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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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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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Posted (edited)
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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so yeah, second day on sonata. first day was at 30mg of the drug, however that may have been too much, so having 5mg capsules in order to fine tune the nightly dose, i reduced to 25mg which is only slightly above the fda recommended max of 20mg/night. i'm going to try 25mg again tonight and i fully expect one of those two doses to keep me stable during the entire day which is reallllllllly weird because of the super short half-life, but the z-drugs are pretty great in this fashion. also, no worsening of depression, appetite is normal, and libido seems to be returning, although i'll have to wait a while to see what remains and what doesn't on the sexual side effect front -- perhaps til the end of the week if i do see gains in the area, and earlier in the week if it's another lunesta experience, but i don't think it's going to be.

 

i think we may have found a winner, kids! and without having to go through the physical and mental pain of changing several of my core medications. i'll update later in the week, but this is really quite promising!

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13 hours ago, basuraeuropea said:

 i think we may have found a winner, kids! and without having to go through the physical and mental pain of changing several of my core medications. i'll update later in the week, but this is really quite promising!

Awesome....that's great news !!

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thanks, @CrazyRedheadi'm feeling okay today - a bit of dysthymia. this medication really isn't a substitute for the magic that was ambien but for whatever reason just doesn't work out. i am okay, though. hopefully things will continue to improve as i continue to take the medication and other medications leave my system.

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i ate a significant amount during the middle of the night tonight, although it wasn't a binge eating episode, i would say that i wasn't able to or wasn't easily able to control my eating. thankfully i was able to stop after eating a number of cookies and i felt terrible.

also, notable in that i took 20mg/zaleplon tonight which means that i may be able to get on on a lower dose of zolpidem, although i think that even on a lower dose of zolpidem i would have problems with major binging.

i'm down to 140 lbs and i can't afford to gain weight after losing 35lbs thus far. i'm naturally a thin person, or that is to say prior to beginning treatment with remeron and ambien together along with the rest of the cocktail, i had always hovered around 135lbs without any problems or issues.

i'm wondering how the hell to get off of remeron but it's doing a lot. it's easier to reduce sonata than remeron by far, but oddly, it's not easy at all to reduce lunesta.

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10 hours ago, Iceberg said:

@basuraeuropea Curious - did you ever try the controlled release zolpidem vs the IR? (Sorry if u listed it can’t see signatures right now) 

@Icebergi haven't. do you think it would make any difference? it was brought up once because i had inquired but both my doctor and his nurse said that it was unlikely to produce a different side effect profile because it's the same compound which makes sense.

 

i was able to reduce to 20mg of zaleplon, btw, and am trying 15mg tonight to see if i can remain stable. this drug does work, although it takes the worst of both zolpidem and eszopiclone, the only benefit being that i can remain on a lower dose of the drug which isn't quite worth it unless side effects remit.

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21 minutes ago, basuraeuropea said:

@Icebergi haven't. do you think it would make any difference? it was brought up once because i had inquired but both my doctor and his nurse said that it was unlikely to produce a different side effect profile because it's the same compound which makes sense.

 

i was able to reduce to 20mg of zaleplon, btw, and am trying 15mg tonight to see if i can remain stable. this drug does work, although it takes the worst of both zolpidem and eszopiclone, the only benefit being that i can remain on a lower dose of the drug which isn't quite worth it unless side effects remit.

I’ve heard the same as you- most docs I’ve talked to seem to think there isn’t much of a difference 

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i made it down to 15mg of sonata which is still a considerable amount, however, it's been halved from the 30mg that i started at. i feel fine and feel that i would be able to reduce it further and with each reduction depression lifts incrementally and sexual functioning improves also incrementally so it's clear there is a correlation here. however, and this is a big however, i ate the entire kitchen last night, so that unfortunate side effect has returned on this drug as it presented itself on ambien. i'm unsure what to do -- switch back to lunesta at a lower dose maybe 1-2mg? i don't know. or to continue on with this drug and keep reducing until i can't any longer. the problem with the latter is that i'll likely continue to binge eat and i'm not about to gain back 35lbs lost. so i really don't know what to do here.

any suggestions would be appreciated.

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i began trintellix last night, @CrazyRedhead and @Iceberg! i thought it was best to do so given the side effects that I was experiencing, the amount of depression that was burdening me, and my desire to better my quality of life. i did take a chance and dropped remeron at the same time, which in the past has been very disastrous, but as of right now, some 10 hours later, i am feeling relatively fine - the same as one would expect to feel when switching from an snri to an ssri and nothing more. no brain zaps to speak of as of yet and i probably won't experience them because i'm going from an snri to an ssri. my anxiety levels are elevated but manageable.

i also switched back to ambien because i prefer that drug more than sonata or lunesta and am taking 10mg currently, but my doctor said to increase back to 15mg as necessary should anxiety levels become uncomfortable to try to counter those.

anyway, wish me luck as i really hope that things change for the better. i'm a bit concerned that my end goal dose of trintellix will be 20mg/day, which is the max as i'm on the max dose of cymbalta, and only because i would imagine that on any high dose of any medication the side effect profile is generally going to be more pronounced.

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2 hours ago, basuraeuropea said:

i began trintellix last night, @CrazyRedhead and @Iceberg! i thought it was best to do so given the side effects that I was experiencing, the amount of depression that was burdening me, and my desire to better my quality of life. i did take a chance and dropped remeron at the same time, which in the past has been very disastrous, but as of right now, some 10 hours later, i am feeling relatively fine - the same as one would expect to feel when switching from an snri to an ssri and nothing more. no brain zaps to speak of as of yet and i probably won't experience them because i'm going from an snri to an ssri. my anxiety levels are elevated but manageable.

i also switched back to ambien because i prefer that drug more than sonata or lunesta and am taking 10mg currently, but my doctor said to increase back to 15mg as necessary should anxiety levels become uncomfortable to try to counter those.

anyway, wish me luck as i really hope that things change for the better. i'm a bit concerned that my end goal dose of trintellix will be 20mg/day, which is the max as i'm on the max dose of cymbalta, and only because i would imagine that on any high dose of any medication the side effect profile is generally going to be more pronounced.

Good luck with the trintellix! I hope it helps!

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5 hours ago, basuraeuropea said:

i began trintellix last night, @CrazyRedhead and @Iceberg! i thought it was best to do so given the side effects that I was experiencing, the amount of depression that was burdening me, and my desire to better my quality of life. i did take a chance and dropped remeron at the same time, which in the past has been very disastrous, but as of right now, some 10 hours later, i am feeling relatively fine - the same as one would expect to feel when switching from an snri to an ssri and nothing more. no brain zaps to speak of as of yet and i probably won't experience them because i'm going from an snri to an ssri. my anxiety levels are elevated but manageable.

i also switched back to ambien because i prefer that drug more than sonata or lunesta and am taking 10mg currently, but my doctor said to increase back to 15mg as necessary should anxiety levels become uncomfortable to try to counter those.

anyway, wish me luck as i really hope that things change for the better. i'm a bit concerned that my end goal dose of trintellix will be 20mg/day, which is the max as i'm on the max dose of cymbalta, and only because i would imagine that on any high dose of any medication the side effect profile is generally going to be more pronounced.

Good luck with the trintellix, and I hope the switch back to ambien works out, too........I have had no weight gain on the trintellix, and I'm on 20mg.

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thanks so much, ladies! i was expecting to crash and burn after dropping remeron but i didn't experience any of the withdrawal symptoms that i have experienced in the past trying to get off the drug.

trintellix didn't make me nauseated either, which i was worried about. at least it hasn't yet. and the switch back to ambien went very well. my appetite today was below normal, which was a welcomed change. i'm within reach of my goal weight as i'm 140 lbs right now and i should be around 135ish, so i don't have much more to go and it seems that this combo will assist greatly.

i'm hoping to perhaps end up on 15mg of trintellix, although i'm not sure how to do that yet, but my mind is constantly working on trying to figure out a solution. my doctor wants me maxed out on 20mg, but i feel like the side effect profile will be more pronounced at that dosage. we'll see.

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