Switching from Prozac to Remeron. Anybody have any experience with this?

Hello,

This is my first post here. First I'll try to give you a brief summary of my symptoms/history. I'll try to keep it as short as I can!
I am a 19 year old male. For about 5 or 6 years, I've been dealing with a lot of fatigue that has progressively gotten worse as I have gotten older. I have also dealt with a lot of anxiety, some depression, and (as I came to find out after I saw a psychiatrist) severe OCD type thoughts. These thoughts mainly present themselves as sort of "paranoid" thoughts when I'm around people. They involve things like thinking people around me are laughing at me, making fun of me, talking about me, etc.
I have felt like I have lived in a fog for the last 3 or 4 years. It has almost been a dream-like feeling. I have been tired, not able to concentrate, and have had a very strange "unreal" feeling around people. Especially my family for some reason. Eventually, I convinced myself that I was going crazy. I thought I was on my way to Schizophrenia. My psychiatrist convinced me that was not the case. I still worry sometimes, however, but not as much.
ANYWAY, about 8 months ago I saw a counselor (psychotherapist) for the first time in my life. I should have done that 10 years ago do to things going on in my life but I didn't until now. Soon after that, I also started seeing a psychiatrist. Initially, she put me on 10mg of Prozac to take in the morning and Klonopin to take at night to help me sleep. The Prozac was quickly upped to 20mg, which is where I am at today. I didn't see any significant improvement in any areas. My psychiatrist eventually put me on Latuda to try. For me, it was AWFUL. I couldn't get off the couch and it increased my fatigue 10x. I also felt really weird on it. I quick taking that after 3 doses. Couldn't do it anymore.
So... about 3 weeks ago, she added Nuvigil for me to take in the morning. I think it helped. It wasn't a miracle or anything, but I didn't feel as tired on it. The problem has been nausea. I can't even think about food without gagging. I've been having to force food down, when usually I'm a big eater. I've lost about 4 pounds, and I CANNOT afford to lose any weight. So we're going to try to replace the Prozac with Remeron because one of its side affects is increased appetite.

What has your experience of Remeron been like? Also, do you guys think it could make me even more tired during the day and living in even more of a brain fog than I already am? I've heard it is fairly sedating. I'm just scared of that.

Thank you for listening to this, and I'm sorry for the long message! If anyone has any advice, I would greatly appreciate it.

Well, Remeron is quite unique. It doesn't fit into the popular categories of SSRI's, or even SNRI's.
It's one of the earliest antidepressants made, along with tricyclic, and both have been almost completely replaced with SSRIs and SNRIs.
20mg of Prozac is a completely useless dose. I didn't feel a damned thing until 40-60mg.
You really should give Prozac another try before switching to a tetracyclic like Remeron.

Thank you for your response. I appreciate it. It isn't that I'm "giving up" on Prozac. It's the nausea associated with the Nuvigil that I have to get rid of. There is no way that I can keep going the way I am with this nausea. The purpose of switching isn't because I have lost hope in the Prozac.

If anyone else has had any experience with this drug I would really appreciate hearing about your experience.

Remeron switched me off like a lightbulb. No affect, no preferences, passive behavior, and bad dreams. I do remember I had little ability to feel fear while on it though, which was curious. I no longer take it.

I've been told before that Prozac is the most activating of the SSRI's, and 20mg is still a low dose. You may feel very different on a higher one and I think a lot of Psychiatrists would give a drug a full trial before adding more.

I think I went up to 30mg Prozac and I had terrible, terrible restlessness. Legs never stopped shaking.

I've also have had my history with Remeron and, I hate to break it to you, but that thing is extremely sedating. Consciousness destroying sedating. Higher doses there is a chance for the sedation to go away and even become activating, but for the lower doses it's an incredible cure for insomnia.

After taking remeron my ocd intrusive thoughts literally disappeared. It gives you a huge appetite and makes you sleepy. I take it an hour before bed. No anxiety whatsoever. I am super sleepy when I wake up but I am also on vyvanse which wakes me up quickly.

My symptoms are different than yours (I am a middle aged woman with bipolar/PTSD) but I have used both Prozac and Remeron. The Prozac did not help my depression ten years ago when I took it. The Remeron though helps me to sleep. I have had insomnia for a long time and take other meds to help me sleep also.

I hope you find what works best for you. It has taken me several years of trying different meds to find my 'cocktail' but I have been mostly stable since 2007.

Thanks to everyone who has responded. My concern is with it making me very sleepy during the day. I'm already very tired all the time as it is. I'm hoping it'll help increase my quality of sleep and that the Nuvigil will give me the boost I need during the day. That's what I'm hoping for. Anyway, I appreciate the feedback and advice. Thanks a lot.

You're saying that your sleep is of poor quality?

Activating meds won't make up for the fatigue caused by little/poor sleep.

I am soooo glad you are seeing a psychotherapist! The help you get from psychotherapy will be lasting and life changing. When our moods and energy level are affected by our perceptions, psychotherapy is what will help the most. It takes time but it works!

I also tend to be paranoid. I hate that if someone is not right in front of me being nice or non-threatening to me, then all kinds of scenarios run through my thoughts. This is about thinking and about needs, and not about brain function, in my opinion. By becoming aware of this pattern that happens with me, I can recognize it as a pattern, and not a truth, when it happens or begins to happen. My therapist and I talked about early childhood development in my last session, and an experiment done with babies and mothers: the babies and mothers were interacting face to face pleasantly and then the mother was to make her face 'go blank', registering nothing (pleasant or unpleasant). The babies reactions were of immediate distress (this was a very short experiment and babies and moms were quickly back on pleasant footing). So my therapist and I were talking about how something like this can happen early and can be lasting. I'm not saying this is why each person can be paranoid, but it is one explanation and it seems to be one that would fit my history.

About the Remeron. I was on Remeron briefly and a long time ago. I seem to remember it making me very tired, even if I took it at bedtime I had a hangover effect, and so I didn't stay on it long.

I don't know, but I wonder if the effect the psychiatrist is looking for is anti-anxiety. Maybe there is something milder of that can be taken as needed for those times?

Thank you for your response. Some days I come out of my psychotherapy session and feel like we have made progress and I feel better. A lot of times I leave wondering why I am going at all. I'll have to say, my therapist is not very engaging. I have to do a lot of the talking. I like him, but I'm not sure sometimes if it is worth the money with him. I will definitely try to keep it up though.

To be honest I don't know what is wrong with me. Something is, but I don't know what. Is it anxiety? A sleep disorder? A personality disorder? OCD? Something physically wrong with me or my brain? Or am I losing it? I just don't know. I just feel bad. I'm tired, emotionally flat, and lots of other things. We're trying to figure it out, but honestly we haven't really made any progress in any kind of a firm diagnosis since I started all of this. My psychiatrist has diagnosed me with generalized anxiety disorder and OCD, but she said she does not like "labeling" people. She's great. I really like her, but I would like to know what's wrong. I don't know. I'm just hoping it'll all work out.

Again, thanks for your response.

I hope you can share this with him

This is how my therapy goes too. What I say helps my therapist know me better. I trust the process and try not to judge the process by one session. I think overall it is helpful.

My therapist also doesn't offer a diagnosis. When I read about Borderline Personality Disorder I thought if fit, and when I asked her about it, she agreed. But she said she doesn't want anyone to dwell on a diagnosis or label. And we don't. It's never mentioned.

Hang in there, you're doing great work !