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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by claire7 on May 8, 2000, at 12:49:03
I have been taking Remeron for about 3 years. Two months ago I discovered I have 3 broken ribs without injury or osteoporosis. Tho my doc says there is no connection, PDR mentions fractures in clinical trials of Remeron, and I read somewhere that bone marrow depression also occured during trials. Does anyone know of any other instances of bone problems in people taking Remeron? I really need to find out what happened to my ribs! Thanks.
Posted by Yoga_Lover30 on June 23, 2009, at 15:19:27
In reply to long term Remeron use, posted by claire7 on May 8, 2000, at 12:49:03
Hi Claire,
I have been taking Mitrazipine for about 3 weeks now, and I have been having Tardive Dyskinesia symptoms. Interestingly, I have also been really concerned about the increased incidence of osteoporosis in people who take this med, as I have noticed in recent x-rays that my bones look thinner than they used to. I'm 29 years old, nearly 30 (eep!!), but I am really concerned about osteoporosis, as I am a thinner person and my grandma and great aunt both had and have this disease. Please email me if you find out anything more about the connection between Remeron and osteoporosis. I am actually looking into weaning off of both the Lexapro and Mitrazipine to start on the EMPower Plus supplement. Have you heard of it? I'm trying to find more info. on it, too.
Take Care,
Yoga_Love30
Posted by yxibow on June 27, 2009, at 23:22:18
In reply to Re: long term Remeron use, posted by Yoga_Lover30 on June 23, 2009, at 15:19:27
> Hi Claire,
>
> I have been taking Mitrazipine for about 3 weeks now, and I have been having Tardive Dyskinesia symptoms. Interestingly, I have also been really concerned about the increased incidence of osteoporosis in people who take this med, as I have noticed in recent x-rays that my bones look thinner than they used to. I'm 29 years old, nearly 30 (eep!!), but I am really concerned about osteoporosis, as I am a thinner person and my grandma and great aunt both had and have this disease. Please email me if you find out anything more about the connection between Remeron and osteoporosis. I am actually looking into weaning off of both the Lexapro and Mitrazipine to start on the EMPower Plus supplement. Have you heard of it? I'm trying to find more info. on it, too.
>
I'm not sure how these posts got together as they are 9 years apart, but EmPowerPlus and the company / person behind them have been investigated quite thoroughly by the Canadian health authorities.
There was even an NIH drug trial of it here which came to the conclusion that there was insufficient evidence of any particular efficacy and the trials were too small in the first place.The ingredients are all there to be searched in Canadian databases, they're nothing that you couldn't put together yourself from vitamin and mineral supplements.
Personally I think the marketing of it which has caused stabilized patients to come off their medications and revert to a serious state is reprehensible but there are few ways that the FDA can do anything except attempt to stop marketing a substance as a "cure" for anything.
I haven't heard anything about Remeron and osteoporosis, if it was that sensitive a connection there would be a black box.
Now if you have a tendency towards it, who knows, a lot of drugs with a very tiny probability of causing an increase in it might be higher for you, I can't say.
Osteoporosis though really is a part of human existence, depending on its severity.
If you think you have extremely early onset bone disorders, that should be investigated by a proper orthopedic clinician and appropriate action that is capable in 2009 should be taken.As for Tardive Dyskinesia from Remeron 3 weeks into it, that I find nearly impossible.
In fact there was a small study (again, not enough for a major conclusion) in Israel in a journal that Remeron had improved Tardive (-late-, as in as little as multiple months to more usually years to decades of treatment) disorders.
Can you describe what you are experiencing ? I would think if it was anything it would be something that is in the EPS (extrapyramidal symptom) or "side effect" category, the name is usually limited to antipsychotics.
-- Jay
Posted by 49er on July 3, 2009, at 7:34:39
In reply to Re: long term Remeron use, posted by Yoga_Lover30 on June 23, 2009, at 15:19:27
Hi,
Osteporosis fracture is listed as a rare side effect on rxlist.com.
http://www.rxlist.com/remeron-drug.htm
Of course, people will say you can't worry about a rare side effect but how many times are things blown off only to be proven later to be a legitimate issue?
Regarding your situation, I am not against supplements but please be careful as I have wasted alot of money on ones that didn't work.
49er
Posted by 49er on July 3, 2009, at 7:54:27
In reply to Re: long term Remeron use » Yoga_Lover30, posted by yxibow on June 27, 2009, at 23:22:18
<<There was even an NIH drug trial of it here which came to the conclusion that there was insufficient evidence of any particular efficacy and the trials were too small in the first place.>>Personally, I wouldn't trust an NIH drug trial as those folks aren't the most objective regarding alternative health. Don't get me wrong as I am not convinced that Empower Plus works but at the same time, I wouldn't rely on NIH to tell me if these supplements were effective or not.
<<The ingredients are all there to be searched in Canadian databases, they're nothing that you couldn't put together yourself from vitamin and mineral supplements.>>
I agree. I remember studying the ingredients and thought that for what they were offering, it was definitely way overpriced.
<< Personally I think the marketing of it which has caused stabilized patients to come off their medications and revert to a serious state is reprehensible but there are few ways that the FDA can do anything except attempt to stop marketing a substance as a "cure" for anything.>>
I am wondering if it is due to the fact that they encourage people to taper way too fast in transitioning to empower plus.
When I foolishly tried Label Me Sane Products, they advocated a 10% taper per week from the starting dose. That would have been a disaster for me.>
>
<<I haven't heard anything about Remeron and osteoporosis, if it was that sensitive a connection there would be a black box.>>Not necessarily. Look at how long it took black box warnings to appear on SSRIS?
I agree that what looks like to be a rare occurrence doesn't warrant a black box warning. But you can't just automatically dismiss it either.
I suffered a hearing loss from Remeron. A few years ago, I couldn't find any information on ototoxic meds. Now, it is more common and includes antidepressants. I still can't find specific information but my point is that just because you haven't heard of it, doesn't mean it doesn't exist.
<<Osteoporosis though really is a part of human existence, depending on its severity.>>
Not if you're thirty.
<<If you think you have extremely early onset bone disorders, that should be investigated by a proper orthopedic clinician and appropriate action that is capable in 2009 should be taken.>>Normally, this is very sensible advice. But if a doctor refuses to consider that it could be an adverse side effect, you are wasting your time.
I did this with my hearing loss and was misdiagnosed with coclear meniere's disease only to realize the hearing loss was definitely from Remeron. I wasted alot of time not trusting my instincts.>
<<As for Tardive Dyskinesia from Remeron 3 weeks into it, that I find nearly impossible.>>
I have to admit I agree with you. But an experience with a supplement I am taking is causing me to say, don't discount anything.
I believe what I am taking worsens my tinnitus considerably even though all the research I have done says this should not be happening. My dilemma is it helps in other ways and doesn't cause insomnia like other ones I have taken. Obviously, I have to make a decision but that is why I am not ready to completely blow off this claim even though I mostly agree with you.
>
<< In fact there was a small study (again, not enough for a major conclusion) in Israel in a journal that Remeron had improved Tardive (-late-, as in as little as multiple months to more usually years to decades of treatment) disorders.>>With all the side effects that Remeron has, I find that hard to believe.
> Can you describe what you are experiencing ? I would think if it was anything it would be something that is in the EPS (extrapyramidal symptom) or "side effect" category, the name is usually limited to antipsychotics.
Hasn't there been some links of TD to long term use of SSRIs? I am drawing a blank as to where i have seen this.
49er
Posted by yxibow on July 4, 2009, at 4:44:57
In reply to Re: long term Remeron use » yxibow, posted by 49er on July 3, 2009, at 7:54:27
>
> <<There was even an NIH drug trial of it here which came to the conclusion that there was insufficient evidence of any particular efficacy and the trials were too small in the first place.>>
>
> Personally, I wouldn't trust an NIH drug trial as those folks aren't the most objective regarding alternative health. Don't get me wrong as I am not convinced that Empower Plus works but at the same time, I wouldn't rely on NIH to tell me if these supplements were effective or not.
Entitled to your opinion...But plenty of "natural" substances have been investigated in mainstream medication for possible use... such as what became Taxol (chemotherapy for breast cancer) -- and it doesn't come without quite a set of side effects.
>
> <<The ingredients are all there to be searched in Canadian databases, they're nothing that you couldn't put together yourself from vitamin and mineral supplements.>>> I agree. I remember studying the ingredients and thought that for what they were offering, it was definitely way overpriced.
Speaks for itself, agreed.
> << Personally I think the marketing of it which has caused stabilized patients to come off their medications and revert to a serious state is reprehensible but there are few ways that the FDA can do anything except attempt to stop marketing a substance as a "cure" for anything.>>
>
> I am wondering if it is due to the fact that they encourage people to taper way too fast in transitioning to empower plus.Well, no its because some people with severe schizophrenia have gone off all their medications for some "promised cure" and have died.... But that's my opinion anyhow.
> When I foolishly tried Label Me Sane Products, they advocated a 10% taper per week from the starting dose. That would have been a disaster for me.>
> >
> <<I haven't heard anything about Remeron and osteoporosis, if it was that sensitive a connection there would be a black box.>>
>
> Not necessarily. Look at how long it took black box warnings to appear on SSRIS?
They've put black boxes on three classes of drugs, antidepressants, anti-epileptics, and I believe Celebrex, the one remaining COX-2 inhibitor because of *ss protection, among a host of medications.
It took years to warn patients on Mellaril, an older antipsychotic that it has a possibility of high QTc irregularity while Geodon was pulled and restudied under another 4000 people and the risk of torsades de pointes is extremely minimal.
SSRIs have had million-patient hours of use for two decades, TCAs for three, and benzodiazepines for 50 years.Laetrile, an "alternative" treatment from apricot pits (cyanide precursors) has killed people.
> I agree that what looks like to be a rare occurrence doesn't warrant a black box warning. But you can't just automatically dismiss it either.
>
> I suffered a hearing loss from Remeron. A few years ago, I couldn't find any information on ototoxic meds. Now, it is more common and includes antidepressants. I still can't find specific information but my point is that just because you haven't heard of it, doesn't mean it doesn't exist.There are rare effects of any medication.. ototoxicity is possible I would imagine.
Although Remeron is reported by some to be relatively free compared to some disposed to tinnitus -- whether that's true, I don't know.
Some of the most ototoxic but yet necessary -- Cisplatin, certain powerful antibiotics.
> <<Osteoporosis though really is a part of human existence, depending on its severity.>>
>
> Not if you're thirty.
>
> <<If you think you have extremely early onset bone disorders, that should be investigated by a proper orthopedic clinician and appropriate action that is capable in 2009 should be taken.>>That's why I said that... I had a sense that this was osteoporosis at a younger age. And that can be hereditary and caused by a number of things.
> Normally, this is very sensible advice. But if a doctor refuses to consider that it could be an adverse side effect, you are wasting your time.
>
> I did this with my hearing loss and was misdiagnosed with coclear meniere's disease only to realize the hearing loss was definitely from Remeron. I wasted alot of time not trusting my instincts.>Well, you might be the one of the first people with that... I'm not trying to deny that it could be... anything is possible.
But Meniere's is fairly rare, often caused by unknown trauma as a result of viruses and other infections, and has a complex progressive stage.
> <<As for Tardive Dyskinesia from Remeron 3 weeks into it, that I find nearly impossible.>>
>
> I have to admit I agree with you. But an experience with a supplement I am taking is causing me to say, don't discount anything.Supplement ?
> I believe what I am taking worsens my tinnitus considerably even though all the research I have done says this should not be happening. My dilemma is it helps in other ways and doesn't cause insomnia like other ones I have taken. Obviously, I have to make a decision but that is why I am not ready to completely blow off this claim even though I mostly agree with you.
Yes, there is always tradeoffs between choices of medical treatments. Benefits have to outweigh the risks, and that's a personal decision.> << In fact there was a small study (again, not enough for a major conclusion) in Israel in a journal that Remeron had improved Tardive (-late-, as in as little as multiple months to more usually years to decades of treatment) disorders.>>
>
> With all the side effects that Remeron has, I find that hard to believe.Actually there are various studies about Remeron and EPS. The study about Tardive syndromes may have been mianserin, I can't locate it -- mianserin is the predecessor to mirtazapine and is structurally similar.
> > Can you describe what you are experiencing ? I would think if it was anything it would be something that is in the EPS (extrapyramidal symptom) or "side effect" category, the name is usually limited to antipsychotics.
It still would be curious to know the effects that you're experiencing and how often they are... because there's a world of difference between EPS, tics, and Tardive syndromes (TD,TDy, etc), and just personally I happen to be acutely aware of that.
> Hasn't there been some links of TD to long term use of SSRIs? I am drawing a blank as to where i have seen this.Rarely... but the cases have often been people who have been on antipsychotics for years, often older, typical antipsychotics.
Zoloft has a slightly higher possibility in this realm of rareness for TD because it has some action on D2.
-- Jay
Posted by SLS on July 4, 2009, at 5:09:11
In reply to Re: long term Remeron use » yxibow, posted by 49er on July 3, 2009, at 7:54:27
Hi 49er.
> Personally, I wouldn't trust an NIH drug trial as those folks aren't the most objective regarding alternative health. Don't get me wrong as I am not convinced that Empower Plus works but at the same time, I wouldn't rely on NIH to tell me if these supplements were effective or not.I guess you have your reasons. I actually trust the NIH to be very objective. At least they have the guts to publish articles describing the inefficacy of the substances they test. Did you know that the NIH began a department for the study of alternative medicine in 1993?
- Scott
Posted by sowhysosad on July 4, 2009, at 15:01:52
In reply to Re: long term Remeron use » 49er, posted by yxibow on July 4, 2009, at 4:44:57
> > << In fact there was a small study (again, not enough for a major conclusion) in Israel in a journal that Remeron had improved Tardive (-late-, as in as little as multiple months to more usually years to decades of treatment) disorders.>>
> >
> > With all the side effects that Remeron has, I find that hard to believe.
>
> Actually there are various studies about Remeron and EPS. The study about Tardive syndromes may have been mianserin, I can't locate it -- mianserin is the predecessor to mirtazapine and is structurally similar.That's ringing a bell with me. I seem to remember my neuro saying one of his patient's tardive syndromes went into remission when she was given Remeron for something else.
> Zoloft has a slightly higher possibility in this realm of rareness for TD because it has some action on D2.Doesn't clomipramine block D2 receptors too?
Posted by yxibow on July 6, 2009, at 6:06:15
In reply to Re: long term Remeron use » yxibow, posted by sowhysosad on July 4, 2009, at 15:01:52
> That's ringing a bell with me. I seem to remember my neuro saying one of his patient's tardive syndromes went into remission when she was given Remeron for something else.
>
>
> > Zoloft has a slightly higher possibility in this realm of rareness for TD because it has some action on D2.
>
> Doesn't clomipramine block D2 receptors too?Yes, I believe you're correct. I take Anafranil currently.
"Efficacy of clomipramine in obsessive-compulsive disorder"
Volume 2 Issue 1, Pages 56 - 57, Wiley, Anxiety
Notes what I believe the conclusion is that it may account for its improvement for OCD.
Probably not nearly as much as the odd set of medications that falls under the tricylic (possibly tetracyclic) class but is a bit different -- amoxapine, which has a rather strong affinity. Similarly maprotiline -- neither are used today particularly.Trimipramine has been compared to clozapine in D2 blockade. And also an unbelievably expensive tricyclic in drug price lists as there are only two makers.
-- Jay
This is the end of the thread.
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