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Doctor insights on: Naltrexone Effexor Mirtazapine

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How would you go about switching from Suboxone to naltrexone? What would the timing and prescription look like? The current dose of Suboxone is 12mg. Thxs

See below: She has to detox first which requires an individualized approach. Afterward-she needs to wait 2 weeks prior to an injection of naltrexone. However, I have a protocol for initiating Naltrexone at small doses after 3-5 days and quickly titrating to a full dose by day 7-10. ...Read more

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Dr. Heidi Fowler
379 doctors shared insights

Mirtazapine (Definition)

Mirtazepine (remeron) is a noradrenergic/specific serotonergic antidepressant [nassa]. It is used for major depressive d/o, various anxiety disorders, chronic pain, and others. In some, it can help ssri-induced sexual dysfunction & "poop out." it can be sedating and also increase appetite -- good for some ...Read more


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Is it ok to start naltrexone and ativan during detox from alcohol while already taking Effexor (venlafaxine) for depression?

Is it ok to start naltrexone and ativan during detox from alcohol while already taking Effexor (venlafaxine) for depression?

Maybe: Are you getting all these meds from one provider? They are all psychoactive but are different chemicals and have different uses. Naltrexone is for narcotic addiction, whereas Ativan is for anxiety and Effexor (venlafaxine) for depression. With guidance of a doctor, you can navigate all of them together, but require monitoring response to this cocktail. ...Read more

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I've been on 30mg mirtazapine for just over a week (switched from 150mg effexor). Have increased anxiety as a side effect. When will this go away?

I've been on 30mg mirtazapine for just over a week (switched from 150mg effexor). Have increased anxiety as a side effect. When will this go away?

Depression: can improve in a week. Anxiety may take a bit longer. Remeron is one of the best antidepressants for refractory depression. It takes a while to get settled in if you discontinuing Effexor (venlafaxine). Some of the action of Remeron is thought to be due to activity at two of the endogenous opiate receptors. Remeron is used as a treatment for anxiety as well as depression. ...Read more

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I was wondering if it is safe to take Remeron (Mirtazapine) and Effexor XR (Venlafaxine ER) six hours apart from each other? E.g. Ven 6pm & Mirt 12am

Caution!: You do not state how come you are taking two different antidepressants - mirtazapine alone taken at bedtime should enable sleep and at gradually increasing doses should take care of the depression. Venlafaxine tends to have stimulating features in many people, perhaps accounting for it. This should be taken early in the day and at proper doses should take care of the depression alone. ...Read more

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Was on Mirtazapine for 1 1/2 years, switched to Effexor (venlafaxine) 4 days ago and it makes me sick/spacey. What would be a good antidepressant thats not an SSRI?

There are plenty: You might be between a rock and a hard place, pharmacologically speaking. You are in Mirtazepine withdrawal, and experiencing initial serotonergic side effects from the effexor (venlafaxine). There are other options, but if your doctor preferred effexor (venlafaxine), I advise to taper off the Mirtazepine for a few more days and obtain regular, non XR effexor (venlafaxine) a titrate after mirtazepine taper from 1/2 37.5 mg. ...Read more

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Been on Suboxone for yrs. Took Effexor (venlafaxine) and it put me into severe withdrawal. Will remeron do the same?

Been on Suboxone for yrs. Took Effexor (venlafaxine) and it put me into severe withdrawal. Will remeron do the same?

Effexor (venlafaxine): effexor (venlafaxine) wouldn't cause withdrawal. you probably just had side effects. its notorious for being difficult to start and stop. remeron is not anything like effexor (venlafaxine) but it will help with sleep and appetite. also, what about tapering the suboxone? shouldn't have to be on it for "years." ...Read more

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I have been out of Klonopin for 24 hours, Effexor (venlafaxine) for 48 hours, and Remeron for 48 hours. I am working on getting them filled. Should I be concerned? What should I do?

I have been out of Klonopin for 24 hours, Effexor (venlafaxine) for 48 hours, and Remeron for 48 hours.  I am working on getting them filled.  Should I be concerned?  What should I do?

Difficult Situation: You're likely going to have withdrawal symptoms. I would see the doctor who prescribed those medicines to get you restarted on those medicines. If unavailable the emergency room would be an appropriate place to consider. Good luck. ...Read more

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Tried zoloft, celexa, now on remeron with Effexor (venlafaxine). If this doesn't work what would be next ? Losing hope with these meds.

Tried zoloft, celexa, now on remeron with Effexor (venlafaxine). If this doesn't work what would be next ? Losing hope with these meds.

Try CBT: All research comsistently finds that optimal treatment includes good CBT therapy and your active involvement. With or without medication, results are sugnificantly better. You learn skills to manage your life overall and if you miss this part - it's very hard to make things better. Best wishes! ...Read more

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On 112.5mg Effexor (venlafaxine) for 6mths. Mood dropped unexp. so upped dose to 150mg. 1mth later mood worse so now on 30mg mirtazapine. What caused mood drop?

On 112.5mg Effexor (venlafaxine) for 6mths. Mood dropped unexp. so upped dose to 150mg. 1mth later mood worse so now on 30mg mirtazapine. What caused mood drop?

Could be many causes: There can be a number of triggers to low mood, including: medical illness, stress, loss, relapse of depression, seasonal changes and even just normal variation. It would be best to talk to your doctor about the possible explanations to see if you need any further medical work-up or if adding other treatment components could be helpful (e.g. psychotherapy). ...Read more

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I've tried Zoloft panic remeron Effexor and I can't get past the extreme anxiety from starting the meds. I don't know what else to do frustrated ?

I've tried Zoloft panic remeron Effexor and I can't get past the extreme anxiety from starting the meds. I don't know what else to do frustrated ?

Untreated anxiety?: Sounds like you sincerely want a cure, but have yet to start medications prescribed? A paradox to be sure, but the drugs can't help if they sit in the bottle. Don't go it alone. Sounds like the best and most courageous course of action is to heed your doctor's advice. Be well-- ...Read more

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Daughter has major depress., suicide thoughts.Had ED @16, age now 19.On 225 mgs Effexor ER for long time, not working anymore. Add Abilify (aripiprazole) or Remeron?

Daughter has major depress., suicide thoughts.Had ED @16, age now 19.On 225 mgs Effexor ER for long time, not working anymore. Add Abilify (aripiprazole) or Remeron?

Talk with MD: It sounds like ur involved ur dtrs care; w/ her consent, you cld schedule a meeting with her & her doc or encourage her to c her doc ASAP. Doc needs to be made aware of ongoing sxs, particularly suicidal thoughts, so that the most effective tx can be selected. A back up plan for active suicidal plan/intent should be discussed. The best med is the 1 that works best 4 ur dtr. Work closely w her md. ...Read more

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Can you tell me about effexor, (venlafaxine) remeron & Vyvanse combination - any insight about combination efficacy for treatment-resistant depression or user experiences?

Can you tell me about effexor, (venlafaxine) remeron & Vyvanse combination - any insight about combination efficacy for treatment-resistant depression or user experiences?

Good combo: Some studies suggest that effexor (venlafaxine) and remeron work better together than independently. vyvanse, i'm less enthusiastic about as i feel it doesn't treat depression per se as much as it increases energy/activation. ...Read more

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At end of rope. Tried Effexor, remeron, celexa, therapy nothing is helping anxiety/depression. I'm a mess all the time. Trouble sleeping. Please help?

At end of rope. Tried Effexor, remeron, celexa, therapy nothing is helping anxiety/depression. I'm a mess all the time. Trouble sleeping. Please help?

Depression: Good question and good for you. People respond idiosyncratically to meds for anx/dep. so there are still a lot of options open and I see this time and time that if you can be patient and work with a psych prescriber slowly and methodically typically you find something that works. Also transcranial stimulation may be something to consider though very new. Keep on trying. I know it is hard. ...Read more

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I am on venlafaxine XR 75mg & about to start taking Naltrexone for alcohol addiction......are they safe to use together?

I am on venlafaxine XR 75mg & about to start taking Naltrexone for alcohol addiction......are they safe to use together?

No drug-drug issue: I found no drug-drug interaction btwn Venlavaxine & Naltrexone at https://www.drugs.com/interactions-check.php?drug_list=1684-0,2296-0. In case you're getting your prescriptions from two different doctors, make sure the other is aware and try to obtain from same pharmacy so that pharmacist can also double check for interactions, too. ...Read more

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Is venlafaxine and mirtazapine a good combo for pain and depression ?

Is venlafaxine and mirtazapine a good combo for pain and depression ?

Hmmmm: SNRI antidepressants are effective for depression and sometimes beneficial with reducing chronic pain. However, prescribing two SNRI antidepressants is sometimes risky with developing serotonin syndrome ...Read more

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Currently taking 150 mg venlafaxine with 15mg mirtazapine but the mirtazapine is no longer working to help sleep? Should i stop the mirtazapine?

Currently taking 150 mg venlafaxine with 15mg mirtazapine but the mirtazapine is no longer working to help sleep? Should i stop the mirtazapine?

Mirtazapine 15mg: If it helped then lost benefit then increase dose to 30mg or even to 45mg [2 04 3 pills at night] as the pill somes in doses 15-30-45mg. Call and talk to your doc. IN all cases if doc not available talk to your pharmacist. ...Read more

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Dear sir, what is difference between venlafaxine and mirtazapine? Which one is the best for anti depression?

Dear sir, what is difference between venlafaxine and mirtazapine? Which one is the best for anti depression?

Both antidepressants: Both venlafaxine and Mirtazapine work well against depression. They both affect serotonergic and noradrenergic transmission, but do this a little differently -- thus having different side effect profiles. Mirtazepine has more sedation and appetite-stimulating effects than venlafaxine. This can be used to advantage in people who need these effects. Venlafaxine can sometimes raise bp. ...Read more

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I've tried sertraline, then citalopram, now on mirtazapine and venlafaxine. Will these drugs ever work ? Losing hope.

I've tried sertraline, then citalopram, now on mirtazapine and venlafaxine. Will these drugs ever work ? Losing hope.

Add CBT therapy: For decades research has shown that optimal therapy outcomes require therapy - it enhances medication and for some is sufficient alone. The need to learn symptom mgmt skills cannot be met w/out it. Don't lose hope - it is also a major part of successful treatment. In fact, w/out confidence it is unusual for any treatment to be a success. So, find a therapist you trust and work at it! Best! ...Read more

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Would smoking a small amount of weed be safe ( for nerve pain ) be ok with other meds I'm taking. Amitriptyline, mirtazapine, venlafaxine ?

Would smoking a small amount of weed be safe ( for nerve pain ) be ok with other meds I'm taking. Amitriptyline, mirtazapine, venlafaxine ?

Most likely.: While federal regulations prohibit me from recommending the use of schedule I medications such as cannabis I can tell you that there is overwhelmingly scant evidence that its consumption with the drugs that you listed would be risky. That said IF you were to consume it any option other than burning it to ingest it would be preferable: i.e. consider an edible, atomized or nebulized form. ...Read more

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Dr. Krishna Kumar
535 doctors shared insights

Venlafaxine (Definition)

It belong to classification of snri antidepressant also help anxiety start slow go slow its approved for depression and anxiety disorder there are some common side effects important never stop suddenly always taper slowly if you ever ...Read more


Effexor (Definition)

Venlafaxine is a non-tricyclic which is a kind of serotonin-norepinephrine reuptake inhibiting drug (atypical anti-psychotic ...Read more