kynkari1
15-06-18, 21:19
Hi all,
I'm a lurker and first time poster, but feeling very alone in a recent relapse of GAD and unsure that I should stick with my current treatment options.
I had a run-in with GAD back in college. My GAD is less initially psychic anxiety, but insomnia and terrible physical symptoms of anxiety.. tense muscles, heart racing and palpitations, nausea, feeling like my skin is crawling. Of course, weeks and weeks of this does lead to psychic anxiety which feeds on itself, and also the hopelessness and sleep deprivation can lead to depression.
After a few disasterous trials with SSRIs (Paxil, Zoloft) and an SNRI (Effexor), I was introduced to mirtazapine. It pulled me out of the anxiety and insomnia spiral in about 4 days, no joke. It was a miracle! I stayed on it for about 18 months at 22.5 mg. I gained a lot of weight, so the doc had me withdraw and I did so without any issues.
Fast forward 15 years with no GAD issues. My husband had a heart attack and a few months later, it seems overnight, I fell apart with the same physical symptoms of GAD and insomnia. My Pdoc tried me on Lexapro. I took 5 mg the first night and had the worst headache of my entire life and severe jaw clenching. Horrible. So I asked again for mirtazapine, knowing the weight gain risks. Again, within a few days, anxiety symptoms were gone and that was on 7.5 mg. I think I settled on 11.25 mg and went on with life.
Stupidly, I came off the mirt after a year. Now it has been 6 years and again, seemingly out of the blue, about 6 weeks ago I started having the physical symptoms and insomnia again. Immediately went to mirtazapine and ... it didn't work! :( I took 7.5 mg for about 3 weeks, and had some spotty success with sleep but largely it didn't sedate me like it used to and I was sleeping only a few hours a night. I moved up to 15 mg and after a few days, the anxiety magically disappeared! Sleep didn't improve much but I was happy to be free of all day long anxiety. For one week... and then it came roaring back one morning and hasn't left since. Doc has moved me up to 22.5 mg. On this dose I slept a little better the first few nights but I've only averaged 4 hours the last two nights. I keep waking up with intense anxiety/panic and a racing heart after only a few hours of sleep which is unusual for me. Usually I just can't fall asleep.
I also feel my anxiety is worse, especially in the evenings, and my mood is total crap. I can't decide if the deteriorating mood is from lack of sleep and fighting the anxiety, or the higher dose of mirt, or both. It doesn't seem like mirtazapine is going to work for the anxiety for me this time, and I'm suspicious that the 22.5 mg might be too much for me and is causing the night time anxiety potentially.
So now the doc has given me the option to move back down to 15 mg of mirtazapine, take trazadone as needed for sleep (25-50 mg) and he gave me a month of 0.5 Xanax XR so I can function during the day and not lose my job.
Has anyone had mirtazapine poop out on them after a week for anxiety and it start working again later? I don't mind being patient on 15 mg if the traz will help me sleep but I am concerned that once it has pooped, it's done. Also, does it seem reasonable that the 22.5 mg dose is exacerbating the anxiety?
I know the Xanax is not the answer and I definitely don't want to take these very long, but I feel trapped. If I'm anxious all day long and sick, I can't work or function, really. So I'll take them as needed and try to limit it but would like a better long term option. I'm not sure if I'm wasting my time at this point with mirtazapine or not.
Thoughts or suggestions for other meds that work well for physical symptoms of anxiety? (also tried propanolol and hydroxyzine, with no real success). Btw, I've also been doing intensive CBT and coping skills/therapy, which are great, but there is only so much grounding and deep breathing you can do with you literally have a low level panic attack going on all day and night, every day.
Thanks for any responses and sorry for the long post!
I'm a lurker and first time poster, but feeling very alone in a recent relapse of GAD and unsure that I should stick with my current treatment options.
I had a run-in with GAD back in college. My GAD is less initially psychic anxiety, but insomnia and terrible physical symptoms of anxiety.. tense muscles, heart racing and palpitations, nausea, feeling like my skin is crawling. Of course, weeks and weeks of this does lead to psychic anxiety which feeds on itself, and also the hopelessness and sleep deprivation can lead to depression.
After a few disasterous trials with SSRIs (Paxil, Zoloft) and an SNRI (Effexor), I was introduced to mirtazapine. It pulled me out of the anxiety and insomnia spiral in about 4 days, no joke. It was a miracle! I stayed on it for about 18 months at 22.5 mg. I gained a lot of weight, so the doc had me withdraw and I did so without any issues.
Fast forward 15 years with no GAD issues. My husband had a heart attack and a few months later, it seems overnight, I fell apart with the same physical symptoms of GAD and insomnia. My Pdoc tried me on Lexapro. I took 5 mg the first night and had the worst headache of my entire life and severe jaw clenching. Horrible. So I asked again for mirtazapine, knowing the weight gain risks. Again, within a few days, anxiety symptoms were gone and that was on 7.5 mg. I think I settled on 11.25 mg and went on with life.
Stupidly, I came off the mirt after a year. Now it has been 6 years and again, seemingly out of the blue, about 6 weeks ago I started having the physical symptoms and insomnia again. Immediately went to mirtazapine and ... it didn't work! :( I took 7.5 mg for about 3 weeks, and had some spotty success with sleep but largely it didn't sedate me like it used to and I was sleeping only a few hours a night. I moved up to 15 mg and after a few days, the anxiety magically disappeared! Sleep didn't improve much but I was happy to be free of all day long anxiety. For one week... and then it came roaring back one morning and hasn't left since. Doc has moved me up to 22.5 mg. On this dose I slept a little better the first few nights but I've only averaged 4 hours the last two nights. I keep waking up with intense anxiety/panic and a racing heart after only a few hours of sleep which is unusual for me. Usually I just can't fall asleep.
I also feel my anxiety is worse, especially in the evenings, and my mood is total crap. I can't decide if the deteriorating mood is from lack of sleep and fighting the anxiety, or the higher dose of mirt, or both. It doesn't seem like mirtazapine is going to work for the anxiety for me this time, and I'm suspicious that the 22.5 mg might be too much for me and is causing the night time anxiety potentially.
So now the doc has given me the option to move back down to 15 mg of mirtazapine, take trazadone as needed for sleep (25-50 mg) and he gave me a month of 0.5 Xanax XR so I can function during the day and not lose my job.
Has anyone had mirtazapine poop out on them after a week for anxiety and it start working again later? I don't mind being patient on 15 mg if the traz will help me sleep but I am concerned that once it has pooped, it's done. Also, does it seem reasonable that the 22.5 mg dose is exacerbating the anxiety?
I know the Xanax is not the answer and I definitely don't want to take these very long, but I feel trapped. If I'm anxious all day long and sick, I can't work or function, really. So I'll take them as needed and try to limit it but would like a better long term option. I'm not sure if I'm wasting my time at this point with mirtazapine or not.
Thoughts or suggestions for other meds that work well for physical symptoms of anxiety? (also tried propanolol and hydroxyzine, with no real success). Btw, I've also been doing intensive CBT and coping skills/therapy, which are great, but there is only so much grounding and deep breathing you can do with you literally have a low level panic attack going on all day and night, every day.
Thanks for any responses and sorry for the long post!