Increase mirtazapine to 22.5mg

[LittleMissAlone]

Hi there

I'm becoming a bit of a veteran to nmp, but would value any feedback. I'm almost at 5 weeks on mirtazapine, the last three days 22.5mg, prior to that 15mg. So far I'm feeling a bit coldy and definitely more on edge. I found 15mg really not working though. I'm taking it for anxiety, not for sleep problems. Last night when I went to bed I felt as if I'd taken a load of caffeine and it took me longer to get to sleep.

I know I should exercise more in the day but am finding a lack of motivation, probably because of the cool weather, but also being out makes me a bit uncomfortable. My social anxiety has worsened over the past few weeks.

Has anybody else tried 22.5mg, or did they you have to go straight up to 30mg. I appreciate that everyone is different.

Thanks.

[Doze]

I couldn't tolerate the increase from 15 to 22.5 for similar reasons. It just felt too activating to take at bedtime and I couldn't get to sleep. I figured 30 would just increase that so I didn't even bother trying. I've stuck at 15mg but it doesn't seem to be doing much tbh.

I would assume that you adjust to it eventually. I don't really notice my 15mg evening dose in the way I used to when I first started.

[unspoken]

I took a few weeks to settle on the 15mg dose and then I had some bad anxiety and insomnia despite it, then I increased it to 22.5mg and I was feeling sleepy again, and also feeling disconnected from my body and not really in control. It was scary so I dropped down to 7.5mg and I'm taking it purely to try to maintain sleep and eating.

I am swinging between anxiety and depression as to which one is dominant. Mirtazapine seemed to make me more depressed, weirdly, but it's hard to judge.

[LittleMissAlone]

Thanks Doze and Unspoken

I should have said that I'm still taking 15mg at night but 7.5 in the morning. I've cleared it with my doctor, it's such an inexact science they pretty much leave you to it. I'm not working, but I don't find that it wipes me out after taking it, as it would do taken at night.

I had a better sleep last night and so far today I'm better in myself too. So I'm hopeful. I felt I had to do something as I wasn't progressing very far at all on 15mg at night, still ridiculous amounts of anxiety at doing slightly more out of my comfort zone.

I really hope you both find medication to suit. Doze, I'll let you know how an extra 7.5 in the morning goes. I've heard that 30mg can really increase the appetite which I don't want because my appetite hits me in the nausea department.

Good luck!

[Shazamataz]

I stated straight on 30 mg two weeks ago as my new psychiatrist diagnosed me with depression on top of the anxiety.

Compared to the nightmare effects of citalopram and setrtaline I haven;t noticed any side effects other than feeling really spaced out in the morning. I certainly haven't had the 'stimulation' I had with the SSRIs.

Also, I am feeling a bit better, though still up and down. Sleep has improved quite a bit though still have a way to go.

Dr said smaller doses were more sedating than the 30mg and it is what is required for therepeutic effects.

Hope this helps!

[LittleMissAlone]

Hi shazamataz

I hope you're ok. Sounds pretty rough for you. My doctor suggested 30mg on the phone this week but I said to stick with 22.5mg. Another doctor at the same practice prescribed only 15mg initially, and didn't say anything about increasing, and he knows my problem is anxiety rather than insomnia.

Never easy!

[LittleMissAlone]

After doing so well with increasing the mirtazapine I seem to have crashed a bit. It's been about 1.5 weeks. When I started on mirtazapine the first time round the same thing happened when I would feel tired and listless at about the same time into it.

Like everything it affects the anxiety levels. Joy!

[sandie]

Perhaps with your GP's agreement, you could try 7.5 a night and 15 mg in the morning ? The lower dose at night will aid sleep, but the combined dose may improve your anxiety / depression. Sadly I could not tolerate Mirtazapine and it did nothing to improve my sleep issues; nor was Sertraline a good fit for me - this had me bouncing off the walls with anxiety and my blood pressure soared.

If possible, do try to stick with it, but if you begin to feel really unwell and unable to cope with the higher dosage, go straight back to your GP - do not be prepared to put yourself through hell for a 'maybe' solution.

Oh and yes, sadly, there is almost inevitable weight gain with Mirt, and it appears that those who have not suffered a weight increase are very much in the minority.

---------- Post added at 13:57 ---------- Previous post was at 13:38 ----------

I gained 11 lbs !

[LittleMissAlone]

Hi Sandie

Thanks for the response. It's interesting you suggest flipping the doses around. Maybe worth giving it a try.

As regards weight, I was put on sertraline early Nov and lost about a stone (with original illness too), couldn't tolerate it at all after almost 6 weeks of trying. Wwhat with one thing or another I've been taking mirtazapine for about a month and a half. Yes I've put back some of the weight, but I've done some running too. I'm determined to not put on any more - the only thing sertraline is good for is weight loss, as far as I can see! I've kept more than half a stone off, and am comfortable size 10 which for mid 40s is not bad.

Also, by not going as high as 30mg a day I'm hopefully not in the category where you get the serious munchies. I found 15mg not working on the anxiety front, which rather defeats the object!

Will let you know how things ago.

Thanks and good luck. X

[Shazamataz]

I'm 3.5 weeks in with the 30mg Mirtazapine. Went straight on that dose at the insistence of the psychiatrist. Towards the end of week two I definitely started to feel calmer and my mood was getting better and I didn't notice any alarming side effects like with the SSRIs, though have not been able to stop eating and have gained 3kg!

That said, I was doing well for a week or so and yesterday anxiety came back with a vengence. Only slept 3 hours last night and was in a terrible state most of today.

Lets hope it's just a wee blip in recovery!

[LittleMissAlone]

Good luck Shazamataz.

I noticed yesterday I was back to square one with anxiety, most annoying. For instance, I went to take back some trousers in a shop and I found it very difficult, and it only took seconds! On top of that beautiful day weather wise, and I do sleep well, so no rhyme or reason. I put it down to trying to readjust the increased mirtazapine. I hope today is a better day.

Sometimes I think I'm wasting my life doing nothing. Anyone else?

[LittleMissAlone]

Hi Sandie

Friday was wonderful, the first day I switched the doses around. I was able to go shopping somewhere I haven't been for ages. However the last two days, not as bad today, I've had terrible ibs cramps! I've had it before but I don't remember it as being as bad as this so suddenly. Will get ibs remedy today. I've got a bit of a stress on at the moment, but not enough to set stomach off like that. May cut back to only 15mg at night.

Not easy, is it?

[Scarra]

Feeling cold is normal as it lowers you white blood cells , hope that helps . I’m normally warm all the time even in winter , not anymore 👍👍

[Scarra]

mirtazapine can cause stomach problems so don’t worry ��