View Full Version : Retrying Mirtazapine
Three years ago I was put on Mirtazapine for anxiety. At first I thought it was a miracle drug as it had no side effects except for feeling sleepy around 4pm every afternoon but I slept like a dream which is a prob for me. Sadly after about 6 weeks it pooped out and I had the worst anxiety imaginable and severe depression. I eventually came off 8 months later when I had tried different doses.
Any how, since that time I have been on Escitalopram but have always had to take Lorazepam alongside it.I am off benzo's now but still getting anxious feelings and insomnia. I saw my psych yesterday and he wants to put me back on Mirtazapine as he says it is odd in his view that I think Mirt made me worse rather than better two months in as people get bad effects in the first two weeks of an Ad not two months later. He seems to think my horrific divorce was down to how bad I felt at that time and not the meds, so tomorrow I start Mirt again. At least I will know what to look for if it starts to make me feel worse down the line.
I just wondered if any one had had a similar experience???? :hugs:
Hi, I am on mirtizapine for the second time and also settraline at 50mg . These 2 got me out if servere anxiety . Currently doing ok & sleeping well . Sometimes people need 2 and they work together better . I have had no weight gain either . I think mirtizapine and settraline are both good medications if you just get past the first few weeks .
been on mirtazapine for nearly 3 years, 2 years at 15mg,s then this year my life caved in so upped to 45mgs. sometime i think it helps other days i'm not so sure. thankfully all side effects worn off quite quickly and i have stop gaining weight, gained 2 stone, but had lost a lot before from anxiety.
my liver function blood test were off recently and i had to get and ultrasound done, thankfully all normal but apparently raised liver function is a known side effect of mirtazapine.
Thanks for your replies guys xxx I wa son it 8 months before and thought it made me miles worse after a couple of months but my psych thinks that is unlikely and my mood and anxiety back then was due to the severity of my divorce (it was nasty!!!)
I've only taken 7.5mg for the past two nights so far and have slept great, no other side effects except for a bit of morning anxiety but I had that any how so probs not even a side effect. Oh and a bit of an headache but again probs down to stress not the meds. I am tapering off Escitalopram and will eventually just be on the Mirt at 15mg's. All anxiety had gone by 8am this morning and I'm not sleepy anymore so fingers crossed this works better than it did the first time around but my life is nothing like it was back then so my psych could be right and perhaps nothing would have helped then. I am scared because I had suicidal thoughts back then but all I can do is give this another go and at least I know what to look out for if this meds just does not agree with me. I know quite a few people who take Mirt and they have gotten really better on it including my ex husband.
I've done 4 days now on 7.5mg's of Mirt and have been good, sleeping well etc but today I have a vile headache and am just crying. I am so scared this meds will make me feel worse rather than better like last time I tried it but my doc wants me to give it another go as last time I was on it I was going through a very nasty divorce. I know this is all normal as the chemicals are changing in my brain so we'll see how I go. Gosh I hate antidepressants though. They're like men, can't live with em, can't live without em, lol!!!!! ;)
MyNameIsTerry
07-10-15, 11:34
We can be a headache too, Karen. A pain at the other end too :winks:
I know you are worried about the previous experience but you were going through a difficult time back then. You've just proved how strong you are by withdrawing from Benzodiazapenes and I'm sure the others on here who have been through that would say it's hard to go through.
You have control and if you need to stop, you know you can but I think you are coming from a position of strength this time so you can do it.
:hugs:
As a man, I know how hard it is living with myself :)
The good thing about Mirtazapine is there's hardly any start up effects. I've had a rotten head all day but that is about it and I felt low early on but that is nothing new. You're right Terry, this time could be totally different and I know what to look for.
Hanshan, I know two men both on Mirtazapine and my last bf suffered with terrible anxiety and depression and he'd been in the VARGOS in L.A!!!
Still got a crappy headache and feel tired but mood is a bit better today.
It's only 4.30am and I've woke up feeling anxious and wide awake, grrrr! Only been taking 7.5mg of Mirtazapine so have taken other half hoping I will sleep but I doubt it until tonight now. I really want my anxiety just to go but not sure if this meds is going to work at all again.
MyNameIsTerry
09-10-15, 06:18
But on a positive note, Karen, it hasn't made you really bad like before. So, it's still early days yet and we can have bad nights with our anxiety over lots of things, including the worry of starting meds. I always say to people, look for patterns, not isolated events. We have so many isolated events which whilst unpleasant, don't repeat or are transient in nature, but until you see patterns of problems they could be just this and nothing that will keep being a problem.
I know insomnia is a massive pain, I've been through it too. At the time you just feel crappy and can't wait for the day to end. All we can do is keep going and try to keep our anxiety levels down and watch our moods don't get too low. Some people get going and perk up, some muddle through hating it and for some like me it's muddling through until I gained the strength to get on with things. Then I started to find I could pull myself out of it more & more.
You've beaten the Benzo's, you can do this!
That's true Terry. I tend to get very anxious if I wake up too early and feel really sleepy but can't drop back off. That's probs good really as I may sleep better tonight now.
Are you on Mirtazapine? I'm still on Escitalopram too but have dropped from 20mg to 10 this week so I may have some wd going on here too. It wasn't working at all for me though.
---------- Post added at 05:43 ---------- Previous post was at 05:42 ----------
PS> Thanks xxx
MyNameIsTerry
09-10-15, 06:58
No, I'm on Duloxetine. It's always very quiet though on NMP about that one so I found talking to the very supportive people on Ven good as they are on here more.
I've been on Citalopram for years before too, which for me worked better.
Yes, I think you will have to chalk it up to meds really as withdrawal is bound to bring some side effects even if they are mild. It's not going to be anything as hard as coming off the Benzo's though I would imagine.
I get my worst anxiety upon waking and for the first half of the day, always have. It's much better now though from working on things over the years and much of my OCD is now gone but thats nothing to do with meds as Duloxetine was what really made them full blown as I really only had GAD before. I too would wake up early, usually an hour before work, and that would make me anxious due to the pressure of needing to get more sleep to get through the day. This was my insomnia period in my relapse whereas when I had my original breakdown I couldn't get to sleep at night but that started due to Citalopram and I was prescribed Zopiclone. The Zop helped but my GP put me on it solid for a month when the Crisis Team later told me it should have been alternating nights for a shorter period. So, I had to spend about 10 days weaning off those with sleep one night, nothing the next, etc and it tooks probably 3 months before my sleep sorted itself out.
We seen to trade one problem for another with a lot of these meds! :doh:
Oh I know Terry, I have been on nightly Zoplicone in the past and it kind of stops working doesn't it or you need more. I think insomnia is the worst thing for me.
I was always on Citalopram in the past too but my doctor took me off it and I was too scared of the start up effects but regret not taking it now whilst I was being prescribed the benzo's. Now I can't have them so have gone on Mirt as it's not really got any start up effects apart from headaches. But it's evil to get off! I'm going to up to the full 15mg pill tonight as 7mg's isn't cutting it at all.
I'm still on 10mg of Esitalopram and that's caused terrible insomnia for two whole years which is why they kept me on Lorazepam but I got so addicted to it and started doubling up. :(
I've not slept a wink all night an dam super anxious. Just taken another 7.5mg half pill but I doubt it will help as it could be the Mirt causing this. Going to go back to my doctor on Tuesday and see what he says. This is just awful!
MyNameIsTerry
11-10-15, 06:45
Yeah, Karen, Zopiclone was a huge relief the first night and I felt a lot better for a good long sleep the next day even though it was day 3 of starting Citalopram. It really helped for just over a week and then it started not doing as much. The big drawback for me was that if you didn't get off to sleep quick, it could be tricky to sleep and that because it only helps you to get off to sleep you only get what you need. The problem with the latter for me was that I was so drowsy the next day I spent more than an hour just trying to get out of bed. It was such an effort just to roll over! Then I couldn't eat more than a few biscuits for hours after that. I would say I felt it's effects for a good 12 hours so getting 6 hours sleep meant I was out of it at the start of the day. I couldn't have worked like that.
I definately developed a tolerance after a month. The Crisis Team said I should have been taking it on alternating nights but my GP never said and just dished them out! So, I used the alternating method to get off them. Whilst I was worried about not sleeping, it certainly wasn't only that and for the first few attempts I would only sleep on the nights I took it. After that I started to get about 5 hours and it went from there. It took about 1.5 weeks to do it but my sleep was messed up for ages. My GP was the typical "they are habit forming, I can't give me" which was great since he messed me up in the first place! Knowing what I do now, I would be complaining.
I honestly believe that if you can come of Benzo's from tolerance like you had, you would handle side effects on start up of others like SSRI's. I don't know but I think others on here who have done both would say this to you.
Have you gone up to 15mg yet or is that the other half of the 7.5mg? The half life of Mirt is 20-40 hours and to get it stabilised in your blood plasma can take up to 5 X the half life. You would be over that now with 7.5mg so as much is going in as coming out. It might abate a bit now it has reached that point? Maybe hanshan and the others would have some ideas on this?
I went up to 15mg two nights ago but feel so anxious. I remember feeling very chilled, very quickly last time I took Mirt, then it pooped out on me I thought. Going to see my doctor if I can get in on Tuesday and see what he thinks as this never worked for me really the first time but they wanted me to try it again as my life was so stressful at the time and they claim it's very good meds.
I hate it when I don't sleep as I just get so anxious.
Karen, I really feel for you. Sometimes you really have to question how "useful" these meds are in the treatment of anxiety disorders and I think that a lot of psychiatrists and to a lesser extent, GPs, are just groping in the dark. Obviously for some lucky people the drugs are successful but for others they just cause more disruption and difficulties and it's very hard to know what to do for the best whilst not compromising physical and mental health.
MyNameIsTerry
11-10-15, 09:10
Is it possible to taper upwards even more gradually, Karen? Like could you split the pills to make it half of the 7.5mg on top of the current 7.5mg to see how it affects you?
Hanshan and SmilingAlbert are often on here so I suspect they will see your thread soon and can offer you some advice as I believe they have experience of this med.
Something I have often seen when it comes to Citalopram is that people taper up starting with 10mg. They have side effects but seem to manage them well. Then they go up to 20mg and it hits them. I guess with some of these meds there is a line you cross where they affect us much more. So, I'm wondering whether this is the case with Mirt?
I agree with pulisa but I think we all know that these meds seem to be very unpredictable as it's an individual thing so we end up as guinea pigs. Some people are lucky and find something that helps straight away, like I found with Citalopram. Some people work through a whole range and I feel very sorry for them as it must be hell. I wish my GP had not tried to get "creative" when I relapsed and just gone back to Citalopram as it would have saved me a lot of problems.
Lack of sleep used to affect me really badly. I got past this stage in recent years by having less & less sleep, not enough, every single day for months and I found I became more resilient to it but I do still have wobble days.
I was just the same with Zopiclone and needed two 7.5mg pills to sleep something silly. So I tapered myself off them. Not one wd thank goodness.
After a week I have decided not to take any more Mirtazapine as I have had high levels of anxiety all day long. When I took it before it I was just the same and the anxiety just got worse and worse. I will speak to my doctor but I'm going to ask for Amytriptyline instead.
Mirt had the same effect on me, Karen. The amitriptyline will have a sedating effect at night and should help you sleep.
SmilingAlbert
11-10-15, 18:56
hi Karen,
Sorry to hear this
If you do want to continue Mirt, you could consider taking 7.5mg at night, and the rest in the AM; or it could be you would benefit from a higher dose, in which case you could do the 7.5mg at night, and 22.5 or whatever in the morning.
I think 7.5mg is possibly the optimum Mirt dose for sleep. But yes, as you say, speak to your doctor; the trouble is many are not as expert in this area as we would all like...
Good luck with it
Albert
Thanks Albert, my anxiety is rocketing again this morning. I didn't take the Mirtazapine last night but wonder if I should just take 7.5mg of it tonight rather than stop altogether. I am seeing my doctor tomorrow morning and then have my first session of acupuncture at 6pm. Just hate feeling so wired.
It's my observation based on people posting to NMP that once they start regularly taking either a benzodiazepine or a "z" drug like zopiclone for sleep, attempts to switch to another med are very difficult. It may be necessary to keep the benzo/"z" as a regular for some time.
bernie1977
12-10-15, 15:07
Have you ever tried phenergan/promethazine? It's an antihistamine prescribed for insomnia. I used it for a short time when I got insomnia after coming off Trazodne and I didn't want sleeping tablets so the doctor gave me this, it did the job. It might be worth asking your doctor about it
I've had some antihistamine or other, doctor used to prescribe that one month and then Zopiclone another. I'm really hoping my doctor gives me Amytriptyline tomorrow as cannot believe how hyper I am on Mirtazapine. I aren't allowed benzo's any more. Thanks guys xxx
Hi Everyone,
I thought that I might share my own experience with some of the meds that have been mentioned. I had been taking 7.5mg zopiclone to sleep. I reduced this to half a tablet (3.75mg) while I was on holiday roughly 3 months ago.
My doctor put me on 15mg mirtazapine to take at night and I was able to reduce the zopiclone some more.
I haven't used zopiclone at all in two weeks now and I am sleeping very well. However, olanzapine (zyprexa) was added roughly two weeks ago also and I am sleeping even more heavily now, as a result of the olanzapine I suppose. It is a lot harder than it had been to get out of the bed in the mornings!
There you go :D
The trouble is olanzapine comes with its own side effects and I think you need to weigh up the pros and cons of going on this med.
The trouble is olanzapine comes with its own side effects and I think you need to weigh up the pros and cons of going on this med.
Weigh up indeed :) Weight gain is supposedly a common side-effect of this drug. It is also a common side-effect of mirtazapine of course. I don't think that I have gained a significant amount of weight so far (after 3 weeks on olanzapine).
However, I took risperidone for several years and it is also associated with weight gain also. I can't say for certain if it caused me to gain weight. At the moment I almost have a healthy BMI. I will see what happens over the next month though.
I can't say that the olanzapine is helping very much by the way. But, I have read that it can take at least a month before it is effective. In some cases.
I got Amitripatyline prescribed this morning. Oddly I cut back to 7.5mg of Mirt and felt more calm this morning though after two days of climbing the walls I was anxious.
I am starting back on mirtazapine again due to extreme tiredness with lack of sleep 30mg
even Zopiclone had little effect my life style now appears to be in bed for most of the day and night.
Somehow I have to have a solid nights sleep which appears to be impossible,
the main thing I dread with Mirtazapine is the weird dreams that at times can be quite disturbing.
Can anyone please post any useful solutions.
Many Thanks.
Maisie.
SmilingAlbert
30-10-15, 00:09
Hope this works for you.
Sorry to hear re your dreams; I have come to enjoy them, mostly. I have bought Freud's "interpretation of dreams" which I am told is his best work. I haven't read it yet, but I gather the main message is this: you remember what is important.
I have had several dream recently which were clearly my subconscious sending me messages about my 'real' life; they were warnings in a way. As they are unavoidable, you may as well put them to use; consider writing them down if you can (not if this upsets you). It can help and be therapeutic and you may start to see patterns.
Good luck
Albert
MyNameIsTerry
30-10-15, 05:11
Hope this works for you.
Sorry to hear re your dreams; I have come to enjoy them, mostly. I have bought Freud's "interpretation of dreams" which I am told is his best work. I haven't read it yet, but I gather the main message is this: you remember what is important.
I have had several dream recently which were clearly my subconscious sending me messages about my 'real' life; they were warnings in a way. As they are unavoidable, you may as well put them to use; consider writing them down if you can (not if this upsets you). It can help and be therapeutic and you may start to see patterns.
Good luck
Albert
I think from an OCD point of view, it's important to remember that he is saying what is important, which can mean negative as well as positive. Is that correct, Albert?
I can't say I know much about dream processes, although it's an interesting topic, but I know people with OCD often see elements of their intrusive thoughts in dreams too and worry about them so I see it as the importance factor you have mentioned, not that there is hidden meaning in them given there is no meaning in them if they are intrusive other than the "ego dystonic" element of them. Perhaps thats the hidden important behind the negative ones? Let us know.
My GP initially put me on sertraline and after 4 weeks of the most horrific side effects and dreadful sleep, I weaned myself off.
I changed my GP because I didn't feel I was getting anywhere with the young newly-qualified GP who had prescribed the sertraline, and the new GP prescribed Mirtrazapine which he said would help with my sleep.
I have depression with anxiety and was experiencing constant panic attacks, heart palpitations, sweats, insomnia, difficulty in breathing and chest tightness.
It is now 11 days in and while I know it is still very early days, at least the awful physical symptoms have reduced dramatically and I am getting some sleep. On 1st October, the first GP gave me 28 x 2mg diazapam (very low dose) to take the edge off the anxiety and I still have 16 of these remaining (some 14 days later). I have started to take just half a tablet (1mg) at night with my mirtazapine and I fall asleep quite quickly and get between 5 and 6 hours sleep. Last night I managed 7 hours !
I think my mood has even lifted slightly.
I am a long way from being 'better' but I do think the Mirtazapine is starting to work. So far - no weight gain either, although my appetite has improved; the sertraline had a terrible effect on my appetite and it was a real effort to force myself to eat.
If you are reading this and wondering about if Mirtrazapine is for you, then I hope my experience to date helps you.
MyNameIsTerry
30-10-15, 08:50
I had that appetite problem when I started Citalopram, Sandie. It was very unpleasant as I felt very hungry with stomach pains but I just couldn't eat. The insomnia tipped me over the edge and Zopiclone helped me get more sleep. Whilst there were still side effects, I found I could fight on much better with some sleep behind me. It really does make a massive different to mental health and when you are going through all this stuff, lack of sleep just makes it 10x worse in my opinion so I'm glad you are feeling a bit better for it.
Maisie - the sleep thing is incredibly important and as such, we place HUGE significance on those occasions when we don't get any sleep.
There is so much out there about the do's and don'ts and advice on how to fall asleep and stay asleep. It all becomes a bit overwhelming.
Obviously, if you are sleeping during the day then you are less likely to sleep at night. But if you are so tired during the day because you didn't sleep at night, then it is inevitable that you try to sleep during the day - it is an awful vicious circle.
There are some very good hypnotic sleep CDs; I bought one some years ago through a suggestion on this site (the company is called Uncommon Knowledge) - they have several downloads designed to help you sleep, and, in combination with the Mirtrazapine, they may just help you.
My therapist has advised that I also cover the clock at night so that I cannot see what the time is if I awake - if it is in the early hours, then it only piles on the pressure to TRY to get back to sleep. I set the alarm on my phone so that I know that I cannot sleep past a pre-determined time, and I make sure the room is dark too.
If I awake I try not to even open my eyes or even 'register' the fact that I have awoken. I do in fact just try 'counting-sheep'.
A warm bed and a cool (but not cold) bedroom; a warm glass of milk and of course the mirtazapine taken a short while before bed.
I really, really hope that the mirtazapine helps with your sleep issue - it has so far worked for me and I only take 15 mg; occasionally - but not always, with 1 mg diazapam. Last night I managed 7 hours - which is incredible for me, and the difference it makes during the day is incredible.
I've decided to stay on it but only take a real low dose of 7.5mg and do not fall asleep at all. I also take Amitriptyline which is supposed to help with sleep but neither touch me, lol. But my anxiety has just about gone now, I feel low now though so cannot win either too hyper or low mood. Hopefully I'll even out in time xxxx
SmilingAlbert
01-11-15, 23:19
>>I think from an OCD point of view, it's important to remember that he is saying what is important, which can mean negative as well as positive. Is that correct, Albert? <<
As I say I haven't got round to reading the book yet, so can't (yet) really comment in detail. But he is perhaps the most famous thinker of them all, and the fact he bothered to write an entire book on them suggests that he think dreams are very important and interesting.
But sleep is very important, and lack of it a total PITA. And I have been there, and I know. As I've said before, i think the optimum dose for sleep is around 7.5mg of Mirt, but of course everyone is different.
I also think that you should try and read interesting, involving books at night, and if you can't sleep, just read and listen to quiet music, Radio 5, etc. And really try not to worry about it; I have had countless sleepless nights over the years, and have got through the dreaded next day just fine; coffee (drunk before 1pm) keeps you going, and usually sheer exhaustion will let you sleep the following one. (don't sleep during the next day even if an option)
But dreams once you get there can be very interesting; I have been lucky to have fairly good sleep recently (am on Pregabalin + Mirtazapine) and they really can seem like my own personal movie. I love the way I dredge up people and events from long ago and mash them all up in a pretty weird fashion.
Dreams are perhaps the most fundamental way our subconscious communicates with us, and will do so all our lives; they should be savoured and enjoyed as much as possible. I occasionally like everyone have distressing ones, at which point we can still wake up positively: it didn't happen!
I have heard of friends being blamed by their spouses about things they did in a dream, which I find endlessly hilarious...:D
So I am now into my third week with Mirtazapine and the sleep thing seems to have bombed out - even if I take it with 1 mg of Diazapam. Now lucky if I get 4 1/2 hours sleep. I am seeing the GP next week, so it may be that he feels I need a higher dose.
Still only on 15 mg so suspect he may want to up it to 30mg.
I am still seeing my CB therapist once a week and she also does hypnosis which I think has helped (together with the Mirtazapine) my general mood. Still getting the panic attacks and intense anxiety- especially in the mornings.
I mentioned to my therapist that I had experienced a really bad anxiety attack a few days ago - and could barely concentrate while listening to one of my hypnosis/relaxation CDs. At the end of the CD I just had to let out the most incredible scream - thank goodness we have no near neighbours and I was alone in the house.
I emailed my therapist (whom I am seeing later today) and told her of this intense and lingering anxiety which had persisted through the CD. She is a lovely caring woman, and yesterday I received an email from her which contained the following
"...I have a lady who will be doing reiki at my clinic. She already has a qualification but is doing another and looking for case studies. This means no payment involved. Have a think and let me know tomorrow. Sincerely, ------ "
To be honest the intense anxiety and panic attacks I feel are often so bad I am prepared to try anything - especially if they help improve the sleep thing, and as there is no cost well I am more than happy too try the Reiki.
Had anybody else needed to up their Mirtazapine in order to improve the sleep thing ?
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