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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by mogger on July 25, 2012, at 0:59:39
Hi there,
Does anyone have experience with dosing over 45mg of Remeron? I haven't had too much weight gain at 45mg and wonder if I increase to 60mg whether that would take weight gain to a whole new level. I have heard that higher doses cause less weight gain but any personal experiences would be great. Many thanks,
mogger
Posted by novelagent on July 26, 2012, at 13:22:11
In reply to any experience dose greater than 45mg of Remeron?, posted by mogger on July 25, 2012, at 0:59:39
I'm surprised you're higher than 30mg-- there's a certain dose where these meds don't do much more, it's a case of diminishing returns. You can try augmenting it with an antipsychotic, or maybe try switching to emsam if you need relief of depression (especially atypical depression) but I really don't see the benefit of going more than 45mg-- in my opinion, you're on too high of a dose as it is.
> Hi there,
>
> Does anyone have experience with dosing over 45mg of Remeron? I haven't had too much weight gain at 45mg and wonder if I increase to 60mg whether that would take weight gain to a whole new level. I have heard that higher doses cause less weight gain but any personal experiences would be great. Many thanks,
>
> mogger
Posted by SLS on July 26, 2012, at 14:16:07
In reply to Re: any experience dose greater than 45mg of Remeron? » mogger, posted by novelagent on July 26, 2012, at 13:22:11
> I'm surprised you're higher than 30mg-- there's a certain dose where these meds don't do much more, it's a case of diminishing returns. You can try augmenting it with an antipsychotic, or maybe try switching to emsam if you need relief of depression (especially atypical depression) but I really don't see the benefit of going more than 45mg-- in my opinion, you're on too high of a dose as it is.
Some people don't respond to Remeron until they reach dosages of 60 mg/day and higher. I don't think Remeron is given an adequate trial unless one reaches at least 45 mg/day. The NIH used 60 mg/day as their maximum dosage during their STAR*D study. Remeron is probably underutilized by doctors because it is always underdosed, yielding disappointing results.
http://www.ncbi.nlm.nih.gov/pubmed/16816220
This is the titration protocol they used:
"Recommended mirtazapine doses were 15 mg/day for the first 7 days, 30 mg/day by day 8, 45 mg/day by day 28, and, if necessary, 60 mg/day by day 42."
http://ajp.psychiatryonline.org/article.aspx?Volume=163&page=1161&journalID=13
- Scott
Posted by mogger on July 26, 2012, at 16:54:15
In reply to Re: any experience dose greater than 45mg of Remeron? » mogger, posted by novelagent on July 26, 2012, at 13:22:11
Quite the contrary for me. 30mg did nothing for me but 45mg started to give me a pronounced response thus my curiosity to go higher.
mogger
Posted by mogger on July 26, 2012, at 16:55:45
In reply to Re: any experience dose greater than 45mg of Remeron?, posted by SLS on July 26, 2012, at 14:16:07
Very interesting Scott many thanks for the article. I am going to forward this on to my psychiatrist as it makes sense to me.
mogger
Posted by novelagent on July 26, 2012, at 20:22:00
In reply to Re: any experience dose greater than 45mg of Remeron?, posted by SLS on July 26, 2012, at 14:16:07
Thank you for this information.
> > I'm surprised you're higher than 30mg-- there's a certain dose where these meds don't do much more, it's a case of diminishing returns. You can try augmenting it with an antipsychotic, or maybe try switching to emsam if you need relief of depression (especially atypical depression) but I really don't see the benefit of going more than 45mg-- in my opinion, you're on too high of a dose as it is.
>
> Some people don't respond to Remeron until they reach dosages of 60 mg/day and higher. I don't think Remeron is given an adequate trial unless one reaches at least 45 mg/day. The NIH used 60 mg/day as their maximum dosage during their STAR*D study. Remeron is probably underutilized by doctors because it is always underdosed, yielding disappointing results.
>
> http://www.ncbi.nlm.nih.gov/pubmed/16816220
>
> This is the titration protocol they used:
>
> "Recommended mirtazapine doses were 15 mg/day for the first 7 days, 30 mg/day by day 8, 45 mg/day by day 28, and, if necessary, 60 mg/day by day 42."
>
> http://ajp.psychiatryonline.org/article.aspx?Volume=163&page=1161&journalID=13
>
>
> - Scott
Posted by papillon2 on July 27, 2012, at 22:13:25
In reply to Re: any experience dose greater than 45mg of Remeron? » SLS, posted by novelagent on July 26, 2012, at 20:22:00
For me Remeron only started kicking in at 45mg. 60mg produced an even better anti-depressant response. I did find the insatiable hunger and uncontrollable weight gain worse at higher doses (note I was eating less than I otherwise would and exercising like a maniac). It's good that these side effects haven't been too bad for you! I'd talk to your doctor about bumping it up to 60mg.
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