Remeron and "real" depression.

[Rhekarid]

I'm in a bit of an annoying pickle, yet the bitterness is not as delicious.

I've been in and out and in again and to psychiatrists, therapists, and other related degree-on-the-wall important types since I was 8.  Currently I'm 22, and nobody can seem to agree what exactly is wrong with me, though the favorites are depression, Asperger Syndrome, ADD, anhedonia, and a handful of schizoid/traumatic/avoidant whatevers.  Medication has been suggested many, many times, but not until recently was I finally, and barely, willing to give it a try.  My most recent psychiatrist strongly wanted to prescribe Paxil, and after a few days of agonized pondering, decided to give it a shot.

Unfortunately, my insurance company feels that Paxil is not allowed as a "first" antidepressant.  Instead I'd have to take something, have it not work, and then be switched to Paxil.  At this moment I'm waiting for the doctor to call back with a list of things that they WILL cover, but he mentioned Remeron as his second choice over the phone.  Not having researched that one, I put up a delay and proceeded to read about it.  It appears to be decently more potent than Paxil.  From what I've seen, and correct me if I'm wrong, the biggest and most likely side effects are intense hunger and intense fatigue.  The hunger I can live with; I'm not far above underweight, and while landing in the overweight range looks to be not unlikely, I don't really care.  I'm not too concerned with how others regard me in terms of how fat I am, and I know enough about the body and fat and so on to know that my health wouldn't really be in danger from being a bit overweight, and I'm confident enough in my self-control to, at the very least, be able to spread the sugar-craving into just eating more in general of a more balanced intake.  The fatigue is another matter: I don't have trouble sleeping, and I DO NOT want to sleep more than I already do, roughly 7 hours.  If I were pushed any higher than 8-9 hours, I would stop taking it immediately, period.  I sure don't need those 14-hour nights I've read about, and am a bit worried about that considering I don't have a sleep problem to begin with.  In that regard, if I do accept the Remeron, I'd probably insist on 30mg doses instead of 15 to ward off the sleeping.

But I've read, at this site particularly, that it's not for light or moderate depression, and that it can cause a great deal of happiness when it works.  I don't want that.  I have an intense fear of drugs that alter mood/personality directly, and something that did that would lead to some serious problems.  But the mention of it is a bit vague, hence the real point of this thread: some clarification.  The site says "when it works."  Does this pill just ram a log of happy down your throat?  Or, if the particular problem it corrects isn't what YOUR particular problem is, does it have no effect in that area?  Does it only change mood if it's really fixing something, or will it cause some insane euphoria in those who aren't actually in the deepest pits of depression?  It's important to me to know exactly what it does.

My depression is an unsteady surface.  I've been diagnosed with that since my age was in the single digits, but as I said before, all these years and doctors later, nobody can really agree and nail down what's wrong with me.  I have an extremely limited ability to process emotions, and have for as long as I can remember, which is about a week.  My childhood is a big gray blob.  Apathy is a sign of depression, but also of AS and other things.  And given all the conflicting diagnosis and my own state of mind, I don't know.  I "feel" very little, and I'm just not all there in many other ways.  I don't honestly know how depressed I am, and neither does anyone else.  So is the Remeron a valid risk?  If it will either clobber a real problem or do nothing is fine, but if it either clobbers the problem or severely overmedicates a nonexistent one is not, and before making a decision I want to know if it's worth a shot.

Sorry about the long post, I tend to ramble a bit in text form.

[zsandoz]

remeron is great for all depression in my opinion.  i wouldnt say im SEVERELY depressed (i.e. suicidal) but it affects my life and functioning a lot.  i like remeron a lot, id say its ok for a first antidepressant, though paxil should be ok too :-/

[StrungOutOnLife]

I'm in a bit of an annoying pickle, yet the bitterness is not as delicious.

I've been in and out and in again and to psychiatrists, therapists, and other related degree-on-the-wall important types since I was 8.  Currently I'm 22, and nobody can seem to agree what exactly is wrong with me, though the favorites are depression, Asperger Syndrome, ADD, anhedonia, and a handful of schizoid/traumatic/avoidant whatevers.  Medication has been suggested many, many times, but not until recently was I finally, and barely, willing to give it a try.  My most recent psychiatrist strongly wanted to prescribe Paxil, and after a few days of agonized pondering, decided to give it a shot.

Unfortunately, my insurance company feels that Paxil is not allowed as a "first" antidepressant.  Instead I'd have to take something, have it not work, and then be switched to Paxil.  At this moment I'm waiting for the doctor to call back with a list of things that they WILL cover, but he mentioned Remeron as his second choice over the phone.  Not having researched that one, I put up a delay and proceeded to read about it.  It appears to be decently more potent than Paxil.  From what I've seen, and correct me if I'm wrong, the biggest and most likely side effects are intense hunger and intense fatigue.  The hunger I can live with; I'm not far above underweight, and while landing in the overweight range looks to be not unlikely, I don't really care.  I'm not too concerned with how others regard me in terms of how fat I am, and I know enough about the body and fat and so on to know that my health wouldn't really be in danger from being a bit overweight, and I'm confident enough in my self-control to, at the very least, be able to spread the sugar-craving into just eating more in general of a more balanced intake.  The fatigue is another matter: I don't have trouble sleeping, and I DO NOT want to sleep more than I already do, roughly 7 hours.  If I were pushed any higher than 8-9 hours, I would stop taking it immediately, period.  I sure don't need those 14-hour nights I've read about, and am a bit worried about that considering I don't have a sleep problem to begin with.  In that regard, if I do accept the Remeron, I'd probably insist on 30mg doses instead of 15 to ward off the sleeping.

But I've read, at this site particularly, that it's not for light or moderate depression, and that it can cause a great deal of happiness when it works.  I don't want that.  I have an intense fear of drugs that alter mood/personality directly, and something that did that would lead to some serious problems.  But the mention of it is a bit vague, hence the real point of this thread: some clarification.  The site says "when it works."  Does this pill just ram a log of happy down your throat?  Or, if the particular problem it corrects isn't what YOUR particular problem is, does it have no effect in that area?  Does it only change mood if it's really fixing something, or will it cause some insane euphoria in those who aren't actually in the deepest pits of depression?  It's important to me to know exactly what it does.

My depression is an unsteady surface.  I've been diagnosed with that since my age was in the single digits, but as I said before, all these years and doctors later, nobody can really agree and nail down what's wrong with me.  I have an extremely limited ability to process emotions, and have for as long as I can remember, which is about a week.  My childhood is a big gray blob.  Apathy is a sign of depression, but also of AS and other things.  And given all the conflicting diagnosis and my own state of mind, I don't know.  I "feel" very little, and I'm just not all there in many other ways.  I don't honestly know how depressed I am, and neither does anyone else.  So is the Remeron a valid risk?  If it will either clobber a real problem or do nothing is fine, but if it either clobbers the problem or severely overmedicates a nonexistent one is not, and before making a decision I want to know if it's worth a shot.

Sorry about the long post, I tend to ramble a bit in text form.

<{POST_SNAPBACK}>

I have never heard of anyone using Remeron recreationally.

[Sunshine]

I've never taken Paxil, but plenty of other SSRIs. I've also taken Remeron. The somatic side effect is more prominent on lower doses (less than 30-45 mg). The typical maintenance dose when used to treat depression is 30-45 mg. If you titrate, you'll probably notice the fatigue for the first week or two. It should fade once you acheive the maintenance dose.

Even when taking lower doses for insomnia, it didn't really have a heavy hangover effect. It was hard to get up and get going in the morning (after eight hours of sleep), but once I was up and showered, I was fine.

It's a really good antidepressant. Other than the fatigue and weight gain, it doesn't have too many side effects. Fewer than Paxil and the like (for me, anyway).

[Rhekarid]

That's good to know, at least, but what about that happiness blitz I read about?  I realize there are worse things to worry about than excessive glee, but I don't want an artificial, drug-induced state of euphoria.  There are plenty of illegal drugs that do that too, and I'm not interested in them either.

[StrungOutOnLife]

That's good to know, at least, but what about that happiness blitz I read about?  I realize there are worse things to worry about than excessive glee, but I don't want an artificial, drug-induced state of euphoria.  There are plenty of illegal drugs that do that too, and I'm not interested in them either.

<{POST_SNAPBACK}>

Like I said before, I have never heard of anyone using these things recreationally.

[Velvet Elvis]

I've never gotten a euphoric state like you describe off any pych med, except maybe for Wellbutrin and that was only for the first 2-3 days.

I've been on tons of meds and I can give you my full assurance that I've still been fairly unhappy a great deal of the time on most all of them. 

Medications have reduced the frequency of the miserable spells and raised the bottom depth to which they can reach, but I've never been "happy go lucky" on any of them.

The best you can expect is that you will feel happy when external conditions are appropriate for you to feel happy and unhappy when it's appropriate for you to feel unhappy.

Rest assured, your fear of sudden excessive happiness is unfounded.

[Rhekarid]

That's good to know, at least, but what about that happiness blitz I read about?

[StrungOutOnLife]

That's good to know, at least, but what about that happiness blitz I read about?  I realize there are worse things to worry about than excessive glee, but I don't want an artificial, drug-induced state of euphoria.  There are plenty of illegal drugs that do that too, and I'm not interested in them either.

<{POST_SNAPBACK}>

Like I said before, I have never heard of anyone using these things recreationally.

<{POST_SNAPBACK}>

Right, sorry.  I'm new to the medication world, so the phrase didn't click at first.  I heard recreation and got these weird images of hang-gliding such.

<{POST_SNAPBACK}>

Ah.

[1badbert]

Sorry I got here late.

I have been suffering from major depression since I was a child. I have tried many different AD meds and aside from a huge dose of Serzone, Remeron is the only med that has had a noticable effect on my depression. I am taking 75mg which is a high dose. I have yet to feel giddy and gleeful but I don't feel like offing myself every minute of the day, either.

I can't see any way to abuse AD meds. You either need them or you don't. And you find out real fast if you need them. If someone is a drug abuser there are far better choices to get high, IMHO.

[null0trooper]

Right, sorry.  I'm new to the medication world, so the phrase didn't click at first.  I heard recreation and got these weird images of hang-gliding such.

<{POST_SNAPBACK}>

Ideally, "recreational use" includes usage for personal exploration of inner/psychological states, general

bordeom relief, "social use", etc.  In other words, the herbs/drugs in question don't have a hold on the

user.

Anyway, several of the diagnoses/symptoms you listed overlap. And 7 hours sleep - while the insomniacs

and atypical/hypersomniac depressives might envy you - is a touch on the sleep deprivation side. So, if

it's depression that's been going on for years (by the way, that's traditional considered major depression)

I'd say try the Remeron and try to give it a full month even if you're oversleeping for the first week or two.

For most depressions that aren't dopamine-dependent, and most aren't,  it should do nicely once you

stabilize.

If it does little or makes things worse, you'd probably need to consider Wellbutrin before Paxil.

It can't hurt to see about testing/evaluation for ADD or Aspberger's.

And as to the "happiness", I suspect it's far more of a "huge weight lifted from your shoulders" or "Wow.

I haven't been totally miserable for no reason so far today" improvement in mood than the "I feel pretty,

oh so pretty. I feel pretty, and witty, and GAY!"  Stepfordization you've been worried about.

[lilie]

I'm on remeron now and am not having such a good time. I'm so "happy" that my muscles clench and I clench my jaw. Paxil did the same to me so I guess I'm not a good candidate for AD's. I wish I were though.

Lilie

[null0trooper]

I'm on remeron now and am not having such a good time. I'm so "happy" that my muscles clench and I clench my jaw. Paxil did the same to me so I guess I'm not a good candidate for AD's. I wish I were though.

Lilie

<{POST_SNAPBACK}>

I think that may be a "too much serotonin" issue  - Lexapro's also noted for aching jaws, as are several of

the recreational drugs that release serotonin. Not all ADs act on the same neurotransmitters the same

way, although the SSRIs (e.g., Paxil) seem to have have broadly similar effects.

A lower dose of Remeron might help the jaw-clenching, but it may or may not be as effective as your

current schedule for depression (which could quickly suck more)  If it's really bothering you, you'll want to

talk to your doctor about alternatives.

[sheismistaken]

I started taking 30 mg Remeron qhs when I was in the hospital in June. 150 mg Effexor XR wasn't managing my depression...increasing it to 225 made me out of my mind crazy and anxious...so my doc said Remeron would be great for me.  He was right. I have always had trouble sleeping too. The first night I took it (my roommate in the hospital had been put on it that day too--she was in the same boat as me) and the next day we both slept off and on all day and walkled around like zombies when we were awake...and we weren't hungry during the day, but once it got close to bed time, we were starving and wanting sweets.

I've done well on Remeron, I have only gained about 5 pounds since I started taking it two months ago and now I am losing that 5. Weight gain is no problem as long as you have a good bit of self control. I can't handle sweets anymore--not even many fruits. The only sweet things I can handle are peaches and cantaloupe. Anything else is just too sweet and I throw it up.

I reccommend Remeron for anyone who hasn't reacted to other antidepressants or whose depression is hard to pin point. It's a good drug, really.