New to this med advice please

[gregcool]

Hi guys and girls..iv been on trazadone for 4 years on quite a high dose.200 ml.anyway just recent my doc prescribed mirt 15mg but told me to come off my trazadone first.so i got down to 100 over about 5 months but when i got to 100ml he told me to just 1 week have 50ml traz then second week stop all together then start 15ml of this mirtazipine.i thought this was a big jump from 100ml traz to zero in two weeks.iv trarted 50 ml trazadone and have stayed on ot for two weeks and feel more anxiety than norm but want to try out mirtazipine to see if there r any good results but just dont know if i should just stop trazadone in the way she adviced me..has anyone eles come off one med straght onto this med also does it realy help and make us feel better.very nervious taking it anyway esp as i live on my own and have no one hear for company if i start to feel crap

---------- Post added at 13:34 ---------- Previous post was at 13:30 ----------


Hi guys and girls..iv been on trazadone for 4 years on quite a high dose.200 ml.anyway just recent my doc prescribed mirt 15mg but told me to come off my trazadone first.so i got down to 100 over about 5 months but when i got to 100ml he told me to just 1 week have 50ml traz then second week stop all together then start 15ml of this mirtazipine.i thought this was a big jump from 100ml traz to zero in two weeks.iv trarted 50 ml trazadone and have stayed on ot for two weeks and feel more anxiety than norm but want to try out mirtazipine to see if there r any good results but just dont know if i should just stop trazadone in the way she adviced me..has anyone eles come off one med straght onto this med also does it realy help and make us feel better.very nervious taking it anyway esp as i live on my own and have no one hear for company if i start to feel crap also iv suffered with DP AND DR on and off for months.iv read hear that others have not had these since being on mirtazipine

[panic_down_under]

Hi guys and girls..iv been on trazadone for 4 years on quite a high dose.200 ml.anyway

Was the trazodone for anxiety/depression, or just as a sleeping aid? If for anxiety/depression, 200mg is barely in the antidepressant range (the typical dose range for immediate-release is 300-400mg, with a maximum of 600mg for inpatients), if for insomnia, it is too high as trazodone becomes less sedating as the dose increase. It is generally most effective at 25-75mg.


just recent my doc prescribed mirt 15mg but told me to come off my trazadone first

Why the switch? Did trazodone stop working?


i thought this was a big jump from 100ml traz to zero in two weeks.iv trarted 50 ml trazadone and have stayed on ot for two weeks and feel more anxiety

Trazodone isn't a typical antidepressant so generally is fairly easy to quit. It also has a very short half-life so plasma levels stabilize to a steady-state in under 2 days allowing dose reductions (or increases) at 3 day intervals. HOWEVER, withdrawal is at least as much about psychology as chemistry and biology so taper down at a pace you're comfortable with.

[PixieP]

Hi Greg
I have been on mirtazapine since mid-December last year. Started on 15mg which immediately improved my sleep and after about 2 weeks I felt fine - no anxiety at all for the next 6 weeks. Then it started creeping back in again so upped the dose twice - 22.5mg for 4 weeks then last 2 on 30mg. I thought I was improving but the last 5 days have been pretty awful. I ended up calling PushDoctor (online service) and had a video GP appointment yesterday morning and he has given me propranolol 40mg to take 3 x daily to alleviate the physical symptoms. I'm not sure that mirt is for me as after initial good results it doesn't seem to be helping and the sedative effect has worn off with the higher dose too so back to not getting a full night's sleep.
Having said that, there's plenty of people on here who have found mirt to be a wonder drug for them so I guess you'll only find out if it's going to work for you by taking that first pill and ploughing on. One plus point is that increased anxiety was not one of the side effects for me and it's not on the list either so please don't be scared to take it!
Good luck and keep us posted.

[Shazamataz]

I don't know anything about trazadone but have taken Mirt. It lifted my mood a little but only slightly reduced the anxiety and only for a couple of months.

[Mermaid16]

Hi! I have never taken trazadone, but do take Mirtazapine. I take it for sleep 15mg at night. I don't think it helped with anxiety at all, but is great for sleep. My anxiety would lessen a few days after increasing dose. I started 7.5mg and went up to 45. I couldn't tolerate it and went back down to 15. It is more sedating at lower doses. I also take Olanzapine and am looking to start decreasing as I have put on a tonne of weight. Do you have any pointers on the best way to reduce. I think I read that you were taking it. Thank you in advance and good luck with the mirt. Tracy

[hanshan]

For me, I would rate mirtazapine as 90+% for sleep but only about 30% for anxiety. But combined with pregabalin, it works fine. This is just how it works for me, however - everyone is different, and it's worth trying different levels over a period of time.

Also, doctors often want to rush cross tapers between meds, but don't be afraid to take your time.

[gregcool]

Thanks guys for the suport and input..my tazadone iv been on was for insomnia to start with 6 yesrs ago 50ml.then as i was suffering deoression it ended up going up and up to 250ml..then after a couple of years while it wasnt helping i was adviced to come down to 200ml.then just got stuck on that for ages.still didnt help but it did with my sleeping.but recently my new doctor has told me to come off it to try out mitazipine for my depression.so i got down to 100ml over about 8 months and felt no side effects doing it this slow
.im also on 5mg olanzipine and have been for 4 years which also has had zero effect on my mental health.both drugs wast of time.they also want me off this olanzipine in time as it can cause type 2 diabities.anyway iv contacted my doctor and she has agreed to ley me come off trazadone atbmy pace..so im going to stick at 60ml for two weeks then 40ml two weeks then 20 ml two weeks then 10ml one week then stop..im unsure about mitazipine as i havnt seen my sucsess storys on it and just dont want to get hooked on yet another medication that i will end up only having to try and come off..sometimes i just think ill be better off on nothing.i gained 3 stone being in olanzipine and have now lost that weight and dont fancy putting more on with mitazipine

[panic_down_under]

my tazadone iv been on was for insomnia to start with 6 yesrs ago 50ml.then as i was suffering deoression it ended up going up and up to 250ml..then after a couple of years while it wasnt helping i was adviced to come down to 200ml

And yet the dose "sweet spot" for trazodone is 300-400mg. :weep:

PS:

im also on 5mg olanzipine and have been for 4 years which also has had zero effect on my mental health.both drugs wast of time.they also want me off this olanzipine in time as it can cause type 2 diabities

...i gained 3 stone being in olanzipine and have now lost that weight and dont fancy putting more on with mitazipine

Then mirtazapine is almost certainly not a good med for you as it can trigger powerful carbohydrate cravings. Plus, it is the most poop-out prone of the antidepressants often quitting within months. Is there a reason why SSRIs, SNRIs, or TCAs weren't considered?

[MyNameIsTerry]

Hi Greg,

I thought you had come down to around 2.5mg on the Olanzapine?

For Ian's benefit (panic_down_under) it would be worth you explaining about your thyroid complication and how it has caused your insomnia as your meds situation isn't as clear cut as it may sound. Ian is a wealth of knowledge on meds and perhaps he can come up with some alternatives that take into account your insomnia?

Mirt can be a problem with weight gain but at 5mg of Olanzapine you already suffered that and when you reduced it, your weight melted off and your appetite drastically decreased. So, if anything did happen, you could come off the Mirt and drop the weight again.

With you saying you have kept the weight off, I took that to mean you didn't increase the Olanzapine again as that was the cause of the weight gain by the sounds of it.

SSRI, SNRI's, etc aren't going to be enough alone from what you've said on other threads about the insomnia caused by your thyroid issues. But maybe they can find a combination of something?

[gregcool]

Hey guys...iv tried ssris in the past and suffered sever anxiety and panic isues so the doctors have avoided putting me back in them..terry sorry mate i miss typed the olanzipine ,yes im on 2.5 and have been for ages not 5ml sorry about that..well it seems to me mirtazipune is not going to be a good option for me because i def dont want yet more weight gain after loosing the weight from olanzipine..that weight alone made my depression much worse...im going to have to realy think about this...as from last night i took 60ml trazadone and plan to take that for two weeks then 40 two weeks then 20 two weeks then 10 two weeks then stop..i may just get off of these meds and olanzipine to see how i feel under it all for all i know i may feel much better not being on any medication...i know before being on meds i wasnt so bad at all and have just got used to being on medication which i feel iv been worse.since coming down to 50ml of traz im starting to feel abit more alive and slightly less anxious so and less sedated and tired in the day.so maybe coming off is the way to go.iv just goto hope my body alows me to sleep without it in my system.so far so good.it does feel good knowing over a year ago i was on 250ml traz and 5ml olanzipine ,and now im in just 2 5 olanzipine and 50ml traz..who knows maybe i just need to be off both meds to recover

---------- Post added at 07:03 ---------- Previous post was at 06:30 ----------


Hi! I have never taken trazadone, but do take Mirtazapine. I take it for sleep 15mg at night. I don't think it helped with anxiety at all, but is great for sleep. My anxiety would lessen a few days after increasing dose. I started 7.5mg and went up to 45. I couldn't tolerate it and went back down to 15. It is more sedating at lower doses. I also take Olanzapine and am looking to start decreasing as I have put on a tonne of weight. Do you have any pointers on the best way to reduce. I think I read that you were taking it. Thank you in advance and good luck with the mirt. Tracy

Hi tracy..as for olanzipine i was on 5mg for ages and got hungry all the time.it realy helped with my sleep but couldnt deal with the weight gain..i just went onto 2.5mg alternate days for about a month then just 2.5 for two days then 5mg two days.did that for a few weeks and then just took 2.5 every night..im going to come off this trazadone and after about 1 month without it im going to start cutting my 2.5 mg olanzipine in half and use the same way to get off that.medication free will be nice.hopefully my sleep will be fine as my brain has been so used to sleeping when it should .

[MyNameIsTerry]

Trazodone has got such a short half life you would very quickly know about withdrawal. It's a good sign that you've been adjusting fine but an even better sign that you are feeling a bit better for it. Maybe this med has been doing very little for you?

When you decreased the Olanzapine it was a different story. You got it down but you had some issues adjusting to the new sleep routine. Since you don't seem to be as bothered by the withdrawal of the Trazodone, and your low now, it feels like the Olanzapine is the one doing the work for your insomnia.

If the sleep is ok, and the issue is the depression, there must be other alternatives to Mirt.

I think you've done really well reducing all that. Do what you feel is best, that doctor was tapering a bit fast for someone who has been on as long as you. And you refused the Olanzapine taper they wanted and came up with a better plan from researching it. You know what you are doing mate. You find the plan and get on with it, its the new attitude you built yourself as you turned things around the other year.

Tracy, Greg is one of 3 people I've known on here who found Olanzapine at 5mg ramped up the hunger. When they reduced below that, their appetite adjusted and the weight came down. Greg will tell you how he was losing tons in a short time.

[panic_down_under]

i may just get off of these meds and olanzipine to see how i feel under it all for all i know i may feel much better not being on any medication...i know before being on meds i wasnt so bad at all and have just got used to being on medication which i feel iv been worse.

Going med free is definitely worth a shot. You're nearly there already. If the depression does begin creeping back then SSRIs are not the only game in town, indeed, arguably they are not even the most effective antidepressants. You have lots of other options, though a thyroid disorder and/or some thyroid medications might complicate the choice.

[gregcool]

Trazodone has got such a short half life you would very quickly know about withdrawal. It's a good sign that you've been adjusting fine but an even better sign that you are feeling a bit better for it. Maybe this med has been doing very little for you?

When you decreased the Olanzapine it was a different story. You got it down but you had some issues adjusting to the new sleep routine. Since you don't seem to be as bothered by the withdrawal of the Trazodone, and your low now, it feels like the Olanzapine is the one doing the work for your insomnia.

If the sleep is ok, and the issue is the depression, there must be other alternatives to Mirt.

I think you've done really well reducing all that. Do what you feel is best, that doctor was tapering a bit fast for someone who has been on as long as you. And you refused the Olanzapine taper they wanted and came up with a better plan from researching it. You know what you are doing mate. You find the plan and get on with it, its the new attitude you built yourself as you turned things around the other year.

Tracy, Greg is one of 3 people I've known on here who found Olanzapine at 5mg ramped up the hunger. When they reduced below that, their appetite adjusted and the weight came down. Greg will tell you how he was losing tons in a short time.

Cherrs terry.allways good advice and thanks for reminding me how far i have come with things.as for the reduction on olanzipine down to 2.5 there was less hunger and was able to loose quite a bit of weight..as for the traz maybe its never dine anything for me because iv never realy been happy on it and feel pritty good about reducing it down on my own advice and will come off it.my sleep is still ok and i get about 6 hrs solid each night which im happy with so once off the traz ill give it a month and see just how i feel.if all is good i think i will focus on coming off this last bit of olanzipine,will be harder because its already a small tablet so will find it tricky cutting that in half then half again..id love to be drug free and see just how i feel on my own..as for the reduction in traz i actualy feel more tired at the moment so dont know if thats some kind of withdraw.

---------- Post added at 16:27 ---------- Previous post was at 16:24 ----------


Going med free is definitely worth a shot. You're nearly there already. If the depression does begin creeping back then SSRIs are not the only game in town, indeed, arguably they are not even the most effective antidepressants. You have lots of other options, though a thyroid disorder and/or some thyroid medications might complicate the choice.

Thanks buddy for your advice on this..yes my thyrode is underactive and currently norm since being on the meds for it.leveythyroxine which caused my insomnia years agao.im not confedant with this med as i dont believe man made drugs can compensate for the real biologicle ones made by our own body.

[Mermaid16]

Thank you very much for the reply Gregcool. It is really appreciated. I've been having a couple of bad days, but hopefully once that is over I can start to cut down. I think I will try cutting them into quarters and dropping by a quarter every couple of weeks. I'm not in any hurry. Slow and steady seems to win the race with coming off meds. Good luck with everything. It would be great to be med free and I hope your sleep returns. Tracy xx

[bdale1234]

Thank you very much for the reply Gregcool. It is really appreciated. I've been having a couple of bad days, but hopefully once that is over I can start to cut down. I think I will try cutting them into quarters and dropping by a quarter every couple of weeks. I'm not in any hurry. Slow and steady seems to win the race with coming off meds. Good luck with everything. It would be great to be med free and I hope your sleep returns. Tracy xx

Hope you feel better.:bighug1:

[PixieP]

Hi Greg
With regard to mirt I haven't put on any weight. However, it hasn't done anything much for my anxiety, one of the symptoms of which is lack of appetite so this may be the reason why. My GP did warn me about possible weight gain though so I went onto the med forewarned and determined not to overeat!
I really hope this works for you as it sounds like you've really been through the mill :hugs:

[panic_down_under]

yes my thyrode is underactive and currently norm since being on the meds for it.leveythyroxine which caused my insomnia years agao

There can be some interaction between the synthetic thyroid hormones and many antidepressants which may have created, or exacerbated the problems you had with SSRIs. Should you need to go back onto an antidepressant then amitriptyline (Elavil) would be worth trying. It is a less potent than the SSRIs in serotonin reuptake, also inhibits noradrenaline and is nearly as sedating as trazodone and mirtazapine.

[MyNameIsTerry]

Greg, if you remember a while back you were struggled to adjust to that level of sleep as you were dropping the Olanzapine to 2.5mg. Now you are ok with that level of sleep despite making great gains withdrawing from the Traz.

Doesn't that show you just how much anxiety can cloud things for us? And how working through to the other side through exposure desensitises and builds confidence? I've found it's often the case of starting something and repeating it until your attitude towards it seems to shift away from the negatives.

Ian, with meds like Mirt that can cause weight gain can people change their diets to try to manipulate this? For instance, adding in high protein to change the response of hormones in the hypothalamus? Also, do these meds cause specific cravings for carbs or fats that could make switching to more protein difficult?

[panic_down_under]

Ian, with meds like Mirt that can cause weight gain can people change their diets to try to manipulate this? For instance, adding in high protein to change the response of hormones in the hypothalamus? Also, do these meds cause specific cravings for carbs or fats that could make switching to more protein difficult?

They can certainly change diets to higher protein and fats (there is a revolution underway in thinking about fats, they are apparently not as evil as has been thought), but, at least for mirtazapine, the carb cravings can remain strong even when protein and fats have satiated appetite.

Weight gain on antidepressants generally is still not that well understood as research is lacking. It isn't even certain how much is chemical+ biological and how much psychological - less stressed/happier people tend to enjoy eating more. There really needs to be more effort put into this as it is a serious health issue given people these days are more likely to be overweight even before they begin taking these meds. But there's not much money in antidepressants anymore so....

[gregcool]

Thankyou guys for all the advice.lots to think about hear.im not sure about going on another med esp if it dsnt work and its yet another med to come off latter.also i dont want to gain weight as that alone makes me feel unhappy.not sure what to do ..also last couple of days iv felt crap since droping this trazadone.very low mood.no interest in anything tired more than normal.and agitated all the time.headache all the time.i dont like this feeling..that something bad is about to happen.edgy .is this withdraw from the traz am i going down to quick

[panic_down_under]

is this withdraw from the traz am i going down to quick

In theory trazodone shouldn't produce physical dependence, but in practice is sometimes does. Certainly, your symptoms are consistent with withdrawal. But psychology will also be playing a part for withdrawal isn't just a problem of chemistry and biology, state of mind is at least as big a factor. Believe you're going to have a hard time of it and the mind is very capable of delivering the full catastrophe.

As an example, those with anxiety tend to have a hard time when quitting benzodiazepines, but epileptics generally seem to have fewer problems even though they have often been on higher doses for longer. In part this may be because neurologists seem to be better at managing the process, but mostly it is probably because epileptics are generally don't have our anxiety issues.