Posted by Elizabeth on July 3, 2001, at 16:22:44
In reply to Remeron - less sedation at higher dose?, posted by Lupercal on July 3, 2001, at 7:24:41
> I have tried 8 AD's thus far without success. SSRI's work great on my depression, but had to discontinue them all because of horrible (non-reversible) tinnitus side effect * I am about to start on Mirtazapine (Remeron).
Good choice. It's a novel AD, and I've known several people who had no luck with several classes of ADs and then had great success with Remeron.
> Previously I have tried Mianserin, which I understand is a very close analog of Remeron.
Mirtazapine is a metabolite of mianserin. They're both pretty strong antihistamines, which is probably why they're so sedating.
> a lot of what I'm reading is that, in theory anyway, the sedation (and possibly weight gain) side effects are inclined to disappear at doses above 30mg per day.
Yes. I started Remeron at 30 mg and had no problems with sedation at all. My pdoc says his experience is that people generally tolerate it better if they start out at a higher dose, so he usually starts people out at 30 mg.
> Would also be interested in hearing from anyone who has taken both Remeron and Mianserin, to compare their experience of the two drugs - though such a person will probably be hard to find in the US.
I never tried mianserin, but mirtazapine is supposed to have a reduced (and very minimal) risk of blood dyscrasias. In general, if you compare a drug and its metabolite, the metabolite is liable to have milder side effects (consider, for example, imipramine and desipramine).
-elizabeth
poster:Elizabeth
thread:68802
URL: http://www.dr-bob.org/babble/20010701/msgs/68849.html