45mg not helping

[southey]

Been on anti D's now for 12 years. Citalopram, Prozac, Sertraline and now Mirtazapine. I suffer from Health Anxiety and Depression and have had a rough few months. The meds have always helped to settle me after a low spell albeit to live in a hazy empty sort of way.
I came off of Sertraline the start of 2016 as I felt I was becoming too hollow, devoid of feelings. It was doing me well for the anx/dep tho. I was started on Mirt 15mg and first day it knocked me out! I increased dose after a while as I was starting to get the old Anxiety back and now am at 45mg. There is no longer any sedative effect.
I have to take it during the morning or day as I get horrendous restless legs at night if I take it several hours before bed. This solves one problem but leads to another, a huge appetite that can't be quelled. I've put on several stone.
I wanted to try mixing it with Venlafaxine but my doc is reluctant instead wanting to keep me on Mirt a bit longer. I've been taking these damn tablets for so long I feel I know they are not right better than my doc does.
The frightening part is that over my anxiety and med journey they have always helped me be stable between yearly or less bouts of intense anxiety/depression. This time it's not working so well and I'm really afraid of not being well again.
Not sure why I'm really posting this, just needed to vent to somebody, see if anyone else is going through similar? Not been on here for 2 years, seems there are more than ever having problems, especially in the HA section!

[Shazamataz]

I tried Mirt and over a few months it did not help my anxiety. I also put on a lot of weight. The doc added venlafaxine and it made a difference fairly quickly. I've now tapered off the Mirt with few issues and no change in anxiety.

[hanshan]

Hi Southey,

Restless legs is a side-effect of mirtazapine that doesn't get much prominence in the patient information leaflet, but it's very real and very uncomfortable.

As well as taking mirtazapine in the morning when you are moving around, you can try taking it just as you go to bed - if you are lucky enough to fall asleep quickly, you can sleep through the "legs".

I actually combine pregabalin (for anxiety) with mirtazapine, and I have noticed that after I started taking pregabalin, the "legs" diminished considerably.

You can combine mirtazapine with venlafaxine, as I think Shazamataz has described, but you need a doctor comfortable with that. Otherwise, you may be able to organise a cross-taper over to venlafaxine. Best of luck to you.

[southey]

Thanks for replying. I've been through horrendous anxiety, both Health and other stuff this week and I'm at breaking point. My doc seems hesitant to work with me in reviewing my meds although I did get a few Diazepam which are the only thing holding me together. Got a psychologist appointment in a few weeks/months.
I seem to not be having much relief with the Mirtazapine for the anxiety, the depression is ok tho. I decided to add in some Sertraline today as I had a few scripts worth left over and really need something to change. Took about 30mg Sert with 45mg Mirt.
I have read up on combining these drugs and the Mirt plus an SSRI seems to be helpful for some cases and well tolerated. I felt my doc wasn't helping me so had to act alone in this. I hope it will help, Sertraline at 100mg did help for many years although it made me loose all feelings which is why I switched.
Hopefully, Steve

[BikerMatt]

Sertraline and Mirtazapine is supposed to be a good combination. Also Venlafaxine and Mirtazapine.
Good luck and I hope you get some relief.

[diamondgeezer65]

I have just started taking 30mg of mirtazapine on top of venaflaxine this week after the dose being upped from 15mg. Feeling rather depressed a sort of flat feeling just want to stay in bed. Will this feeling subside after the body adjusts to the meds?