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General Medication Discussion This section is to be used for general medication discussion and other medications not broken out in their own respective forums.

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  #1  
Old 09-07-12, 07:27 PM
samtastic samtastic is offline
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Experience w/ Vyvanse & Mirtazapine (Remeron/Avanza/Zispin/etc)

Just in case anyone encounters a similar situation:

I posted a while back about how my pdoc wanted me to take Remeron (mirtazapine) with Vyvanse, as he was concerned about my weight loss on Vyvanse. He also cited sleep as a reason to take it, though I didn't indicate (or have) any sleep issuess with Vyvase-it wears off (12 hours my foot...) long before I go to bed. My experience:

Weight (Last 2-3 Months)
Before Taking Vyvanse: 119lbs

(enter Vyvase, 40mg titrated up to 60mg)
After One Month of Vyvanse: 114lbs

(enter 15mg mirtazapine in the PM, Vyanse@70mg in the AM)
One Month Later: 125lbs


I'm 5'1" on a good day, narrow shoulders/narrow hips...what most call "small boned". Basically, I fit comfortably into most overhead storage compartments. I have always weighed between 106 and 110 pounds-so 119 was actually above what I was used to. At 114lbs I felt fine and was eating (healthy, for a change)--just eating less. But at 2nd appointment, doctor is concerned, enter Mirtazapine 15mg. I fill it and take it with much apprehension (Link: see my previous post as to why I was concerned), and my experience with the effects have been consistent through the 4 weeks since I began taking it.

Nausea is a common side effect, but I didn't experience that, or ANY other side effects, for that matter. But that could be because I was so out of it I couldn't tell if I was nauseous or not. Waited until a Friday to start--I was concerned about how it would affect waking up for work, and thank god. Benadryl, Unisom, other OTC sleep aids don't touch mirtazapine; I've taken Ambien & Lunesta for sleep in the past, and mirtazapine rivals (even surpasses) them both in the "knocks you the **** out" department. I was down for the count within 20 minutes, and slept like the dead for almost 10 hours. When I finally did wake up, I was sluggish, 'blah' feeling, and not totally awake for at least 3-4 hours, despite taking Vyvanse immediately upon awakening. Mirtazapine is POWERFUL stuff.
Splitting the dose (7.5mg @ night) yeilds similar results, with 8-9 hours of rock-like sleep followed by 2-3 hours 'waking up' slugishness. Even after the inital few hours in the morning and with 70mg Vyvanse I'm still rather zoned, totally unmotivated, and very lethargic throughout the day.

At some point within the first two days, my sleep--excuse me, my COMA--began to be interrupted after a few hours, but only for one thing: to eat.

I began eating in the middle of the night. (Which, by the way, was totally unnecessicary because I was eating enough during the day for three people. Three large people. Who are training for a marathon. And bodybuilding. And are quite possibly pregnant.)
It didn't matter that I got full, I was still starving...or it felt like it anyway. And the worse side (not the downside, this appetite is a 'downside' in and of itself) was that I don't crave fruit, or veggies, or healthy starches/grains like rice, potatoes, etc. I wanted carbs, but I wanted the forbidden carbs.The fattening, sugary, avoid-these-carbs kind of carbs, and lots of them.

The first time I sleep-ate, I ate a peanut butter sandwich ('a' as in ONE, one sandwich) with four slices of white bread, peanut butter on each one, and SUGAR...which I dumped on top of the peanut butter, on every slice of bread before assembling my edible tower o' calories. Yep. Just plain old granulated cane sugar. In the middle of the night.
What. The ever-loving. Hell.

I can go through a box of 40 mini chocolate eclairs in two days, and saying 'two days' is being generous. I eat constantly at work, free snacks be damned. Just INSANE amounts of food. Impulsive eating to the point of being ill from it. I have never in my life eaten so much food. Essentially...used as a sleep aid? An appetite stimulant? Well...it WORKS!

So, after taking it for 2 weeks straight, 7.5mg on work nights & 15mg on Fri/Sat night, I stopped taking it during the week. (Who KNOWS how much I would've gained otherwise), and went to taking 15mg Friday night and 7.5mg Saturday night. Doc is aware of all these changes, btw.

I am dismayed. I physically feel awful, and on my small frame, a 3lb weight gain is noticeable, and at least a pants size or two...so emotionally, my self-image and esteem ain't feeling so hot either. My wallet and bank account are also upset, as they have had to shell out for some new jeans. The intense help that Vyvanse gave me was almost cancled out by the zombie state I would be in on the post-Remeron days. What a CRAZY medication.

Saw my doctor today. Staying at 70mg Vyvanse, and he prescribed 7.5mg mirtazapine and told me to break them in half--3.75mg, 1x day, at night. And if it's still too much food/sleep, take that dose, but only on the weekends again. My body is used to the Vyvanse, and the appetite suppression is gone entirely, but my doctor doesn't want me to be under weight. He's willing to eliminate the mirtazapine entirely. I don't mind the help sleeping, or the appetite. But they're both so pronounced that it's life-altering when taken on a daily basis.

Sorry that was long. But just in case anyone was looking into taking that alongside an ADD med, it's INTENSE.
**QUICK DISCLAIMER: I am not dually-diagnosed (I talked about this in my previous post) and this wasn't prescribed for ANY mental benefit at all. I am not a doctor and definitely acknowledge that it's different strokes for different folks, and that a comparable or higher dose could be necessicary and/or beneficial for someone who was treating any condition other than appetite suppression with it.

But for those who just need a food boost and a little help sleeping, proceed with caution. Stock up on enriched flour-based products, salty goodies, and sugar by the pound. Then make sure you have nothing planned for the next morning, or for at least 3 hours after waking up.

Maybe my body just had an intense reaction to this stuff, but JEEZ. I am not a fan.

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Old 12-24-12, 02:43 PM
ben5628 ben5628 is offline
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Red face Re: Experience w/ Vyvanse & Mirtazapine (Remeron/Avanza/Zispin/etc)

Thank you SO much for this. I was just just represcribed Vyvanse, and I'm heading to fill my first Remeron (15mg) very soon. Before I read this I thought it was a very small dose or something. Hard to imagine myself following my pdocs advice to split it into half or even quarter doses to see how it affected me. Hah, now it sounds like some kind of elephant tranquilizer - but I think it will do good for my anxiety, especially the Vyvanse part. Ideally, I would be one part crack-fiend Twitch McDexamphetamine and one part The Dude.

Of course, now I'll be sure to keep an eye out for any of that nasty lethargy and the crazy appetite. Don't go well with my type of depression, and I'm glad I have a bit more info before I dose this stuff. I lost a tonne of weight on Vyvanse (through hard-work, mostly. Or so I like to think.) though I've gained at least 10 pounds already making the mistake of dropping Vyvanse and trying damn Concerta for less than a month.

And hey, I had to write something today. Maybe Vyvanse makes typing replies all the more exciting. Either way...

Cheers,

Ben
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Old 12-24-12, 04:17 PM
ben5628 ben5628 is offline
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Red face Re: Experience w/ Vyvanse & Mirtazapine (Remeron/Avanza/Zispin/etc)

Thank you SO much for this. I was just represcribed Vyvanse, and I'm actually heading to fill my first mirtazapine rx Remeron (15mg) very soon. Hooray...? I'll know if it's cause for celebration by tomorrow, friends.

But onto this convenient thread. Thank you, OP. Before I read this I thought 15mg was a very small dose or something. Hard to imagine myself following my pdocs advice to split it into half or even quarter doses to see how it affected me. Honestly though and as ridiculous as this now is to me, at the lowest dose I thought titrating down would be the least of my concerns. Hah, now it sounds like some kind of elephant tranquilizer - but I think it will do good for my anxiety, especially the Vyvanse part. Ideally, I would be one part crack-fiend Twitch McDexamphetamine and one part The Dude.

Of course, now I'll be sure to keep an eye out for any of that nasty lethargy and the crazy appetite. Don't go well with my type of depression, and I'm glad I have a bit more info before I dose this stuff. I lost a tonne of weight on Vyvanse (through hard-work, mostly. Or so I like to think.) but I made the mistake of dropping Vyvanse and trying damn Concerta. And boom! In less than a month I've gained 6 1/2 kg, apparently. Damn you, extended-release methyphenidate. Why can't you starve me as well as Vyvanse does?

And hey, I had to write something today. Maybe catching up on my Vyvanse has made typing replies all the more exciting. Yes, another reason to curse Concerta, folks... Or perhaps just my lousy psychiatrist. I believe her specialty in adolescent ADHD psychiatry is probably not the best combo with a terrible prejudice towards teenagers. I actually found this written in my file in her office: "No matter what he says, don't let him even think for a moment that any medication other than Vyvanse or Concerta would be best for him. Those teenagers are all the same, and they'll go out their way to abuse anything. Better to assume all of them are liars and addicts just looking for their next fix." However, it is also very likely that I'm a smartass. Maybe I'll go write about it. Either way...

Cheers,

Ben


PS: I turn 18 in four days. Woohoo!

Last edited by ben5628; 12-24-12 at 04:17 PM.. Reason: a typo, god damn it. Why else?
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Old 06-28-18, 08:56 AM
samilia samilia is offline
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Re: Experience w/ Vyvanse & Mirtazapine (Remeron/Avanza/Zispin/etc)

how did everyone go on the mirtz? did they gain weight??
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Old 06-28-18, 09:26 AM
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Re: Experience w/ Vyvanse & Mirtazapine (Remeron/Avanza/Zispin/etc)

Quote:
Originally Posted by samilia View Post
how did everyone go on the mirtz? did they gain weight??
The last response to this thread was from 6 years ago. I do not think you will get a response and I encourage you to make
new thread for your questions.
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