Feeling agitated after taking 15mg advice please

[jane2011]

I have been taking 15mg at 930pm an going to bed at 10pm I have been taking it for about a month. I started about a week ago either taking ages to fall asleep because I was soo restless or sleeping for about hour and half then waking for a couple of hours really restless. Should I wait longer to go to bed ir take it and go to bed sooner? Any suggestions thanks x

[ShaunD]

Hi , I normally take it when I go to bed no matter what the time and fall asleep within half a hour .

[jane2011]

Hi shaun
I might try that apart from night 1 I haven't found it makes me feel sleepy at all though. None of this out for the count for 8 hours business. it's definitely worth a try though. I do find I seem to have most energy in the evening from about 4pm and once I take it I feel even more awake. I can't sleep in day either. I was given it purely for insomnia which made me anxious not depression. Diazepam an zopiclone didn't work at all.

[hanshan]

Hi Jane,

Are you still taking 15 mg? I suggested trying 30 mg a week or so ago. You could also go up to 45 mg, which I find beneficial. But each person must find what works for them.

[jane2011]

Hi Hanshan

Yes you did suggest trying 30mg tbh a couple of reasons I haven't. I have been getting a few hours every night sleep. And after 3 babies I can function quite well on little sleep. My anxiety has gone it's more like restless legs but all over my body just fidgety like when you have drunk too much coffee. Also I have been worrying about weight gain on 30mg. I was hoping I was just getting the timing wrong. I am at the docs in a week or so I will ask her. When I last saw her she wanted me to stay on 15.

[ShaunD]

Hi, correct me if I am wrong but I thought the lower the mg of mirtizipine the more sedating it was so 15mg should help you sleep better than 30mg but I am no doctor just previous experience of being on this for nearly 2 years x

[SmilingAlbert]

>>Diazepam an zopiclone didn't work at all.

Very surprised to hear this; while most find Mirt useful for sleep, I don't think I've ever heard of anyone who didn't find those two worked; neither are a very good idea because of the dependence & tolerance problem, but are very effective short-term, anecdotal & clinical trial evidence suggests.

The fact that they don't work suggests anxiety is a real issue for you, and something that tackles that specifically will be of the bigger help. Mirt is mainly an anti-depressant; its effectiveness for anxiety is less noted.

Albert

[jane2011]

Hi Albert the mirtazapine has sorted my anxiety. I think I was having a sleep problem am wasn't anxious to start with only anxious when diazepam an zopiclone didn't work. Was quite hysterical then was a babbling wreck after 4 days of no sleep I had been hearing and seeing things when I tried to sleep. My Gp then decided to try mirtazapine she is going to refer me to sleep clinic too.

[hanshan]

The idea of mirtazapine being more sedating at lower doses was hypothesized some years ago on the basis that mirtazapine functioned primarily as an antihistamine at a low dose, and antihistamines were known to have a sedating effect. Also, in short trials, patients frequently reported both daytime and nighttime sleepiness.

It sounds simple, but it isn't. It has since been discovered that mirtazapine's effect on sleep is also due to its effect on serotonin receptors. In addition, the antihistamine effect has been found to reduce after several weeks, so a prolonged response for sleep may be due to the serotonin effect, not the anti-histamine effect.

Another factor is genetics. One study found that the sleep-promoting property of mirtazapine varied according to genetic differences in serotonin receptors in those taking it.

[jane2011]

Hi Hashan do you think 30mg would work better on my serratonin levels and therefore help me sleep. I think I must have a high tolerance to anti histermine because nytol never worked for me.? I had rough night went to bed 1030 did not get to sleep till after 2am slept fitfully until 6.am i think i am going to try mirt two hours before bed tonight .Xx

[hanshan]

Hi Jane,

There is a possibility that 30 mg may work better to increase your serotonin levels. 30 mg may also work better if you have developed a tolerance to the antihistamine effects.

All that aside, I think the main point is to try different doses over time until you find what works best for you.

[jane2011]

Thanks for the advice hanshan will give 30mg a go I think .