Increasing from 30mg to 45mg??

[xrachykinsx]

Hi, This is my first post here. Hoping to find some support/advice on my particular med. I am currently suffering from my first episode of anxiety/depression. It was all triggered by Insomnia last October when I had a sinus infection. I got really worked up about not sleeping and once I finally got the sleep sorted, the anxiety and low mood stayed with me. I'm 22 and have a 3year old son. The doctor has diagnosed me with GAD, and said that I probably had Post natal depression and left all my other stresses bubbling away ( I have had a lot of stress in last few years as my son is possibly ADHD, speech delay, I got married last year, tried to go back to work but it didn't work out)

My doctor prescribed me 30mg of Mirtazapine as my first starting dose. I felt some relief almost instantly the next day- perhaps the sleep element really was all it was, but then I've had a really bumpy ride. I've been very up and down and today marks the 8th week of being on mirtazapine. As a whole...I'm much more stable HOWEVER I do not feel completley comfortable. I'm still feeling very unsettled and uneasy with myself. I can shake it off if I'm busy or out somewhere, but mornings and particularly evenings are quite miserable for me. I'm petrified of slipping back and although I've made some progress on mirtazapine 30mg, I feel like it's not doing anymore. Is it still too early to be completley feeling good? or is it likely that an increase may help?

I tired citalopram briefly, but lasted out 5days on it as I literally had 0hours sleep in 5 days, wasn't particularly helpful because the reason for my anxiety was triggered by insomnia. Sleeping tablets didn't even work in an attempt to stick out citalopram.

[SmilingAlbert]

:welcome:

Hello there,

If you have sleep issues, mirt is by far and away the best AD to be on, IMHO.

Please be aware that mirt is more sedating at lower doses. Noone is quite sure what the most sedating dose (and everyone is different) but it seems it is in the 7.5mg-15mg range for most people.

I was on 45mg about 10 years ago; at first I tried taking 45mg all in one go in the evening. Big mistake - got no sleep at all. I solved it by taking 15mg in evenings, then 30mg in the morning. I am not a doctor and you should discuss this with yours, but this approach worked for me.

Mirt is effective at 45mg for anxiety and definitely worked for me, after a while. As it 'worked' and the anxiety jitters went away I put on a ton of weight very quickly, so watch out for that when it comes: keep salad and fruit handy, and don't give into the carb cravings that will probably come.

Best of luck

SA

[xrachykinsx]

I'm not sure if I would have the sleep problems again but being as it was the cause of my anxiety...I am comfortable taking an antidepressant that helps me go to sleep. I have been prescribed an increase to 45mg...but I'm still a bit unsure of whether to take it or not. I seem to have a couple of good days..and then I start having bad days again. My anxiety seems to be about 'how I'm feeling'...I'm just generally anxious that I won't get better.

I'm having a few bad days again, I just feel the anxiety never completley goes away. I'm struggling to just relax and just be me. Thanks for your reply Albert. I personally don't think taking 30mg in the morning would work for me as the 30mg still makes me sleepy after about 1hour and a half of taking at night. Hopefully the 45mg will not disturb my sleep. I'm thinking of taking my first 45mg tablet as I don't really have anything to lose by doing so at the moment.

[keggsy]

Hello rachy, like you my anxiety is predominantly insomnia based.
Have been on 15mg mirt, but 30mg for last 6 weeks.
Can't say mirt helps me to sleep that much, as anxiety gets in the way too much.
Have zopiclone for emergencies, keep a sleep diary which tells me not all nights are bad. Sometimes I've been getting 6 or even 7 hrs which isgod.
What I have found is that sometimes I feel better next day on a night when I've only had 5 hrs approx, which tells me quality of sleep is as important as quantity.

[xrachykinsx]

I wouldn't say I have a sleep problem now after taking the mirt for just over 2months. My sleep is back on track and the mirt perhaps only slightly helps with getting off to sleep but that's good. I've just somehow managed to keep hold of the anxiety in the day instead...which is so strange considering it only started as an anxiety of sleep! I think I've decided to take my 45mg tonight, nothing to lose! I can only hope it will help my anxiety that bit more :)

[Sam100322]

I am also on 45mg of mirt. I sometimes have difficulty sleeping as the tablet doesn't make me as drowsy as when I was on 15mg. I have good days and bad days as we all do. But I am in a much better place then I was thank god. How are you doing now? X

[xrachykinsx]

In general, I'm much better than I was at the end of last year. It really upsets me to think about how bad I got :( It's almost as though I'm a bit traumatised by it if that makes sense- not sure if that sounds stupid. I just still don't feel comfortable completley...I'm fine if I'm out and about and with company but as soon as I'm home alone with my son...I just get really panicky inside and I don't know what about really...I guess just 'am I ever going to be back to me again' and I constantly assess my mood...

[keggsy]

Can relate to being worse at home.
Having too much time to think is unhelpful. I had a day off on Fri and felt crap.
Keeping busy is good.
Am tempted to go back down to 15mg but doc wants to keep me on 30.
He did not want to add a low dose of amitryptaline either that I suggested, due to increased risk of side effects he said.

[xrachykinsx]

I took my first 45mg dose last night...didn't knock me out like doctor said it would at first again... but when I did get sleepy, I took a while to actually go to sleep which was odd...possibly was that I was a bit panicked and worried about taking my 45mg dose tbh! Felt okay when I woke up this morning...but had a bit of a dip early evening, unsure of whether that's something I should expect in first few days or even week of this new dose.

You are so right though, having time to sit and think is not good for anxiety! my son starts nursery soon...really trying to get myself a job as I think that would help me 'forget' about my anxiety...I have waaaay too much time on my hands at the moment!