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MN Psychiatrist
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience:  Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
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How can I get my auto-adrenoceptors less sensitive? With the

Resolved Question:

How can I get my auto-adrenoceptors less sensitive? With the current sensitivity I can not use meds like trazodone or seroquel because they cause too much arousal and keep me awake.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Camille-Mod replied 2 years ago.

Hi, I’m a moderator for this topic and I wonder whether you’re still waiting for an answer. If you are, please let me know and I will do my best to find an Expert to assist you right away. If not, feel free to let me know and I will cancel this question for you. Thank you!

Customer: replied 2 years ago.

Hi,

 

I'm still waiting for an answer (but meanwhile I've been sleeping).

 

Regards,

Wim

Customer: replied 2 years ago.
Relist: Other.
No answer
Expert:  Camille-Mod replied 2 years ago.

Thank you. Sometimes, finding the right Expert can take a little longer than expected and we thank you greatly for your understanding. We’ll be in touch again shortly:-)

Customer: replied 2 years ago.
I'll wait.
Expert:  MN Psychiatrist replied 2 years ago.
Hello, I am a psychiatrist.

For me to best help you, I need to know why you think you have an adrenoceptor problem, as opposed to another kind of sensitivity that is keeping you up when you take Trazodone or Seroquel. Also, are you taking any medications at all right now, and if so, what are they (and what are their doses)?.
Customer: replied 2 years ago.

Hello,

 

I have the same problems with 30mg Mirtazapine (not 15). With this dose the medicine becomes an alpha-2 antagonist resulting in NE. Also problems with Valdoxan, which acts as a 5-ht2C antagonist resulting in NE. For Trazodone it's when the mccp becomes active and for seroquel it appears to be the NET-inhibition of it's metabolite. I don't have such problems with SSRI's, but they don't help.

 

Regards,

Wim

Expert:  MN Psychiatrist replied 2 years ago.
I see.
In line with what you're saying, I have found that many patients sleep much better on 7.5mg, 15mg, or even 22.5mg of mirtazapine than on 30mg or more. Are you able to take a low dose of mirtazapine for sleep?

Also, have you tried other sleep agents? Using a sleep agent that is independent of adrenoceptor issues is a more direct route of getting you to sleep than trying to compensate for increased noradrenergic activity due to certain medications.
Customer: replied 2 years ago.
I don't know any other effective medicines, besides hypnotics. Mirtazapine doesn't work. Is it so difficult to desentisize noradrenergic receptors?
Expert:  MN Psychiatrist replied 2 years ago.
I don't know that it's difficult, but if they are desensitized enough so that you can sleep, I suspect that it will affect you in other ways, such as causing low blood pressure, fatigue, weight gain, etc.
Customer: replied 2 years ago.
I think you're right. But what can I do? Accept many sleepless nights while taking a NE reuptake inhibitor?
Expert:  MN Psychiatrist replied 2 years ago.
Can you take a small dose of mirtazapine? Even if that doesn't help your insomnia completely, does a small dose help at all? Also, is there a reason you cannot take sedative-hypnotics?
Customer: replied 2 years ago.
Mirtazapine in a small dose doesn't help. And I want to get rid of the zopiclone which I already use for years (3 pills of 7,5 mg, similar to 3 pills Lunesta). If I knew that it would take a week of sleepless nights in order to become tolerant for the NE-action of Trazodone, I would do it. Do you think that this is possible? Or more exercise?
Expert:  MN Psychiatrist replied 2 years ago.
To be honest, I don't know if you'd get used to the Trazodone or not. If the zopiclone works, it might make the most sense to just stick with it.
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience: Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
MN Psychiatrist and 3 other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.
Thank you.
Expert:  MN Psychiatrist replied 2 years ago.
You're welcome. I wish you the best.

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