Adding SSRI to Mirtazapine - initial worsening?

I've been taking 45 mg of mirtazapine for close to 3 months now, with only a slight improvement in anxiety. My pdoc decided to augment this with 50 mg of sertraline. I've been sertaline by itself and the first few weeks were horrid - my anxiety went through the roof - before gradually abating.

I'm feeling a bit apprehensive about going through this phase again. Anybody added an SSRI to ongoing mirtazapine treatment and experience a worsening, or did the mirtazapine 'block' this from happening. I would really appreciate your inputs!

Hi I've been on mirtz for 2 years for depression and sleep now I want off it doctor is adding leprexo for anxiety but it's been 2days and it's not great I was hoping it would help so I can get off my mirtz ,side effects are killing me,not sure this med will help while trying to come off mirtz ,but it's early days hope you get relief ,for me I'm confused what drug may help me progress off this medication maybe none
But I know I need off mirtz soon,any advice from others would be good

I'm sorry to say I tried fluoxetine while on Mirtazapine (15mg) and I lasted 2 weeks before the side effects proved too much for me.

I also tried citalopram while on Mirt, and I had no problem with that at all, never felt ill, just gave up because of sexual side-effects.

I'm now on an SNRI which is similar, alongside the Mirtazapine, and the start up effects again have been very unpleasant, worse than fluoxetine for me, but I'm getting through them, as I'm running out of medication options and I'm determined to see this through.

If you decide to go that route I'm sure any start up effects may be lessened by the fact you've been on it before.