switching from citalopram to mirtazapine

[housetoad]

Hi all,
Would really appreciate some help.

Unfortunately after being on cit for about 2 months (since 19/04/18) it didn't seem like it was working out for me. Appeared to make my moods low, I felt considerably low and empty and on top of that my anxiety seemed to come back, even with an increase in dose.

I am now in the process of weaning off, went from 20mg for 2 weeks, to 10mg for 5 days, and for the last few days have been on the 5mg to an eventual stop.
One thing I have noticed that my mood is definitely more normal with the weaning off. The problem I had with the cit is that it seemed to make me feel empty which as a result made me very depressed. I have identified I only seem to get low when my anxiety is bad, which is the main issue. But all in all I just didn't feel like myself on the Citalopram which was unpleasant and inevitably lead to more anxiety, fear that I would never feel like my normal self again etc. I even had moments on the cit where it felt like I wasn't real, and that it was some sort of bad dream I couldn't escape from. Horrible really.

Now the plan is to see how my mood and anxiety is without the Cit. I'm hoping I'll be okay enough to not need meds, but my therapist and I have identified that drugs like diazepam work really well for me, as they calm me down completely and make my mood feel quite normal. So this leads to us believing a sedative type antidepressant might work well for me, and the doctor suggested mirtazapine. I'm aware it can make you gain weight and feel groggy but this is not a problem really as my anxiety has caused me to drop weight like there's no tomorrow.

Has anyone else been through the same thing? Did citalopram not work out for some of you? Is mirt easier to tolerate/good for anxiety?

Any help/opinions/advice would be greatly appreciated.

[SmilingAlbert]

Hi Housetoad,

Sorry to hear you've been in the wars. I've never taken Cit so can't comment on that I'm afraid.

But it sounds like your doctor knows his/her business - it does sound like you need calming down, and Mirt is usually very good for that. As you have probably heard, it's usually taken at night. Oddly, it is more sedating at lower doses (7.5mg-15mg) than higher ones, where it is more enervating.

It is much easier to tolerate for most people than conventional SSRIs - it may make you feel a bit groggy at first, so take it easy, especially if driving, etc. It can make you very hungry, so even if weight isn't an issue you should pay close attention to make sure it stays that way: eat a healthy diet, and avoid tanking on junk and carbs.

There is plenty of evidence it can have an impact quite quickly - when I first took it it made me feel appreciably better within 24 hours.

It is strictly speaking an AD not an anti-anxiety medicine, but as we all know the borders between those 2 are very fluid. So the chances are it may help if calm is what you're after.

As ever, it doesn't always work for everyone, but there are plenty of people here who've had success on it, including me, but you won't know until you try it. Hope it goes well, and keep in touch here as there are plenty of fine people who can help. AnxiousJomo has just started on it and is writing a diary, and fingers crossed but he seems to be doing well on it, so might be worth reading if you want reassurance.

Best wishes,

Albert

[anxiousjomo]

Hi,

Yeah - I am about 2 1/2 weeks in on 15mg and it is working pretty well so far. I had a rough time on citalopram (bad side effects of increased anxiety and insomnia and all the rest), and also had a rough time on Prozac (after it having worked for me for quite a few years).

My mum is on mirtazapine and it seems to be working for her as well.

The start up is, from my experience and from quite a few others on here, in general much easier than SSRIs - you will feel groggy during the day (i described it like having taken a Nytol or Night Nurse during the day and trying to stay awake), and there was some dizziness etc too. Weight gain seems to be mostly about craving carbs and sugars, but I think that can be managed by just keeping on a decent diet and exercising. But at the end of the day I would rather be a few pounds overweight and happy...

As with all these drugs it is a complete roll of the dice when you start taking them, as it is impossible to know how it will go. I would say give it a try and review after a couple of weeks.

[housetoad]

Thanks for your replies- its great that they seem to be working for you!

I am completely med free as of today so will see how it goes until my doctor's appointment next week. Of course I'm hoping I can manage without meds, but I won't hesitate to take the mirt if I feel it could help me.
My mood seems really normal without the SSRI, it's just the anxiety that lingers. Argh
If I take mirt does it have a numbing effect on the mood? That's one thing I didn't like about the cit. I couldn't feel my good emotions, and ultimately that's what made me feel more depressed.
But the mirt works for your anxiety though??

[anxiousjomo]

Yes re the anxiety, no to the numbing.

The effect on the anxiety is not particularly strong, however, and I am having a bit of an anxious/jittery day today. But it is still very early days for me on this med, so I don't know how I will feel in 6 weeks time.

The only real negative I am experiencing at the moment is this mild dizziness. It is just present enough to be noticeable, and is certainly not ideal, but I plan on giving it a few more weeks to see what happens.

I think if I am still having some dizziness/grogginess in about 3 or 4 weeks, and if the weight gain is become an issue, for example, I may consider going off again. But I know it is way too early to tell right now how this will work.

I don't think I want to go up to 30mg as I can already tell (what with the restless legs etc) that this may well kick off the anxiety/jittery unpleasantness. I think if I was more depressed and, for example, struggling to get out of bed and keep moving, I may want to go on a higher dose. But for anxiety it seems to work better at the lower dose where it helps with sleep (and lack of sleep is a killer for anxiety I find) and just tones down the anxiety a little.

Good luck!

[Ethansmom]

I hope you don't mind me jumping in here. I too have just been prescribed mirtzapine and suffer from anxiety and now depression. I have already gained so much weight from other meds (like Klonopin, Zoloft, Cymbalta, etc._, and i'm scared to put on another pound. I used to be a normal weight and now i'm chunky. Should I try it when I am on vacation next week. I have a wedding to go to on Saturday and really don't want to try anything new before then.

[housetoad]

Hi Ethansmom,
Of course I don't mind you jumping in, everyone is welcome to comment on this thread and I hope we can help!

I think it's definitely worth giving a try. This is a med that could potentially benefit you, and surely if it does it will get you to a point in which it is easier to manage weight in the sense that you may be more motivated to- I hope that doesn't sound patronising. But my theory is if you help happier, exercise may seem more rewarding and you will feel more motivated.
At the end of the day though, like anxiousjomo has said, would you not prefer a couple pounds overweight and happy than to be sad?
Meanwhile I have the opposite problem, gaining weight is just as hard!!
My opinion is that you should try it as soon as possible- it's a med that could potentially help, I think putting it off would be wasting time, but I could understand if you wouldn't want to potentially suffer side effects before a big event such as a wedding.
Hope I was some help!

[Ethansmom]

Thank you housetoad! You are right. There is also the potential of not gaining weight. My doctor she has patients on it that have not gained a single pound. I'm just worried that I won't be able to loose weight on it even with dieting. I guess i'll never know until I try it. I'm already on Klonopin, so i'm hoping if this does work, I could start reducing the klonopin. I don't want to be over sedated. that would not be good either! I guess I don't understand how this drugs works over let's say.. ssris