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Re:Remeron--Question, tina

Posted by Adam on May 14, 2000, at 18:16:42

In reply to Re:Remeron--Question, posted by tina on May 11, 2000, at 21:34:02

I'm not sure, but I think that Remeron has yet to be tested rigorously for anxiety. It might not hurt to try it, but you may either want to consider a safe augmentation strategy that more directly addressed your concerns with anxiety, or just look elsewhere.

It seems for many anxiety disorders, SSRIs are among the first-line treatments of choice, and venlafaxine may prove to be about as effective for the same spectrum of disorders.

Remeron does have the benefit of little or no sexual side-effects, which I think may be its most significant selling point. It might be possible to combine its use with an anxiolytic like buspirone or a benzodiazepine, though I think the combined sedating effect of Remeron and a benzo. might be too much.

The combination of Remeron and buspirone could be an interesting one. Buspar is thought to exert its anxiolytic effect by acting as a potent 5-HT1a receptor agonst. Mirtazapine (Remeron), meanwhile, is a 5-HT2 and 5-HT3 antagonist, and acts on the 5-HT1a receptor indirectly by a) not interfering with it, and b) increasing the secretion of serotonin, which then acts as the natural 5-HT1a agonist. In theory, the two should synergize nicely. In practice, who knows?

I'm not certain what the status of buspirone is as a treatment for, say, social anxiety. My feeling is, based on what I have seen in the literature, and what I have read here, that it is not a good first-line, or even second-line choice for this indication. I imagine benzos, SSRIs, and then phenelzine, more or less in that order, are the primary treatments. But as with everything in psychopharm., your miliage may vary greatly.

Talk to your doctor about it.

Best of luck!

> I have more anxiety than I do depression. I think my depression is caused by the panic disorder cuz I can't go anywhere, do anything without the fear of having a panic attack. I do admit to depression but Remeron sounds like just the right thing for me. What do y'all think??? Need input--Thanks Tina> >
> > > This is just a random link I got off of hotbot:
> > >
> >
> >
> > James here....
> >
> > I read another monograph after I posted this and Remeron is indeed an antihistamine. Perhaps because i take a low dose, 15 mgs, it has little effect as when I was injected with histamine I had a good response.
> >
> > james




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