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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by BRC on June 27, 2009, at 16:52:02
Hi,
I haven't posted here in a while. So, I will fill you in on latest details. My psydoc of 7-8 years retired a while back. He referred me to one of his collegues for continued treatment. I saw the new psydoc about three times. The only thing she changed was increasing my Remeron from 30mg to 45mg. This was due to a discussion we had about Remeron causing my weight gain. She said that in some people Remeron in higher doses did not increase there appetite as much and told me just to try it at 45mg and see what happens. I couldn't tell any difference.
Then my old psydoc that retired came back into practice. He is a very well known and respected psydoc where I live. He even has part of the major hospital here named after him. I was lucky to get him. He is older but wise. He had went to volunteer to help soilders returning from Iraq with ptsd and deceided he missed seeing and treating patients.
So, when he came back into practice he took over my treatment. I saw him last month and it was time for all new scripts for my meds. I told him about the other psydoc increasing my Remeron from 30mg to 45mg. When I recently got the scripts filled he wrote my Remeron to take 1 to 2 30mg pills at night with a sixty pill month supply. This would mean I would take 60mg of Remeron if I wanted each night. But I thought I was maxed out at 45mg.
So, my concern and questions are the following?
Is 60mg of Remeron commonly prescribed?
Is 60mg of Remeron dangerous?
Has anyone taken this amount? and if yes what if any were the side effects?
I ask this b/c my med regimin is 60mg Cymbalta, 4mg Klonopin, 200mg Luvox, 300mg Lyrica, and then the Remeron topped of by 40mg of Lipitor.
My meds work. All my tests for liver enzymes, etc. are fine. And I am in overall good pysical health. I am 33 years old.
Sorry for such a long rambling post. Just had a lot of info. for such a simple question.
Thanks,
BRC
Posted by bleauberry on June 27, 2009, at 19:08:21
In reply to Is 60mg of Remeron a SAFE Dosage?, posted by BRC on June 27, 2009, at 16:52:02
> Is 60mg of Remeron commonly prescribed?30mg to 60mg is common, with occasional cases of 90mg.
>
> Is 60mg of Remeron dangerous?There are risks with all prescription or over the counter drugs. Routine blood tests 4 times per year should be done to look for abnormalities developing. And you should print out the information on serotonin syndrome at psychotropical.com (recognition, diagnosis, and emergency treatment protocol) so that you know it well, and keep it with you in case you ever end up in the emergency room. I say this because of all the other meds you are on.
>
> My meds work.
So why change the remeron dose???
Posted by BRC on June 27, 2009, at 19:31:52
In reply to Re: Is 60mg of Remeron a SAFE Dosage?, posted by bleauberry on June 27, 2009, at 19:08:21
Hi,
Thanks for the response. Very sound and wise advice. Thanks again.
BRC
Posted by Phillipa on June 27, 2009, at 22:00:29
In reply to Re: Is 60mg of Remeron a SAFE Dosage? » bleauberry, posted by BRC on June 27, 2009, at 19:31:52
If it ain't broke don't need fixing. Phillipa
Posted by yxibow on June 27, 2009, at 23:40:08
In reply to Re: Is 60mg of Remeron a SAFE Dosage? » BRC, posted by Phillipa on June 27, 2009, at 22:00:29
> If it ain't broke don't need fixing. Phillipa
I agree with that, and I also agree with routine blood testing which should be done for polypharmacy if at all possible -- the standard of care is usually every 6 months, but if copays are possible for 3 months, that's even better.
I am curious though about 3 antidepressants -- two of which act on NE, all three of which act in varying degrees and ways on serotonin. I assume your doctor is aware of the dangers of SS (serotonin sysndrome).
And then there are two mood/anxiety stabilizers there but those two combinations are much more common.
Lipitor isn't completely innocuous but its not in the scope of what I'm more concerned with, which is SS.
As for it being a safe dosage ... well I'm probably more of a heavy set and fast metabolizer than you are when I took Remeron... I did go up to 52.5 (7.5 mg tablets). 60mg is probably not much a difference from that but I wouldn't really go too much higher.
Its pretty groggy making for at least the first while anyhow.
More isn't always better (I went to 120 Cymbalta when I took it, and it wasn't clear, nor did the drug company have any evidence that 120 was any better than 60, but it probably did a bit more for me.)
Cymbalta ha around a 6:1 serotonin to NE ratio so its lower acting if I recall on NE than it is on serotonin.
Good luck and just monitor your mood and state of mind occasionally -- SS though is really hard to pin down because the patient doesn't actually often know they have it.
I suppose anything I say could be processed/construed as a warning, but I'm not trying to upset the balance of your medications nor is that my intention to scare someone.
If they've been working fine, average monitoring by your doctor should be sufficient enough.
-- tidings
Jay
Posted by BRC on June 28, 2009, at 11:49:10
In reply to Re: Is 60mg of Remeron a SAFE Dosage? » Phillipa, posted by yxibow on June 27, 2009, at 23:40:08
Maybe this information will shed a little light on why I am on three AD's. I have a tumor in my spine that causes nerve damage in my left leg.
The Cymbalta and Lyrica is intended for the neropothy.
My pych. diag. is Major OCD, anxiety, and depression. I take the Luvox for OCD, Klonopin for anxiety, and the Remeron for both depression and insomnia.
BRC
Posted by yxibow on June 28, 2009, at 16:04:07
In reply to Re: Is 60mg of Remeron a SAFE Dosage? » yxibow, posted by BRC on June 28, 2009, at 11:49:10
> Maybe this information will shed a little light on why I am on three AD's. I have a tumor in my spine that causes nerve damage in my left leg.
>
> The Cymbalta and Lyrica is intended for the neropothy.
>
> My pych. diag. is Major OCD, anxiety, and depression. I take the Luvox for OCD, Klonopin for anxiety, and the Remeron for both depression and insomnia.
>
> BRCOh dear I'm sorry that you have multiple diagnoses to deal with.
I'm guessing because its on the spine its potentially too dangerous to operate.
-- Jay
Posted by Phillipa on June 28, 2009, at 20:23:25
In reply to Re: Is 60mg of Remeron a SAFE Dosage? » BRC, posted by yxibow on June 28, 2009, at 16:04:07
Also sorry do the meds work for the pain? Love Phillipa
Posted by BRC on June 29, 2009, at 12:08:52
In reply to Re: Is 60mg of Remeron a SAFE Dosage? » BRC, posted by yxibow on June 28, 2009, at 16:04:07
Yea, docs say there is no way to operate (unless an absolute emergency).
The tumor is not cancerous (Thank God). Rather it is called an meningioma, meaning it is a blood filled tumor on the meninges of the spinal cord. So, for instance if I got extreme blunt force trama to the area in my back where the tumor lies, it may rupture the tumor causing it to bleed. Then they would have no option but to try and operate.
But the Pysical ailment is nothing compared to the OCD, anxiety, and Depression.
Thanks for your posts and concern.
BRC
Posted by BRC on June 29, 2009, at 12:12:11
In reply to Re: Is 60mg of Remeron a SAFE Dosage?, posted by Phillipa on June 28, 2009, at 20:23:25
Yea, the Lyrica works wonder's for the nueropothy. But I couldn't tell that much difference with the Cymbalta.
BRC
Posted by Phillipa on June 29, 2009, at 19:54:28
In reply to Re: Is 60mg of Remeron a SAFE Dosage? » Phillipa, posted by BRC on June 29, 2009, at 12:12:11
My Daughter has a meningioma on her eye lid and around the corner of her eye. Phillipa
Posted by BRC on June 30, 2009, at 16:03:49
In reply to Re: Is 60mg of Remeron a SAFE Dosage? » BRC, posted by Phillipa on June 29, 2009, at 19:54:28
Sorry to hear that. My thoughts go out to you and your daughter.
Since your daughter's meningioma is on the surface (the skin) can or could doctor's remove it? Or are they concerned about blood loss and complications that go along with removing meningiomas?
Posted by Phillipa on June 30, 2009, at 21:52:26
In reply to Re: Is 60mg of Remeron a SAFE Dosage? » Phillipa, posted by BRC on June 30, 2009, at 16:03:49
Thanks for asking she's an adult now and it never grew larger. Too risky of losing eyesight. She's fine. Love Phillipa
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