[WillShakey]

Hey all - I've had a couple of posts on this site, but pretty minimal. The long and short of my history is that I've tried almost everything under the sun (so it feels) in regards to anxiety/depression and nothing seems to help. The one I've stayed away from is Effexor, mainly because I have read a lot of bad things as far as side effects and withdrawal.

Well, I will finally be taking the plunge with Effexor starting on Monday along with Remeron to help me sleep and hopefully give a little extra boost in the anxiety/depression department as well. I'll be tapering off of Nefazodone for a few days then start working my way up on the Effexor.

Along with the general anxiety, social anxiety, and depression; I also feel like I have some symptoms of ADHD (Predominantly Inattentive Type). Lack of focus, concentration, motivation, confidence, forgetfulness, easily distracted, unorganized, no energy and basically just feel drained/exhausted all day. Hopefully the Effexor will help with some of this too!

In a way I guess I just wanted to get this off my chest... but if you have any experience with the combo (good or bad), or any advice please let me know.

Thanks!

 

[Recipe For Disaster]

Uhh, why do you call this CRF? What does it have to do with rockets?

 

[beaches09]

For your symptoms you ought to really consider an SSRI/Bupropion combo. Effexor may work very well for you though. Everyone reacts diff to all meds, with that one in particular though, most people either love it or hate it.

I have your exact symptoms and for me as well as many others on this board, remeron is pretty well known for making those things worse. I would sleep like a baby, but brain fog, lack of motivation, focus, everything else, etc etc, were all magnified much worse.

I also tried California Rocket Fuel in many different dosage combos. It was a nogo for me. Although I didn't try it in the highest doses of both. Say 375mg effexor with 45mg remeron. That may work for you as long as the extreme antihistamine reaction doesn't kick your *** too much. For me the more remeron I took, the more tired I got. If Remeron didn't have that Histamine antagonism it would be pretty damn great. Maybe there is something else with a similar profile.

I won't say much on how Effexor was for me on it's own, because I was one that didn't really like it. One thing in particular was extreme short term memory impairment, where normally without I was pretty sharp. I was seduced into it because the first few times I took it I felt very great, then after that it was pretty much all down hill. Though I will say if you're going to give it a go, definitely work up to the higher doses because they are better, especially with your symptoms. The withdrawal is definitely a pain, but if you add 150mg Bupropion XL while tapering off it makes all the difference in the world. If you're still having a hard time, a couple stretched out doses of prozac will go a long way because of it's long half life. And also either benzos here and there, or a mood stabilizer like Trilepal to take the edge off. I've been on and off many drugs, but Effexor was the only one that left me in an extreme hypervigilent state of mind when I stopped. Had I had something to chill me out at the time, it would have gone a long way. I'm possible Bipolar though so don't take that to heart. But yeah as you've said, it's pretty well known for having a horrible withdrawal.

 

[WillShakey]

Not sure if you were serious or joking, but california rocket fuel is one of Doctor Stahl's "heroic combos" and he knows his stuff! http://books.google.com/books?id=zqvVZOea2JAC&pg=PA204&dq=california+rocket+fuel+stahl&hl=en&sa=X&ei=wuS-T_voHOTH6AGx6bmoCg&ved=0CDYQ6AEwAA#v=onepage&q&f=false

Beaches09, thanks for the response... very helpful! I have tried the SSRI/Bupropion combo but it didn't do anything for me. I have tried Remeron on it's own, I slept well but was worthless the next day. The doctor said that if you increase the dose it should actually lessen the sedation.

Hoping for the best, who knows... maybe I'll have to add some adderall what a mix of meds that would be!

 

[Porterdog]

Mirtazapine + effexor to rocket fuel is what matches are to an a bomb.
****ty combination that does absolutely nothing. I wouldn't be surprised if the name was some sick joke.

 

[istayhome]

I was pretty excited to try the combo with a name like that. I was at 225 mg of effexor. It wasn't doing anything for me, actually it was miserable, so I decided to add in the Remeron to see if that made things better before I quit effexor. It really only made all of the side effects I was experiencing worse. So I quit both. I think I have bipolar 2 though, so it makes sense that these medications would only make my condition worse. i.e. It really amplified manic-depressive episodes.

 

[Recipe For Disaster]

I was prescribed this combo way back in 2003 and it did nothing except cause to me to become suicidal after about 6 months and cause a physical dependence on effexor, thats why I question the name. No doctor who "knew his stuff" would prescribe junk like this combo in my opinion and certainly not under such a retarded and innapropriate name.

 

[Recipe For Disaster]

Ah I read the link, apparently these two drugs have a great degree of "theoretical synergy" (keyword "theoretical") hence the name. For whatever reason, it doesn't work the way it's meant to on paper.

 

[WillShakey]

We didn't really come up with this combo by either of us saying "lets give california rocket fuel a try". It was me finally being ok with trying Effexor. Then I also need help with sleep so we decided on Remeron over anything else seeing how it may have some positive effects on anxiety/depression as well.

Not sure that I would be considered bipolar 2. I actually took lithium and depakote for a little while with no help. Then my doctor said he would be very surprised if I was bipolar.

Like everything else, I'm sure it effects everyone different.

 

[swim]

I missed the opportunity to try the CRF back then...

 

[riptide991]

I basically had very similar symptoms. I had the worst concentration problems. I couldn't read a page from a book for the life of me. I tried Lexapro and that just made me fatigued and gave me brain fog. I then started Remeron and Zoloft and worked my way up to 200mg/45mg This combo is amazing. I'm reading more than ever now and get lost in books. Zoloft has a high affinity for dopamine receptors, higher than wellbutrin and buspar I believe.. Now, this typically happens only after you have over saturated the serotonin receptors since its affinity for serotonin receptors is even higher, so you typically need a big dosage. I believe at 50mg it only has an 80% saturation rate. I didn't notice benefits with focus till 100mg.

 

[ahmad]

I asked my psychiatrist about combination with remeron, he said this is for major depression .

 

[WillShakey]

took the first dose of remeron last night and feeling pretty out of it today. i know it was the first dose so i don't want to overreact too much, but do you think increasing the dose would help? or will the next day "brain fog" decrease over time?

i was even thinking about holding off on the remeron and just trying effexor for the anxiety/depression, then use something else for sleep (klonopin has worked well in the past for me).

i might call the doc today but helps to hear if any of you have gone through something similar.

 

[GregW]

I wanted to try venlafaxine plus mirtazapine for ages, as I imagine they could give a balanced serotonin-norepinephrine increase with Effexor's side effects minimized, but mirtazapine's sedation is just too much of a side effect for me. It feels like an alcohol or massive pot hangover, which lasts all day (that is just in my case) and hadn't reduced at all in 3 days. I would need something stimulating, bupropion at minimum, to take with mirtazapine. The related drug mianserin works similarly, and had a shorter sedation period (I was alert within the first 2-3 days when I took a comparable dose to mirtazapine). It also has more norepinephrine effects from memory than mirtazapine. Maybe Effexor plus mianserin (Tolvon, Lumin, various other names) could work without the mirtazepine sedation?? Anyway, they're just some ideas about the topic, not medical advice.

 

[riptide991]

I wanted to try venlafaxine plus mirtazapine for ages, as I imagine they could give a balanced serotonin-norepinephrine increase with Effexor's side effects minimized, but mirtazapine's sedation is just too much of a side effect for me. It feels like an alcohol or massive pot hangover, which lasts all day (that is just in my case) and hadn't reduced at all in 3 days. I would need something stimulating, bupropion at minimum, to take with mirtazapine. The related drug mianserin works similarly, and had a shorter sedation period (I was alert within the first 2-3 days when I took a comparable dose to mirtazapine). It also has more norepinephrine effects from memory than mirtazapine. Maybe Effexor plus mianserin (Tolvon, Lumin, various other names) could work without the mirtazepine sedation?? Anyway, they're just some ideas about the topic, not medical advice.

What time did you take the mirtazapine? I take it at night and it does help me get to sleep so this keeps me off the zopiclone. I take 45mg and initially I felt it in the morning but after about a week or 2 that went away. Initially I would be dragging myself to bed because I was so sedated but nowadays I am pretty normal all the way up until I go to sleep and then I just fall asleep quicker than usual. I take it 2 hours before bed time. Mine is the disintegrating kind that melts in your mouth.

 

[WillShakey]

i've been taking it about an hour or so before bedtime. i still feel "out of it" today but not quite as bad as the first day. i haven't called the doc yet, i'm just dealing with this for now since i know it is a common side effect and hoping it will go away soon on its own or when i up the dose.

 

[upndownboi]

I've taken california rocket fuel, 150mg venlafaxine + 30mg mirtazapine, as an antidepressant it wasn't any better than straight venlafaxine

 

[rikongs]

I have been taking Effexor XR 150mg for about 5 weeks and added Remeron 7.5mg about 2 weeks ago.

I sleep right after taking the Remeron and early mornings have been a little easier. However, after I take the dose of Effexor in the morning I get worse anxiety and for the rest of the day I am generally miserable.

I think it's too much norepinephrine from the combination. Seems it's not working at all. I have been getting worse and today I am suicidal. I'm seeing pdoc this Tuesday.

Anyone can relate to increased anxiety with the combo?

 

[Inshallah]

I can see that happening indeed. Stahl has it under antidepression combo's as well.

 

[rikongs]

Yes I saw it under Stahl's heroic combos and I suggested it to my pdoc a few week ago as Effexor 150mg was not doing the trick.

Today I saw the doctor and he told me to stop the Remeron and up the Effexor to 187.5mg. Since starting the Remeron I have been going downhill terribly. This feels like a real nightmare.

Thanks

Rick