From October 2008: Just so that people know, this is not a popular med combination. It tends to be tried when other strategies have failed. And neither Remeron not Effexor are all that popular singly, never mind together. Still, there is something to be said for a shotgun effect that hits a lot of different receptors. Folks swear by it.
California rocket fuel a combo of Remeron and Effexor which can give a triple boost to the serotonin system, a double boost to the norephinephrine system, and a single boost to the dopamine system.
This combo has an all-or-nothing reputation in the biz, when it has any reputation at all. Many psychiatrist have never heard of it by this slangy term. The "nothing" being all side effects and little mood improvement. But it's a combination some folks have had great relief from if the Effexor wasn't doing it for them. It is also very cool to say - the sort of medicine that makes you think "Gee, I wish I was depressed so I could try that."
I want to know more about this.
Norephinephron has been reported as helpful to some autistic people. Particulars are escaping me, I read it some years ago in the Autism Research Institute newsletter.
I take 5-HTP, trying to generate some serotonin, and Effexor to make it stick around. I'm assuming that a dismal paucity of serotonin is why I'm so heat sensitive and not really comfortable until the surrounding temps are in the low fifties. Everyone else freezes in my house.
I'll have to look up Remeron and see what that is.
Ok, I looked up Remeron. Sounds nasty.
I looked it up too and it doesn't sound any worse than a lot of anti-depressants.
My son has a lot of trouble staying on his meds because most of them increase his muscle spasms (his problems are from a closed head injury) and he hates the weight gain side effects that so many have.
I don't know if he's ever been prescribed a trycyclic before.
It's interesting what you say about heat sensitivity, because Effexor is commonly prescribed for hot flashes in breast cancer patients.
I haven't tried it yet, because the thought of having to take another pill freaks me out.
Though after this post, maybe it could be my excuse to try and get some partial "California Rocket Fuel."
Remeron is actually one of the "nicest" antidepressants out there. Few side effects aside from a little weight gain, and you can go right off it with little to no withdrawal. It doesn't numb you completely like a lot of other AD's either. And if you have trouble sleeping, it's definitely the one to look into! I say all this from experience.
Remeron's main Achilles heel is that it *can* quit on you if you use it as monotherapy (though not always).
5 weeks ago I was prescribed remeron in addition to duloxetine (similar drug to venlafaxine) after battling depression and lethargy for 15 years. The results were instant, I feel better than I have in years!! I'm full of energy, my sense of humour has returned - infact I feel 18 again. In order to cambat the weight gain I have joined a gym and weight watchers.I sleep soundly at night and no longer need to sleep in the day. From my experience the California rocket fuel is worth a try. kay
After 25 years of trying various drugs (SSRIs, SNRIs, trycyclics, tetracyclics, ampetamine, mood stabilizers, anti-psychotics and stuff I don't even know how to categorize) for my bipolar disorder, 'California Rocket Fuel' seems to be working. I gained some weight, but I am working on that. It's worth it to not be miserable all the time. If you have treatment-resistant BPD or MMD, it is worth a shot.
Effexor will give a false postive for PCP
I've been on a combination of 120mg Cymbalta and 150mg Seroquel for a few months. Before that I tried Zyprexa, Citalopram, Prozac, Diazepam and Zoloft. Not as many medications as what I have read on forums but the regular switching always made me feel apprehensive. I got sick of the fact that I would try a new prescription, it would work wonderful, I was feeling great and then suddenly, after a few months, it just stopped and I went into a massive depression.
A few weeks ago I had such an episode and my psych suggested 'a CRF combination'. It basically meant adding a small dose (30mg) of Avanza (as it is called here) to the mix.
My psych often says that when changing medication 'things can become worse before they get better'. Getting used to the medication for me was tiredness, increased appetite and a little bit of dizziness. But I must say, after about 2 weeks I felt better in a way I have not felt in a couple of years. It is absolutely fantastic for me.
Don't get me wrong, this is not a sure thing combination. It works for me at least.
Couple of comments that I would like to leave here, based on my own experiences:
1. Yes, it is true that drugs can work brilliantly and then stop working suddenly. It is well documented and it is one of the things that frustrate people with any form of depression.
2. Stating the obvious, NEVER self medicate. I was on antidepressants through my psych and then went to my GP to get Zyban (to help stop smoking). My GP was unaware of the consequences and I can tell you I went through hell, even to a point of being suicidal. Turned out that there was a strong interaction between my meds at the time and Zyban. Should my psych had known he would have never allowed me to take that medication. So my strong advise is to ALWAYS work with a qualified healthcare professional (preferably a psychiatrist). If you meet a psychiatrist and you don't feel you can trust him or her, find a new one. It is an investment that's worth it.
3. I often hear people talking about the medication they are taking, but not the timing. In my experience, the time you take certain medication can have a significant effect on how you feel the next day. If I take Avanza just before bed time, I wake up like I've been out drinking until 3am and it takes a few hours to clear my head. Same counts for Seroquel. Work with your psych to find the right TIMING of taking the medication. It all has to do with when the medication works the strongest, half-life of the medication, etc.
4. I hardly see any people on these forums that take 'slow release' forms of a drug. I take Seroquel XR, which is slow release and does not knock you out an hour after taking it. Initially I had 'normal' Seroquel and it turned me into a zombie. If I take the XR late in the afternoon, the effects are the strongest during the night (when I need it).
Some ideas and suggestions. If I would have the magic combination of drugs or could point to a drug that does the trick for everyone, I would probably be twice as rich as Bill Gates. The simple and hard truth is that there is no magic combination. Side effects are different for everyone and depend on a large range of factors. Things like alcohol use, liver function, blood pressure, current stresses, certain vitamins, even stupid things like your appetite for grapefruit!
Hope this has been any help.
Happy to hear any comments, suggestions, disagreements, etc.
Vincent, the comment was valuable enough that I am reprinting the whole post, even though it is years old. Well said. Good luck.
I had the same experience and I started over a year ago. D.
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