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Question
Posted by: Maria | 2011-03-12

Remeron - Anxiety

Hi CS

I used to be on Aropax, Trepiline, Epitec and the occasional Xanor SR for major depression and mood swings with some anxiety. Then earlier this year I said to my p-doc that this isn''t working for me. I had the terrible nightmares and unsettling dreams from the Aropax, and even though the Trepiline kept me asleep I would wake up feeling shattered some mornings. I also felt that I was experiencing dysthymia despite all the meds.

He suggested that we try replacing all of those with Remeron. I was not open to dropping the Epitec as I really don''t want to experience mood swings again, so we decided on a 4 week schedule to change over from Aropax and Trepiline to Remeron, with 0.5mg Xanor SR to be taken when I feel it necessary. Towards the end of the 4 weeks I really wasn''t coping so he booked me off on sick leave for 2 weeks. By the end of this I was (still am) on 60mg Remeron and 200mg Epitec.

Now I''m definitely not depressed at the moment and although I still have weird dreams sometimes it''s nowhere near as bad as it was on Aropax, for which I am exceedingly grateful. However I am experiencing worsening anxiety. P-doc said I must take 1mg Xanor a day and see how it goes. Some days are great, as long as I take 0.5mg as soon as I open my eyes, and another one at lunch time before I pick my daughter up from school. And some days like today that is just not enough, and I spend the day feeling edgy and irritable, and overreacting to stimulus.

Can this be a Remeron side effect? Isn''t Remeron supposed to make anxiety better? Or was the anxiety previously masked by the meds I was taking and now it''s come to the fore? I am truly and utterly FED UP with being a loony. I want to know with reasonable certainty from one day to the next that I can trust myself to react in a reasonable manner to whatever life throws at me. Oh I know nobody reacts appropriately all the time, that''s not what I''m aiming at, I just want to be kind of " normal" . You know? And as much as I want it, I''m sure my husband and my poor daughter want it just as badly.

I''m seeing a new psychologist and we are working on my tendency to put everybody else''s needs ahead of my own and to always feel I must be busy, busy. So I''m not just expecting the meds to work magic.

I will discuss this with my p-doc as well, must give him feedback next week on the efficacy of 1mg Xanor. Just want another opinion. Oh and about the Xanor, I''m so scared of becoming dependent, I know the SR makes that less likely but it''s still a possibility, right?

Tummy scratches for kitty. One of our darling cats spent what felt like the whole of last night either running across me or sleeping on top of me. Got to love the furries!

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Our expert says:
Expert ImageCyberShrink

Remeron as an alternative AD may be worth considering - it's not a mood stabilizer, though, as you point out, and can't replace those if they are needed.
Managing these disorders is far more complex than we might make it sound when trying to describe the rationale. NOTHING, for instance, helps anxiety, or depression, as such. They all influence specific brain chemicals, some more than others - but then if you increase or decrease the activitity of one chemical that in itself influences the levels of others, and so on. Generally, the chemical effects of the chemicals we use as AD tend to be helpful in depression, but among their possible effects can be some ( like nightmares ) that are inconvenient.
Its good that you are also working with a psychologist, because I think too many people, especially psychiatrists who might happen to lack and therapeutic skills, ignore the need for psychotherapy as well as whatever meds they use.
Dependency is always to be borne in mind with any of the benzo's ( which is why some use small doses of prinarily anti-psychotic meds instead ), but needn't be a major problem. The SR formulation might or night not be easier to come off of more smoothly, but wouldn't be in itself less likely to produce dependency, as I see it.
Am plotting to take the cat to a vet for posible surgery. Though supposedly speyed before she came to me, it's clear that vet botched the job, and she has been left with highly over-active ovaries, and has now been on heat since before Christmas, with only an occasional one-week break of near normalcy which we both really enjoy !

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Our users say:
Posted by: cybershrink | 2011-03-13

Remeron as an alternative AD may be worth considering - it's not a mood stabilizer, though, as you point out, and can't replace those if they are needed.
Managing these disorders is far more complex than we might make it sound when trying to describe the rationale. NOTHING, for instance, helps anxiety, or depression, as such. They all influence specific brain chemicals, some more than others - but then if you increase or decrease the activitity of one chemical that in itself influences the levels of others, and so on. Generally, the chemical effects of the chemicals we use as AD tend to be helpful in depression, but among their possible effects can be some ( like nightmares ) that are inconvenient.
Its good that you are also working with a psychologist, because I think too many people, especially psychiatrists who might happen to lack and therapeutic skills, ignore the need for psychotherapy as well as whatever meds they use.
Dependency is always to be borne in mind with any of the benzo's ( which is why some use small doses of prinarily anti-psychotic meds instead ), but needn't be a major problem. The SR formulation might or night not be easier to come off of more smoothly, but wouldn't be in itself less likely to produce dependency, as I see it.
Am plotting to take the cat to a vet for posible surgery. Though supposedly speyed before she came to me, it's clear that vet botched the job, and she has been left with highly over-active ovaries, and has now been on heat since before Christmas, with only an occasional one-week break of near normalcy which we both really enjoy !

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