![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Jasmine Neroli on July 19, 2003, at 14:35:34
Was on Celexa 20mg for 1 year...helped with anxiety & depr. to an extent, however insomnia not helped at all and sexual dysfunction then kicked in. (Am menopausal and KNOW that all my problems are HIGHLY connected to hormone sensitivity!). 6 days ago, on advice of my GP, cold turkey off Celexa and started 30mg Remeron. Suffice to say, lack of sleep is no longer a problem! Drowsy most of the time, dizzy off and on. I read that lower doses of Remeron, due to histamine blocking, are more sedating and that at 45mg+ the NE effect counteracts. So I increased 3 days ago to 37.5mg. Slightly less drowsiness now ( due to increase, or adjustment to Remeron?). But for past 3days have a lot of ankle and knee swelling, some facial puffiness and abdominal puffiness by evening. Knees and ankles feel stiff, due to swelling. This is worse on sitting or standing. Exercise daily, but not as much as prior Remeron (too sleepy). OK, questions? 1. Does increasing Remeron cause fluid retention? If so, why/how? 2. Is there a hormonal relationship here (I used to retain fluid like crazy at PMS time)?. 3. Could there be a connection between fluid retention and low blood presssure (have not had BP checked, but am usually on the low-side of normal and I think the dizziness may be a low BP sign too)?4. Is the fluid rentention part of Celexa withdrawal instead?. 5. Will increasing to 45mg get rid of all those side effects?? (hoping, hoping!!). O yeah, I forgot to add that I'm also VERY irritable last few days too! Thanks for your input. I am learning a lot about neuro-science, but it's obvious that there is so much unknown out there!
Posted by Essence on July 19, 2003, at 17:06:55
In reply to Remeron dosage-up for drowsiness,down for edema?, posted by Jasmine Neroli on July 19, 2003, at 14:35:34
Hi Jasmine;
I will try to help with some of your questions, I've been on Remeron 30 mg since January 2002 with good results. The drowsiness passes, for some it takes a few weeks, others a bit longer. Initially I was a zombie but welcomed the sleep after having months without any. Now I'm alseep by 11pm and up at 5:30am alert and refreshed.
>1. Does increasing Remeron cause fluid retention? If so, why/how?
Remeron can cause fluid retention at any dose, why I'm not sure. Until a cpl of months ago I had real problems with fluid retention when I pulled a 12 hr shift, then I did something out of the ordinary that changed that for me. I had always avoided coffee/caffeine because it always exacerbated my anxiety, anyhow at work one day a nurse suggested I drink coffee on my long shifts and to my amazement it worked, I no longer have the edema after working a 12 hr shift. Oh I should mention, I only seemed to experience edema on the days that I work, strange huh? and I don't drink coffee on the days I don't work.
>2. Is there a hormonal relationship here (I used to retain fluid like crazy at PMS time)?.
Well part of it might be hormonal, but it's also a listed side-effect of Remeron.
>3. Could there be a connection between fluid retention and low blood presssure (have not had BP checked, but am usually on the low-side of normal and I think the dizziness may be a low BP sign too)?
Actually, Remeron can raise your B/P. The dizziness is also a listed side-effect, and is transient but to be on the safe side, contact your doctor and get your B/P checked.
>4. Is the fluid rentention part of Celexa withdrawal instead?.
Don't know about Celexa withdrawal, never taken it.
>5. Will increasing to 45mg get rid of all those side effects?? (hoping, hoping!!).
Most of the side-effects are transient or diminish with time, and yes, some are alleviated with a higher dose, ie, the drowsiness/fatigue.
>O yeah, I forgot to add that I'm also VERY irritable last few days too!
O yeah, I hear you on the irritability, I was a proper **tch for about 3 weeks, but that also passes with time or at least it did with me and a few others that I know on this medication.
Good luck.
Ess
Posted by Jasmine Neroli on July 19, 2003, at 17:20:51
In reply to Re: Remeron dosage-up for drowsiness,down for edema? » Jasmine Neroli, posted by Essence on July 19, 2003, at 17:06:55
> Hi Jasmine;
>
> I will try to help with some of your questions, I've been on Remeron 30 mg since January 2002 with good results. The drowsiness passes, for some it takes a few weeks, others a bit longer. Initially I was a zombie but welcomed the sleep after having months without any. Now I'm alseep by 11pm and up at 5:30am alert and refreshed.
>
> >1. Does increasing Remeron cause fluid retention? If so, why/how?
>
> Remeron can cause fluid retention at any dose, why I'm not sure. Until a cpl of months ago I had real problems with fluid retention when I pulled a 12 hr shift, then I did something out of the ordinary that changed that for me. I had always avoided coffee/caffeine because it always exacerbated my anxiety, anyhow at work one day a nurse suggested I drink coffee on my long shifts and to my amazement it worked, I no longer have the edema after working a 12 hr shift. Oh I should mention, I only seemed to experience edema on the days that I work, strange huh? and I don't drink coffee on the days I don't work.
>
> >2. Is there a hormonal relationship here (I used to retain fluid like crazy at PMS time)?.
>
> Well part of it might be hormonal, but it's also a listed side-effect of Remeron.
>
> >3. Could there be a connection between fluid retention and low blood presssure (have not had BP checked, but am usually on the low-side of normal and I think the dizziness may be a low BP sign too)?
>
> Actually, Remeron can raise your B/P. The dizziness is also a listed side-effect, and is transient but to be on the safe side, contact your doctor and get your B/P checked.
>
> >4. Is the fluid rentention part of Celexa withdrawal instead?.
>
> Don't know about Celexa withdrawal, never taken it.
>
> >5. Will increasing to 45mg get rid of all those side effects?? (hoping, hoping!!).
>
> Most of the side-effects are transient or diminish with time, and yes, some are alleviated with a higher dose, ie, the drowsiness/fatigue.
>
> >O yeah, I forgot to add that I'm also VERY irritable last few days too!
>
> O yeah, I hear you on the irritability, I was a proper **tch for about 3 weeks, but that also passes with time or at least it did with me and a few others that I know on this medication.
>
> Good luck.
> EssHi Essence!
Thanks so much for the info. I found it very encouraging. It's interesting that your fluid retention only occurred on working days(presumably you were on your feet a lot?). I find that I get it all the time, unless I'm lying down! I'll try drinking more caffeine and see if it helps. Anyway, I'm going to persevere at 37.5mg, then check in with my doc next week! Thanks for the support :)
JN
Posted by McPac on July 19, 2003, at 23:12:43
In reply to Re: Remeron dosage-up for drowsiness,down for edema? » Jasmine Neroli, posted by Essence on July 19, 2003, at 17:06:55
"Actually, Remeron can raise your B/P"
>>>>>>>>>>Ess, I recall reading that a long time back....yet, recently, I read that Remeron had no effect on blood pressure....do you have a link to info saying Rem affects blood pressure...I know that since I started Remeron my blood pressure often reads higher than it used to.....one other question/comment---I hope that Remeron DOES keep making me sleepy at the higher dosages (I NEED something for terrible insomnia and Rem has been great at low doses....I'm hoping that I can make Rem my only anti-dep, but I'll have to raise its dosage a lot to compensate for stopping my other anti-dep...and I'm hoping that I will STILL get some sedative effect at that higher dose...it would actually be BAD for me if it totally lost that effect....do you also have ocd Ess (don't recall if you mentioned that before or if it was another poster)? I'd love for it to be effective for BOTH my dep. & ocd, we'll see...take care!!!
Posted by McPac on July 19, 2003, at 23:18:36
In reply to Remeron dosage-up for drowsiness,down for edema?, posted by Jasmine Neroli on July 19, 2003, at 14:35:34
Many of your side effects are very likely to diminish or fade away as your body adjusts to the new med......as for your comment, "I'm also VERY irritable last few days too!"
THAT could be caused by stopping the Celexa....starting Remeron may also cause irritability at first (until your body adjusts...lastly, it could be a combination of those 2 effects---stopping the Celexa AND also starting the Remeron.....that feeling SUCKS but it will go away in time...take care!!!!
Posted by Jasmine Neroli on July 19, 2003, at 23:32:29
In reply to Jas, dosage-up for drowsiness,down for edema?, posted by McPac on July 19, 2003, at 23:18:36
Thanks for your support, McPac...yeah it does suck, I felt really crappy today!! But I'm looking forward to another good night's sleep:). The edema is worse today than ever and muscle weakness. I'm wondering about too much aldosterone causing these side-effects. If that's the case (a beta-androgenic effect??) dopamine will help. I'm considering talking to my doc about augmenting with Wellbutrin in the a.m. Any comments?
Posted by jemma on July 20, 2003, at 8:55:04
In reply to Re: Jas, dosage-up for drowsiness,down for edema? » McPac, posted by Jasmine Neroli on July 19, 2003, at 23:32:29
I've had problems with edema, and did a little research. Antihistamines definitely cause water retention, because they're vasodilatory. At lower doses remeron acts almost exclusively as an antihistamine, so I would think a higher dose would help with edema.
Oh, and for McPac - my partner's blood pressure went way up on Remeron. His pdoc says it's a frequent side-effect, though not much discussed in the literature. For him, it's worth it though - it's been almost miraculous for anxiety, insomnia, and sleep apnea.
- Jemma
Posted by McPac on July 20, 2003, at 14:07:47
In reply to Re: Jas, dosage-up for drowsiness,down for edema?, posted by jemma on July 20, 2003, at 8:55:04
Posted by McPac on July 20, 2003, at 14:10:45
In reply to Re: Jas, dosage-up for drowsiness,down for edema? » McPac, posted by Jasmine Neroli on July 19, 2003, at 23:32:29
"I'm considering talking to my doc about augmenting with Wellbutrin in the a.m. Any comments?"
>>>>>>>>>>> I believe that Wellbutrin can be very activating for many people, making many more anxious and nervous......take care!!
Posted by Jasmine Neroli on July 20, 2003, at 14:49:10
In reply to Re: Jas, dosage-up for drowsiness,down for edema?, posted by jemma on July 20, 2003, at 8:55:04
Thanks Jem, I had been looking at the beta-adronergic effect, causing more aldosterone secretion - causing fluid retention. That's why I was looking at maybe finding a dopminergic drug too, since it's supposed to have an inhibitory effect. Hadn't considered the histamine effect on fluid retention. I'm probably going to increase my dose...experimenting on myself,as usual! I was thinking that at my dose of 30mg, it was enough to have the NE effect kick-in, but maybe not, seeing as some ppl need 60mg!!! Thanks again all for your info. This board has been so good for me!
Posted by Essence on July 20, 2003, at 19:52:32
In reply to Ess, dosage-up for drowsiness,down for edema?, posted by McPac on July 19, 2003, at 23:12:43
Hi McPac;
I work in a hospital and elevated B/P is listed in our drug book, also, I was to a internal specialist about a month ago and she also emphasized that Remeron causes elevated B/P.
Regarding your comment/concern about Remeron losing it's effect to help you sleep, it does level off and you will find that you don't go to sleep as quickly after taking it, but it does still help with sleep. I take my medication at 8:30 pm and in the beginning I was alseep by 9 pm and would sleep late in the morning, now I fall asleep around 11 and wake early, feeling refreshed and energized, so although the length of time I sleep has shortened, the quality of sleep I get is great.
To your last question, yes I have OCD minus the compulsive side of it. I obsessed over everything and anything, my thoughts were erratic and unrelenting. Remeron took care of that problem for me as well. Hope this helps, take care.
Ess
Posted by Zena on July 23, 2003, at 18:21:42
In reply to Re: Jas, dosage-up for drowsiness,down for edema? » jemma, posted by Jasmine Neroli on July 20, 2003, at 14:49:10
Have been on about all the anti-depressents without any luck until Dr. put me on Remeron. It has been a God sent. I control the possible weight gain by watching what I eat and have increased my exercising. I take 15mg and 1 mg of Klonopin daily. I also have the swelling in my ankles & feet but started with the abdominal puffiness. I didn't know this was a side effect. I also have problems with constipation but not enough to discontinue the meds.
Posted by jasmine neroli on July 23, 2003, at 23:18:24
In reply to Re: Jas, dosage-up for drowsiness,down for edema? » Jasmine Neroli, posted by Zena on July 23, 2003, at 18:21:42
Hi: Yeah, fluid retention is reported by the manufacturer as a less common side-effect.But I have noticed MANY people complaining of this on various message boards. IMHO, if you can handle the side effects, you should stay with what's working for you. However, you might want to discuss raising the dose with your doctor. I increased to 45mg 2 days ago and I have no side effects at all now!!! Best of luck.
Posted by Zena on July 24, 2003, at 8:25:15
In reply to Re: Jas, dosage-up for drowsiness,down for edema? » Zena, posted by jasmine neroli on July 23, 2003, at 23:18:24
Jas- I tried the 45mg.& couldn't hardly get out of bed. Let me know if your puffiness goes away on the 45mg. I hate it especially around my abdominal area. I have always had some swelling in my ankles & feet-more in the summer when it gets so hot but haven't noticed a big increase due to the Remeron. I have extreme anxiety so the Remeron with the Klonopin has been wonderful. I am on the smallest dosage of both. I do have days when I am irritable also.Keep me posted about your swelling.
Posted by Jasmine Neroli on July 24, 2003, at 22:51:33
In reply to Re: Jas, dosage-up for drowsiness,down for edema?, posted by Zena on July 24, 2003, at 8:25:15
Hey Zena: I've been taking the 45mg for 4 nights now and the swelling has stayed away the whole time! I do have a bit of leg and abdominal puffiness by the end of the day, but like you, this is normal for me on hot days. Until today, I have not felt sedated or drowsy on this dose, although I am groggy for up to an hour, when I wake up in the morning. Today has seen a return of a bit of "spaceyness" , I'm not quite sure why. I do try to make sure I take it at around 8pm (as long as I'm at home, cuz I'm drowsy within an hour or so) - this way I'm sedated at the right time and it wears off about 13 hours later. As far as the irritability, that pretty much went with the puffiness. But again, I did get a bit of that today with the dizzy feeling. Remeron has been fantastic for my insomnia and so far anxiety and depression haven't returned. Good luck! Hope the higher dose works for you.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.