View Full Version : Anyone take anything alongside Mirtazapine? Help required please.
I have an appt coming up in December with the MH team psychiatrist.
At one time I was taking Seroxat, Mirtazapine and Propranolol. I decided to rid myself of all meds in 2015 so came off Seroxat which took nearly a year then the Propranolol in 2017. I've stayed on Mirtazapine but I'm really struggling and have done for a long time. I tried Venlafaxine a couple of years ago and the side effects were severe so stopped and then got offered Qutiapine but decided against it.
Any advice would be appreciated on what people take or have taken with Mirtazapine? Or should I try Qutiapine (still with Mirtazapine)? Just won't to arm myself with info before my appt.
Ta
panic_down_under
13-10-19, 04:36
Any advice would be appreciated on what people take or have taken with Mirtazapine? Or should I try Qutiapine (still with Mirtazapine)? Just won't to arm myself with info before my appt.
Firstly, is this for an anxiety disorder, depression, both?
Quetiapine and mirtazapine pretty much hit the same receptors to the same extent with the main difference being quetiapine binds to one of the dopamine receptors a little more strongly. So there's not much point taking both. I'm not a fan of either as, imho, the often modest response is outweighed by the side-effects risk, particularly the common weight gain.
How much paroxetine (Seroxat) were you taking and was it fully effective? I'm guessing not if it was being supplemented by mirtazapine and propranolol.
Hi PDU,
It's for anxiety, depression, daily panic attacks and I've been having suicidal thoughts.
I was taking Seroxat 20mg when the Mirtazapine was added in 2014 and Propranolol 80mg xr in 2015.
I didn't think the Seroxat was doing anything and wanted to take the chance to come off it as it's a monster to come off.
Not worried about weight gain but when I tried Venlaxafine it had me laying in a pool of sweat, wooshing in my ears, nausea from another planet and gave me a horrific headache.
panic_down_under
13-10-19, 22:45
Hi PDU,
It's for anxiety, depression, daily panic attacks and I've been having suicidal thoughts.
I was taking Seroxat 20mg when the Mirtazapine was added in 2014 and Propranolol 80mg xr in 2015.
So paroxetine wasn't working well enough and instead of increasing the dose above the minimum your GP decided to just keep adding more meds in the hope something would stick?
Did paroxetine work for a while and then poop-out, or not really work at all?
I didn't think the Seroxat was doing anything and wanted to take the chance to come off it as it's a monster to come off
It is the second most difficult AD to quit because of its short half-life and lack of an extending active metabolite.
Not worried about weight gain but when I tried Venlaxafine it had me laying in a pool of sweat, wooshing in my ears, nausea from another planet and gave me a horrific headache.
Most believe that venlafaxine is the hardest AD to quit, again because of its half-life which is even shorter than paroxetine's, although it does have an active metabolite. Given your experience quitting paroxetine I suggest you give it, and all the other SNRIs, a very wide berth. Despite the claim, venlafaxine is just another SSRI, not a SNRI, having only a weak affect on noradrenaline/norepinephrine reuptake even at the maximum dose so doesn't have much, if any, advantage over other SSRIs.
Hi PDU, I had taken Seroxat for around 10 years and didn't really feel it was working.
I have now paid to see a Neuro-otologist as I had been referred to London through the NHS, but my appt isn't until Jan after waiting 13 months.
The Neuro-otologist suggested Venlafaxine (which I can't tolerate), Gabapentin or Pizotifen.
I started Gabapentin on Thurs. I wanted to try the gabapentin as it also has good reviews for anxety/panic (off label) as well as trying to sort out my 24/7 dizziness.
Hi Matt , good to see you are still in the land of the living, that is some list of meds and f**k you’ve been trying different ones for some time , I don’t do meds myself due to them putting me in this position in the first place but I know they work for some , my partner tried Mirtazepene and said it was awful with no benefits, a couple of people I’ve spoken to on here seemed worse on it and once they came off it they got better and left the site , it’s all a bit suck it and see with meds docs don’t seem to have a clue , once they suggested putting me on anti psychotics I thought f**k that I’ll treat myself .
So I don’t have the answer no one does , I take CBD oil every day and the odd diazepam to take the edge off on a real bad day , a couple of weeks ago I tried home made shock therapy, I stood behind a Typhoon jet taking off at RAF Coningsby which nearly gave me a heart attack and I also stood in front of the sea wall in a storm , my theory was it would scare me so much everything else would be a doddle , it didn’t really work but I have noticed a difference since taking the cbd .
I saw Doc on tv last week saying 50 % of people taking anti depressants got better then he added 25% given placebos got better , it’s a very complicated bowl of noodles we carry round on our shoulders .
Take care mate and good to read you lad is doing better as well .
panic_down_under
20-10-19, 22:50
Hi PDU, I had taken Seroxat for around 10 years and didn't really feel it was working.
So you feel it never worked during the 10 years, or that it stopped working recently?
The Neuro-urologist suggested Venlafaxine (which I can't tolerate), Gabapentin or Pizotifen.
Why a neurologist and not a psychiatrist?
Gabapentin works well for some though these days the similar pregabalin (Lyrica) is prescribed more frequently.
Pizotifen is a migraine med which is little prescribed these days because of its side-effects. Like most antihistamines it can ease anxiety by sedation and antagonizing (blocking) some of the same serotonin receptors as mirtazapine, which might be enough for some, but it's not a first line anxiety med. I don't recall anyone having been on it.
So you feel it never worked during the 10 years, or that it stopped working recently?
Why a neurologist and not a psychiatrist?
Gabapentin works well for some though these days the similar pregabalin (Lyrica) is prescribed more frequently.
Pizotifen is a migraine med which is little prescribed these days because of its side-effects. Like most antihistamines it can ease anxiety by sedation and antagonizing (blocking) some of the same serotonin receptors as mirtazapine, which might be enough for some, but it's not a first line anxiety med. I don't recall anyone having been on it.
PDU, I have been suffering with 24/7 dizziness, off-balance, bobbing/swaying and walking on a mattress feelings since July 2017. A neuro-otologist specialises in disorders that cause dizziness and he thinks it might be migraine variant balance disorder and some treatments for this medication wise cross over with anti anxiety meds.
This has all made me feel the worse I have ever done MH wise as it's taken so long to get as far as I have with the NHS and 24/7 dizziness isn't fun and has landed me begging for help from the MH team, but I'm having to wait until December (4 1/2 months from referral) for the Psychiatrist appt.
Seroxat never made me feel how I think it should've as I made a massive effort with lifestyle changes/removing stressors from my life, CBT, Stress management courses etc.
I just know that the Psych is just going to want to slap me on meds but some of the combos and mg I see people taking here is scary. I'm happy to add something to my Mirt.
Ps They won't prescribe Preg here often as Gaba is so much cheaper. I'm keeping Gaba to a low dose and seeing the Neuro-otologist again mid November. I'm going to ask him about Preg and if he says yes my GP will more than likely have to prescribe it.
panic_down_under
21-10-19, 11:28
Ps They won't prescribe Preg here often as Gaba is so much cheaper. I'm keeping Gaba to a low dose and seeing the Neuro-otologist again mid November. I'm going to ask him about Preg and if he says yes my GP will more than likely have to prescribe it.
The problem with gabapentin is that it has low bioavailability and this becomes progressively less so as the dose increases, but the side-effects impact tends to be more linear. At the usual minimum 900mg daily dose only about 60% (https://www.drugs.com/pro/gabapentin.html#s-34090-1) is absorbed for an effective dose of 540mg, at 2,400mg bioavailability is only 34%, so taking 2.7 times as much just increases the amount of drug in the system by only 50%. Taking it with food slightly increases its bio availability, but avoid taking it within 2-3 hours of taking an antacid.
Pregabalin is absorbed faster and has much higher (~90% (https://www.ncbi.nlm.nih.gov/pubmed/20818832)) linear bioavailability so less med needs to be taken and the side-effects tend to be less severe at equivalent effective doses, especially at the upper end of their ranges.
Have you actually been diagnosed with a vestibular condition, Matt? What were the results of the MS assessment?
I'm sorry you've been messed around for so long and are still waiting for something definitive to come of all this.
Have you actually been diagnosed with a vestibular condition, Matt? What were the results of the MS assessment?
I'm sorry you've been messed around for so long and are still waiting for something definitive to come of all this.
Hi Pulisa,
Neurology sent me for NCS and EMG (travelled a good distance) end of Sept 2018. EMG not performed, NCS results start of Dec 2018 (over 2 month wait) ulnar nerve damage left arm, nerve damage left leg, never heard anything ever again from Neurology and as they couldn't of shown less interest if they tried about my 24/7 non-stop dizziness I went to ENT. They sent me to audiology who said PPPD.
ENT referred me to Neuro-otology UCLH London Dec 2018 as it's been dizzy 24/7 since July 2017.
Phoned and emailed UCLH all year and in the end I payed to see Neurotologist Dr Surenthiran at the Spire Tunbridge Wells. Who said maybe migraine variant balance disorder or perhaps an isolated brain stem lesion such as ischaemia. So yes Dr S said I have a problem somewhere problem is so many types of vestibular problems PPPD, VN, VM, BPPV and so on.
He has agreed to see me under the NHS at his clinic Medway Hospital. I have an appt mid Nov when he will arrange vestibular rehabilitation therapy and an MRI of my IAM/CPA region.
I got in touch with UCLH again after this and threatened to take things further and got an appt within 48hrs but it's not until January so waited 13 months since referral.
Brain MRI in June last year showed foci within the white matter which is generally something people get with old age and I'm 46.
Ta for asking x
The problem with gabapentin is that it has low bioavailability and this becomes progressively less so as the dose increases, but the side-effects impact tends to be more linear. At the usual minimum 900mg daily dose only about 60% (https://www.drugs.com/pro/gabapentin.html#s-34090-1) is absorbed for an effective dose of 540mg, at 2,400mg bioavailability is only 34%, so taking 2.7 times as much just increases the amount of drug in the system by only 50%. Taking it with food slightly increases its bio availability, but avoid taking it within 2-3 hours of taking an antacid.
Pregabalin is absorbed faster and has much higher (~90% (https://www.ncbi.nlm.nih.gov/pubmed/20818832)) linear bioavailability so less med needs to be taken and the side-effects tend to be less severe at equivalent effective doses, especially at the upper end of their ranges.
So Gaba is the crap version of Preg? Sort of.
Hi Matt , good to see you are still in the land of the living, that is some list of meds and f**k you’ve been trying different ones for some time , I don’t do meds myself due to them putting me in this position in the first place but I know they work for some , my partner tried Mirtazepene and said it was awful with no benefits, a couple of people I’ve spoken to on here seemed worse on it and once they came off it they got better and left the site , it’s all a bit suck it and see with meds docs don’t seem to have a clue , once they suggested putting me on anti psychotics I thought f**k that I’ll treat myself .
So I don’t have the answer no one does , I take CBD oil every day and the odd diazepam to take the edge off on a real bad day , a couple of weeks ago I tried home made shock therapy, I stood behind a Typhoon jet taking off at RAF Coningsby which nearly gave me a heart attack and I also stood in front of the sea wall in a storm , my theory was it would scare me so much everything else would be a doddle , it didn’t really work but I have noticed a difference since taking the cbd .
I saw Doc on tv last week saying 50 % of people taking anti depressants got better then he added 25% given placebos got better , it’s a very complicated bowl of noodles we carry round on our shoulders .
Take care mate and good to read you lad is doing better as well .
Oi Oi mate,
Good to here from you. I've not been around much as had so much sh#t going on this Summer that wouldn't believe, so trying to catch up on everything.
I see you've been having a hard time mate good idea with the Jet! Lol
I often go down the seafront on windy days and when thunder and lightning is about. Just got to be careful at night up the seafront as the woofters might think you're there for a game of rubby knobsie!!!!
I din't want to take the junk meds they throw at you but living with this 24/7 dizziness is a nightmare.
Yeah ta my lad is doing better. Thank goodness.
Tell me more about CBD pls.
panic_down_under
21-10-19, 23:39
So Gaba is the crap version of Preg? Sort of.
Yes, or at least the first version. Gabapentin has been around for many decades, pregabalin is relatively recent. Both were developed by Pfizer. Not sure why pregabalin should be much more expensive as it appears to be out of patent and, at least here in Oz, there are several generics.
I think your best bet lies with the vestibular tests and the consultant you saw at the Spire, TW. Beware the dreaded "Gaba Fog" and stick to meds targeting your vestibular issues in my opinion.
I think your best bet lies with the vestibular tests and the consultant you saw at the Spire, TW. Beware the dreaded "Gaba Fog" and stick to meds targeting your vestibular issues in my opinion.
Will do.
There is a massive crossover with anti anxiety/depression meds and vestibular issues. Venlaxafine, Sertraline and Prozac are often the main ones used. Nort, Ami and Gaba also.
Audiology said PPPD and try Prozac. ENT consultant wasn't happy with that so referred me to UCLH, you know the rest with those muppets and it's supposed to be the best Neuro-otology place in the country! Not on the clerical side tho!
I wish you lot could talk to my other half so she could confirm that 2 years + ago and for nearly a year I was clinging to the walls to walk to the toilet. It's now 25% better than back then.
I'm a member of a vestibular group, people out there aren't being taken serious soon enough and for things like vestibular neuritis which can cause permanent damage, so they're are stuffed.
Dr Surenthiran was very good.
I did a search on NMP on Gaba when I started taking it last week that you had been offered it at one time but refused to take it. Side effects?
Mine was prescribed for a chronic pain condition but one of the side effects which even doctors admit to is brain fog which I just couldn't contemplate being a carer and having to face an inquisition every day!:D
UCH is a great hospital but waiting lists are mega-my son goes there. You will see an expert there who will diagnose you properly.Don't lose heart, Matt-seeing the right consultant will be the start of your recovery.
Yeah it will be good to go to UCLH. Neuro-otology is based at ENT Grays Inn Road.
Been to all of the London hospitals when I went to London everyday for work. Going to GOSH always gave me a lump in my throat.
Are you still going to pain management Pulisa?
Yes, or at least the first version. Gabapentin has been around for many decades, pregabalin is relatively recent. Both were developed by Pfizer. Not sure why pregabalin should be much more expensive as it appears to be out of patent and, at least here in Oz, there are several generics.
Thanks PDU, I'm seeing the Neuro-otologist in just over three weeks, so I will stay on low dose Gab and ask to swap to Preg.
I see the Psych the following month, so hopefully Preg is something she agrees with.
MyNameIsTerry
23-10-19, 01:53
Yes, or at least the first version. Gabapentin has been around for many decades, pregabalin is relatively recent. Both were developed by Pfizer. Not sure why pregabalin should be much more expensive as it appears to be out of patent and, at least here in Oz, there are several generics.
Likely all about the bucks. Last year the NHS had to go to court to stop Pfizer who wanted to prevent generics being used in the UK. So, I'm guessing prices are slowly decreasing as Pfizer loses it's grip?
panic_down_under
23-10-19, 11:53
Likely all about the bucks. Last year the NHS had to go to court to stop Pfizer who wanted to prevent generics being used in the UK. So, I'm guessing prices are slowly decreasing as Pfizer loses it's grip?
I don't know about NHS pricing, but gabapentin is cheaper here at low doses, they nearly reach parity at 1,800mg (3 x 600mg) gabapentin compared to the equivalent 300mg (2 x 150mg) pregabalin and at higher doses pregabalin becomes progressively cheaper because of the gabapentin bioavailability issue.
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