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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by SalArmy4me on July 16, 2001, at 2:50:13
From Dr. Preskorn, Professor and Chair of the Department of Psychiatry and Behavioral Sciences at the University of Kansas School of Medicine - Wichita.
http://www.preskorn.com/cgi-bin/sp.pl?words=clomipramine&wt=be&bl=an&d=/books/omd_s7.html"There are no published fixed-dose studies which empirically establish that doses of mirtazapine higher than 15 mg/day are more effective or better tolerated. There are anecdotal and theoretical reasons to suspect that higher doses will decrease the problem of sedation (ie, offsetting arousal effects as a result of alpha-2-adrenergic blockade at higher concentrations [Figure 6.4])..."
Source: Janicak PG, Davis JM, Preskorn SH, Ayd FJ Jr. Principles and Practice of Psychopharmacotherapy. 2nd ed. Baltimore, Md: Lippincott, Williams & Wilkins; 1997.
Posted by Janelle on July 16, 2001, at 15:13:21
In reply to Remeron: Only 15 mg Is Really Needed, posted by SalArmy4me on July 16, 2001, at 2:50:13
SalArmy4Me - wow, I meant to say thanks for posting that link to the site comparing different meds and their effect on the different neuro's, that helps me so much because I'm interested in trying Luvox (fluvoxamine) due to my obsessive and compulsive tendencies. And that link with the charts (I could not understand the "medicalese" in the written portions!) seems to confirm what my pdoc said - she's concerned that Luvox may not be as effective as some of the other S(S)RI's for depression. Ack. I just wanna find the RIGHT a-d for me. So far, I've struck out with Celexa and Effexor. If you're at all interested in emailing, feel free - my addy is mermaiden22@hotmail.com.
Posted by Edward on July 17, 2001, at 18:47:15
In reply to Remeron: Only 15 mg Is Really Needed, posted by SalArmy4me on July 16, 2001, at 2:50:13
> "There are no published fixed-dose studies which empirically establish that doses of mirtazapine higher than 15 mg/day are more effective or better tolerated. There are anecdotal and theoretical reasons to suspect that higher doses will decrease the problem of sedation (ie, offsetting arousal effects as a result of alpha-2-adrenergic blockade at higher concentrations [Figure 6.4])..."
I've been on this stuff for months gradually increasing the dose (now 60mg) waiting for something to happen. Am I wasting my time or is the article just saying that the research hasn't been done? (Sorry if this seems a stupid question).
Posted by SalArmy4me on July 17, 2001, at 18:59:46
In reply to Re: Remeron: Only 15 mg Is Really Needed, posted by Edward on July 17, 2001, at 18:47:15
I assume you're wasting your money on higher dosage.
Posted by Shar on July 17, 2001, at 23:07:47
In reply to Re: Remeron: Only 15 mg Is Really Needed, posted by SalArmy4me on July 17, 2001, at 18:59:46
I would treat that quote as a suggestion. It does mention 15 mgs. ceiling but does not provide any compelling evidence that this is empirically so. Moreover, there are many things that can determine how much of a med a person needs--just like any med, some people may need more or less of it to get an effect.
Sal, to state that "I assume you're wasting your money on higher dosage" puts you in the position of having a great deal of responsibility toward what this person does. If the person goes from 60 to 15 based on your printing the quote (not really an article), and then telling him/her you assume etc. and sounding quite credible, you share in whatever consequences occur--good or bad.
Very, very little in medical land is hard and fast. Mostly, these meds are shades of gray (if I am correct, I recall you don't take meds?). The docs do their best, and it helps if the client can do some research and understand basically what is happening. What is scary is that you will make unsupported, black and white statements such as you did here; with God's help, that person will get real medical advice before messing with his/her dosage.
Don't mean to offend, Sal, but I consider this a serious issue.
Shar
> I assume you're wasting your money on higher dosage.
Posted by Edward on July 18, 2001, at 13:04:25
In reply to Re: Remeron: Only 15 mg Is Really Needed?????, posted by Shar on July 17, 2001, at 23:07:47
> If the person goes from 60 to 15 based on your printing the quote
Actually I was just thinking of ditching mirtazapine completely. The only thing that's improved my mood lately is staying up for 36 hours straight. I'm not sure why this worked, but I was feeling happier today and I didn't bother going to sleep last night.
Posted by Amy Blue on July 18, 2001, at 13:33:59
In reply to Remeron: Only 15 mg Is Really Needed, posted by SalArmy4me on July 16, 2001, at 2:50:13
Not necessarily true. Since Remeron causes more sedation at lower doses, it would follow that taking a higher dose would alleviate the excessive drowsiness one may experience at 15 mg. So if one was taking 15 mg and feeling a good response to their depression but overly groggy, then they could increase the dose to alleviate the groggy feeling while keeping the AD properties. Higher dosage may also reduce the weight gain many report with Remeron.
"There are anecdotal and theoretical reasons to suspect that higher doses will decrease the problem of sedation"
Posted by MB on July 18, 2001, at 14:50:29
In reply to Re: Remeron: Only 15 mg Is Really Needed?????, posted by Edward on July 18, 2001, at 13:04:25
> > If the person goes from 60 to 15 based on your printing the quote
>
> Actually I was just thinking of ditching mirtazapine completely. The only thing that's improved my mood lately is staying up for 36 hours straight. I'm not sure why this worked, but I was feeling happier today and I didn't bother going to sleep last night.
Interesting. That works for me, also. Sleep deprivation has an antidepressant effect on me too!!
This is the end of the thread.
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