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Re: Remeron and sleep (Lots of it!) and OCD

Posted by Adam on November 6, 1999, at 19:42:01

In reply to Re: Remeron and sleep (Lots of it!) and OCD , posted by Carol on November 6, 1999, at 18:26:00

I have what is known as an "OCD spectrum disorder", (I was diagnosed by Dr. Judith Rapaport herself while I was
working at the NIH and subsequently got into a study there, so I'm confident of the diganosis) and have exhibited,
on occasion, more "classic" OCD symptoms. I have tried mirtazapine for OCD, at a dose of up to 45mg/day, prescribed
by my pdoc at Mass. General (who works in their OCD clinic, but also has a great amount of experience treating
depression). Mirtazapine was suggested to me while I was in the hospital, as a treatment for both depression and
OCD, and I relayed this info. to my pdoc, who felt it was worth a try. I trust the judgement and expertise of my
current doctors, and feel, like they do, that mirtazapine is not an outlandish choice for the treatment of OCD. The
reason it was suggested (along with traylcypromine, itself not a conventional choice) was that I found the side
effects of SSRIs intolerable (specifically, I put on a ton of weight, and they destroyed my sex life).

Unfortunately, I don't think it did much for my illness (though it wasn't entirely ineffective), and it created an
almost intolerable state of somnolence at the highest dose. I felt this effect even after a month at the highest
dose, and after three months on mirtazapine in total. My choices (in relation to dose) seemed to be zombification
or inefficacy. I opted for neither and tried something else.

An option that seemes worth trying, to me and to some with actual credentials, is to combine mirtazepine with an SSRI.
This might a) be more efficacious as a combinaition therapy for depression and/or OCD, and b) counteract some or all
of the sexual side effects of the SSRI. I have yet to see or hear a single firsthand account of someone using such an
approach. If you're out there, I would love to hear your story. Did it work as described?

The obsessive and compulsive components of OCD are just what they sound like: the disturbing and intrusive thoughts or
images labeled as obsessions and the ritualistic behaviors these obsessions compell the sufferer to engage in. There
are cases in which relentless, disturbing and intrusive thoughts and images are present but do not result in a compulsive
act. This would be OCD without the compulsive component, and would fall under the umbrella of a "spectrum disorder".

Hope this helps.





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