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Murdo
24-02-15, 21:45
Hi everyone, I'm new to the forum.

I am a long-term sufferer of PTSD which mostly manifest in chronic anxiety (panic) attacks.

I have been prescribed Half Inderal LA 80mg Capsules (now discontinued and I now get "Half Beta-Prograne 80mg Sustained Release Capsules" [Propranolol Hydrochloride 80mg] instead), and Diazepam 5mg X3 daily, since 1998.

I had undergone a fairly rigorous course of Cognitive Behavioural Therapy for 52 weeks, finishing up in 2007, at which time I was prescribed "Cipralex®" and then Citalopram along with the Propranolol and Diazepam. I honestly found that the Citalopram was of no benefit to me unfortunately, for the anxiety / PTSD, and the side effects were awful for the entire year of taking them; (dry mouth, feeling MORE anxious, nausea, decreased appetite, low sex drive), without getting any helpful therapeutic benefit. In short, after giving the Citalopram a fair chance for a year, I just decided to take myself off them, as I had finished an intensive FIFTY TWO week course of CBT. I withdrew from the Citalopram, "cold turkey" if you like. It was horrible... it felt like there was an electrical storm in my head for a good few days. I've often seen these described as "brain zaps", which describes the sensation quite well.

I had been managing better with my anxiety without the SSRI Citalopram, as the side effects outweighed the benefits (I honestly never found any benefit from them, unfortunately, and a year was a long enough time to decide that they simply were not benefitting me).

Fast forward almost 8 years to present, I have certainly had my ups and downs with anxiety attacks and PTSD, with some very severe attacks in this time. Over 4 months ago, I had the most severe anxiety attack that I have had in 2 and a half years, and very worryingly I had this in my home, with no obvious trigger to me. In short, this has had a catastrophic effect where I have been pretty much developed agoraphobia once again, as the anxiety attacks have really manifested in themselves, where I am constantly feeling anxious, and I am continually getting really debilitating anxiety attacks, which leave me a gibbering wreck, curled up in a ball on the ground. I have lost 30lbs in this last 4 months, which is very worrying also, as I am just a shadow of my former self. I have seen my doctor a lot in this period and have had just about every physical test carried out on me (all physical tests; blood tests, ECG, Xrays, ultrasound etc. came back negative), and have been referred to my local primary care mental health liaison service. Things were quite slow moving as they are very busy, but I finally got to see a Psychiatric doctor last week for a medication review and had been added Mirtazapine / Zispin 15mg to be taken at night for 3 weeks, which on evaluation can be increased to 30mg at 3 weeks and in turn a max dose of 45mg can be prescribed at 6 weeks.

However, I have been having some very undesirable side effects with the Mirtazapine / Zispin even at 15mg this last 2 days especially. The first night, it made me very tired and I had to go to bed within about 20 minutes of taking the first one. I kind of got the sensation of my throat swelling and that horrible taste in my mouth after the first one, but fell asleep quite quickly the first night, slept well (apart from waking in the middle of the night with my tshirt soaked through in sweat) and woke up the next day feeling very groggy. This was no big concern, after what I had been through previously for 4 months with the anxiety attacks. The sedative effects seemed to decrease the last 2 nights, and by the 3rd day taking Mirtazapine / Zispin, I was getting a massive headache after taking it. This last 2 days, as well as the numb mouth and lips with horrible taste in my mouth, unfortunately I have felt "increased" anxiety, and on waking after what little sleep I get and terrible vivid nightmares, as well as the sweats. I was having lots of racing thoughts that was very unusual for me, on waking, while still groggy. For example when my eyes were closed I could see an image like a jumper or whatever, and then it would be distorted by a "bouncy ball" bouncing up and down extremely rapidly.

Another racing thought I had when my eyes were closed, was of a metal spring, which in this intrusive thought, I could see the momentum of the spring coil from one side to the other very rapidly, and all of a sudden in the thought, it seemed to have attached itself to a rib above and below my heart, and the momentum of the coiling was pulsating really fast from one side to the other. This made me very anxious, and as much as I tried to put the thought out of my mind, it seemed to stay, even though I would tell myself it was just a stupid passing thought. I had to open my eyes and sit up in bed and exercise deep abdominal breathing exercises to make it stop. I have never experienced anything quite like this before.

It was very windy outside, so I am not sure if this was the "inspiration" to the next intrusive thought, which was of particles and objects that I visualised when my eyes were closed trying to rest, either being blown across, from right to left, or simply the particles themselves being blown very fast.

Again on waking this morning after very little, broken sleep, and 3 tshirt changes, all sweated right through, I again had terrible anxiety all day with another strange sensation that I had not experienced before today. It was as if someone was constantly shaking a metal tin box full of iron-filings / ball-bearings inside my head, and feeling really uncomfortably over-stimulated, which left me feeling like I drank about 5 cups of strong coffee, causing the anxiety to go through the roof with racing-heart, dry mouth, nauseous, no appetite and all that goes with severe anxiety. That is the effect that the Mirtazapine / Zispin seems to be having on me at the minute, and I am wondering should I continue with it, and if anyone else had experienced any of these symptoms at the early stages? I feel like I have lost too much weight already, and that I can't afford to get much lower than this just now, until I am built up a little bit. Should I take tonights 15mg dose of Mirtazapine / Zispin, or leave it for tonight and wait to hopefully hear back from the Psychiatric doctor who prescribed the Mirtazapine / Zispin, and wait to hear what they say, in regard to me continuing to take the Mirtazapine / Zispin or to stop now? Your suggestions are most welcome, and sorry for such a long-winded introductory post.

Hoping to hear from you all with your experiences / views, and many thanks in advance.

ohwell123
25-02-15, 11:19
hi you seem in quite a bad place to start with I think you have to accept that to start with or youll just fuel more anxiety

I have been on mirtazapine for a week now my understanding is its a brilliant but evil drug it has completely squashed my anxiety and depression however its temp side effects are quite disturbing

the first eve I got quite bad acid/indigestion and a buzzing feeling throughout my body

the 2nd eve I had funny aches and pains all over esp in my face and a wearing a cap feeling not quite a headache

last night after taking it I felt like I was riddled with arthritis however this morn im fresh as a daisy it was all like a bad dream

ive urinated a lot ive had body zaps that go through me to wake me up as im drifting offand im full of RAGE!!!!!!!!!!!!
all this seems to get better every day its early days

think of this drug like a DJ's graphic equaliser light that goes up and down but sometimes into the red to the music its just findings its level and I believe you will feel better

HOWEVER LOL!!! if you do start to feel better for a few hours here and there and feel worse for one hour DO NOT DWELL ON THAT ONE HOUR

people on here sadly dwell on negativity

hope ive helped

kris

Murdo
25-02-15, 12:49
Thanks for the reply Kris.

I decided to take it last night and try phoning the Psychiatric doctor who prescribed it to me, to ask their advice on it, if I can get them today.

Thanks again.

ohwell123
25-02-15, 13:16
I now take mine and expect the side effects within minutes of taking the drug then upon awaking in the morning with a dry mouth like never before!... the rest of my day seems to be working out just fine!!! I even went BACK to work last night to save for my holiday..im self employed and usually cant wait to finish work at 4-5pm deff not go back lol

has also caused bad constipation and frequent wees since taking it however today I have been for the most normal looking number 2 I have done in 3 years of anxiety and depression can only be took as positive?

the only concern I have is the hugely noticeable RAGE it has given me im already quite a no nonsense lad so to add rage is not good however im prepared to sit out a few weeks and hope things get better

---------- Post added at 13:16 ---------- Previous post was at 13:12 ----------

sorry forgot to add if you already are riddled with anxious thoughts the meds will push pull fight these for the time being its a bit like when you drink alcohol it cures everything but it comes back twice as hard

I used to get exactly what you had without any meds anxiety is a ******* I used to dream about the worst things its as if my mind was there waiting to call for me once id gone to sleep

sit tight hope all turns out good

hanshan
25-02-15, 13:45
Hi Murdo,

How is your blood pressure? Prazosin, which is usually prescribed for blood pressure, has been found to be useful for PTSD. (I think the explanation is that it's an alpha-blocker, but don't quote me on that).

I have some prazosin, and have found it wonderful in helping me get off to sleep if I wake up around 3 am. On the other hand, it it reduces bladder control, so be careful drinking coffee in cold weather.

Apart from that, pregabalin is my anxiety mainstay - all the rest put together don't measure up to it, at least for me.

Murdo
25-02-15, 15:36
So I just got a phonecall from the Psychiatric doctor who prescribed the Zispin, who when I described the side effects as above, told me to stop taking the Zispin as sometimes increased anxiety is an unfortunate side effect and make an appointment with my GP and ask them to prescribe me Duloxetine. I almost feel as if this last week of going through the discomfort of introducing another foreign chemical to my body was a complete waste of time, and that I have had to go through all this increased anxiety for nothing.

Anyone ever heard of / had experience on Duloxetine? Seems to be an SNRI as opposed to be a SSRI. This is torture!

---------- Post added at 15:36 ---------- Previous post was at 14:37 ----------


... has also caused bad constipation and frequent wees since taking it however today I have been for the most normal looking number 2 I have done in 3 years of anxiety and depression can only be took as positive? ...

Yes, the constipation has been really bad on this for me also! So much so that when I finally got relief on Monday that there was blood from the force of pushing! (sorry for the graphic image, but this wasn't something that I needed to see after having the nightmares I had while taking it, and that particular night included one with a lot of blood). Had just been on it for 7 days, and today I still feel the constant rattling iron filings in a tin box sensation inside my head (sounds odd I know). Did you experience anything like that?

Thanks for sharing your experience on Zispin, with me.

Murdo
26-02-15, 02:12
After taking Mirtazapine for only 7 days, and being off it for 24 hours, I am still getting a ringing sensation in my ears, which I have never experienced before taking Mirtazapine. I believe that this is called tinnitus. So, I am going to put out the warning to anyone who is thinking about taking Mirtazapine, that since taking Mirtazapine 15mg for just one week (7 days), that I believe that Mirtazapine has given me "ototoxic" tinnitus, and if anyone else has experienced this sensation also, I hope this gives you some comfort in the fact that you are not the only one. It's just gone past 2:12am and this is keeping me awake. I am not best pleased about this, and hope that it goes away in time. Please comment if you have also experienced this side effect either while taking Mirtazapine, or withdrawing from it. I think I understand now why my Psychiatric doctor who prescribed Mirtazapine to me, just a week ago took me off it earlier today (technically yesterday now).

ohwell123
26-02-15, 13:17
all the side effects apart from constipation and rage usually happen just after taking the drug and are gone by the time I wake up I also feel like my gums are swollen but they are not

I especially don't like aching muscles esp chest and back as im only 31 but feeling 70 at times

Murdo
01-03-15, 13:36
Hi Murdo,

How is your blood pressure? Prazosin, which is usually prescribed for blood pressure, has been found to be useful for PTSD. (I think the explanation is that it's an alpha-blocker, but don't quote me on that).

I have some prazosin, and have found it wonderful in helping me get off to sleep if I wake up around 3 am. On the other hand, it it reduces bladder control, so be careful drinking coffee in cold weather.

Apart from that, pregabalin is my anxiety mainstay - all the rest put together don't measure up to it, at least for me.

Hi hanshan,

Thanks very much for your reply.

Sorry I had meant to reply to your post, but didn't get round to it as I had been feeling so rubbish.

I have honestly never heard of the medications you had mentioned before; "prazosin" and "pregabalin", and I have been feeling that the whole medication route can be so frustrating and confusing, especially when you have had some bad experiences with medications you have been prescribed. I wonder does anyone ever feel if a "class" of medication, simply may not work for them, due to everyone's unique biochemical make-up, or what have you... Any thoughts on that anyone?

I believe that my blood pressure is fine, but I can't be sure, as I don't have any kind of blood pressure monitor, like a GP would have. Perhaps an inexpensive (but accurate) blood pressure monitor might be something that it is a good idea to have in the house, just so that I can know. I had never really thought about this before.

Anyhow hanshan, back to the medications that you had mentioned; "prazosin" and "pregabalin" - had you been prescribed any medications prior to being prescribed prazosin and pregabalin, and if so, what were they, and how did you find them in comparison to these medications that you were on? I'm just trying to get an idea if you have been through a whole "trial and error" type of scenario where you have been prescribed and tried several different medications, before finding that these 2 were the ones that really worked for you? Hoping to hear from you soon, and many thanks for your input.

hanshan
02-03-15, 03:19
Hello Murdo,

It seems my whole life has been a trial-and-error sequence of taking medications at different times, and other times with no medication. Some medications go back a way, and aren't frequently prescribed today, so I won't mention them. However, one medication that is frequently prescribed today (paroxetine) caused an immediate and unpleasant set of side effects.

Especially with the various antidepressants (including different classes of drug), it is still pretty much hit or miss. If you check around the various medication sub-forums on NMP, you will find that most people happy with a particular medication only came to it after trying several others.

Pregabalin has been available for anxiety since 2006. It's still under patent, which makes it expensive to prescribe in the NHS. It's licensed for general anxiety, not panic attacks, but may be helpful in lowering overall levels of anxiety and help reduce the triggers for a panic attack.

Prazosin isn't an anxiety drug as such - it's for lowering blood pressure. However, it has been found useful for reducing nightmares in PTSD. This use is still somewhat experimental, but you can check it out on the web.

keggsy
03-03-15, 17:19
Had ringing in my ears on starting up mirtazapine. Horrid while it lasted but went away after a few days.

A Nervous Nigel
16-03-15, 16:43
Been on 30mg for a month now, missed two nights because left tablets then came home for a couple nights. I took my 30mg yesterday night and within an hour I was very slow/no thoughts struggling to put a sentence together. For the whole month on mirtazapine I never once felt like this. Woke up this morning and felt riddled with anxiety.. So I remembered the doctor had gave me some 15mg tablets as I was thinking of moving up to 45mg per day (30 at night 15 at morning) so me being me thought i would take the 15mg. Specially since I'd missed 2 days. Well I've been anxious still, very slow , taking ages to make a choice, not wanting any food, and just feel really weird.. Something is not right! Was watching funny programme knew it was funny but felt tears ready to pour .. Feeling so unsociable.. Has anybody experienced something similar? Scared to take my 30mg tonight and defo not moving up to the 45mg now. 30mg had some improvement since before mirtazapine.

Hope someone has felt like this. Really spooked lol

A Nervous Nigel
16-03-15, 21:14
So I rang 111 telt them everything because I didn't know if it was wise to keep taking tablets she said take them tonight and then go to my closest gp first thing tomorow tel them they sent me. Pfft rather annoying , was so emotionless most the day then crying on phone to the woman haha.the past three years ave been on and off more medication then I care to count. I swore this was my last antidepressant, I think I should go down to 15mg cos its stop my intrusive thoughts and help me kip.. Even tho that affect has decreased dramatically. I'm so up and down tho and have never been able to fully contrate on anything and I'm never happy. Hate who I am, I don't understand how people can get up go to gym then work come home then get up the next day 5 days per week.. I can't manage 1 day of uni a week.. And when I do go I never go to the second lesson cos feel like anxious or crap. Can't hold a job down.. 3 years I've had depression now and am I any better now? Nah! What a failure..

3000 word essay and presentation for Wednesday.. Done none of it and embarrassed to ask for ANOTHER extension teachers barely believe me now.. I've handed nothing in! This forum is great but wish I felt like I could speak to friends and family.. My mother would worry ,my father is a man man if ya get me. My friends don't understand.. And I always regret it when I mention something like that to someone. Been mumbling all my thoughts to myself the past 3 hours ha! Can't stop.. But better than earlier where I had no thoughts. So scared to take my tablet again now.. But it might end up working again soon. Life eh! Sorry for the rant.

hanshan
17-03-15, 03:05
Hello Nigel,

If you are running out of extensions and understanding from your lecturers, then you really need to go down the path of getting a medical deferment. If not and you don't complete all assignments, eventually your lecturers will have to record a fail. You need a letter from your doctor and appropriate paperwork - also, it would be good to discuss it with a university counsellor. Doing this is not a sign of weakness. You have an illness that is preventing you doing the work.

Be very careful with missing doses of medication. It really can throw your emotional balance off kilter. The usual advice is just to take your normal dose if 24 hours or more have passed since the missed dose (not double up).

It might be an idea to start a regular blog on NMP recording how you are every two or three days. Just a few lines, but it will give you a sense of continuity and some stability, and also a chance to get feedback from others on NMP.

nedmcg
20-05-15, 14:04
This is a great thread although I do agree with hanshan that thete are many people this medication is a lifeline for. I have found it really hit and miss for me I am on 30mg and have been for nearly 4 weeks now but don't feel any benefits with the anxiety.

Not sure how long I should give it before saying enough is enough and try something else. I was on citalopram for many years but recently went through a relationship break up and my anxiety all flared up again and thought I grew tolerance to citalopram. Since then I have been on fluoxetine which I found was a evil drug and made me worse.

So just going to tick down the drug list I guess