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euphoricontin17
09-11-2010, 12:10 AM
As some of you know, I've been in a deep, dark hole as of late and recently was prescribed 30mg of Mirtazapine to help me keep a more positive outlook on life and deal with "involutionary depression". Involution meaning as your not "evolving" your "involving" a.k.a. dying. Who the fuck wouldn't be depressed about "involving"? Oh well I figured might as well give it a shot.

A little background from what I've gathered- Mirtazapine is NOT a typical anti-depressant meaning it is not a selective serotonin reuptake inhibiter (SSRI) or selective norepinephrin reuptake inhibiter (SNRI). It is in a class of anti-depressants called "Tetracyclic anti-depressants" meaning it has four rings in it's structure. There are a few other tetracyclics out there. These are similar to "Tricyclic anti-depressants" except that tricyclics have 3 rings. Tricyclics are more common, though both are far, far less prescribed than the typical SSRI's like zoloft. Tricyclics like Amytriptiline (Elavil) were the first anti-depressants to come out (1950's) and are usually not prescribed until it has been established that more common anti-depressant's don't work. This is because Tri and Tetra-cyclics tend to have far more severe side effects such as drowsiness and weightgain to name a couple. These types are usually used for "treatment-resistant" depression because they have been shown to be more effective than SSRI's etc. and that by the time your in need of being prescribed them, in most cases the side effects are worth the benefit, which is why most dr.'s wait to try more common ones first.

Tetra and Tri-cyclic anti-depressants differ from SSRI's and SNRI's in that instead of simply inhibiting the reuptake of serotonin and norepinephrin, they actually cause your brain to produce more of these neurotransmitters. So it can be helpful for some people (I.E. drug users who have depleted amounts of these chemicals) because SSRI's may not work well if you don't have enough serotonin being produced in the first place to be inhibited, know what I mean? So these may be especially effective if you have depleted levels because they help you to produce more. That's my therory at least...
Anyway, I have treatment-resistant depression, usually just self-medicated with opi's but

the way things have been going, I want to give this a shot....

I've been on this for about 5 days now and can say the sleep and hunger side effects are hitting me HARD. Fortunately it's great for me because I NEED to gain weight and I have trouble sleeping. This has been the ONLY anti-depressant that has ever done anything for me. I did all the research about them which I explained above and I think the reason why it's helping me so much more than others is because I may have depleted neurotransmitters from drug use etc.

Anyway (con't), I'm actually feeling pretty decent lately, and each day gets better, I'm not feeling great, but pretty damn good for where I'm at...

On a side note it says these types of anti-depressants can also cause Mania in a percentage of paitents. God, I hope i'm part of that percentage. I would sure as love to be manic right about now. I mean that too. I was reading up about another tricyclic called "Imipramine". It causes mania in almost %25 percent of paitents, if the remeron doesn't work out I'm going to try to get prescribed that haha! I wonder why it's not scheduled? I was reading reviews from some people taking it and some stated it made them extremely euphoric and giddy, but it's hardly ever prescribed because of that. Some people said they felt the same effects from (albeit a much smaller percentage) mirtazapine, amytriptiline, other tri-tetra cyclics too. Anyone have any experience with these or any Atypical anti-depressants? I never knew about these or any others besides ssri's and it's really piqued my interest as I'm feeling alot better and didn't think I could be helped but my mind has been changed...

EDIT: saw danny made a thread on mirt awhile ago, sorry for not bumping, just saw it now.

wisegal
09-11-2010, 12:23 AM
SO strange that you posted this tonight because I was at my sisters a few hours ago and when we were in her room i saw a bottle of it on her dresser. The prescription bottle had the doctors name on it, and it is the psychiatrist that we both go to.

I knew that she got an adderall and valium script every month but she never told me about these..
But yeah she has tried numerous SSRI's and anti-depressants in the past with little (or one time HORRIBLE) results, so she said he prescribed them for her seemingly untreatable depression and that shes been on them for three months now and feels more motivated, happy, and has higher self esteem and more confidence...she tends to get VERY down on herself and fall into periods of severe depression... But feels great on these things...so hopefully you could get a similar effect!

Also: She is OBSESSED with her weight, takes adderall basically to curb hunger, works out a lot, portions meals and eats like a bird....SO im sure that if they boosted her appetite she would have said something....so maybe thats just a different effect you're getting from the med. and I'm glad for you because like you said putting on weight is a GOOD thing for you :)

And there certainly is a lot of happiness, fullfillment, and pleasure in good food and wine. ALOT. So I hope you take advantage of it and eat all kinds of delicious foods! I am a fantastic chef (not professionally or anything) but my grandmothers from Naples, Italy and she taught me...so I specialize in Italian food. I SO WISH that I could make you a big antipasto salad, YOUR favorite italian dish, and canolis and cheesecake to bring you!!!

......Hope you're doing well sweety. Have a good night.
Love,
wisegal

betmylife
09-11-2010, 12:42 AM
my shrink gives me 150,mgs of welbutrin twice a day, and 50mgs of remeron at bedtime.....the remeron seems to work better than the welbutrin in my opinion.

sweetpain
09-11-2010, 01:06 AM
Hey EC. Hope this works for you. I've been on Elavil (Amitriptyline) for oh around 4 or 5 years now. Tried Welbutrin-didn't work, Paxil-worked, then after awhile stopped working (OMG, when I went off Paxil, I thought I was gonna die-that's a whole new story), and Prozac 20mg in the morning and around 6pm I take my Elavil (you're supposed to take it 12 hrs b4 you wake up-bcz of the fuzzy head feeling you get the next mornng if you take them too late). So, if it were to take them at 10pm and wake up at 6 or 7am, I feel disoriented, head feels fuzzy and tired all day. But, it's so wierd, if I take it (50mg) 12 hrs or sooner, I don't get any of that. I wake refreshed.

I can't take the Elavil too early tho cuz they do make me dizzy and I usually fall asleep few hrs after taking them. Alot of people gain weight on them but not me. My sis gained 50 lbs so went off them. Me, havent' gained an ounce, ha. Also, Elavil is being used (off label) for pain. I gotta say it does help me w/pain. When I stopped taking them (went few months w/o insurance btw jobs) I had increased pain but soon's I got on them again, the pain was reduced again (not gone, but reduced).

Not familiar with what you are taking and haven't heard of anyone I know taking them. Are they fairly new?

tui
09-11-2010, 01:14 AM
awesome to hear you're feeling better darling ec :)

interesting info about anti-depressants, thanks...

was just watching a news story about how over-prescribed they are. Particularly in kids. I can't believe how common it is to prescribe to under 9s, and even under 4s now.

I take paxil, with no side-effects, except for terrible dizziness and nausea if I miss a couple of days.

all the best <3

danny
09-11-2010, 04:40 AM
im really fuckin glad its helpin you out e/c, unfortunately i didnt get on with it at all
i must admit im a bit pissed off really, cause its supposed to be the best thing to give junkies that suffer from depression and the least likely to give side effects
not only that as was mentioned earlier it does give you an appetite, i didnt need that but if you do it might also help in that respect too

dieselbaby
09-11-2010, 06:54 AM
Glad to hear you're in a better headspace, still disappointed that I never heard back from you after our conversation the other night. Still hoping for an update, but also not really going to waste too much time waiting for one. You know what you have to do. Take care and stay safe.

Your friend,
dieselbaby

goagirl23
09-11-2010, 07:31 AM
EC,

I too am very happy to hear that you are in a much better head space, not to mention gaining weight! Thanks for that info, I've always been kinda skeptical and a bit afraid of anti depressants, but I must say I've seen them work wonders and completely pull people out of severe depression.....I hope things keep looking up for you, you are still very much in my thoughts........

blackman
09-11-2010, 10:42 AM
I'm glad you're feeling somewhat better, man.

I hope the mirtazapine works out for you. Take care.

limitless_euphoria
09-11-2010, 10:57 AM
Hey Euphoric,

Yeah I had a junky friend who went to a cash-and-carry doc and he got #90 1 mg k-pins a month and remeron for sleep. He said he really liked it for that. I guess the doc wouldn't give 'em BOTH benzos and Ambien or what have you...

I mean, dude, your depression is most definitely situational! Yeah, realizing your own mortality is something... something I cannot even fathom. I think you should be able to get whatever the fuck you want at this stage. If you wanna do speed balls, do fucking speed balls, if you gotta shoot some uppers to get around, do it. It's your final days: YOU get to decide exactly WTF you want—you've earned that right!!!

-LE

the good doctor
09-11-2010, 11:32 AM
Mirtazepine is an antagonist of serotonin and norepinephrine, except for partial agonism at the 5HT1a receptor. It is, unlike any other anti-depressant, effective, and supported in its efficacy by both the published and unpublished literature. It is one of only three anti-depressants (excluding opioids and amphetamines) that consistently perform better than placebo in all trials conducted, along with venlafaxine and selegiline, although mirtazepine is more effective and with a lesser incidence of side-effects.

If you need an anti-depressant, mirtazepine is by far the most effective drug currently marketed on-label for the treatment of depression available, and with some of the fewest adverse effects. Some MAOI drugs, specifically the ampetamine-like hydrazine drug phenelzine, or tranylcypromine, have a similar efficacy to mirtazepine, but have severe side-effects and dietary and medical restrictions imposed due to life-threatening interactions.

If mirtazepine loses its efficacy - it's known to "poop out" in a decent number of patients within four to six weeks - you may want to ask your doctor about transdermal selegiline, brand EMSAM patch, an older MAOI with very few risks and restrictions compared to the "classical" MAOIs, as in lower doses, it is selective for subtype B of monamine oxidase. This drug is highly effective in treatment-resistant depression as well, and along with mirtazepine and venlafaxine, are the only three drugs that I believe can be recommended (although many doctors and pharmaceutical companies would vehemently disagree with me) based on the entirety of the evidence, submitted to the FDA for approval, both published and unpublished (withheld literature; this withheld literature makes other anti-depressants appear more effective than placebo when they are not, by only publishing favorable literature: see the recent Cochrane Collaboration meta-review) supporting their use for the indication of depression.

hydro chris
09-11-2010, 01:03 PM
Hey Euphoric,

Yeah I had a junky friend who went to a cash-and-carry doc and he got #90 1 mg k-pins a month and remeron for sleep. He said he really liked it for that. I guess the doc wouldn't give 'em BOTH benzos and Ambien or what have you...

I mean, dude, your depression is most definitely situational! Yeah, realizing your own mortality is something... something I cannot even fathom. I think you should be able to get whatever the fuck you want at this stage. If you wanna do speed balls, do fucking speed balls, if you gotta shoot some uppers to get around, do it. It's your final days: YOU get to decide exactly WTF you want—you've earned that right!!!

-LE
true, i look at it both ways, you can abuse you body by doing speed balls all day..
or eat and live health as possible maybe possibly to extend well- being. but, would i even wanna too?
i dont even know what id do, cant even use my imaginary.
EC. glad your feellin better..hope you find peace with -in yourself. im sure you will.
also, i think youll be just fine.

limitless_euphoria
09-11-2010, 01:19 PM
true, i look at it both ways, you can abuse you body by doing speed balls all day..
or eat and live health as possible maybe possibly to extend well- being. but, would i even wanna too?
i dont even know what id do, cant even use my imaginary.
EC. glad your feellin better..hope you find peace with -in yourself. im sure you will.
also, i think youll be just fine.

Yeah, I mean, I say he's earned the right to do whatever he chooses.
'
He should feel no shame in getting high if he wants to if it helps.

Tony
09-11-2010, 10:33 PM
EC,So very glad to hear you found a good one. You sure deserve a break! I used to take Elavil a long time ago. It seemed a little like speed to me....Peace

euphoricontin17
09-12-2010, 01:53 AM
Thanks for all the support guys! Also, thank you so much, TGD, for you excellent info as always. I am very curious about MAOIs and how they differ from other anti-depressants...Does anyone care to share? All I really know about them is that they tend to be quite effective but you have HUGE dietary restrictions and actually read somewhere once about this guy who had to be hospitalized from eating soy sauce while taking one. I've heard they sometimes have a speed-like effect. The main reason why I am so enthused about this is, I never really put too much faith in any of the SSRI's because everyone and everywhere I looked told me the same thing basically "It won't make you happy, it will just keep you from getting depressed" well... fuck that. I'm the type of person where if I'm going to get on another med, I at least want it to benefit me. Might sound stupid but I was kind of holding out for an anti-depressant med that while it may not make me euphoric, I at least want it to keep me in a decent mood you know? Not the "emotionally numb" feeling that is known with SSRI's. It seems this mirtazapine is actually doing what I hoped.

I'm curious as to whether MAOIs are similar in that aspect? Finally, I feel like I've found a REAL anti-depressant. Before when I was on zoloft awhile ago, I spent most of my time in a state of mind that was "meh" I wasn't wanting to die, but wasn't too happy to be alive either. Not trying to promote this too much but I feel like anti-depressants should at least make you feel a "little" happy. Not high, no, but at least like life is worth living, NOT just "tolerable" like I've seen with the others...

sorry if all that doesn't make sense, i'm a bit worn out. I've been going out more...shooting up less...trying to at least die with some dignity. I had a conversation with a member of this board that really inspired me recently. This person really changed my point of view on things and really got me thinking about what I wanted the rest of my life to be like. I realized that while I love getting high, I've been doing that non stop for a while now and I want to just relax and do my best to die without track marks at least. Be happy without being so wasted... I don't know if it will work but i'm going to try and put down the needle and take my meds by mouth and see if I can be happy without being high. it's a start...

the good doctor
09-12-2010, 02:15 AM
Selegiline, in the form of Emsam patches, requires no dietary restrictions and is significantly less dangerous than other MAOIs, due to its B selectivity, while maintaining all of the good effects.

As far as the "speed" effect goes: manic-depressives, without mood-stabilising drugs, on SSRIS: less than 5% become manic. SNRIS: less than 7.5% become manic. On TCAs: ~20% become manic. On MAOIs: ~50% become manic. It definitely has a speed effect.

MAOIs are different as they effect not just one neurotransmitter, but the entire range, and don't just effect one aspect of the pharmacological profile, such as potency, efficiency, or efficacy; they don't change the actions of neurotransmitters, or necessarily alter the balance, they just increase concentrations of them all, including trace ones, such as octopamine, along with DOP, 5HT, and NOR. MAOIs that aren't subtype selective, or are selective for the A subtype inhibit breakdown of tyrosine, which is what causes the hypertensive crises and need for dietary restrictions. MAO-BIs don't, not to a dangerous degree. However, MAO-B selective MAOIs in extreme doses lose their selectivity; in the case of selegiline, this begins around 15mg/q24h and is complete around 30mg/q24h, and it becomes a nonselective MAOI; however, lower doses, such as the 12mg/q24h patch, are much safer.

Some of the effects of tobacco smoking that nicotine replacement therapy does not adequately address are mediated through inhibition of MAO-B to a small degree, though this is rather more of a fact of trivia instead of a matter with bearing on the situation.

If the mirtazepine continues to work well, continue to take it. Don't try to trade good enough for better and end up with worse; it's not a guarantee, nor even that likely, that if you were to quit taking the mirtazepine and switch to another anti-depressant, and not like it, that the mirtazepine would be nearly as effective, if at all, if you switched back to it.

euphoricontin17
09-12-2010, 11:26 AM
Wow thanks alot for that info TGD. If mirtazepine, stops working in 4-6 weeks which I'm afraid it might (heard it's pretty common), I will ask about segiline. Sounds like really interesting stuff.

WalkingLucid
09-13-2010, 02:46 PM
I was prescibed Mirtazapine about 7 months ago. I took it as prescribed for the next 3 months, however, I noticed NO positive effects from the drug as far as an elevation of mood is concerned. I honestly this all forms of anti-depressants are bullshit.

They treat the symptom, not the cause.



(You wouldn't be popping benedryl and downing peptobismol to get rid of the w/d's if you had an extra shot left... would you?)

ka11ink
09-13-2010, 03:09 PM
I've been on amytrip and mirtazapine and noticed no effects or side effects at all. Was like I was taking a sugar pill, hope it works for you though.

michellebaines
09-13-2010, 05:07 PM
And there certainly is a lot of happiness, fullfillment, and pleasure in good food and wine. ALOT. So I hope you take advantage of it and eat all kinds of delicious foods! I am a fantastic chef (not professionally or anything) but my grandmothers from Naples, Italy and she taught me...so I specialize in Italian food. I SO WISH that I could make you a big antipasto salad, YOUR favorite italian dish, and canolis and cheesecake to bring you!!!

......Hope you're doing well sweety. Have a good night.
Love,
wisegal

I shall join wisegal in her banquet preparations and bring along my alfredo & marinara lasagna with italian sausage, a big basket of garlic bread and my favorite in the whole world macaroni & cheese from my favorite restaurant (its made with penne pasta, cream, sharp pinconning and cheddar cheeses with a buttered bread crumb crust on top).

While I don't have experience with mirtazapine, I do have experience with topomax (sp?), I took it about 7 years ago and had no problems with it, then I took it again about 4 years ago and went totally manic off my rocker. And its an anti-psychotic given to me to prevent mania.

I'm glad to hear that you're feeling better. Please keep us updated on how your doing.

Many hugs and much love from the Mitten.

the good doctor
09-14-2010, 09:23 AM
I shall join wisegal in her banquet preparations and bring along my alfredo & marinara lasagna with italian sausage, a big basket of garlic bread and my favorite in the whole world macaroni & cheese from my favorite restaurant (its made with penne pasta, cream, sharp pinconning and cheddar cheeses with a buttered bread crumb crust on top).

While I don't have experience with mirtazapine, I do have experience with topomax (sp?), I took it about 7 years ago and had no problems with it, then I took it again about 4 years ago and went totally manic off my rocker. And its an anti-psychotic given to me to prevent mania.

I'm glad to hear that you're feeling better. Please keep us updated on how your doing.

Many hugs and much love from the Mitten.

Topamax is nothing like any anti-depressant, or any other psychoactive for that matter. It is a weird kind of sulfonated sugar, with many theories but no evidence for a mechanism of action or a set of receptor binding profiles. I find it hard to believe it made you manic; it is a strong epileptic, as well as a mild sedative, but in lieu of any evidence as to why it does what it does, anecdotal evidence is stronger than it would be otherwise.

However, beware: you might as well be comparing valproic acid, haloperidol or quetiapine to mirtazepine, as to compare topiramate to it. They are completely different drugs, for completely different indications; comparing all medicines of dissimilar structure is at best an apples-to-oranges comparison; comparing a sulfonated sugar anti-epileptic mood stabiliser with a tetracyclic norepinephrine/serotonin antagonist anti-depressant is like comparing apples to elephants.

clonaze-whammed
09-14-2010, 01:45 PM
It is one of only three anti-depressants (excluding opioids and amphetamines) that consistently perform better than placebo in all trials conducted, along with venlafaxine and selegiline, although mirtazepine is more effective and with a lesser incidence of side-effects.


Anyone have much experience with Effexor/Venlafaxine?

Ive been interested in both mirtazepine and venlafaxine for quite some time.