorize about mirtazepine is true), taking Remeron initially, maybe
up to 30mg/day, and then adding an SSRI might protect against the sexual side effects of the SSRI, due to 5-HT2 and 3 blockage. Perhaps a fairly
activating and "anorexic" (so they say) SSRI like fluoxetine, in combo with mirtazapine, might not be a bad thing to try. I might have tried it too
except my issues with depression have been so severe I decided an MAOI was the way to go.

> Thanks, Adam. I have tried Remeron. It might not have been long enough or the right dosage, though. I didn't experience weight gain or sexual dysfunction, but I didn't seem to get any relief from my social phobia. Perhaps it's worth another try at a different dosage (???)
> Thanks very much for taking the time and energy to respond. JohnB




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