# Remeron!



## coverto (Mar 13, 2007)

I had really given up hope to be prescribed any meds at all, since I have made the firm decision not to try any SSRI. My psychotherapist recommended that I seek medication for depression and anxiety. First GP doc seemed insistent that I try an SSRI first. Today I had a first appointment with a psychiatrist, who was touting the low reported sexual side effects of Lexapro. He was impressed that I knew all of the issues and under-reporting of side effects, PSSD, etc., and when I mentioned Remeron, he was quick to agree, unlike the first GP who insisted that was not a good med for me.

He's starting me out at 30 mg. - I understand that 15 mg. is a more typical starting dose. It remains to be seen whether that's going to hit me like a ton of bricks or help me skip past the sleepy/groggy phase. I'm on the fence about whether to start tonight or wait for the weekend when I won't have to get up for work. I will report back.

I am happy as a lark to try this. I had given up all hope on getting a med and was putting all of my eggs in the CBT basket.

Yay, me! Wish me luck!!!

:boogie


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## foxtrot (Feb 17, 2007)

good luck coverto, glad to hear you got yourself some remeron in the end!

its certainly helped my sleep schedule which is really good though Im not too sure on anything else.

probably wait till the weekend if you have to be up early for work as the first few days are likely to be a sleep-fest


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## Scott77 (Dec 10, 2006)

Keep us updated! I just got prescribed Remeron also for SA. I'm a little wary to try it because of the sedation and the weight gain. I'm a lean healthy guy like you, but I want to stay that way. Don't want to get sugar cravings.  The sedation is probably what worries me the most, but my pdoc kept wanting me to try it, so I said OK.


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## coverto (Mar 13, 2007)

Thanks, guys! I decided that I didn't want to wait. Took the Remeron well before my regular bedtime, as I had a morning appointment with my psychotherapist and I would be able to go to sleep early and wake up a bit late. The 30 mg. certainly did knock me out! The first few hours in bed it seemed part of me was struggling to stay awake, as my sleep was fidgety and restless. In the morning I had to make a bit of an effort to not hit snooze for the third time. Even considering that the first part of the night was restless, it was more real sleep than I have had in as long as I can remember. 

I could certainly feel the presence of the drug, but through the morning the fog was certainly not as bad as the thick fog of depression that I was experiencing a month or so back. Even this first day I'm feeling some positives - interactions with others aren't triggering anxiety, I'm looking people in the eye quite well (one barometer I use to judge my SA level), not ravenously hungry or craving sugar, so far so good on those counts. 

But there are some kinks that will need to be ironed out upstairs. The feeling last night as I was trying to get to sleep - one part restless against another part groggy - seems to also be the theme of the work day. I am a bit nervous and fidgety. Not so much any emotional symptoms of anxiety, but as I sit at my desk I feel an odd sense of urgency and anticipation. Getting up and walking around is helpful. Part of me wants to go run a couple of miles, and part of me wants to take a nap. Part of me wants an alcoholic drink to calm down, the other part wants coffee.

Is this me rationalizing and projecting from what I know of the drugs norepinephrine effects (perhaps making me nervous and edgy) and its antihistamine-type action (perhaps making me sleepy)? Maybe. Is this chemical confrontation actually taking place? Maybe. I do feel that the Remeron has set some opposing forces at work, which I hope will settle out.

I am sure that today is a challenge and I imagine the next few, at least, will be as well. I am sure that it is far too early for me to make any judgment one way or the other about Remeron.

It's the drug I asked for, and I very much want it to work for me. Especially after my first session of CBT this morning... I honestly do not think CBT is going to do much of anything for me. I want to be wrong about that and will stick with it... but... my instincts are not holding out a lot of hope on that front.

I'll report more as it develops!


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## foxtrot (Feb 17, 2007)

*Re: re: Remeron!*



coverto said:


> Is this me rationalizing and projecting from what I know of the drugs norepinephrine effects (perhaps making me nervous and edgy)


and


wikipedia said:


> (with regard to norepinephrine) As a stress hormone, it affects parts of the human brain where attention and responding actions are controlled. Along with epinephrine, norepinephrine underlies the fight-or-flight response, directly increasing heart rate, triggering the release of glucose from energy stores, and increasing skeletal muscle readiness.
> Norepinephrine is released when a host of physiological changes are activated by a stressful event.


Well, I didnt know much about norepinephrine's effects but how exactly is this supposed help anxiety? What with remeron being prescribed more often now for SA partially as it isnt supposed to have a nasty come up period of anxiety like other SSRIs?


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## Mysca2 (Mar 27, 2007)

hehe I remember the brief stint of me on Remeron, i had the disolving tablets you stuck under your tongue at a small dosage of 15mg (lowest dosage I think).....

zzzzzzzzzzz for two weeks straight, I sat and stared at walls... fiance thought I was the perfect woman at that point... I didn't #^$* about anything, was always cooking (always hungry lol) and really didn't care enough to say no to bedtime favors (as long as they didn't require serious effort on my behalf lol)

in short... it didn't work for me, was like something out of the stepford wives (could be wrong movie title heh). Sedate wasn't a good word to describe me... border-line comatose was more like it!

Dissapointed my doc since he wanted me to put on a few pounds while at it and figured the munchies remeron gave might help. From the sounds of it though you are actually having a much much better go with it than I did, hope it works out for you! As for the munchies/weight gain ... just think of the extra mass you can burn to muscles hehe


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## Speak Easy (Jun 27, 2006)

*Re: re: Remeron!*



foxtrot said:


> coverto said:
> 
> 
> > Is this me rationalizing and projecting from what I know of the drugs norepinephrine effects (perhaps making me nervous and edgy)
> ...


it [allegedly] helps from an anxyolitic point of view because it calms that fight/flight response, which releases adrenaline. when you are in fight/flight mode, the body's adrenal glands release adrenaline, your heart starts pumping faster, you sweat/blush/etc, and you will ultimately grow more anxious.


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## foxtrot (Feb 17, 2007)

*Re: re: Remeron!*



LDG 124 said:


> foxtrot said:
> 
> 
> > coverto said:
> ...


thanks


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## coverto (Mar 13, 2007)

Re norepinephrine's role as discussed by foxtrot and LDG 124: It is difficult to read a description and get a handle on what norepinephrine "feels like," isn't it? The best I can infer is that it is somewhat synonymous with adrenalin, that it promotes alertness and keys the fight-or-flight response, rather than calming it.

How could that possibly be a benefit to an anxiety patient? Good question. Perhaps the answer is that Remeron is intended primarily for depression, and in such patients a little kick in the pants of adrenalin is a good thing. And it is balanced by the calming of seretonin and the sleep-enhancing antihistamine qualities it possesses. It's use for anxiety is listed as an off-label application, if I recall correctly. And if I am feeling keyed up and edgy on this med, bear in mind that I am keyed up and edgy by nature. Maybe it's not the med for me... though I will give it much more chance than one day!

It is very possible that my read of all of this is off the mark, too. The information available certainly requires interpretation and inference, doesn't it?


 :stu


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## Jimiam (Jan 8, 2007)

I looked up remeron online and I heard that it was common for this drug to poop out frequently. I would not want to invest in remeron and then it just poop out.I also heard that remeron is just legal marijuana and that you will want to invest in Krispy Creme doughnuts after you're on it for a while. they said eating sugar straight out of da bag is not out of the question.


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## coverto (Mar 13, 2007)

Jimiam said:


> I looked up remeron online and I heard that it was common for this drug to poop out frequently. I would not want to invest in remeron and then it just poop out.I also heard that remeron is just legal marijuana and that you will want to invest in Krispy Creme doughnuts after you're on it for a while. they said eating sugar straight out of da bag is not out of the question.


crazymeds.org - I remember that off the top of my head. My hat is off to those brilliant folks and I may make a donation soon. But bear in mind that the three creators of the site all share a quite unusual spectrum of problems.


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## coverto (Mar 13, 2007)

Yet another day one entry: Ate a normal size dinner and while it may have tasted particularly good, I am still quite sated an hour later. No sugar cravings. Ran two miles after dinner. Wine with dinner and a vodka/club soda after the run are taking the edge off the edginess. Just popped the Remeron at 7:30 CST... I bet I'll be crawling to bed in an hour's time, a good four hours ahead of regular sleepytime. I'll post if it's otherwise.


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## foxtrot (Feb 17, 2007)

From that wikipedia article and other articles that I have read I would agree with covertos' comments about norepinephrine's actions appearing to be synonymous with the action of adrenaline (ie activating rather than calming on the fight or flight response). Which really does beg the question again how the heck is this supposed to help anxiety!? Yes, maybe the serotonin/antihistamine effects may balance it somewhat but the presence of the norepinephrine doesnt seem necessary for an anxiety patient. 
After maybe six weeks of using I can say that I find it fairly easy to control my appetite if I desire to although I do notice I am enjoying more sugary foods than before. The sedative effect is under control by now too but my sleep cycle is improved. I would say I feel less depressed which is a good thing. But I dont know if it's helped the big kahuna yet- I am still a real mess in some social situations. 
I dont know if reading up on the effects of various drugs and neurotransmitters is that helpful to be honest! For example, after discovering this about norepinephrine it almost makes me more nervous almost through a placebo effect. However, it's a bit like pandora's box- once opened it's very difficult to stop wanting to know everything! Which is a good thing I guess in a way- its good to be informed. (However, when I used effexor years ago I knew nothing about depression, anxiety and pharmaceutical drugs and just trusted my doc blindly with good results. The terrible withdrawal that was unbeknown to me coupled with my increasing anxiety after quitting stimulated my interest in actually wanting to know everything about these disorders and their treatments). [sorry, ive gone off on one a bit there]


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## coverto (Mar 13, 2007)

Good post, foxtrot. Just where is that line drawn, between being as informed and proactive in your treatment as you should be on the one hand, and on overanalyzing and overthinking things on the other? Just because Remeron has a norepinephrine enhancing effect and just because I felt nervous and edgy on the first day of taking it does not mean I should draw any hard and fast conclusions. In fact, so far today I'm not feeling nervous and edgy. The Remeron didn't knock me out as hard on night two as it did the first, either. So, I'll have to wait and see.

Different people react to meds differently, too. I have to wonder how it is that anyone with anxiety could tolerate Wellbutrin at all. That stuff had me crawling up the walls and made me a nonfunctioning, miserable wreck. But others around here react differently. Shrug. I know that researchers don't understand exactly how and why AD meds work. So I guess I can't expect them to know how and why they might not work, either...

Anyway, day two is looking better, so far, at least! I hope you will keep posting about your experience with Remeron, foxtrot. I'll do the same.


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## Jean (Jan 18, 2007)

well, i am happy to see some more satisfied remeron consumers! i've been on it for 4 weeks now (i think i started it just after foxtrot, from the look of our previous posts). i would just like to chime in and say that i still like it a lot for regulating my sleep so perfectly. i've also not experienced any of the adverse sides yet, no weight gain or "eating sugar straight out of the bag..." :lol gotta love crazymeds.org... i have not, unfortunately, experienced and anxiety relief but oh well, i have other meds for that. 

good luck converto! keep us posted.


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## Douleur (Apr 1, 2007)

I have been taking Remeron for 3+ years. After being on 150 mg Effexor. But my problem with Effexor was that I had to take sleep medications and neither one my doc prescribed worked well for me. Remeron works well, stabilized my mood and sleep, doesn't really help to curb my anxiety, though. I gained some weight in the beginning and had craving to sugars. But after some time the cravings are gone. I'm so happy I don't have to take sleep medications and for me Remeron has less sexuall sides effects than SSRs.


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## Noca (Jun 24, 2005)

*Re: re: Remeron!*



Douleur said:


> I have been taking Remeron for 3+ years. After being on 150 mg Effexor. But my problem with Effexor was that I had to take sleep medications and neither one my doc prescribed worked well for me. Remeron works well, stabilized my mood and sleep, doesn't really help to curb my anxiety, though. I gained some weight in the beginning and had craving to sugars. But after some time the cravings are gone. I'm so happy I don't have to take sleep medications and for me Remeron has less sexual sides effects than SSRIs.


No sexual side effects is one of Remeron's selling points.


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## JCar (Nov 30, 2004)

I loved remeron and was on it for 1 year. I liked it mostly because it was like a sleeping pill that never wore off. The grogginess wears off eventually, although I remember when I first took it I basically slept the whole weekend. It was a nice relief though.

It's potent stuff too. Unlike most SSRI's it will knock you out and calm you down right away if you are anxious.

Down sides:

-I gained 20 pounds (which I lost after I went off of it)
-After a while it seemed to start wearing off and I would get anxious towards the end of the night before I took it again. I ended up just going off of it after a year though. I wouldn't mind getting back on if I ever needed it again, though.


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## Mysca2 (Mar 27, 2007)

I am seriously debatin ggiving remeron another try, my main concern is do you need benzos with it or are you all finding the remeron is enough?


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## Speak Easy (Jun 27, 2006)

*Re: re: Remeron!*



foxtrot said:


> From that wikipedia article and other articles that I have read I would agree with covertos' comments about norepinephrine's actions appearing to be synonymous with the action of adrenaline (ie activating rather than calming on the fight or flight response). Which really does beg the question again how the heck is this supposed to help anxiety!? Yes, maybe the serotonin/antihistamine effects may balance it somewhat but the presence of the norepinephrine doesnt seem necessary for an anxiety patient.
> After maybe six weeks of using I can say that I find it fairly easy to control my appetite if I desire to although I do notice I am enjoying more sugary foods than before. The sedative effect is under control by now too but my sleep cycle is improved. I would say I feel less depressed which is a good thing. But I dont know if it's helped the big kahuna yet- I am still a real mess in some social situations.
> I dont know if reading up on the effects of various drugs and neurotransmitters is that helpful to be honest! For example, after discovering this about norepinephrine it almost makes me more nervous almost through a placebo effect. However, it's a bit like pandora's box- once opened it's very difficult to stop wanting to know everything! Which is a good thing I guess in a way- its good to be informed. (However, when I used effexor years ago I knew nothing about depression, anxiety and pharmaceutical drugs and just trusted my doc blindly with good results. The terrible withdrawal that was unbeknown to me coupled with my increasing anxiety after quitting stimulated my interest in actually wanting to know everything about these disorders and their treatments). [sorry, ive gone off on one a bit there]


increased norepinephrine is essentially the same thing as having too much adrenaline, so you will feel nervous, jittery, shaky, and ultimately, anxious. norepinephrine is essential for the physical manifestation of anxiety symptoms such as rapid heart beating, blushing, sweating, etc. low levels of norepinephrine are associated with depression and lack of attention (norepinephrine increase in stimulants is the reason people who have anxiety should be hesitant in taking them). so why the norepinephrine/noradenaline increase in remeron? well, that is simple. remeron is an antidepressant, and only used an anxyolitic off-label. my advice: take a norepinephrine antagonist that will decrease the apparency of norepinephrine neurotransmitters, thus, inhibiting the norepinephrine actions. an SNRI could work, such as effexor, although i would never recommend that drug to anyone. but guess what i would recommend? benzos! GABA is essentially a norepinephrine inhibiting neurotransmitter, which is technically why benzos work so damn well. consider klonopin (norepinephrine inhibition) the polar opposite of ritalin (norepinephrine increase).


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## Speak Easy (Jun 27, 2006)

*Re: re: Remeron!*



Mysca2 said:


> I am seriously debatin ggiving remeron another try, my main concern is do you need benzos with it or are you all finding the remeron is enough?


i think taking benzos while taking remeron is almost paradoxical, simply because remeron will increase norepinephrine while benzos will ultimately lower it, so taking klonopin, for instance, while taking remeron would only be inhibiting one of remeron's actions, so why not just take a different antidepressant. if remeron doesn't work for your anxiety, but you are still taking it because it works for depression, then by all means, throw a benzo into that cocktail, but if you are taking remeron for anxiety only, then that would be completely nonsensical to continue using it with the addition of a benzo.


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## foxtrot (Feb 17, 2007)

*Re: re: Remeron!*



LDG 124 said:


> increased norepinephrine is essentially the same thing as having too much adrenaline, so you will feel nervous, jittery, shaky, and ultimately, anxious.).


Reading up on the role of norepinephrine here and from what you can glean from other sources certainly suggests this. It just surprises me that it (remeron) is even used off label for anxiety considering its NE actions. I suppose what works for someone with anxiety may just exacerbate it in another and variablity in reactions is likely. By all accounts remeron seems good for underweight depressed insomniacs and maybe pretty good for more general anxiety, I dont know. Personally Ill keep trying with it to see if it can help for SA, while some of its others side effects are helpful.



LDG 124 said:


> i think taking benzos while taking remeron is almost paradoxical, simply because remeron will increase norepinephrine while benzos will ultimately lower it, so taking klonopin, for instance, while taking remeron would only be inhibiting one of remeron's actions, so why not just take a different antidepressant. if remeron doesn't work for your anxiety, but you are still taking it because it works for depression, then by all means, throw a benzo into that cocktail, but if you are taking remeron for anxiety only, then that would be completely nonsensical to continue using it with the addition of a benzo.


Yeah, that sounds sensible, unless the remeron was giving you any other benefits.
Id quite like some benzos though unfortuantely any benzo procurement is strictly illegal what with being from the UK and all.


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## coverto (Mar 13, 2007)

I think it might be prudent not to jump to hard and fast conclusions about the norepinephrine enhancing qualities of Remeron. The first day or so I *thought* I could feel something in my mood/state of mind that would correspond to an uptick in norepinephrine, but no one should put much stock in that. After that first day I can say that I can find nothing in my mood/state of mind that seems like heightened anxiety. Again, no one should put much stock in that, either. My reaction seems pretty different from the anecdotal one given over at crazymeds.org - I like and respect those folks - but anecdotal experiences should be viewed as no more than that... useful and interesting but NOT a good basis to make assumptions.

The actions of AD drugs is poorly understood by scientists and when you've got a med whose mode of action is as complex as Remeron's, all bets are probably off when trying to predict patient response to one affected neurotransmitter. At about six days into my regimen of 30 mg., I'd say that I have been able to shrug off anxiety more easily. GAD and my slight OCD tendencies are improved. SA is reduced but not to the same extent... I don't feel increased social confidence as with benzos, just indifference to any possible anxiety triggers. 

I had good luck a few days ago supplementing my Remeron with .5 mg of some "leftover" Klonopin I have. Tried again today with less success - I'm really just feeling sleepy more than anything!


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## foxtrot (Feb 17, 2007)

*Re: re: Remeron!*



coverto said:


> I think it might be prudent not to jump to hard and fast conclusions about the norepinephrine enhancing qualities of Remeron. The first day or so I *thought* I could feel something in my mood/state of mind that would correspond to an uptick in norepinephrine, but no one should put much stock in that. After that first day I can say that I can find nothing in my mood/state of mind that seems like heightened anxiety. Again, no one should put much stock in that, either. My reaction seems pretty different from the anecdotal one given over at crazymeds.org - I like and respect those folks - but anecdotal experiences should be viewed as no more than that... useful and interesting but NOT a good basis to make assumptions.
> 
> The actions of AD drugs is poorly understood by scientists and when you've got a med whose mode of action is as complex as Remeron's, all bets are probably off when trying to predict patient response to one affected neurotransmitter. At about six days into my regimen of 30 mg., I'd say that I have been able to shrug off anxiety more easily. GAD and my slight OCD tendencies are improved. SA is reduced but not to the same extent... I don't feel increased social confidence as with benzos, just indifference to any possible anxiety triggers.
> 
> I had good luck a few days ago supplementing my Remeron with .5 mg of some "leftover" Klonopin I have. Tried again today with less success - I'm really just feeling sleepy more than anything!


good points. it's prob not a good idea to dwell on the myriad of possible effects of medications. im glad that remeron is working for you on certain levels, long may it continue


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## Jean (Jan 18, 2007)

just wondering how everyone's doing on the rem so far? 
i've been on 30 for two weeks now and i've been feeling awfully depressed for the last few days, with a major jump in anxiety as well. last week, however, i felt really great. even euphoric at times. hmmm. i'm not sure what to think. 
the sleep is still great. 
i'm just sick of all these mood swings. 
anyone else care to report?


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## foxtrot (Feb 17, 2007)

Ive been on this quite a while now. Im not really sure what to think either as Ive been up and down. Howver, no antidepressants gonna make you feel great if there's a whole load of **** in your life. as for SA, not too much help, gonna keep trying with it.

funny thing is, various sites recommend effexor and remeron as the drugs to use if nothing else will bust you out of depression (this is of course ignoring the whole SA helping part that many of us are hoping for). i find this strange, effexor blew the hell out of me and i agree with these sites on that but remeron seems so unaggressive I cant see how its supposedly so powerful for depression.

(i realise after all the SSRIs/SSNRIs etc the MAOIs are the big guns for depression; these sites [such as crazy meds] are only talking about modern depression drugs when referencing efex and rem)


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## Jean (Jan 18, 2007)

*Re: re: Remeron!*



foxtrot said:


> Ive been on this quite a while now. Im not really sure what to think either as Ive been up and down. Howver, no antidepressants gonna make you feel great if there's a whole load of @#%$ in your life. as for SA, not too much help, gonna keep trying with it.


yeah, i guess i'm just of the mindset that, well, if i'm going to keep paying for it (granted, not all that much) and taking it every single day then i want it to _something_ and i especially don't like feeling suicidal, which i just mention here to underscore how deep my depression has been a few times this week-- not as any kind of threat. i have spoken to my pdoc about this and all she can suggest is just upping my dosage, from 30 to 45. i think i read somewhere that 90mgs is the max. not sure though... 


> funny thing is, various sites recommend effexor and remeron as the drugs to use if nothing else will bust you out of depression (this is of course ignoring the whole SA helping part that many of us are hoping for). i find this strange, effexor blew the hell out of me and i agree with these sites on that but remeron seems so unaggressive I cant see how its supposedly so powerful for depression.
> 
> (i realise after all the SSRIs/SSNRIs etc the MAOIs are the big guns for depression; these sites [such as crazy meds] are only talking about modern depression drugs when referencing efex and rem)


so far i've been on paxil, celexa, lexapro and now remeron. while the rem has been the best so far (yay sleep! and zero sides) i think i'm done with ss/n/ri's. :sigh and i have definitely given up hope for any kind of anxiolytic relief from them. but maybe 90mgs is the answer? if i can withstand all that norepinephrine that is! i have noticed that i've been taking more benzos since i went up to 30. but there's no way i'm going on effexor, i've heard too many horror stories about that one...


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## foxtrot (Feb 17, 2007)

Hey there Coverto, you haven't posted in a while. Hows the remeron treating you?


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## Scott77 (Dec 10, 2006)

Coverto, what's the word? How's the remeron? My pdoc wants me to go on it, but I'm not sure if I want to yet. Any progress??


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## foxtrot (Feb 17, 2007)

With regard to the norepinephrine debate that I, Jean, Coverto (where are you!?) and others have been having...

I saw an emminent (expensive) psychiatrist today who's messed with my meds again but thats in another thread.

I asked about whether the increase of norepinephrine caused by remeron could cause increased anxiety.

I was told that the norepinphrine in the brain is regulated and acts in a totally different way to norepinphrine produced within other parts of the body. My medical knowledge is poor and I had difficulty remembering most of the terms he used but I was assured that increases in norepinphrine caused by ADs does not cause an increase in the 'fight or flight' response as is the case when the body produces it and thus the AD will not cause an increase in anxiety.

for what it's worth.


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## Jean (Jan 18, 2007)

wow. that's really interesting! i wish my psdoc was so smart!


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## Scott77 (Dec 10, 2006)

bump


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## Jean (Jan 18, 2007)

where is foxtrot?! 

i'm still on 30, still the same. been sleeping ridiculous amounts though, all of the sudden. sometimes all day long. not good. 

moving up the lamictal ladder too, so it will soon be hard to tell what is what.

how are you doing, scott?


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## foxtrot (Feb 17, 2007)

*Re: re: Remeron!*



Jean said:


> where is foxtrot?!


right here! i think another good question is where the heck is coverto, this is his thread after all!

even though my doc suggested moving to 45mg (from 30mg) i still havent made the jump but am likely to soon, just to see if it helps, its worth it i guess. so far all i can say about remeron (and ive been on it months now) is that its a helful sleep aid and doesnt mess you right up with most AD side effects so thats all good. however, i dont know if it makes me feel less depressed but it probably does in an unoticable kind of way cos i bet if i came off it id be in a right state. most worrying thing for me considering ive always had bad insomnia is that the day i come off the rem i bet ill be awake for a week!

does nothing for me for anxiety mind which was what i was really hoping for clearly as a member of this forum!


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