# How does Remeron work exactly



## peaceandlove09 (Aug 10, 2010)

I tried to figure it out by reading wikipedia but it confused the hell outta me :blank

Can someone explain how it works and what neurochemicals it targets exactly? 


Thanks


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## Canadian4Life (Sep 27, 2010)

It's a 5-ht2 receptor antagonist. It also causes serotonin and norepineprine to be released. It stimulates the 5-ht1a receptor too. Sedating in low doses and energizing in high doses.


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## jim_morrison (Aug 17, 2008)

Basically it blocks the negative feedback loops on serotonin and noradreneline receptors thereby promoting the outflow of these neurotransmitters.

In more detail;

It's mechanism of action is thought to be mediated by it's blocakade of the alpha-2 adrenergic and serotonin 5HT-2 receptors. Unlike most modern antidepressants *It is not a reuptake inhibitor.*

Basically think of the alpha-2 adrenergic receptor as an inhibitory receptor which would usually act to turn off Noradrenaline and Serotonin release, by blocking this receptor mirtazapine allows for an enhancement in the neurotransmission of these chemicals.

Similarly, the 5HT2-C receptor usually has the same inhibitory effect on the neurotransmission of Noradrenaline and Dopamine, so by switching this receptor off mirtazapine will also enhance the transmission of these.


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## rockyraccoon (Dec 13, 2010)

Yeah Remeron will prevent the reuptake of serotonin and norpinephramine. I started at 15 mg then went to 30 mg. This drug will make you eat junkfood non stop. Everynight I would go to the store and buy chocolate bars and chips. It was a little sedating at 15 mg, but once my doc increased it to 30 mg it caused insomnia. I was on this drug for about 3 months, and it did not work for depression or anxiety.


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## jim_morrison (Aug 17, 2008)

ihl said:


> This drug will make you eat junkfood non stop. Everynight I would go to the store and buy chocolate bars and chips.


Yeah that's the worst thing about this med, it just makes you want to eat, eat, eat non stop, and it feels like you can never get full. The carb cravings are just too intense for it to be a useful med IMO.

And I'm not saying this entirely from a vanity perspective either, it was beginning to give me pre diabetic syndrome.


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## mikoy (Aug 12, 2010)

For me alpha 2 antagonism is the worst part of this drug. And then h1 ant.


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## jim_morrison (Aug 17, 2008)

For me I think the 5HT2-C antagonism is the worst part, as it seems to be largely responsible for the appetite. Also the half life is too long. It's great for sleep, but I wish it would just knock me out for 7 hours then vanish, and without the appetite thing lol, then it would be ideal.

Benzo's never shut my mind off or helped me sleep half as well as Remeron unfortunately .


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## peaceandlove09 (Aug 10, 2010)

jim_morrison said:


> Yeah that's the worst thing about this med, it just makes you want to eat, eat, eat non stop, and it feels like you can never get full. The carb cravings are just too intense for it to be a useful med IMO.


So it's just an URGE to eat carbs? Can one use self control to not eat?

Or it is like an overwhelming "i must eat crap food" feeling


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## peaceandlove09 (Aug 10, 2010)

ihl said:


> Yeah Remeron will prevent the reuptake of serotonin and norpinephramine. I started at 15 mg then went to 30 mg. This drug will make you eat junkfood non stop. Everynight I would go to the store and buy chocolate bars and chips. It was a little sedating at 15 mg, but once my doc increased it to 30 mg it caused insomnia. I was on this drug for about 3 months, and it did not work for depression or anxiety.


Couldn't you just tell yourself "nah, it's the med" and eat good foods instead?


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## jim_morrison (Aug 17, 2008)

peaceandlove09 said:


> So it's just an URGE to eat carbs? Can one use self control to not eat?
> 
> Or it is like an overwhelming "i must eat crap food" feeling


It is like an overwhelming "i must eat bad food" feeling, believe me I am a health freak, I work out 6 days a week and generally eat super healthy. On mirtazapine I could not help myself eating, it's almost impossible to resist.

I've taken it on a full stomach feeling completly unhungry, and 30 minutes later I find myself thinking that I'd almost sell my soul for a chocolate cake.

What is your primary reason for wanting to try it if you don't mind me asking, depression, or insomnia?
As I think their are better options to try first ie; maybe some combo like Effexor + Ambien or Trazodone could replicate it without the crazy appetite thing.


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## peaceandlove09 (Aug 10, 2010)

Hmm damn. Because i'm a gym nut too. I work out 3-4 times a week and try to eat "clean foods" for the most part. It's not encouraging that you being a gym guy would sell your soul for a chocolate cake lol

I'm taking wellbutrin right now and im trying to find something to augment it with that has minimal sexual side effects. I tried zoloft but i had to stop because i couldn't get it "up" and couldn't finish. So logically i thought remeron might work because it has low sexual dsyfunction.

I can't think of any other meds (non ssri) meds that i can add to wellbutrin.



jim_morrison said:


> It is like an overwhelming "i must eat bad food" feeling, believe me I am a health freak, I work out 6 days a week and generally eat super healthy. On mirtazapine I could not help myself eating, it's almost impossible to resist.
> 
> I've taken it on a full stomach feeling completly unhungry, and 30 minutes later I find myself thinking that I'd almost sell my soul for a chocolate cake.
> 
> ...


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## peaceandlove09 (Aug 10, 2010)

LaRibbon said:


> I tried, but failed. You end up eating more sometimes without realising, and sometimes you do realise but you don't have the will power because you're craving junk food so bad. I gained 3 kilos which isn't terrible, but I couldn't get it off until I stopped the remeron. When I stopped my weight dropped back to normal within a month without me making any conscious effort.


3 kilos is about 6 pounds? Not too bad....

Did the med help you? How would you rate it on a scale of 1-10 (junk food cravings aside)


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## mikoy (Aug 12, 2010)

jim_morrison isn't 5-ht2c antagonism responsible for anxiolytic and antidepressant effect (agomelatine)?


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## jim_morrison (Aug 17, 2008)

mikoy said:


> jim_morrison isn't 5-ht2c antagonism responsible for anxiolytic and antidepressant effect (agomelatine)?


It can be yes, it also seems to enhance appetite though.


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## jim_morrison (Aug 17, 2008)

peaceandlove09 said:


> I'm taking wellbutrin right now and im trying to find something to augment it with that has minimal sexual side effects. I tried zoloft but i had to stop because i couldn't get it "up" and couldn't finish. So logically i thought remeron might work because it has low sexual dsyfunction.
> 
> I can't think of any other meds (non ssri) meds that i can add to wellbutrin.


Trazodone, Benzos, Stimulants, Modafinil?


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## Foh_Teej (May 5, 2004)

peaceandlove09 said:


> So it's just an URGE to eat carbs? Can one use self control to not eat?
> 
> Or it is like an overwhelming "i must eat crap food" feeling


You have no self control when your brain says eat that whole box of sugar cookies or a dozen cupcakes. I gained nearly 50lbs on remeron. I slept about 12 hours a day and felt groggy as hell if I didnt. It worked the best of any med I ever took but trading for fat and lazy isnt my idea of progress.


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## mikoy (Aug 12, 2010)

When I'm in depression I have decreased apetite - for this reason I like apetite stimulant effect of mirtazapine. When I'm taking stimulants or SSRI my apetite decrease. I don't like any food, maybe sweets, but when I'm taking mirtazapine I like any food - and this is good. I like sweets, but I know that I can't eat it becouse I can be fat.


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## peaceandlove09 (Aug 10, 2010)

jim_morrison said:


> Trazodone, Benzos, Stimulants, Modafinil?


Trazodone i am worried about priapasim. Benzos and Stimulants no thanks- i have an addictive personality. I would abuse stimulants and be too dependent on benzos.

Provigil.... yes.. but adding another stimulant doesn't seem like a great idea :blank


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## peaceandlove09 (Aug 10, 2010)

Foh_Teej said:


> You have no self control when your brain says eat that whole box of sugar cookies or a dozen cupcakes. I gained nearly 50lbs on remeron. I slept about 12 hours a day and felt groggy as hell if I didnt. It worked the best of any med I ever took but trading for fat and lazy isnt my idea of progress.


50 pounds? LOL sorry to laugh but that's crazy!! On the upside it did help your mood... hmm

The thing is, my house doesn't have much junk food. The best I could do is polish off a box of sugary cereal... which isn't that bad for me anyway.....


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## rockyraccoon (Dec 13, 2010)

You shouldn't experience any sexual side effects while taking Remeron. I didn't get any sexual side effects. It's not like the SSRI's sexual side effects. Some people may disagree with me on this, but it is possible to outthink the "I must eat phase". I was on Seroquel for sleep and I would get up out of bed and cook up a huge dinner, despite just eating a huge dinner before going to bed. This happened every night for about 5 years. (I didn't put on any weight because of a high metabolism). Then one day I came to the realization that I wasn't really hungry; it was just the meds playing tricks on me. If you can get your mind around that then you won't get the appetite cravings. However, with Remeron I couldn't outthink the medication. I just had to eat. 

Be strong. If and when you do start Remeron, try to resist the urge to eat junkfood. It may take a few days. Try to outthink it. It might work.

Good luck.


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## Foh_Teej (May 5, 2004)

peaceandlove09 said:


> 50 pounds? LOL sorry to laugh but that's crazy!! On the upside it did help your mood... hmm
> 
> The thing is, my house doesn't have much junk food. The best I could do is polish off a box of sugary cereal... which isn't that bad for me anyway.....


laugh all you want as it was a direct effect of it. It made me fat and lazy as **** and is worth a laugh. you WILL crave food not like anyhting ive ever known. Id order 5 chicken sandwhichs from Jack in the Box while on it. Off of it, i can barely do 3 if im realy starving. going into a store and passing by the bakery, you WILL want to endulge in the sugar. Its very tough to argue with yourself if you want to eat it. befreo taking it, i knew from readin anecdotal reports of people eating out of a bag of sugar. I didnt exactly do that but the sweet tooth was there and something im not normally into as I dont care for sweets much.


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## livewire (Jan 23, 2011)

*Remeron*

Before I started reading the posts on this forum I had never read that Remeron can have a freak out component to it if ya don't watch out!
My psychiatrist prescribed Remeron for insomnia for its sedating side effects. He prescribed it at 30 mg. at bedtime. Then I researched it and read somewhere that the lower the dose is the more sedating it was - consulted with my pdoc and he said it was fine to take a lower dose. So I broke them in half and that worked fine for awhile. At the end of last semester they pooped out on me so I went back up to the prescribed 30 mg. Oh - I also ate everything I could get my hands on that was junk: cookies, cake, chips and dip, an occasional entire side of beef. I am a 5'9 female and went from 140 to 158 in three months.

The 30 mg. turned me into a wad of anxiety. I was practically curled up in a fetal position sucking my thumb. NOT good when trying to study for finals and write 15-page papers. My doc stopped the Remeron immediately and put me on Restoril for sleep and Klonopin for anxiety until the Remeron got out of my system. This took about a week. Had to take incompletes in two classes for medical reasons with a note from my doc.

I also have ADD and could not even think about taking my Adderall this entire time. Turns out that between the Adderall and the Remeron I was seriously double-dipping in the norepinephrine department. I'm just glad I have a good doc and he figured it out and gave me the meds to get through it. At the point when I called him I had been awake and in freak-out mode for three days. What a ride. :afr
*___________________________________________________*
Sign on my psychiatist's wall:
"I have A.D.D. I'm very smart, very talented, out of box thinker & witty. Don't worry, I take medication for this disorder....so relax."


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