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Re: Wash out Period for Remeron

Posted by TonyZ on February 28, 2008, at 21:48:03

In reply to Wash out Period for Remeron, posted by maryjo on February 11, 2008, at 13:24:00

I took remeron for a while years ago along with wellbutrin. I started with 30mg of Remeron for the first night then went up to 45mg for about 3 weeks then stopped the wellbutrin and remeron cold and started taking amitriptyline which had worked for me in the past. In terms of side effects amitriptyline has lots of them; I experienced constipation, dry mouth, occular pressure, shakiness when doing sports such as cycling.

Since you were on Remeron for a longer period of time, I would strongly urge you to discuss with your doctor the best way to come off. Since I wasn't on it that long, I don't think I experienced any side effects.

As for natural remedies you may also want to consider SAM-e (sadenosylmethylionine) It is a natural substance in the sense that it is synthesized in the body. The real expertise with this is in Boston Hospital. In some trials it has been shown to be as effective as tricyclic antidepressants in alleviating major depression. Do a search on SAM-E and Maurizio Fava. Exactly how it works is probably not fully understood but some possibilties are (1) increases the breakdown of neurotransmitters such as serotonin and dopamine (2) regulates production by speeding production of receptor molecules, (3) may make existing receptors more responsive.

For some people it can be a bit stimulating so if you take multiple dosages you might want to consider something like 8am and 2:30pm. There have also been complaints of some stomach sensitivity although research I've read indicates that there is actually no damage to the stomach lining - it is more of neurological thing. I seem to remember that it actually makes the stomach lining healthier.

I won't go into all the chemistry now because I'm kind of suffering with depression now and I don't fully understand it all. But just a couple of caveats. SAM-E gets manufactured by your body. There is some idea of how it works with respect to depression (above items 1-3). As part of the breakdown of sam-e in the body a substance known as homocysteine is produced. This is not a good thing, but B-vitamins can help convert the homocysteine into methionine which is used by your body as one of the building blocks of SAM-E.
So after you research sam-e a bit if you think you might want to give it a try, make sure you have some b-vitamins (maybe just taking a multi vitamin a day is enough - I don't know). Co-enzyme Q10 is something that has also been shown to reduce homocysteine levels and may be good to take. There are some books about sam-E, I don't know how much details they go into. I think it is something worth taking a look at. In the US studies I know have shown it to be far more effective than ST John's wort, but then everyone is a bit different.

It can be a bit pricey and since it is a supplement it is not covered by insurance. Some people with mild depression like yours have reported good results with small dosages.

I think it is a noble effort on your part to try and find a natural solution. Best of luck to you.


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