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16 minutes ago, gb84 said:

I will ask for some trazadone.  Does remeron have any withdrawal?   I've been taking 7.5mg for about two weeks. 

It's been reported, but I did not have any withdrawal. Took it for 2 months. Went from 45mg to 0 and never felt better when i dropped it.

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4 hours ago, gb84 said:

I will ask for some trazadone.  Does remeron have any withdrawal?   I've been taking 7.5mg for about two weeks. 

Not likely at that low a dose for that short a duration.

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On 1/17/2019 at 4:03 PM, argh said:

It's been reported, but I did not have any withdrawal. Took it for 2 months. Went from 45mg to 0 and never felt better when i dropped it.

You are right.  2 days off and I feel so much better.  It's like a fog has been lifted.  Plus on it I was eating 6-7 times a day, now eating maybe 3 times.  Feels good to be back to a more stable reality.  If that makes any sense.  The only thing aside from the appetite change is a lingering headache, but that is going away.  I think I am going to stay off AD's fo a while and let my brain rest. 

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1 minute ago, gb84 said:

You are right.  2 days off and I feel so much better.  It's like a fog has been lifted.  Plus on it I was eating 6-7 times a day, now eating maybe 3 times.  Feels good to be back to a more stable reality.  If that makes any sense.  The only thing aside from the appetite change is a lingering headache, but that is going away.  I think I am going to stay off AD's fo a while and let my brain rest. 

Ha, yeah the hunger. I ended up gaining about 8 % of my body weight in two months on it and to add insult to injury, it gave me a fucking cavity from all the sugar I was eating. I don’t blame you for wanting to stay off and ad for a while.

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44 minutes ago, argh said:

Ha, yeah the hunger. I ended up gaining about 8 % of my body weight in two months on it and to add insult to injury, it gave me a fucking cavity from all the sugar I was eating. I don’t blame you for wanting to stay off and ad for a while.

10 lbs in two weeks.  Sometimes I think the drug manufacturers make a medication trigger weight gain on purpose.  You know, just to make us feel better about ourselves. 

  • Haha 1

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On 1/17/2019 at 7:40 AM, browri said:

In my experience with Saphris, it would make me ravenously hungry about 15-30 minutes after taking it, BUT any weight gain was dependent on my food intake. So I didn't really gain an appreciable amount of weight as long as I ignored the hunger.

OMG so THAT'S why I can't stop snacking right before bedtime!

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An ideal antidepressant that usually DOES NOT come with weight gain problems is Reboxetine, aka. Edronax, if you can get hold of it.

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I would also recommend Tranylcypromine (Parnate), but it's an MAOI and you don't want to take an MAOI unless you REALLY need to.

Fortunately there is a half way house that ALSO comes without the hunger games - Moclobemide (Manerix or Aurorix). It's an RIMA or reversible, selective MAOI. It's kind of like a gentle MAOI without the diet. Wonderful drug. Just wasn't strong enough for me. However, it remains my favourite psychotropic drug ever!

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On 2/8/2019 at 4:26 PM, DollfaceDee said:

OMG so THAT'S why I can't stop snacking right before bedtime!

Saphris is a potent 5HT2C antagonist. That receptor is responsible for mediating satiety (i.e. "feeling full"). When you block it, it makes you more hungry. Activate it and it reduces appetite. However, blocking 5HT2C on its own shouldn't cause weight gain independent of food intake.

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If I am using Remeron 15mg at bedtime for insomnia, as an AD, and to help with anxiety, how long until usually does one find AD and anxiety relief? I know the typical time for most ADs prescribed, the SSRIs, is about 1-2 months or 4-6 weeks and I know the feeling of for example, Paxil, coming on and how it feels to really not care about anything and how this is the mechanism to fight depression and anxiety. I know the SSRI has kicked in once I start becoming extremely social at work/school/home and gain 100 new friends in a month. So does the AD and antianxiety effect of Remeron also feel/act how an SSRI does by making you not care (about other people thinking about you/about being self conscious/ about how you look etc.) or does it not give you this feeling? Im wondering when it will kick in and how I will know when it kicks in, because I know at least I can say it's easy to tell when an SSRI kicks in and you perceive reality/conversations/situations completely different and handle things with such less anxiety... How does trazodone compare in the sedation feeling vs seroquel and remeron if one has tried both or one of those? At what dose would trazodone's sedation equal to 15mg Remeron, or does this not occur/trazodone maxes out sedation at X dose and going higher wouldnt be worth trying for insomnia?

Also, if one wanted to get off Remeron and go to traz, should the trazodone be enough to act as an AD? or would you have to go much higher in dosage? My mom and grandmom take 50mg and it works great for them, they love it. If only a medication worked for my insomnia that doesn't make me stumble, delirious, out of it, looking like you are on something when you can't hold yourself to walk, and not able to move ice cream from the container to my mouth without dropping it on my clothes several times. Seriously having to use heavy duty crap sucks; seroquel, zyprexa, remeron, saphris all are intensely sedating. I feel like such drugs should be scheduled because of the harm which may result from oversedation, at least class V in there with lyrica and ambien, it might stop doctors from very widely and openly off label prescribing these heavy duty meds

 

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2 hours ago, mmaryland said:

If I am using Remeron 15mg at bedtime for insomnia, as an AD, and to help with anxiety, how long until usually does one find AD and anxiety relief? I know the typical time for most ADs prescribed, the SSRIs, is about 1-2 months or 4-6 weeks and I know the feeling of for example, Paxil, coming on and how it feels to really not care about anything and how this is the mechanism to fight depression and anxiety. I know the SSRI has kicked in once I start becoming extremely social at work/school/home and gain 100 new friends in a month. So does the AD and antianxiety effect of Remeron also feel/act how an SSRI does by making you not care (about other people thinking about you/about being self conscious/ about how you look etc.) or does it not give you this feeling? Im wondering when it will kick in and how I will know when it kicks in, because I know at least I can say it's easy to tell when an SSRI kicks in and you perceive reality/conversations/situations completely different and handle things with such less anxiety... How does trazodone compare in the sedation feeling vs seroquel and remeron if one has tried both or one of those? At what dose would trazodone's sedation equal to 15mg Remeron, or does this not occur/trazodone maxes out sedation at X dose and going higher wouldnt be worth trying for insomnia?

Also, if one wanted to get off Remeron and go to traz, should the trazodone be enough to act as an AD? or would you have to go much higher in dosage? My mom and grandmom take 50mg and it works great for them, they love it. If only a medication worked for my insomnia that doesn't make me stumble, delirious, out of it, looking like you are on something when you can't hold yourself to walk, and not able to move ice cream from the container to my mouth without dropping it on my clothes several times. Seriously having to use heavy duty crap sucks; seroquel, zyprexa, remeron, saphris all are intensely sedating. I feel like such drugs should be scheduled because of the harm which may result from oversedation, at least class V in there with lyrica and ambien, it might stop doctors from very widely and openly off label prescribing these heavy duty meds

 

Remeron's AD effects supposedly kick in, in as little as 2 weeks. During the brief periods that it did work, it was somewhat subtle, I didn't care much, but it was more along the lines of carefree, not flat. I'd say this was about at week 3 for me. To be fair, however, I've only tried two SSRIs and they both did nothing for me.

There were periods where I felt good, not great but good. Like if you asked me if I was doing good, I could honestly say it was..not the usual lie. When it worked it was great, it just didn't work consistently or at any length of time to outweigh the downsides.

For me, trazodone, in the doses I take it (25-50mg) don't compare at all to remeron. Trazodone feels more like falling asleep naturally, with little to zero morning sedation, so long as i got the hours in. Remeron felt like, what I would imagine a sleep dart would feel like. Super heavy, if i'm not in bed soon, i'm going to fall asleep wherever I currently am.

Trazodone is supposedly an AD at 200-400mg. There are some members of this board who tried it years ago. The general consensus, is that it's great as a hypnotic, but awful as an AD. My pdoc also shares the same sentiment. There is an ER version, oleptro which is supposedly better, but there are no generics or coupon codes. That 21 AD lancet meta-analysis did show that trazodone was better than placebo in RCTs. It actually wasn't dead last.

That one psych that really digs MAOIs questions the validity of meta-analysis however, https://psychotropical.info/lancet-21-antidepressants-meta-analysis/

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8 hours ago, mmaryland said:

If I am using Remeron 15mg at bedtime for insomnia, as an AD, and to help with anxiety, how long until usually does one find AD and anxiety relief? I know the typical time for most ADs prescribed, the SSRIs, is about 1-2 months or 4-6 weeks and I know the feeling of for example, Paxil, coming on and how it feels to really not care about anything and how this is the mechanism to fight depression and anxiety. I know the SSRI has kicked in once I start becoming extremely social at work/school/home and gain 100 new friends in a month. So does the AD and antianxiety effect of Remeron also feel/act how an SSRI does by making you not care (about other people thinking about you/about being self conscious/ about how you look etc.) or does it not give you this feeling? Im wondering when it will kick in and how I will know when it kicks in, because I know at least I can say it's easy to tell when an SSRI kicks in and you perceive reality/conversations/situations completely different and handle things with such less anxiety... How does trazodone compare in the sedation feeling vs seroquel and remeron if one has tried both or one of those? At what dose would trazodone's sedation equal to 15mg Remeron, or does this not occur/trazodone maxes out sedation at X dose and going higher wouldnt be worth trying for insomnia?

Also, if one wanted to get off Remeron and go to traz, should the trazodone be enough to act as an AD? or would you have to go much higher in dosage? My mom and grandmom take 50mg and it works great for them, they love it. If only a medication worked for my insomnia that doesn't make me stumble, delirious, out of it, looking like you are on something when you can't hold yourself to walk, and not able to move ice cream from the container to my mouth without dropping it on my clothes several times. Seriously having to use heavy duty crap sucks; seroquel, zyprexa, remeron, saphris all are intensely sedating. I feel like such drugs should be scheduled because of the harm which may result from oversedation, at least class V in there with lyrica and ambien, it might stop doctors from very widely and openly off label prescribing these heavy duty meds

 

I wouldn't say Remeron is a "heavy-duty med" at all. For most people, it has just two side effects: appetite increase and sedation. I think you are being really unfair to the other meds you listed also. Just because a med is sedating does not make it "heavy duty." Also, meds are scheduled due to addiction potential, not sedation.

With regard to trazadone, at low doses trazadone is really just a sleep aid. The antidepressant doses are higher, and it is not that great of an antidepressant for a lot of people. That's why it is usually just prescribed as a sleep aid now.

I'm going to talk about the elephant in the room. If your signature is correct, you are taking 60 mg of dexamphetamine. I took dexamphetamine (in the form of Dexedrine Spamsules), and I could not sleep. It was really bad. So when my doctor decided to add stimulants back into my cocktail we added Ritalin (methylphenadate). I find it to be much milder yet it helps concentration and augments my antidepression well also. Ritalin does not affect my sleep. There are also non-stim meds for ADHD, and there are tools you can learn in therapy to reduce your reliance on meds for ADHD. I'm just throwing this out there because I know how dex can wreck your sleep.

 

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17 hours ago, mmaryland said:

If I am using Remeron 15mg at bedtime for insomnia, as an AD, and to help with anxiety, how long until usually does one find AD and anxiety relief? I know the typical time for most ADs prescribed, the SSRIs, is about 1-2 months or 4-6 weeks and I know the feeling of for example, Paxil, coming on and how it feels to really not care about anything and how this is the mechanism to fight depression and anxiety.

The reason why SSRIs and SNRIs take so long to kick in is due to auto-receptor desensitization. By inhibiting the transporter, those medications increase serotonin in the synapse, which binds to pre-synaptic 5HT1A auto-receptors and slows down the serotonin pump. Over time, the 5HT1A auto-receptors become desensitized and serotonin release begins again the way it was before starting the SSRI, except the net serotonin activity is much higher.

Because mirtazapine (Remeron) mediates its effects through receptor antagonism and partial agonism, the action is much more rapid. This is why mirtazapine is often given in conjunction with the initiation of an SSRI because it will cause an SSRI to kick in more quickly than it normally would and it also helps to treat some of the side effects caused by SSRI treatment such as reduced appetite (5HT2C antagonism), nausea (5HT3 antagonism), or insomnia (H1 and 5HT2A antagonism), and maybe even sexual dysfunction (5HT7 antagonism).

17 hours ago, mmaryland said:

How does trazodone compare in the sedation feeling vs seroquel and remeron if one has tried both or one of those? At what dose would trazodone's sedation equal to 15mg Remeron, or does this not occur/trazodone maxes out sedation at X dose and going higher wouldnt be worth trying for insomnia?

It's really hard to make this kind of comparison because trazodone and mirtazapine mediate their sleep effects somewhat differently. They both do so through 5HT2A antagonism, but mirtazapine is a potent H1 histamine antagonist as well, which trazodone is not. This is likely why people find that trazodone has less next-day sedation like your family members said.

17 hours ago, mmaryland said:

Also, if one wanted to get off Remeron and go to traz, should the trazodone be enough to act as an AD? or would you have to go much higher in dosage? My mom and grandmom take 50mg and it works great for them, they love it. If only a medication worked for my insomnia that doesn't make me stumble, delirious, out of it, looking like you are on something when you can't hold yourself to walk, and not able to move ice cream from the container to my mouth without dropping it on my clothes several times. Seriously having to use heavy duty crap sucks; seroquel, zyprexa, remeron, saphris all are intensely sedating. I feel like such drugs should be scheduled because of the harm which may result from oversedation, at least class V in there with lyrica and ambien, it might stop doctors from very widely and openly off label prescribing these heavy duty meds

 

So trazodone is TECHNICALLY an antidepressant, but it's fallen out of favor for that usage because of its metabolite mCPP (meta-chlorophenylpiperazine), which is a serotonin reuptake inhibitor, serotonin releasing agent, and a serotonin agonist at most all the receptors it touches. As we know that antagonizing serotonin receptors can have antidepressant effects, you can imagine that AGONIZING those receptors would have the opposite effect (except at 5HT1A). mCPP is sometimes sold as a subsitute for ecstasy and it's been reported to not be a desirable experience. So the reality is that the body breaks trazodone down into a compound that actually hinders much of trazodone's legitimate antidepressant effect.

The short of it, if you need something for sleep but it also needs to have an antidepressant effect, you're better off with mirtazapine and trying to get to a higher dose that overpowers the antihistaminergic effects with adrenergic enhancing effects.

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