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Question
Posted by: Maria | 2012/01/11

Valdoxan

Hi CS

So I saw my p-doc on Monday and we decided that I would start on Valdoxan and slowly wean off Remeron. Well I took the Valdoxan on Monday night and woke up Tuesday morning feeling terrible - nauseas and dizzy. I only felt well enough to leave home for work at 9:00, and only really woke up at around 11:00. In the afternoon my mood felt a bit unnaturally elevated.

With schools starting today I just couldn''t be in such a state again, so I decided to postpone trying Valdoxan for a couple of weeks. My husband has some workshops and things coming up which means he will leave home early, and if I work on a possible two weeks of side effects before it stabilises, I have to make provision for my daughter in the mornings.

I''m thinking of starting the wean off Remeron in the meantime. My p-doc says I''m unlikely to have withdrawal symptoms but if I don''t replace it with the Valdoxan I will probably have sleep issues. Having gone through hell with withdrawal while weaning off Cymbalta and Aropax, forgive me if I''m sceptical about this! In your experience, how common is Mirtazapine withdrawal problems? And how do you distinguish between withdrawal symptoms and a recurrence of symptoms? I''m on 60mg, and will go down in 15mg increments with at least 2 weeks on each level. That''s the plan.

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Our expert says:
Expert ImageCyberShrink

Hmm. I wonder what your pdoc thinks ! Of course you will have read the ProductPackage leaflet that should ALWAYS be included with the package o ALL tablets and meds.
The usual summary of side-effects would be summarized as : " The most common side effects with Valdoxan (seen in between 1 and 10 patients in 100) are headache, dizziness, somnolence (sleepiness), insomnia (difficulty sleeping), migraine, nausea (feeling sick), diarrhoea, constipation, upper abdominal pain (tummy ache), hyperhidrosis (excessive sweating), back pain, fatigue (tiredness), increases in liver enzymes and anxiety. Most side effects were mild or moderate in intensity and happened within the first two weeks of treatment. Some of these side effects may be linked to the patient’s depression rather than Valdoxan itself."
rankly, I haven't much used Mirtazepine, but it shouldn't provide major withdrawal effects. Lets see how your plan works.
Agomelatine, working mainly on the Melatonin system rather than other chemical systems, is expected to normalize sleep early on, and not by a primarily sedative effect. In America where it has been quite easily available, people often use over-the-counter Melatonin to help with sleep problems, including jet lag.
Distinguihsing between side-effects, withdrawal effects, and a return of original symptoms is always rather difficult, and best done by a clinician who has observed you over time and has noticed the nature of each, in you.

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2
Our users say:
Posted by: Maria | 2012/01/11

I''m also on 200mg of Epitec and 1mg of Xanor SR a day. I would love to get off the Xanor as well, but get very anxious if I don''t take it. It also suppresses the restless legs caused by Remeron. Epitec is the one pill I''m happy to keep taking as it made such a huge difference when I started.

By the way, are you familiar with Jim Phelps'' work? I''m reading his book " Why am I still depressed?" , and it''s very interesting.

Reply to Maria
Posted by: cybershrink | 2012/01/11

Hmm. I wonder what your pdoc thinks ! Of course you will have read the ProductPackage leaflet that should ALWAYS be included with the package o ALL tablets and meds.
The usual summary of side-effects would be summarized as : " The most common side effects with Valdoxan (seen in between 1 and 10 patients in 100) are headache, dizziness, somnolence (sleepiness), insomnia (difficulty sleeping), migraine, nausea (feeling sick), diarrhoea, constipation, upper abdominal pain (tummy ache), hyperhidrosis (excessive sweating), back pain, fatigue (tiredness), increases in liver enzymes and anxiety. Most side effects were mild or moderate in intensity and happened within the first two weeks of treatment. Some of these side effects may be linked to the patient’s depression rather than Valdoxan itself."
rankly, I haven't much used Mirtazepine, but it shouldn't provide major withdrawal effects. Lets see how your plan works.
Agomelatine, working mainly on the Melatonin system rather than other chemical systems, is expected to normalize sleep early on, and not by a primarily sedative effect. In America where it has been quite easily available, people often use over-the-counter Melatonin to help with sleep problems, including jet lag.
Distinguihsing between side-effects, withdrawal effects, and a return of original symptoms is always rather difficult, and best done by a clinician who has observed you over time and has noticed the nature of each, in you.

Reply to cybershrink

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