California Rocket Fuel

After my unfortunate experience with the drug Emsam, (read My Sad, Stupid Emsam Story, April 2010) I swore off ALL drugs forever - even aspirin.

That lasted about 5 months.

During those 5 months I slowly began to realize that my state of "normalcy," when drugless, was teetering on the verge of tears. It angers me so much that a grown man can be brought to weep so easily. One can only endure this existence for so long. It has become clear and ever so sad for me to be resigned to using antidepressant medications for the rest of my life. The irony is they really don't do what they're supposed to do, at least for me. They do take the edge off my emotions which helps me to get through the day but that's where it begins and ends. There's never been a lifting of spirits or relief from the depression itself. Alternative treatments have proven to be disappointing, expensive and futile. I found myself going back down that same slippery slope that leads to the psychiatrist's office. This time with my tail tucked beneath my legs. The doctor put me back on an antidepressant that I had taken prior to my quitting them altogether because I tolerated its side effects quite well. This time she added Ritalin.

Ritalin I asked? I picture hyperactive children bumping off classroom walls when I hear that term. Why Ritalin? It will give me an energy boost I'm told. It's quite common to prescribe Ritalin with an antidepressant. At this point I don't really care anymore. I'll eat rocks if they'll pull me out of this hellhole. So Ritalin it is.

I go on my merry way with my new prescription wondering what I'm in store for now. Weeks go by and there's barely any detection of change. I am less weepy but ever so slightly which is better than nothing I suppose but falls miles short of the relief I desperately seek. I find that the Ritalin causes me to grind my teeth. I catch myself grinding my molars together which is unnerving.

It's been over 4 weeks now and I'm due back for another psych appointment. I tell the doctor there is really no change. She seems stumped and proceeds to ask questions like when was the last time I felt happy to which I responded around the age of 10. There was awkward silence as she jotted notes on her lap. I gazed at the floor reflecting on the words I had just uttered. It's true. I haven't felt joy or happiness since I was a child. What happened? She asks about my libido. I tell her it's definitely declined over the years and I attribute it to my age which she scoffs at. You're only 49 she says. She asks if I've had blood work done recently. I had my regular doctor send me to the lab a couple of years ago to see if there was anything off kilter but all tests came back normal. She thought it wouldn't hurt to try again so she requested a total of 14 blood tests to see if there's some medical indication that's been overlooked.

She decides to bring out the big guns now. A drug called Remeron is prescribed. I've never heard of it. It's a "tetracyclic" antidepressant — whatever that means. She wants to combine it with the Lexapro and Ritalin I'm already taking. Three drugs now. THREE. At the same time. I feel like a lab rat again. It's all trial and error in this world of psychotropic medications. What are the side effects? Vivid dreams, dry mouth, dizziness, grogginess, appetite stimulant, weight gain. She says I could use a few pounds anyway. Whatever.

I ask how long it will take for positive effects to which she responds 3 - 4 weeks. She then tells me about a phrase that was coined by some prominent psychotherapist — "California Rocket Fuel" referring to a combo of Effexor and Remeron which gives a double boost to the brain's neurotransmitters. She'd like to wean me off the Lexapro and pump me up with this potent drug cocktail but not right away. I took Effexor combined with some other drug a few years earlier without any success.

The appointment is over. I take the prescription slip, schedule another appointment, and make my way to the pharmacy. I want to start on the new stuff right away. One pill is 15 mg. Have to take one pill for three days at bedtime then TWO pills thereafter. About 45 minutes after taking the first pill the drowsiness hits me pretty hard. I'm out in no time which is fine by me because getting to sleep is always a chore. Unfortunately, it's a short lived sleep. The rest of the night is a restless slumber. Next two nights is the same story. Now the fourth night I have to double the dose. Again, I'm out like a light but this time I wake countless times in the night. I experience leg flinching, night sweats, crazy dreams, parched mouth, dizziness, grogginess, disorientation. The mornings on through the late afternoon are an unbearable surrealistic journey through my tedious daily routine. Concentration is difficult. Reading is difficult. Interacting with people is a nightmare but I somehow bulldoze my way through the first week thinking what a mistake it is to resort to these synthetic chemicals to feel "happy." What a joke. The side effects are kicking my ass and ruining one day after the next. Since I've run out of options, I have no choice but to ride this out in hopes that the side effects will subside and the med will eventually do what it's supposed to do.

Ten days later I can't bear it anymore. I put in a call to the doctor and leave a voice mail but she doesn't get back to me for whatever reason. I make the executive decision to immediately stop taking this stuff. The next day I'm much better and feel validated for my decision. I don't have a doctor appointment for another three weeks so I just continue with the other meds. Remeron was a dismal failure to add to the growing list of dismal failures. Each time a new med or treatment falls short it takes a piece of my hopes away.

There will be no "California rocket fuel" in my future. On to the next.


  1. Very interesting comment.Some french psychiatrists start to use Stahl's protocole well-known as "california rocket fuel" and I must say it's an awful experience for me.I have 4 prozac pill per day,2 Remeron,60mg of Ritalin,lithium and so on.The result:Today I've had a minor form of serotoninergic syndrome.Fortunately,I knew and had one of the antidote which is propranolol.There will be no chemical experiences of that type in my future too.

  2. I thought I was taking a complicated drug cocktail. You've got me beat. I can't imagine 2 Remeron per day let alone 1. Terrible stuff. It sickens me that we have to resort to these medications to the point where we can never get off them. I hope you take it day by day and find what you need to enjoy life. Stay in touch.

  3. I feel for you buddy. I can only say that I and others have always described me as a "hard as nails" motherfu@$er stemming from a horrible childhood and a a long history of being a bone breaker for a living. I had a life changing event a few years ago and became just like you, a grown man that is on the verge of tears most of the time. I understand how horrible it is to feel like you shouldn't be the way you are. The embarrassment, the anxiety and the feelings of no self worth. I've been a lab rat on a wheel of medications for some time now and some work a bit and some not at all and my doctor and I are still looking for the right combo. Keep your head up mate. We will endure.

  4. Anonymous,
    Your post is greatly appreciated. It's as though we are comrades. We're both playing the drug game because there's really nothing else to fall back on. I'm sure the pharmaceutical industry delights in that very notion. They're all probably sugar pills that intentionally don't work so we can move on to the next one, then the next....

    I continue to trudge through each day though I don't know how and I don't know why. Again, thank you for taking the time to send your message to me. Keep me posted on your progress.

  5. You're quite welcome mate...I found your blog completely by accident as I was researching "California Rocket Fuel"...I fought tooth and nail against pharmacology for the longest time. My depression is on top of, or as a result of, (the jury is still out on that one, even though I have my own thoughts on where my life went wrong) a degenerative condition that is slowly taking away my ability to live my life as I am accustomed. Robbing me of my physical abilities to do my job and some days to even leave the house. In addition, I was recently diagnosed with Fibromyalgia. As if everything else wasn't enough. I live my life, day to day, in constant and horrible pain. Unfortunately I have no choice but to rely on narcotic pain meds or I would never get out of bed. That in itself is horrible. If the pain doesn't wake me in the morning then the physiological need (short term withdrawal) for the oxycontin will. The "California Rocket Fuel" caught my notice as there seems to be some research regarding the analgesic properties of Effexor (on top of the depression treatment) when taken in large enough doses and the Remeron seems to help with sleep. I haven't slept more than 3 or 4 hours uninterrupted in a very long time. Anyway, I'm rambling now. Tends to happen when it's late and I'm a little in my cups.

    Soldier on mate, what other choice do we have when we have people who love us and rely on us. Now that I've found your blog I'll keep an eye on it to see how you are doing and I'll let you know if anything comes my way that may be of interest to you....or to just say hi....I don't know about you but because of all of this I have found it exceptionally difficult to maintain any kind of relationship with friends so I find myself most often just talking to myself and sometimes to my girlfriend. She is awesome and the one true light in my world but there is only so much you can burden someone you care about with...

    Take care...



  6. Anonymous,
    I really enjoy your posts because I relate so well. I find myself nodding my head because I've "been there, done that" if you know what I mean. I couldn't tolerate Remeron. It made everything seem surreal and made it hard to function. Though right now I'm physically fine, about 9 years ago I experienced a pinched nerve in my back. The pain traveled down my right leg. It was the most excruciating pain I had ever endured. It lasted 6 months. In that time (just like with depression) I was prescribed endless pain meds, even narcotics. Oxy was one of them. None seemed to help.

    Nothing's worse then mental AND physical pain simultaneously. As you say, we must soldier on. There's no other alternative. Take care and hang in.

    PS: May I ask where you're from?

  7. I'm from Toronto, Ontario Canada.Moved around a little bit but this is where I live now and have always called home...

  8. Today, I had an appointment with my Doctor as I needed to tell him that the most recent round of medication was completely useless. I had been on Cymbalta for several months as it seemed like the best bet to deal with the depression and the Fibro pain at the same time. Unfortunately the side effects, horrible sweating, weight gain (thank God I'm 6'3" and can carry a few extra pounds) nausea and fatigue compounded on top of what i deal with already, were just too much and I had to go off of it. My doc started me on Wellbutrin thinking that if we got the depression under control it might make it easier to deal with the Fibro pain. They know so little about Fibromyalgia that everything with it is a stab in the dark. Anyway, after 6 weeks the Wellbutrin was doing absolutely nothing, not even a hint of anything, so I felt it was safe to say it was a done deal on it being completely ineffective. I've really been wanting to try a drug called Savella but it hasn't been approved in Canada yet so I decided that we would try Effexor on its own to start, beginning at 37.5mg/day and working up to the 225mg/day over a month or so. That's the dosage required to achieve the max analgesic effect on top of the anti-depression treatment. My doc is really cool about letting me try and guide my treatment as with all of the complicated issues I am really outside of any textbook case that he could draw upon for info. As long as my own research (I bring him all of my documentation at each visit) sounds reasonable then he is ok to let me give it a whirl to see where it goes. As it stands, the degenerative condition I have is only treatable with pain meds so the rest of this is all in addition to what i take for that. There are some new things that are in development that involve killing nerves with electronic energy to decrease your pain levels but it's all very new and there have been some serious issues with it and spinal cord damage so it's not ready for prime time as of yet. I'll take being in any level of pain over not being able to walk any day, lol...

    So the wheel of meds continues and, as I do every week now, I'm just resting up until I have to start work on Thursday. I'm down to just going at it part time 3 or sometimes 4 days a week for 5 or 6 hours a day as that about all I can take and even at that it just wears me out to the point where I struggle to be able to do anything with my girlfriend when we have time together. I bloody kill myself to make that happen though, as I have mentioned before she is the one true joy I have in my life, and I'll be damned if I am going to let anything shortchange our relationship. She knows though when I'm on the verge of collapse, even when I hide it, and if we are out somewhere she will suggest that we call it a day because she's done or seen everything she needed to etc...She's awesome and I love her so very much. I really don't know what i would do without her.

    Ok, well that's it for now. I'm tired as hell and my last dose of pain meds for the day is really starting to hit me so it's best I stop writing while I'm still making sense, lol...

    Take care mate...


  9. A few week ago,I have posted a comment about that"California rocket fuel" newly used in france by some psychiatrists.I received ritalin,prozac and remeron,plus lithium xanax and zolpidem(known in France as"stilnox") and the result was awful.Nevertheless,I have decided to remove lithium and ritalin and my psychiatrist decided to try remeron(45mg per day)plus Effexor and the result is absolutely amazing.i don't suffer from any bad side effects and my depression has gone after 30 years of nightmare!I can't believe it.It's a miracle.

  10. I had a terrible experience with Remeron but I'm glad it worked for you. I've actually used all those medications you mentioned but not simultaneously. Sounds like a very potent cocktail. I would like to live life pill free but that seems impossible at this point. Thanks for sharing your story.

  11. Wow, can't believe it's been that long since my last post to you. Sorry mate. Update. the Effexor on it's own at 225mg/day is doing nothing yet after starting at the low dose and titrating up to 225mg/day for the last couple of weeks. I'm hoping that it's just because I haven't been on it long enough yet. It's not doing squat for my Fibromyalgia pain so that makes the entire time (7 weeks I believe) I was on Wellbutrin and all of the time I have been on Effexor (6 weeks including all of the titrating) added together to equal over 3 months that I have had nothing but my Oxy to try and make me feel more comfortable. Late this week, way early for the first time ever, I am going to have to go to my Doc to get my oxy script refilled over a month early. I'm not looking forward to that discussion but he has to understand that none of my other meds are helping with the Fibro pain so I have been literally eating my oxy like candy. it keeps my L5/S1 back issue comfortable but doesn't do a lot for the Fibro pain unless I take a lot more than I am supposed to as of my last script. I was offered an opportunity to up my work shifts and even though i shouldn't have I said yes. the money is to good to turn down and after talking to my g/f about it we came to the conclusion that, based on all of my health issues, I needed to take this work and squirrel away as much money as I could in preparation for the possible eventuality of not being able to work very much. All of my meds only cost me $7/script because of our insurance so there's not much of a cost issue with taking more of them. I'm just worried that my Doc is not going to be very impressed about my upping my doses without talking to him. As much as I hated, and couldn't deal with, the side effects from the Cymbalta, I miss it. It was really helping my Fibro pain and was doing wonders for the depression. Since going off of it I am a bear most days. Add to that the Androgel testosterone replacement therapy I am on as a result of the Fibromyalgia and the Adderall to keep my bloody eyes open at work and it just gets worse. Picture this and try not to laugh. I actually laugh about it sometimes so it's ok if you do. Now that I'm back to working 5 days a week I'm usually jacked up on testosterone, and amphetamines (adderal is basically just clinical speed) most every day. I can't even tell you how hard it is to keep the aggression under control and that just compounds the depression.Having random explosions at people just tends to make you feel really guilty, especially when it is at my girlfriend who I adore and who doesn't deserve it. What can I say though? She is so awesome and understanding. Last night (Monday) we celebrated our 3rd anniversary and went out to a creole restaurant for some food and drinks and it was awesome. We haven't been out together in ages because of our differing schedules and my ummmm dislike for the general public when I am not working.

    Alrighty then's 4:15 am here so it's off to bed for me. Again I am sorry that it's been so long since my last post to you but I'm sure you understand how things pile up and you have difficulty catching up.

    Take care and I'll try to post again sooner this time :{)=

  12. I am sorry about your trouble with CRF. I am on it and it has literally saved my life. I have done remeron withdrawal before and it is weird, but do-able. I hope CFR is not much worse, but for now it is the best thing I have ever used.

  13. Well, I never really had trouble with it because I never made it past the Remeron. That was god-awful stuff for me which prevented moving ahead to all the meds for CRF. I'm glad to hear it was successful for you. I haven't found the right cocktail to "save my life."

  14. I have been taking Remeron for about 10 years, but never really had my depression at all. Within the past couple of months I fell into one of the worst depressions I've had. My doc decided to try adding Efexor to the Remeron, and it is the most positive life-changing thing that's ever happened to me! I suffered from ill-treated depression from between the ages of 13 - 43. California Rocket Fuel has opened up a completely new world for me.

  15. I envy you. Remeron wasn't for me. I too have been suffering since the age of 13. I've yet to find a "cocktail" to benefit from. I'm glad for you. Stories such as yours offer a bit of hope that some day I'll find the right med or treatment that will transform my world. Thank you for your comment.

  16. Heya man...just a quick note as I'm feeling really down today and just need to vent a little.

    Last night my girlfriend exploded on me out of the blue and it turns out that for quite some time now she's been holding a lot of stuff inside. My illness apparently has just finally gotten to be too much for her and she feels like she has lost the man that she met and fell in love with. She feels like I am so consumed with my problems that I'm no longer a part of our relationship and that my frustration with there being no improvement and my general foul mood and my lack of energy to participate is just not something she wants to deal with any more. She's not a horrible person and I can see how this has gotten to this point and it's my fault I guess. We've been together for 3 years and lived together for 2 and even though I haven't shown it much lately I do adore her and I'm completely heartbroken at the thought of losing her. We're talking but I honestly don't know what, if anything, I'll be able to do to salvage our relationship if she really feels this negative. She told me that she's been thinking a lot lately about how different her life would be without me as I am now. I honestly don't know what i will do if she leaves me. On top of everything else I just don't think I will have the ability or desire to carry on if that happens.

    Anyway, that's it. I just needed to tell someone...


  17. Dale,
    I can't tell you how much I relate to that. I've only had three relationships in my life. I'm convinced that the first two ended because they couldn't take my chronic sadness anymore. I'm certain that my wife has stayed with me throughout the years because we have two children. If not for the kids, she would have disappeared long ago. When the first two relationships went down in flames, I was devastated for a long time. One thing I can tell you is that time hurts and time heals. If she should leave you, don't let that end your life. Give time a chance to heal you. It can take what seems to be forever but it eventually fades. Hang in there buddy. You're not alone.

  18. Thanks man. Things are rough. Out of sheer desperation I went to my doctor and begged him for more/different pain meds and a medication that is being used with some success off label to treat fibromyalgia. I tried to keep it together during the appointment but the stress of this has just been too much and ended up completely breaking down in my doc's office. it's a damned good thing he's known me for 20 years or he probably would have had me locked up for a 48 hour evaluation. Anyway, I left the appointment with some scripts that I have to go and pick up here shortly because the pharmacist had to order them in. The off label meds are going to take 2 months just to titrate up to the dosage where I will see results IF I see results. We rotated me off of the oxy IR and CR that Ive been on for a couple of years and onto Dilaudid instant and timed release. I hate this shit but I can't function without it. I'm hoping that the anti-siezure med that I'm taking off label will work well enough so i can cut way back on the opiates. I can't get off of them alltogether because of the severity of my back but I'm seriously considering having the nerves in my back taken care of permanently. it doesn't fix anything but I just won't be able to feel anything any more. there are some drawbacks but it's starting to look like that might be my only option. The girlfriend and I are talking every day or night depending on our schedules. I'm working as much as I can and it's killing me but I have no choice. There's no money in the way of disability benefits for me to get from the government even if I could get past my pride and apply. Because my g/f makes a decent living she is expected to support me so far as the government is concerned. She makes a decent living for one person, not for 2.It's ridiculous.

    It's funny, in a tragic sort of way, how things change. I was re-reading my posts in this thread, from start to finish and when I started there I was telling you to soldier on and have hope.....


  19. Well, news from shitville, at least that's what I'm calling my life now. If a couple of weeks ago you heard something that sounded like a sonic boom and it rattled your windows it was just the sound of the other shoe dropping when I lost my job. The guy that contracted me out to the bar I was working at not only just walked in and took my job because he decided that he would rather be there than the bar he was working at but I knew he had dropped the bar he had been working at so I gave him a lead on another bar that had been hounding me, trying to be a good guy and help him out, so when he fu*ked me over that was my first call and strangely that guy won't even return my calls now nor will anyone else in the industry that knows where I have been working for the last year and a half. For absolutely no reason this guy has gone out of his way to fu*k me over. August was really slow shift wise so I was already hurting for money and then I just manage to get flush again and BAM I'm fired. I couldn't even keep my head up and look her in the eye when I had to tell my girlfriend. Sure, he fired me for no reason, like that sounds really believable. I mean hell, it's true sure enough. I was the model employee. Showed up for every shift on time, no bad habits, never asked for any time off, no drinking on the job like a lot of the guys do or worse like a lot of the guys deal on the side out of the bars. Nope, I was a perfect straight arrow but because I was working in a spot that the boss wanted to be in I was out.

    So I had to tell the girlfriend that I wouldn't have any money for rent for November. Meanwhile, she's just gotten a raise at her job and is busy as hell at work and I think that's actually been a good thing because she's hardly home and when she is I've made supper and I stick a plate and a glass of wine in front of her and then do dishes and clean up and by then she's watched some tv and hit the rack.

    I'm looking for work but honestly, I'm a 46 year old white guy and nobody wants me. I've got tons of experience in a lot of areas but I can't work full-time and I can't work mornings because I just can't seem to get my body to respond to anything before early afternoon no matter what I try. Anyone I have sent a resume to so far reacts to it the same way. They look at it and think that I'm some guy who is way over qualified and just looking for something to hold him over until something better comes along and then I try to explain to them about the health issues making it impossible for me to work full-time and then they think that I won't be reliable at all even though I try to assure them I can work part time 3 days a week or so. It's a frigging nightmare.

    The girlfriend seems ok right now but I don't know how much of that is that she's actually ok and how much is she's just too busy to worry about it right now. She's got a week off coming up in the first week of November and I'm dreading it. I'm scared to death that losing my job was the straw that broke the camels back and that she just hasn't had the time to deal with it and knowing she has the vacation time coming she's just put it off until then. If that's what happens I'll try ans remember to send you off 1 last little note before I get bounced outta here as I really appreciate you listening to me ramble on and on the way I do. Truth is I don't have anyone else to talk to about all of this crap.


  20. Dale,
    When I hear of other folks' misfortunes and suffering, all I want to do is help but I know I can't. The only thing I can do that may help a bit or not at all, is to assure you that you're not alone even though we both feel we are.

    I appreciate you sharing your thoughts with me. I'm not very good at being someone that a person would turn to. I'm barely strong enough to carry myself through the day.

    Please keep trudging through muck. If each of us continues to do that, one or the other may find relief which will in turn give hope to the one who hasn't made it that far.

    I wish I could give you more. Please take care.

  21. I've been thinking about adding Effexor the Remeron AKA California Rocket fuel and I am glad I at least seen one positive review of it.
    One thing that comes to mind is why noone (or if I have missed it) talks about Parnate or Nardil ? The only thing which could be an issue is tyraminehigh diet. But ackording to Stephen M stahl Essential Psychoparmacology rev 3 that risk is exaggerated and at the same time the risk of combining it with OTC-drugs have been somewhat downplayed (or gone unnoticed).

    Another thing is those taking opiates against pain. This I think you already mentioned. Effexor and Remeron might have some pro-opioid properties. The Molecular skeletur of Effexor(venlafaxine) is quite similiar to Tramadol however of course changing an atom here and there probably might do much.

    And the last thing I've read about. Low dose Naltrexone < 4.5 mg. ackording to at least anectdotal it seems promising. Even for MS.

    Take care.


  22. I know the feelings posted on here, I know the pain that we all go through. Sometimes you ask is this it, is this my life, there are the very few occasions where the world opens my eyes and i feel better for the meds, most times is just. Bluurgh. I KNOW there is hope, relief from this, but everytime i turn a corner, BANG like a dark shroud he cometh to take that happiness away. I think its as said before, that somehow, we must muscles through, what other choice is there? death? I had my choice when i was at the bottom, I chose life. You know, it is nice to know there are many others like me, Ive been depressed since god knows when, never really felt right since i was back in school. But now im on my second episode in so many years im commited to going forward, I dont want to die, so I must live, instead of asking myself what is the meaning of life, im asking, what meaning can i give to my life.

    "I laugh, I love, I hope I try, I hurt, I need, I fear , I cry. And I know you do the same things too, so we're really not that different, me and you"

    "anyone can give up, it's the easiest thing in the world to do. But to hold it together when everyone else would understand if you fell apart. That's true strength"

    And finally, "being happy doesn't mean that everything is perfect. It means that you've decided to look beyound the imperfections"


  23. One variation of "California Rocket Fuel" is a Remeron plus Cymbalta. There is a synergistic drug/drug interaction going on, and Effexor and Cymbalta are interchangeable for this purpose, and Cymbalta is (I believe) better tolerated with fewer side effects. Either way, it's one of the most powerful antidepressant tools available.

    "California Rocket Fuel" is the only antidepressant combination that has been truly effective for me. I have a love/hate relationship with Remeron, because while it has saved me from suicide, it also causes substantial weight gain. It's a constant battle with food cravings, particularly for carbs. I go off the stuff, I diet, I lose weight, I have a depressive meltdown, I'm a danger to myself, I go back on the stuff, I balloon again. I just had a terrible breakup. Without the stuff, I would be hanging from the clothing rod in my closet by now.

    At lower doses (<30mg) Remeron causes _substantial_ drowsiness, as you experienced. At higher doses (>=30mg) this goes away, and the drug becomes incredibly stimulating. Can easily induce mania in those with bipolar tendencies.

    You need to ramp up on this (and all psych meds) very slowly. Do 7.5mg increments for several days each. Give your body time to adjust. If I jump to 15mg after months of not taking the stuff, I'm a zombie the next day. If I start with 7.5mg, I'm fine.

    I'd give the stuff another chance. But I'm biased. "It worked for me" is an anecdote, not data.

  24. Anonymous,
    If you read my most recent posts you'll see I've completely quit all psychotropic drugs. Completely done. They have hurt me more than helped me. I do feel a heavier sadness now that I'm off them but it's not much of a change from being on them. I don't have to contend with side effects anymore which is a blessing unto itself. I don't recommend you go off your meds by any means but for me, they were a waste of money and high hopes for too many years. I have no clue where to turn now but I want my future to be drug free. Thanks for all your support and input and all the best to you in your search for all that eludes you.

  25. I've been on effexor + remeron for years now, I remembered being very skeptic at first, but eventually when the dose of both drugs became higher I started doing better and better. For me this combination of drugs has been part of a big turnaround in my life.