So, I found a really cool website for people like me (in this particular “like me” I’m referring not to vegans, pagans, trade unionists, or queers, but rather to those who are medicated. Yep, welcome to the wild and crazy world of neuropsychopharmacology! That said, of course, one of the great “levellers” of mental health issues is that they really and truly can and do affect everyone and anyone, so actually, “like me” is like any, all and every aspect of me.

Right, where was I… oh yeah, crazymeds – a website packed with wry, witty, dry and canny tips hints and quotes about living life with (prescribed) chemical assistance. The site is written with just the right amount of humour and realism. It has an exhaustive list of all drugs that are used to treat all kinds of mental health issues, together with the things the doctors don’t tell you – straight from the mouths of those who know, i.e. our fellow crazies. Nobody is in a better position to tell you the truth about side-effects, complications and interactions than someone who is actually experiencing them…

The crazymeds forum “for the mentally interesting” – more on that later but what a great name! I’m not mentally ill, I’m mentally interesting 🙂 I haven’t done much there yet, what’s the expression? a “lurker’? But reading what other people have to say is really supportive. Peer support in situations like this is so powerful and affirming.

Some of you will know I was on Citalopram, an SSRI, since last autumn, which was helping manage my condition (depression, aka clinical depression, aka major depressive disorder) well, but I wasn’t sleeping well with it, and the situation had got to the point where I was awake until well past 4am during the week, which obviously impacted on the rest of my life. So my GP suggested I move to Mirtazipine aka Remeron, which is a Tetracyclic. This was because Mirtazapine has a drowsy effect, so I take it in the evening and it helps me sleep. Mirtazapine not only selectively inhibits the re-uptake of serotonin, but it also leads the brain to create more. It also does the same for norepinephrine. And dopamine. So they don’t get re-absorbed so quickly, there is more of them, and also they speed at which they travel to the receptors is increased. “it’s like stepping on the accelerator and cutting the brakes” 🙂

I had to go “cold turkey” for 5 days clear between the two drugs as they work on different neurotransmitter receptor sites. Normally, you come off an antidepressant gradually over a period of weeks or months. This is because your brain gets used to the new chemistry and you have to wean off it. Also, because these drugs work inside your brain and work on mood, just like with booze n fags, your brain likes the extra stuff that’s whizzing around in there and doesn’t let go of them easily… However, I didn’t have the time to do this as the sleeping issue was affecting everything else. Now, I remembered coming of Citalopram last time, and it wasn’t pleasant. But at least I knew what to expect… dizziness, nausea, disorientation, “whooshing” in my limbs and head, spasms, “the shakes”, losing track of what I was saying or doing…….

I was effectively going through drug withdrawal. But, as antidepressants take some time to get to an effective dose, there wasn’t enough of the new drug in my system to dampen down the fires of my emotional trauma and so on, so I was crying all the time and, yeah, basically it was all rather bleagh.

Anyway, my doctor signed me off work for a couple of weeks to give me a chance to get accustomed to things, which was very helpful. Somewhat amusingly, an unexpected side affect was manic episodes, which was a nice new thing. I harnessed this energy to good effect, sorting out and getting rid of two sacks of old clothes, 4 sacks of old bills and shredded documents, and 2 boxes of old newspapers and magazines. I finally built the shelves I had bought two years ago, rearranged my storage, moved the armchair out of the kitchen and into the spare room, put up pictures that had been on the floor since I moved in in 2009 and generally making my flat a nicer place. The mania did come with a downside, of course – what goes up must come down – and a couple of days of up were followed by a couple of days asleep, a little cycle, but I felt so much better.

A month on the 15mg starter dose, and now I’m 2 weeks into the 30mg “normal” dose (my GP remarked upon issuing my prescription for the 30mg that it was clearly the “normal” dose as it was cheaper than the 15mg!)… My moods are so much better. I still cry a lot, but it’s a different kind of crying. Not so much despair and pain, more crying with understanding and empathy. I don’t want to be numb, I still need to be able to feel, and I am an emotional person  anyway… but this way, the emotions don’t hurt so much.

One of the other common side effects is weight gain. I know, ironic, right? Antidepressants make you fat. They’re antihistamines. Plus they stimulate the bits of the brain that are all about cravings… argh. And boy have I noticed it! Last year I lost a stone and a half from being ill, stressed, anxious and depressed… I’ve gained that back and more, sigh. Next task is to figure out how to deal with cravings for carbohydrates – sugar, bread, biscuits, doughnuts… I can’t stop eating.

Thanks to Crazy Meds though, I feel reassured that it’s not just me. Like I said before, knowing that what you’re going through is the same or similar as someone else makes you feel so much better.

Here’s what they say about it:

13.  Comments

At any dosage it will make you crave doughnuts. Seriously. You will want to invest in Krispy Kreme stock (or maybe something along similar lines that isn’t tanking); as Remeron’s antagonism of the serotonin 5HT2C and H1 receptors gives you the munchies for carbohydrates and sugars like you were 16 and smoking the best pot ever in the parking lot of a strip mall with a 24-hour doughnut shop beckoning you with glazed and jelly-filled ecstasy. People dipping spoons into a bag of sugar and eating it as is – not unheard of when on Remeron. This stuff is nothing more than legal marijuana, and if I knew crap about biochemistry I could probably prove that crazy statement. From a purely molecular-chemical perspective THC and mirtazapine are nothing alike. But there’s just something about how the two drugs work that is really close. And people who have self-medicated with pot respond really well to meds that really push the norepinephrine, and hard. Strattera, reboxetine, Cymbalta, and the more potent TCAs. And Remeron.

The production of extra serotonin and norepinephrine, and not just soaking neurons in what neurotransmitters are available for a longer period of time, is sometimes the best solution to recalcitrant depression. When it works it makes people feel really good. I mean really good. Remeron is the closest thing to a happy pill on the market. Until you get all bummed out about how much weight you’ve put on and how little you do because you’re sleeping all the time.
As Remeron encourages your brain to actually produce more of the neurotransmitters serotonin and norepinephrine, talk to your doctor about taking their respective precursors, 5-HTP (or l-tryptophan) and l-tyrosine. Neurotransmitter/monoamine depletion is a controversial hypothesis, but it explains too many things, like antidepressant poop-out (tachyphylaxis) to dismiss outright.

Remeron is not for mild to moderate depression, it’s for people who are seriously depressed, who are willing to put up with the weight gain and the sleeping because those side effects suck much less than the dark pit of depressive despair one finds oneself in.

Hey ho. Sho ’nuff. Tru dat. etc. Meh. I’m in a place that is so much better than I was. I can deal with some weight gain – like it says above, dealing with that is a piece of piss compared to the what I was going through…

Right. This is my first real blog, I think. Gosh. I seem to have written quite a lot. I wonder who will read it.

Bed-time now, anyway. xx

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