View Full Version : Mirtazapine good for depression ?
What dosage of Mirtazapine works best for depression?
I've been on 30mg since may last year. Improved greatly from the citalopram which was tapered off over a week after 10 weeks of hell. Found I was still struggling so my GP increased it to 45 mg. went downhill and crisis team psychiatrist introduced sertraline . I lasted 4 days I think and ended up back in hospital. The sertraline was tapered off and mirt reduced back to 30mg. The hospital psychiatrist introduced pregablin. After discharge the crisis team psychiatrist added quetiapine into the mix. So from September last year I have been taking a cocktail of 3 meds ( pregablin, mirt, quetiapine).
My anxiety has greatly improved I can get out and do things and the physical symptoms have nearly all gone. The problem is the mornings, I've struggled for a year with mornings at first it was anxiety related ( physical symptoms, shaking, hyperventilating, fast heart rate, churning stomach ) but now my psychiatrist thinks my morning difficulties are due to depression, my fear of the day ahead and feeling overwhelmed. She has increased my mirt back to 45mg so I'm currently taking
45 mg mirt
600 mg preg
100mg quetiapine
I know I'm waffling but I guess I just want to know if mirt is the one that will lift my depression as last time the increase made me worse
Istherehope?
06-03-16, 20:11
I can't honestly say I know....like you I felt worse on the higher levels of Mirt. I suppose the only way to find out is to try but that really sucks when you're not feeling great already and worried about getting worse. After ten weeks on Mirt I had Venlafaxine added which made a huge difference to anxiety and depression. For me Mirt only really helped with sleep and if anything it made my mood worse.
Sorry to not be more helpful.
I've read about that combination is it not referred as ' California rocket fuel' ?
I'm pleased it's working for you
I think I mentioned it to my GP last year but she said a psychiatrist would have to prescribe it and then I forgot all about it
It's awful all this trial and error when your not in a good place and having to wait weeks to see if it's going to work or not. If I could sort these mornings out I'd be good to go and get back to work
Istherehope?
06-03-16, 22:15
Yes it is known as Californian Rocket Fuel and it has made such a difference for me. It was prescribed by a crisis team psychiatrist after I became suicidal on Mirt alone.
You're so right, the trial and error aspect is a nightmare. I used to get those terrible mornings too, overwhelming, relentless waves of dread and panic...it's truly horrible and I really feel for you...I really hope the mornings improve for you soon.
Thank you
Can I ask did it take long for you to notice improvement ?
The increase in mirt also made me suicidal last time so that thought is in the back of my mind. I wasn't on pregablin or quetiapine then tho so they might make a difference.
Next time I see my psychiatrist I will mention 'rocket fuel' and see what she thinks of it as an option for me
Istherehope?
07-03-16, 16:48
I went from 45mg Mirt to 30mg Mirt and 75mg of Ven. I noticed an improvement between 2-3 weeks but when it plateaued I increased to 150mg Ven. Again I noticed the improvement between 2-3 weeks and two months on I feel pretty much "normal". The Ven didn't seem to produce much in the way of side effects for me which was also a relief as I have also reacted badly to Citalopram in the past.
I can see why you're wary about increasing Mirt again, but I really hope the other meds make it a different experience for you. If it doesn't help though the rocket fuel might be another option.
Oh I had a terrible time on citalopram... A nightmare infact. 10 weeks of hell, no sleep, not eating, constant adrenaline rushes. I couldn't leave my bed and needed diazapam to get me to doc appointments. Ended up in hospital for 2 weeks
It's so strange though as I had been on citalopram for a few years previously and they worked great but this time was a big no no
I know one thing when I do get sorted I will take whatever cocktail works and never come off them again
Istherehope?
07-03-16, 17:11
Sounds like we respond in a similar way to some of these drugs - like you I had taken Citalopram previously and it had worked, but I couldn't go back on them - I think I only managed five weeks of hell before a crisis team psychiatrist took me off them. She won't prescribe SSRIs for me at all now.
And I agree, I don't ever want to come off my current combination and I really hope you find the cocktail that works very soon.
I've been checking through the mirt threads and it seems a lot of people struggle at 45mg which isn't giving me much hope !
I hate it when I feel like this because I become obsessed about my medication, googling looking for other people's experiences and reassurance.... It does my head in
Istherehope?
07-03-16, 20:04
Yes, the endless search for something that will tell us it's going to be ok...I was the same a few months ago...wish I could make it better for you :hugs:
Thank you for replying, knowing someone is listening helps. I'm pleased your meds are working for you
I've just been to see my GP who says it could be 6-8 weeks before I see any improvements and I could get worse before I get better. So I'm going to have a fun couple of months! She renewed my sick note till beginning of may that will go down like a lead balloon at work
3 weeks since I increased and it seems to be doing the trick ( hope I'm not jinxing myself)
I feel the fog lifting and my mornings are improving. I don't have that awful fear of the day as intense as I used to and my motivation is improving too
Last time I increased it ended badly but I think the combo of pregablin and mirtazapine are finally working well together :yesyes:
Really good news, Lan! Fingers crossed that things continue to improve for you and that life can become more manageable. I admire you for how much you have persevered with your meds through thick and thin-hopefully this time you've cracked it and have a good Summer to look forward to and beyond,of course! xx
Thank you pulisa
It's been one hell of a fight and I'm hoping this depression and anxiety has finally surrendered lol
I just need the work issue dealt with so I can hopefully move on with my life
MyNameIsTerry
28-03-16, 05:08
Hey Lan,
Have you looked back at your posts from ages ago? I bet you would see how different you seem to us now. You come across as focussed on recovery as opposed to the struggle of meds and symptoms.
Well done. :yesyes::yahoo:
Hi Lan,
More strength to you. Don't worry about how it goes down at work - they will cope. Someone else will be happy picking up the extra work, I am sure.
Whoever is in charge of hiring staff will have to deal with it, but they will. You are giving lots of notice, not a couple of hours before you are due to start, which is the real angst for supervisors.
Istherehope?
28-03-16, 10:02
That is such good news Lan, thanks for letting us know. It is amazing when we finally find a combination that works...I still just feel grateful that I'm able to enjoy the simple things like sitting down with a cup of tea or making caramel shortbread for the kids (and me).
Don't know much about your work situation but hoping you can get that sorted soon and are able to keep enjoying the improvement.
Thanks peeps
I'm not out of the woods yet like I say but I think I see a clearing ahead.
Just had a quick look at my old posts, helped me realise how far I have come.
I've done everything I can think of to help myself mainly forcing myself out of the house everyday, joining groups and meeting new people. Some days are easier than others. I also enjoy just being able to sit and relax watching TV or reading a book.
Whatever happens on Friday happens, I do hope I keep my job but maybe I'm not meant to return there ! Maybe I'm supposed to do something else .... I still believe some things happen for a reason
Istherehope?
28-03-16, 19:48
You've done so well to keep persevering Lan. I can understand that feeling of being better but still fragile - not out of the woods but seeing the clearing.
Will be thinking of you on Friday :hugs:
Speaking as someone who really struggles with being able to sit still and relax it must be great to be able to do these things now, Lan. I wish you all the very best for Friday-what will be, will be! xx
Thank you both for your well wishes
I've had a strange couple of days, looking for things to do. I've cut my hedge, fixed my gate and then painted it :ohmy:That's not like me at all lol my son is bemused by it all
As you can imagine I'm quite chewed up about Friday so I took a 2mg diazapam I've had left from last year ( kept them for emergency use) and today felt like an emergency. Spoke to my union rep and we are meeting prior to my meeting to discuss matters, I must say he seems unconcerned about it, but I feel like I'm about to be executed
I still fear that agitation returning I think that was one of the worst symptoms, not just been able to relax and constantly clock watching.... Awful
Istherehope?
29-03-16, 18:32
I agree, the agitation is awful - the morning version of doom laden terror is my worst experience of all time I think.
It sounds sensible to make use of Diazepam while you've got Friday hanging over you. I'm guessing/hoping that it can't be as bad as your fears are telling you, but I know all too well that it can be impossible to calm yourself even if your rational mind knows it may well be OK.
I'm glad you have a union rep, I hope he's good.
I hope he's good too
I think I've jinxed myself, the past 2 days have been awful. The cloak of doom and gloom wraps itself round me when I walk down stairs every morning. Why can't I just wake up normal on a morning ? It dose my head in....
I haven't been out much either as a lot of my groups are off for Easter and the course I was doing finished so waiting for a new one to start.
I want to go back to work so badly but I'm so scared about it, my mind can't stop thinking about it
'Could I work feeling like this ?'
' maybe I should just resign', ' how come other people manage to go to work with anxiety what is wrong with me that I can't ',
I'm fed up I feel like a proper loser
Good luck for tomorrow, Lan. The waiting's nearly over now xx
Istherehope?
31-03-16, 19:40
Oh Lan I'm so sorry you've had a horrible couple of days. You are most definitely not a loser. You are someone with a horrible illness who has persevered, fought very very hard to get better, continued caring for the people around you and has provided a lot of support to people on this forum as well as multiple other great things I don't know about. The fearful stuff is the anxiety illness talking and it isn't you, you are a wonderful, brilliant human being.
Having said all that, I know how hard it is to believe anything good once the negative mind chatter kicks in and you have my utmost sympathy.
You may find that once you get through tomorrow - and you will get through tomorrow - that things calm down again. It would be normal to be a bit anxious about a meeting like that even if you were well - whilst trying to recover from anxiety it is almost impossible to think about it calmly.
I'm cheering you on tomorrow. What time does it happen? I'll be thinking of you.
:hugs:
Lan, I missed your last post. Anticipation of tomorrow will make your anxiety so much worse but it will be temporary. You won't go back to those dark days-you've come out the other side now. Get tomorrow over and move on? Don't overthink about how you will cope-take it one step at a time and get through the meeting? xx
MyNameIsTerry
01-04-16, 10:30
Good luck with the meeting, Lan.
I agree, it's the anticipation causing you a blip. It will pass soon, if it hasn't already. I sometimes found with mine that on the big days things changed as I felt more like there was a reason and something to fight against.
If you need to take a break during the meeting don't be afraid to ask, they should have no objections.
When the day arrives I often find that I am much more in control too-it's that terrible waiting which can be so awful and overwhelming...
Really hope that you have a positive meeting, Lan xx
Thank you everyone
I survived the meeting, my face kept burning up like when your embarresed I've never had that happen before
My union rep was great I couldn't of done it without him. My return date has been finalised and I have to wait to hear back from my employer about a phased return and a move to a different department. Also I shall be paid for all my untaken holiday from last year which is about 3 weeks so that shall be a big help.
So in 5 weeks I shall be back to work :ohmy:
Thank you once again for your kind words everyone
Oh and I am covered by the equality act by law
Istherehope?
02-04-16, 17:53
Thanks for letting us know Lan and well done - you did it!!
Really glad you had such a good Union rep too, it helps so much to get that kind of support.
How do you feel now it's happened? I hope your body is able to relax a bit now you've got through that hurdle, though I realise the thought of returning to work in five weeks may not be easy. I hope you can ignore it for now though and just take each day at a time.
You did really well to cope with all that! Don't think about returning to work for the time being-5 weeks is an age away but at least you have something positive to work towards and none of your fears materialised!
I hope your agitation symptoms have lessened a bit now but I know it can take a while..Really well done though-going through that is no mean feat!
My body is relaxed it's my mind that seems to struggle with that. I know I will be chewing it over for the next 5 weeks so I'm not looking forward to that.
We never discussed reducing my hours as my rep thinks it's best to evaluate this once I'm back and see how it goes
Back to see psychiatrist on tues so see what she has to say. I think if I could up my mood and stop the negative thinking I'd be in a much better place
That's easier said than done though. You've had a lot of anxiety in the build up to this meeting and its bound to have some effect on your mood afterwards. It's not easy just to turn off those thoughts. See what your psych says on Tuesday?
Your right pulisa, I never thought of it that way. It's just so annoying when you think you may be turning a corner then it's like going back to square one. I've been feeling slightly agitated again too and I'm getting worked up about the dreaded mornings.....
I guess I'm just feeling a bit sorry for myself :weep:
Like you I rate agitation as the worst symptom of this illness-you've been there and you know that you would do anything to avoid it in the future. You've been under huge pressure with this meeting and it's going to have some impact especially as you have only recently felt yourself to be more like your old self.
This will pass. Have confidence that it will? You have your appointment on Tues and this will be a chance to discuss everything and get some moral support and expert advice x
Thanks for putting things in perspective for me pulisa, I just get caught up in my negative thinking spin x
Don't be hard on yourself-you've got a lot to contend with. At least you know you have support from the professionals and aren't dealing with this on your own. It may take a short while before you are feeling more "stable" again but you won't go back to those dark days. xx
Hi Lan,
Hope you return quickly to the positive thoughts you had before the work meeting came along. You have some time you need now to grow stronger.
MyNameIsTerry
04-04-16, 06:36
Well done, Lan!!! :yesyes::yahoo:
I'm glad your rep was good too. Remember, it's not a legally binding contract, if a date needs to change, it is based on your health.
Feeling washed out is always likely with big events like this. It's like after a period of high anxiety or a panic attack when the fatigue comes on and all you want to do is sleep. It knocks you about a bit BUT it doesn't cancel out all the hard work you have been doing for these months, it's just a slight setback, a blip.
You had this enormous thing building in your head but in reality, how bad was it really? I remember mine, when the day came I was soldiering through it all!
Did anything come of the sneaky bit about your work that they she was trying to bring in? I hope your rep slapped her down on that one.
Terry the competency wasn't even mentioned, but I did inform my rep about it.
Hanshan I know you take preg (600mg) but what dose of mirt are you on? I have been debating about taking all my dose on an evening ( pregab).
Pulisa thanks again for the reassurance, I feel rather selfish as I know you have a lot to deal with yourself x
I'm wondering if this increase is doing more bad than good, but it has only been 4 weeks and they did say 6-8 weeks. I really need something to settle me on a morning this has been my biggest issue since day 1.
I'm now waiting for my sons social worker to arrive to discuss his housing issue and hopefully get him out of hospital and into the community
Hi Lan,
I take 45 mg mirtazapine daily - mostly in the evening with pregabalin to help stop the waking anxiety thing. It works to the extent that I don't wake to feelings of anxiety or impending doom like I used to. However, I still get waking nightmares, which I've had in varying forms for decades (a kind of post-traumatic stress problem from childhood family problems).
But on balance things are much better now than they've been. As Leunig (a cartoonist in Australia) says: "The whale of despair in the middle of the night turns out to be a sardine on toast in the morning" (I'm probably misquoting a bit).
Hanshan I sleep really well now, it's taking a long time but I now average about 8 hours + every night. I never thought I would get a decent night sleep again a few months back. Them waking nightmares sound awful and scary and your quote is very true.
Hanshan - I love that quote, and have used it today; a friend of mine has a daughter who is going through a very difficult time and is making early morning (1 am two nights ago), phone calls to her parents with all sorts of imagined problems.
I have suggested she tell her daughter the quote - it fits so well !
Leunig is an unofficial national treasure in Australia. If I could encapsulate his work, it is that in the darkest of dark, things often seem overwhelming, but hope sometimes shines a light. The balance between overwhelming despair and hope shifts in his work, just as life does.
Here is a link to some of his work:
http://www.leunig.com.au/cartoons/cartoons
MyNameIsTerry
08-04-16, 06:28
Yes, I like that too, hanshan.
:roflmao: at the butterfly and the man.
Istherehope?
09-04-16, 19:59
Never come across Leunig before - loving him now thanks Hanshan!
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