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Ask Dr. Ed Wilfong Your Own Question
Dr. Ed Wilfong
Dr. Ed Wilfong, Psychologist
Category: Mental Health
Satisfied Customers: 1528
Experience:  Twenty-five years treating all ages; Specialities: psychopharmacology & diagnosis, MMPI-2, testing.
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I am taking 45 mg of Remeron at night for depression

Resolved Question:

I am taking 45 mg of Remeron at night for depression. My feet hurt. My feet also swell. The bottoms of my feet hurt (heels) and the inside curve of my feet hurt.  There is also a lot of swellingI have also gained 27 lbs by eating all the time. Is this normal?
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Ed Wilfong replied 5 years ago.

Dr. Ed Wilfong :

Swelling in extremities and weight gain have been reported with remeron. Still, this seems far too much to put up with. I would ask for different medication. Something such as Cymbalta or Pristiq are unlikely to cause either symptom and Cymbalta is especially effective if you have any pain issues. Remeron I often get reports of adverse effects.

Customer:

Does Cymbalta have many side effects?

Customer:

I'm also taking Tranxene, Busbar, and Ativan

Dr. Ed Wilfong :

Most people do very well on Cymbalta. I see "horror stories" on internet, but on net, everyone complains so rare side effects sound like the norm. I actually think it is good medicine. There are initial side effects for a couple weeks, like all antidepressants, but just a little uncomfortable, nothing like you are getting on Remeron. By the way, Buspar, in my opinion, does nothing (good or bad). Tranxene and Ativan are virtually the same thing. I have trouble imagining a reason for all 3 drugs, especially tranxene plus ativan. They will likely help you you through any initial side effects of Cymbalta (sometimes initially it can cause a little anxiety then then after a couple weeks it will control anxiety. Often ativan is given for first few weeks of starting any antidepressant used for anxiety.

Dr. Ed Wilfong :

I am assuming you do not have diabetes or cario-pulmonary issues that can account for pain and swelling in feet. If you do, please tell me.

Dr. Ed Wilfong :

I would also try to eventually eliminate Tranxene and Buspar and just take appropriate amount of ativan to take the place of all three. I would wait until you are stable on new medication (also unless you are one of the very few that Buspar helps, you can get rid of that pretty easy)

Dr. Ed Wilfong :

Also, may want MD to consider diuretic to get foot swelling down.

Customer:

Thank you. The reason for all three anxiety drugs is the fact that I was hospitalized for 2 weeks with such extreme anxiety. I was on Neurontin but blamed that for the pain and was given Tranxene instead. I see my psychiatrist Wed and I want to go in very informed.

Customer:

I'm not sure my reply posted. I was on Neurtontin but I thought that caused the pain. My doctor added Tranxene when he took me off Neurontin. I was hospitalized for 2 weeks for extreme anxiety and depression. I see my psychiatrist on Wed and want to go in well informed as to what is going on with me

Dr. Ed Wilfong :

I haven't seen Tranxene used for pain before, but I am not a pain specialist. It is a benzodiazapine just like ativan.

Dr. Ed Wilfong :

Yes, it posted....

Dr. Ed Wilfong :

Depending on priorities, may want to consider pristiq or lexapro more for anxiety but cymbalta is usually much better with pain. With any of them, make sure you have something for anxiety when starting any of them. I have seen Neurontin not be effective (it is hit and miss) but first I have heard of it making pain worse or causing it. No real harm on tranxene plus ativan, just getting two essentially same meds for same thing so dose may seem lower than it actually is.

Dr. Ed Wilfong :

Inside curve of feet (arches) may be different issue - inflammation of tendon connecting to heel (planter faciatis). Ice will help that if it is the problem. Usually have to submerge feet in ice water, which is not much fun, so I would have that guess confirmed before treating that. Psychiatrist unlikely to think of that.

Dr. Ed Wilfong :

Also, you have this posted twice. It looks like our chat is posted under both, but let me know if a problem.

Customer:

did you get my last post?

Customer:

Thank you. I will talk to my psychiatrist on Wed. You have been very helpful

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