Mirtazapine seems to have stopped working!

[lunaloomer]

Hello,

I was prescribed Mirtazapine 15mg about 5 months ago as I was suffering from depression, insomnia and panic disorder. It had been working fantastically aside from some daytime grogginess.

The past 3 days or so my panic symptoms have come back out of nowhere - since then I'm constantly on the verge of having an attack and have a headache and metallic taste on one side of my mouth (which I had before taking them). Strangely I can still fall asleep as well as I normally do.

A few nights ago I took an extra half (so 22.5mg) because I woke up in the middle of the night and couldn't get back to sleep - might this have something to do with it?

I don't know if taking a higher dose or a lower dose would help, I have a GP appointment on Tuesday but I'm not dealing with this well at all, any advice would be well appreciated if anyone has been through something similar!

[hanshan]

A single extra half a tablet should make very little difference, except temporarily. This is because the half life of of mirtazpine is quite long - thirty hours or so - so there is always a fair amount remaining in the body.

Even when taking ADs, it is possible to experience a blip lasting from days to weeks. It doesn't mean the med has stopped working - just your body has thrown up a diversion or two on the way to becoming well.

[SmilingAlbert]

Sounds a bit weird; too early I think to say it's "stopped working"

Were there any particular reasons for you being stressed more: work, family pressures etc.? Sadly, these sorts of things can have an impact which no pill can entirely offset.

I was on 15mg for a while some time ago and had panic symptoms; I eventually went all the way up to 45mg (split the pill - 15mg at night, 30mg in the morning) and that resolved things pretty quickly, so if this persists talk to your doctor and consider taking this route if need be; might be easier than transferring to a new med.

Albert

[lunaloomer]

I did have some family issues which triggered me quite badly but I've managed to deal with it before without this happening.

I was under the impression that the higher the dosage the less sedative it is? I've read online about Mirtazapine "pooping out" and really hope this isn't the case as it's worked so well. Very very fragile and sensitive at the moment, spending my days in bed because I'm depressed and can't do anything.

Hopefully the GP visit can resolve it, I just need something to take the edge off. Can't imagine being like this for weeks and I just want to be back to my normal self.

[lunaloomer]

Saw my GP today and she increased my dose to 30mg to take at night, feeling doubtful that it'll work and nervous that it'll make my panic even worse.

Quite strongly hinted that I felt like I needed to be put on something more sedative (like Diazepam) to take the edge off but she didn't take it on board and referred me to a psychiatrist which will probably take months to go through. Don't think she was very knowledgeable about mental health issues - way too common in past experience!

Will see how I'm feeling tomorrow and if there's no change (Mirt usually works on my panic symptoms pretty instantaneously) I'll have to call them up and see if anything can be done. All this is making stress worse, blah, it's never ending.

[Istherehope?]

I'm sorry things are tough...how did you get on with 30mg last night?

So hard waiting for appointments and things, I'm really feeling the strain of waiting for a psych appointment and not knowing if there's anything that will help.

Really hope today's a better day for you.

[lunaloomer]

Woke up today feeling super zonked (my housemates were convinced I was on something) but honestly feeling a little better. The panic has subsided for the most part, there's still a teeny bit but nothing that would lead to a full blown attack. I imagine it will go away the longer I take the dose, as will the grogginess.

I'm sorry about your wait for the psych appointment, I know how hard it can be when each day is a struggle. Hope it won't be too much longer for you and you'll get the treatment that you need.

[Istherehope?]

Good to hear you're feeling a little better...and hope the grogginess passes soon. I have an assessment with the crisis team tomorrow so I'm hoping I might get some more input, hopefully from people who know what they're talking about.

Hope tonight is another good one for you, sleep well!

[karenp]

Hope your appointment with the Crisis team helps, I never find they do much except ask me why I feel anxious, if only I knew why, lol. But it sometimes helps to talk I guess and not feel like you are going insane.
I am at my doctors in an hour, I am on 30mg of mirtazapine and woke up at 4 today just so low and anxious, so I dunno if it is ever going to help me or making me worse. My dose keeps getting changed about. I just want to go back on Lorazepam as that is the only thing that really makes me normal but they took me off it after two years so I doubt they will give me it again even though I am so fed up now. would rather be addicted to that and normal than off it and feeling like I can't function day to day x

[sandie]

I am weaning off Mirt. It really didn't suit me and I think it has made me even more anxious - especially first thing in the morning. I dropped from 30 to 22.5, for a week, and last night dropped to 15 mg.

The Mirt has never helped my sleep either - in fact if anything it has made it worse.

I hope your appointment with the Crisis team goes well - be absolutely upfront and honest with them about how you are feeling.

[Istherehope?]

Thanks all, I saw a very kind crisis nurse and I was totally honest, and he is going to arrange for me to see a doctor (presumably psychiatrist?!) either tomorrow or Monday...and wants to arrange CBT too. I do feel they are doing all they can, there's just no quick fixes are there...which is tough when things feel so difficult.

How are things for you lunaloomer? I hope you were able to sleep last night.

xx

[karenp]

Glad Crisis team meeting went well, I always find talking does nothing for me once I walk away, lol.I always want the quick fix though, like the benzo's that work right away1 Bad, bad, bad! lol, All the best of luck darl x

[lunaloomer]

Have been sleeping quite well, thank you. A few very stressful / triggering situations have happened the past couple of days which I won't go into as I'd be trailing off the subject of the thread... but I'm lucky the panic subsided beforehand otherwise I would have been sent over the edge.

Did you get to see a doctor / psych today, or will it be on Monday?

[karenp]

Oh that's good...the Mirtazapine must be doing something then hopefully xxx I am back down to 15mg but just could nto sleep at all last night, I dunno why and did feel relaxed. My mood is crap today now though because it was about 2.30am before I finally dosed off and then I woke up at 6, grrrr! But I should be ok tonight now. I am taking Doctor prescribed antihistamines too but had a fizzy drink late on so think it could have been that, too much sugar. lol. Hope your stressful events have all calmed down now darl xx

[Istherehope?]

Glad you're still sleeping well loonaloomer but sorry to hear about the stress/triggers.

I have an appointment on Monday with a psychiatrist so we shall see what s/he thinks...I'm a bit scared they'll say there's not much they can do, or that they will do something and I'll have to try new meds. Hmmm basically I'm scared and anxious really!!

Hope you stay OK and that the stress factors die down if possible. xx