Increase from 15mg to 30 causing problems.

I am hoping that someone can help me with this.
I have been on Mirtazapine 15mg for over 3 years and feel that I have done reasonably well in that time. I have had no side effects to speak of. No weight gain or drastic changes in blood test results. I have generally slept well and felt that I was coping. So far so good. My Dr has, however decided that my IBS, which has been particularly bothersome, would benefit from a higher dose and has told me to start taking 30mg a day and see him in 4weeks. I am in the second week and my insomnia( cured by the 15mg) is back. I hardly sleep during the night and waken feeling thick headed and zonked, but at the same time strangely anxious and wired. I have not had a panic attack for a long time but now feel that I am continually on the verge of one. I want to go back to the 15mg but am afraid that the Dr will be annoyed and put this down to my anxiety. Any thoughts please...Thankyou. Xx

Hi Valleybear - Sorry to hear of your mirtazapine woes. There are so many variables here. It could be your anxiety playing up, as many people experience increased anxiety with a new dose of a med. On the other hand, mirtazapine is a strange beast, and noradrenergic effects kick in at higher doses, which may be causing your side effects, but these may reduce as your body adjusts to the new dose.

So what to do? If possible, persist a little longer, but if there is no change, don't be afraid to go back to your former dose, and don't be afraid to tell the doctor. It's something they deal with all the time.

Definitely choose what's right for you and don't be afraid to discuss with your doctor. Is Mirt known to help IBS? Maybe there's another med for this?

Thank you both for your help. I suspect that he thinks the IBS is flaring because of anxiety? Not sure. I sometimes think that he doesn't know what to do with me and my woes lol!!!
I really can't tolerate 30mg so have been taking 22.5 for the past few nights, slept a bit better (but that is maybe exhaustion) Still feel headachy and drugged all day but can just about cope. Will have to go back and face the Dr ...but he will definitely not be pleased. Thanks again for replying...Take care and be well.

Hi Valley,

One option may be to chop up your pills - 7.5mg (oddly I know, it's a mirtazapine feature) may help you sleep better than a higher dose; then take the rest in the morning. This worked for me when I was on a higher dose. A £2 pill cutter from Boots should do the job. Might be worth discussing with your doctor.

Albert

Thank you, that is a thought, although he did go a bit mad when I told him I was quartering Zopiclone a year or so ago! Won't give me them now! In week three of the 30mg I am now struggling with muscle pain in chest and back, still feeling unsafe to drive any distance and have headaches and lethargy all day. Feel I just want to go back to 15mg or to take one and a half to test that out but I know that he won't go for the latter�� Thanks again

Mirtazapine is a bit faster acting than other ADs, so if you get past week three and you are still feeling consistently worse rather than better, it's probably quite reasonable to call it a day and go back to your previous dose. You are still taking the med, so I can't see how the doctor will be upset.

Thank you Hanshan, I am going into week three now and have muscle pain ( especially in my chest) which wakens me at night ..so a bit frightening. I have excercise exhaustion and generally feel rough! I have an appointment for a week on Monday so will try to hang in til then. Do you think I will find it difficult to drop back to 15mg then, after nearly 4 weeks on 30mg. Thanks again for you help.

Hi, I have also just increased my dose from 15mg to 30mg 3 days ago. When I started 15 mg I had no problems whatsoever, however ever since I have increased the dose I have been feeling horribly. My anxiety is worse, but more than that I have been feeling very depressed. Could that be from the increased dosage and I should give it more time?

I use Remeron (Mirtazapine) since years, due the lacking in sleep at night times, I used to it, I like it, I worship it, it's the magic pill to me. If I take 30 I could sleep longer, If I take 15 I could sleep but not that longer, not that big difference it's just an hour. I used to take 30, nowadays I'm trying to be on 15, not that good to me generally, what I want to tell you, that if you increased the dosage, your body would adapt accordingly, that's why decreasing the dosage would make a difference, yes I admit that on the morning I feel like killing someone, so bloody mood.. still even during the day, I feel so snappy and I may ruin my life on spot, since my behavior is so intense plus I couldn't control myself when get upset or angry while talking with *******s.