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Best and Worst Combination: Zolpidem and Mirtazapine


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On 5/4/2021 at 8:51 PM, basuraeuropea said:

tonight it seems 7.5mg of remeron while dropping zonegran is the plan. wish me luck. i may or may not survive the sleepless night, nausea, diarrhea, night sweats, etc., associated with reducing remeron.

I'm so sorry you are still having problems.....Changing and/or reducing meds is tough.....I am surprised your doc suggested restarting the lunesta.

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Would you be willing to try other sleep meds instead of the zolpidem? I’m thinking sonata or belsomra. Remeron is a bit unique in the us, there aren’t many 1-to-1 replacement options with the same act

yeah, know that ambien can be really love/hate in that it is the only option for some and be a total mess for others. have you ever tried any of the tricyclics? they can sometimes be sleep promoting,

Have you ever tried Trazodone?......It's technically an anti-depressant, but is prescribed very often for insomnia due to it's sedating properties.....It has a pretty wide dosage range....For instance

8 hours ago, CrazyRedhead said:

I'm so sorry you are still having problems.....Changing and/or reducing meds is tough.....I am surprised your doc suggested restarting the lunesta.

thanks @CrazyRedhead! it's beeeeeen toooooughhhhh to say the least. right now i'm on lunesta as i couldn't handle the decrease in remeron. i messaged him today asking to try sonata, the z-drug that i have yet to try. i'm really surprised that my doctor also suggested lunesta, but here i am back on the medication, although hopefully not for long.

 

if he lets me try sonata, then i will, if not, then he wants me to cross-taper from cymbalta to trintellix which i'm not opposed to, however, he also wants me to drop remeron and i'm not sure that i can do that as trintellix works nothing like remeron and prior to adding remeron i was still in panic purgatory and it does a lot despite the small dose. i expressed this to him via email today when a nurse called me to make the change and i wasn't comfortable discontinuing both cymbalta and remeron and replacing with trintellix because i feel like that's a recipe for disaster.

 

as of now, i'm on lunesta sans amantadine because it made me incredibly sleepy to where i felt like i was going to fall asleep driving. i feel like lunesta is very, VERY risky in that i've fallen suicidal twice on this medication and so i hope to be off of it tomorrow if sonata works and he allows for it. if not, then i'm not quite sure how i'll get rid of lunesta because i'm physically dependent on the drug, but notably both ambien and lunesta not only provide for sleep, they provide for anxiety relief, so they serve a dual purpose.

 

i dunno any longer. what i do know is that it's a total mess. he thinks cymbalta is doing more harm than good and i don't think so, that said, i mean, if he wants me to try out the medication and i'm really against it, then i can pretend to try it (which i've done before when i've thought the risk outweighed the potential benefit) and then make up some bullshit on how i either fell unstable or had some horrible side effect or something. i'm supposed to still be on amantadine, for example, but i'm not taking it because the lowest dose makes me sleep all day.

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13 minutes ago, basuraeuropea said:

i mean, if he wants me to try out the medication and i'm really against it, then i can pretend to try it (which i've done before when i've thought the risk outweighed the potential benefit) and then make up some bullshit on how i either fell unstable or had some horrible side effect or something

... not trying to lecture, but isnt that also pretty risky to have pdoc on bad information?

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9 hours ago, CeremonyNewOrder said:

If you don't want to try the med then you don't have to. I'd just refuse rather than lying.

because of the prominence of this particular psychiatrist and his ego attached, sometimes it's just better to lie because he can be very staunch on his suggestions and viewpoints, but is also really quite open to trying new things and is comfortable prescribing the scheduled medications that i depend on to keep me stable. there are a lot of benzo wary doctors out there and mine realizes the benefits for certain patients of these as well as other scheduled medications. that said, he can insist that i try amantadine, for instance, which i did, and i reported back to him that it was making me sleep all day and feel super drowsy at the wheel. he insisted that i keep taking it as that would pass - maybe it would have, but i can't fall asleep at the wheel, so i stopped taking it and i'm gonna just tell him in a week that it never passed.

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9 hours ago, Iceberg said:

... not trying to lecture, but isnt that also pretty risky to have pdoc on bad information?

i don't think so. if it's not a core medication, then no. if it's intended to be a core part of the cocktail, then yes, and i have flat out refused in the past as well -- i have now told him that under no circumstance will i ever take an antipsychotic again due to the extreme negative side effects that i experienced on various atypicals - from movement problems, to cognitive problems, to emotional problems, to health problems. the drug class is horrible for me - helpful for others, but for me they've been devastatingly horrible, so i've flat out refused.

with minor drugs like amantadine? it's not worth the trouble trying to convince him, so if the medication doesn't agree with me (see the post above) then i'd rather stop taking it and then report back in a week that i gave it a chance (which i did, just not as long as he'd often like) and then stopped it.

 

another important instance is that he wants me to stop remeron while cross-tapering from cymbalta to trintellix. i don't know how he thinks that's possible given what remeron is doing and also given that remeron works in a totally different fashion pharmacologically speaking than trintellix does and so there is going to be a deficit left there and he thinks trintellix will fill both cymbalta's and remeron's shoes while i know - after trying to come off of remeron a number of times - that it won't and that i'll fall unstable. and if that's the case, i don't see the point in going through the trouble of cross-tapering cymbalta to trintellix at all because there is no real benefit. i'll still have to take lunesta because i won't be able to get rid of remeron. i get what his rationale and intention, but they're not correct.

Edited by basuraeuropea
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sonata denied due to ultra-short half-life.

he wants me to stop remeron and cross taper cymbalta and trintellix. the cross taper is slow enough that i feel comfortable doing it, but again, the cessation of remeron is quite concerning because it was added for a reason and it does work quite well for me. removing it leaves me vulnerable and my stability surprisingly fragile given the dose i'm taking.

i'm not sure what to do as right now i'm on lunesta, not ambien, and i'm okay. i'm not feeling depressed, although i am effectively chemically castrated save for if i take a small dose of dexedrine which i haven't done because it's hard for me to take.

so my plan is to reduce remeron by half while trying out this taper. the ultimate goal dose to be reached is 20mg/day of trintellix which i think is going to really maximize the side effects. i really don't understand how trintellix would be any better than cymbalta because i have serious super serious concerns about my ability to remove remeron successfully.

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progress: my psychiatrist did prescribe sonata which i switched directly to last night from lunesta. i was expecting anxiety like right now because of the very short half-lifef, but nope, i'm fine and hopefully i'll remain fine throughout the day and through the weekend. also, no increase in appetite over night and my appetite is still normal right now.

 

hopefully this goddamn z-drug will be a suitable replacement for lunesta (which i can already tell will)  however, i also hope that the side effect profile is milder than lunesta's and the benefits are more like ambien's.

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