Mirtazapine sedative effect lost

[valleybear]

I have been on 15mg Mirt for nearly two years and my anxiety, depression and panic attacks are much improved. However I have severe issues with insomnia and for the first year thought I had found the much longed for answer with this drug and enjoyed a good night's sleep and no after effects. Now, however the sedative effect seems to have worn off and I am no longer sleeping again. Some nights I am awake all night and others I cannot sleep till around 4.00 or 5.00am. Otherwise Mirtazapine has been excellent, no weight gain and no significant drowsiness during the day. The lack of sleeping is now becoming chronic and I don't know whether to get Dr to change the meds or change the dosage( I understand that the lower dose is best for sleep) . Anyone found that it ceases to work? Does it kick back in ever..I am getting desperate! :weep:Thanksxxxx

[LittleMissAlone]

Hi

That's very encouraging that mirtazapine 15mg has been so effective for you regarding your anxiety and other symptoms. I've been taking the same for over 3 months and I must say my anxiety is still relatively high, though I'm sleeping very well. Sleeping has never been an issue for me.

Could you ask for sleeping tablets to take on top of the mirtazapine, to save you increasing or decreasing it? It sounds as if you have the holy grail as you have no side effects either.

Take care.

[valleybear]

Thanks. Yea, Dr gave me a few Zopiclone at one point but is reluctant to prescribe more, even though a half of the lowest dose is enough for me. Just used them when I had had a run of bad nights. Hope that you can persevere with the Mirt as I have had no problems whatsoever, except the fact that the sedative effect seems to have permanently worn off.
Good luck and hope that you see an improvement soon.xxx

[LittleMissAlone]

Oh thanks.

Because it's such a low dose I'm trying to do more alternative therapies too. The latest thing is reducing my caffeine intake. Makes sense as caffeine can make you jittery, and upset your stomach, which are my main bugbears.

Why would your gp be reluctant to prescribe something that works for you? I suppose they're worried about side effects.

Good luck.

[valleybear]

Probably NHS pressure not to supply sleeping tablets on a regular basis, or worried that they will be habit forming. The last time I had 10 Zopiclone prescribed
they lasted me for 6 months so don't think that that was too shabby! Haha! Goodness know what the GPs think. Thanks for your input. Take care.xxx

[SmilingAlbert]

Sorry to hear this Valley.

The sedative effect is related to an anti-histamine effect that the med has. This can indeed wear off over time. Have you been very stressed recently? That can certainly bring on insomnia, sadly.

It may be worth trying 7.5mg (rest in the AM), or even 3.75mg (you'll need a pill cutter) (rest in the AM) to see if that helps as short-term ideas at fixing this.

Zopiclone etc. is good for occasional insomnia certainly, but as you know they can be habit forming. If you are suffering stress, it might be good - if possible - to try and work through the reasons for that and tackling those. Easier said than done, I know!

You should talk to your doctor; some folk here (incl. me) also take Pregabalin, and this combo seems very good for overall calm, including sleep. You may need your GP to refer you to a psychiatrist to get this however if they are not familiar with it - or try and get to see a GP in same practice who is a MH specialist; there aren't enough of these, but your practise may have one.

Best wishes,

Albert

[Catsjulieanne]

I have been on Mirtazapine for 6 weeks and it has in no way helped me with sleep. Was taking 7.5mg too which is supposed to be the best dose to help with sleep, doctor added Zopiclone to it too but still no improvement with sleep. Have increased to 15mg but six weeks in, the depression is not lifting, if anything it is getting worse, which I think is largely due to the not sleeping.

[Shazamataz]

I've been on Mirt 30 mg for about 12 weeks and it's never helped with my sleep. I've been battling insomnia for months and the whole lack of sleep was very stressful.

BUT I asked the doctor for some melatonin as we can't buy over the counter here. 4th night on it and slept really well and have now had over 8 hours 3 nights ion a row! Maybe worth a try?

[LittleMissAlone]

So glad your sleep has improved Sharon! Great advice and very encouraging.

[Johnf]

Hi there new to this forum. Just wanna share my experience with mirtazapine and to see if anyone can help.
I started on 15 mg bout Feb 2016 and first nite it knocked me out I slept for hours but felt really groggy the next morning which also contributed more to my low mood as I'm not a morning person anyways. Took this for 2 weeks and I cudnt handle the feeling the next day so they tried me on citalopram 20mg. I took this on a Sunday nite and I cudnt sleep had stomach cramps was awake all nite sweating being sick blood I phoned an ambulance went to hosp waited round for ages just for someone to come talk to me and they got me in contact with a crisis team. In the mean time they gave me one diazapam while I was sat in the hospital.
I got an app with crises team went thru and explained all that had happend in my life and he prescribed me with promethazine at that that wud work and I'll be right as rain. Wrong. It didn't do out
I started to get more depressed as I want sleeping so Bak to docs they tried trazadone took this for 2 days I was really angry cudnt sleep so Bak to docs got put Bak on mirtazapine 15mgs. Again first nite knocked out and went to sleep felt really groggy the next day. I persisted with this as I wanted it to work. Started getting really good sleep which was good I liked the sedation it have u on a night also i was eating more. Then few weeks in felt like it stopped working. So they upped me to 30mg. Took this and it sedated me loads which was ok but agen groggy next day but by the afternoon I was ok. Eating loads aswell which was ok with me. Then I felt it was too much so I cut some in half for 4 days and I went backwards I had low mood agen doc sed shudnt of cut in half it don't work like that. So went Bak up to 30mg was ok for few days. Then went up to 45 mg and this is where it all happened. First day or two felt ok then the next 2 weeks have been hell been really suicidal and racing thorts of anything and everything and can't get thorts out my head like I need to do it. Phoned my doc and pschayatrist and both sed stick at it it'll go so I did and it got even worse to the point I was so close so doing something stupid. So last nite I only took 15mgs to c if I wud feel any better. Fell asleep as they say it's more sedating at lower doses woke up tossed n turned. But slept a bit. Had racing thorts agen of wots the point all time but that probs coz I was just laid there. So dragged myself out of bed and sat down stairs with my mam. Thorts Wernet as racing as on 45 mg. but I still feel a little down and a bit shaky. I read the paper and do this book thing and feel a litle better. Anyways sorry for the long post just wanted to know if anyone else felt suicidal on the 45mg. Was it too much. Plz reply soon

[SmilingAlbert]

Sorry to hear your tale of woe John.

A few things - firstly, feeling groggy the morning after taking something that has helped you sleep is completely normal, especially when first taking something. I'm afraid it's part of many such meds - you just have to accept that, and consider drink coffee in the AM (but never past lunchtime as it might impact your next sleep) to help counteract this if need be. I personally always accepted grogginess as the price one pays for having some nice sleep.

Adjusting doses of meds can often have adverse effects, but these are usually very short-term. You have to understand that, and realise that the bad feelings will pass and you will feel better, but it can take time. Negative thoughts and worse I know are very disturbing, but they are just thoughts, and they cannot harm you. You have to remind yourself of that; you would never act upon them.

It sounds like you are using distraction techniques like reading etc. That is great; I also recommend exercise - swimming is my thing, but running and long walks can be good too. Think about what you're most interested in, and spend some time learning more about those things; maybe get yourself down to the library. I personally found podcasts really useful while walking - there are tons on itunes, google play etc., nearly all for free. Talking to close and trusted friends and family is also useful, and for now at least, try and avoid problematic people...

I have only briefly been on 45mg, but found it too enervating to take at night; using a pill cutter I took 15mg in the evening, the rest in the AM, and it worked out well, and it fixed my issues pretty quickly. From what you say though, 45mg may be too much for you, for whatever reason.

Everyone is different, there is no single answer, but people here can only share their own experiences as we aren't doctors, only patients, like you. It does sound like you're getting medical support, but you shouldn't be afraid to ask for more help, as that is what they are there for. And yes, I know it's not simple since demand for MH services is off the scale in this country, as in most, but you should seek medical advice. You should also get on the list for CBT and other counselling, as this can often be useful too.

But you need to accept you're in the wars - as all of us sometimes are (including me!) - but all wars end, your situation will move on, and there is always a tomorrow.

"If you're going through hell - keep going!" Winston Churchill

Best wishes,

Albert

[LittleMissAlone]

God John, that's all so terrible. Please don't do anything silly, you've already been so strong.

The only thing doctors can do is to chuck drugs at us, causing so many more problems.

I've been on mirtazapine 15mg since Feb and I've had few side effects, but they haven't been a staggering success either. I sleep well and usually don't feel groggy but I don't have very much energy either. As you know when you're tired it makes little things even like going to the post office difficult.

I really don't know what to say to you except after everything you've tried mirtazapine seems to be the best, it's just getting the dosage right now I guess.

We will support you in this website, just hang in there.

---------- Post added at 05:11 ---------- Previous post was at 05:07 ----------

I've just read Albert's post and that's very wise advice. It's only temporary, not permanent and it's just a matter of being patient.

I hope you don't have work commitments, you need time to heal.

[Johnf]

I have to go Bak to work next week which I'm dreading. It's just seems like there's nothing in life that excites me anymore. I have a lovely gf and daughter and it distresses me the thorts I'm having I just can't concentrate on anything. Nothing seems to matter anymore. I've spoke to my pscy a few times and he just looks at me and says just challenge urself and I say u don't understand it's too hard to do when nothing is exciting me any more. Apart from addiction to porn. I know just the thort of my gf and daughter shud be enough to help me but I just can't help having horrible thorts it worrys me. I don't know wot to do with medication do I stop or keep taking it. I took 15mg the last 2 nites from 45 but still feel shit. Pscy sed take 30 but every morning is the same wake up feeling shit

[valleybear]

To everyone who responded to my original post ..a huge thank you. Your comments and suggestions are all welcome and it just means a great deal to know that there us so much caring support out there. Hope that everyone finds the help that they need. Didn't sleep again last night but hanging in there. Best wishes .xxxx

[LittleMissAlone]

Hi John

I know how frustrating it is getting the dosage right. You can take some at night, some in the morning and of course you want to sleep well and have energy during the day and you want it to take the anxiety away.

Good luck with it all, you're not alone.

[keggsy]

How are you doing now John and Valleybear.

Chronic insomnia is like torture and creates real fear for me in the day about what the night will bring.

[Dave123 4]

Hi

That's very encouraging that mirtazapine 15mg has been so effective for you regarding your anxiety and other symptoms. I've been taking the same for over 3 months and I must say my anxiety is still relatively high, though I'm sleeping very well. Sleeping has never been an issue for me.

Could you ask for sleeping tablets to take on top of the mirtazapine, to save you increasing or decreasing it? It sounds as if you have the holy grail as you have no side effects either.

Take care.


Hi canI ask you if you are still taking Mirtazapine. I have been taking 15mg for3 weeks. Things seems to be ever so slightly better but over the last two days my anxiety has heightened. Doc wants to up my doze. Took 1 propananol 10mg and on top of aerating effects of mirt, I was out of it for most of the day.
Thanks

[misterbubbles]

Hi all.
I am quite a new user with Mirtazapine.

Started off with Cymbalta and had a nightmare reaction to that so after 4 days stopped.
Wish i had never started that, as it caused me bad insomnia, which i have never had. So got stuck now taking meds. I do have a little bit of depression so hopefully this is not completely in vein.

Started with 7,5mg about 10 days ago, very zombie like the first few days. I am still at the point where everything feels like a chore. Started taking 15mg 2 nights ago. I felt my sleeping like a log changed considerably going to 15. Felt like i was up half the night turning in my sleep etc. Was suprised 15mg would not have such strong sedative effects. From what i have read online i gathered it was still quite potent.

Right now cant say i feel much of anything. Quite numb. So panic or anxiety. But feel weak. Muscles in legs and arms feel very heavy. Yesterday i had some weird heart palpitations in the day time.

Cannot but think this is making everythign worse as i just feel tired. Feel like my head is heavy and muscles in legs will let go when i walk. Thankfully i work for myself and do not have to go to work, as i have no idea how i would manage that.

Just curious as to how long i can continue to expect to feel on this stuff. Im sure its doing something, probably for anxiety, but at the same time i do feel weird. This stuff does mess with you. Hoping my sleep will improve on this though.

Cheers all!
Chris

[Mermaid16]

Hi Chris. I'm relatively new also to this medication. I started on 7.5mg on the 5th of August and have just increased to 15mg last night. I have a bit of a pill reaction phobia, I guess, so I slowly increased up. I have been a bit hit and miss with this medication. I have always slept well on it, if I wake up once during the night it isn't a bother. Anxiety wise I have noticed some decrease since taking it. I still have morning anxiety, but it is not as bad as it was before taking it. I usually take my dose around 9pm and am asleep by 10pm. I do find it takes longer to fall asleep on the higher dose, so maybe taking it 1 hour before you are ready for sleep, might be more beneficial. I get up at 6.00am to be at work by 7.00pm. I get up and get moving and the groginess goes. Although in saying that, I do tend to laze around in bed on the weekends. I don't have the muscles in the legs thing, but I have heard someone else describe the feeling as trying to walk through treacle, so others must have experienced this also. I find that when I get anxious or panicky, the feelings feel blunted if that makes sense. It is supposed to be a very good medication for depression. I suffer only from anxiety, and it has helped, but definately hasn't cured it. I also take 100mg of sertraline, which I have taken for ten years or more, but the doctor thinks this has stopped working which is why I have start the Mirt, and once I am more settled will start to taper the sertraline. I believe at the higher doses it loses its sedative affect, but helps more with depression. This may leave you with bad sleep though. I guess it is a trade off. I did read someone that any thing that has a sedative effect to get you to sleep will leave you feeling groggy in the morning because that is how they work. Maybe it is worth discussing with your doctor. I think I will give it a good month to see how I'm going before I decide if it is for me or not. Tracy

[misterbubbles]

Hello there Tracy!

Tks for writing and thanks for your story. Ok, so we are on quite a similar situation right now then.

You know i got a great tip and funny i did not think about this myself. As i found taking 15mg really makes it much harder for me to fall asleep. Someone suggested breaking the pill in half, and initially taking the 7,5mg about an hour before the other. So just before your about to fall asleep take the other half. I tried this last night and worked well.

This is my first morning having to wake up to alarm clock. Did feel quite tough to wake up, so I feel for you having to go to work. I can just work from home which is a plus now.

On 15mg though i have not had many bad effects. But in the evenings around 5pm or so on passed 2 days i have been hit with episodes of extreme fatigue. Im not able to fall asleep but its just like a sheet of tiredness comes over me. Had to go lie down it was so strong last night, and it passed in like an hour. Not very nice.

Guess we all experience this very different. No wonder the instructions for this med and side effects is about the size of a newspaper inside the package hehe.

Cheers! =)

Christian