Still on 15mg mirtazapine after 4 weeks - is this right?

[haziefantasie]

Hi Everyone

I started taking 15mg mirtazapine 4 weeks ago on 11th November, mainly for stress and anxiety due to a relationship break up, debt problems etc. My doctor at the time said Id need to increase it to 30mg after 4 weeks, however I have since moved house so have had to change doctors. I went to my new doctor on tuesday who said to continue on 15mg for another 2 weeks and see what happens.

However Im worried that this isnt right, due to what my last doctor said and also as I seem to be getting worse. Since the weekend Ive been feeling so hopeless and down, Im either crying non stop or just feel numb. Ive got so much to sort out for christmas etc and I just dont have the motivation to do anything.

Im wondering if anyone else has been on 15mg for a long period, from what Ive read I thought it needs to be 30mg or more to have an effect on mood? And is it normal to get worse before you get better? Im half tempted to just take 30mg anyway but obviously they will run out quicker and Im worried about going against the doctors advice.

Sorry for such a long post, I just feel so hopeless at the moment and am panicking that it wont get any better x

[JT69]

Hello,

I started taking mirtazipine in February initially 15mg then after around 4 weeks went up to 30mg and stayed on this dose until around 10 weeks ago when I reduced back down to 15mg and am currently still on this dose.

30-45mg is a thereputic dose and is a better dose to deal with mood etc, and yes anti-depressants do make you feel worse before you feel better.

I found 30mg helped me alot more and luckily the increase didnt have too much effect (side effect wize) on me either.

If I was you I would go along and see the same doctor you saw the first time and he will probably increase your meds for you and then in no time at all you should be feeling alot better.

Let us know how you get on and I do hope you feel better soon.

Jo.xx

[Vixxy]

I was on 15mg for a long time before I went up to 30mg. I would give it another few weeks as your new doctor suggested and see how you feel. The meds don't really come into full effect until around the 6 week mark. So you might find in a few weeks that the 15mg dose is enough for you, or you might need to go to 30.

[haziefantasie]

Hi guys

Thanks for your advice, it helps just knowing that others are in or have been in the same situation.

Unfortunately I cant go back to the first doctor as I have now registered at a new practice. So I rang my new doctors & booked the next routine appt on 20th dec which is with a different doctor again. By then ill have been taking them for nearly 6 wks so hopefully ill be feeling better by then. If I get any worse I think ill just have 2 book an emergency appt or something.

Whats worrying me now tho is work, as im finding it harder to get up in the mornings & when im there I just cant concentrate. Have you been working whilst on these meds? x

[Vixxy]

I did a year at university whilst taking them. I found its best to take them around 9-10pm as that way I could wake up in the mornings. If I take it past 11pm, then I won't be up before midday.
Its trial and error finding a time that will suit you.

[ElizabethJane]

Deat Haziefantasy I'm sorry that you are still unwell on 15mg. Yes some of us still work whilst taking these meds. I did not have any time off when I first went on to mirt nearly two years ago. I found it hard going and it is still hard going at times and yes I still go to work. If you can have some time off whilst adjusting to the mirt then do so? Your posts seem to be telling us quite strongly that you are not coping on 15mg? I agree with the others that you need to be seen at the drs sooner rather than later. It would not be unreasonable for you to have an emergency appointment? I also agree with Vixxy and Jo that 15mg is not a therapeutic dose and it will take up to six weeks for you to feel any benefit from the mirt. You might be sleeping better though which is a positve side effect of lower doses of mirtazapine. When I first went on the drug all I wanted to do was sleep. I am taking 45mg at night with other meds. Your doctor may have a perfectly good reason for keeping you on 15mg? He is new to you so he might want to see you settled on 15mg before increasing? You might have had an adverse reaction to anti ds in the past? You might be combining mirtazapine with other meds as an 'add on'? This was indeed the case for me when I first went on to mirtazapine. There might be perfectly sound medical reason why he is not increasing your meds or something that you are unable to tell us for personal reasons? If you are really unwell and not coping then my suggestion to you is to go back. Take care. I hope that you begin to feel better soon. EJ.

[haziefantasie]

Hi again

Well I went back to the doctors this morning, I decided last nite that I couldnt cope any more & managed to convince myself I wasnt going to get any better unless the dosage went up. I got an urgent appt with the same doctor, I think last time he just wanted to keep me on 15mg to check how I was on it as he didnt know me. Im not on any other medication, I was depressed when I was about 15 and was on chlomipramine (??) but I had quite bad side effects, which I think is why I was put on mirtz this time. Anyway, I think this time he realised I wasnt coping so hes upped the dosage to 30mg and has referred me to the community mental health team, hopefully ill be able to get cbt through them as I think thats what I need. He has also signed me off work for 2 wks which im very anxious about but I just have to try not to worry about it (easier said than done!). Ive realised that ive been trying to put up a front that I can cope and that everything is ok for so long, whereas I just need to accept that im ill but I will get better x

[Markham40]

hi im new here , ive suffered from depression for four years, i used to take fluxeotine (10 mg) then doc upped to 20mg then 40 mg and when i s;tarted the 40 Mg i was admitted to hospital with suicidal thoughts and also had gastoenterritis (four days before xmas 2010), doctor changed tablets to citalopram in 2011 - 20 mg... then before me and my partner got married in aug 2011, my depression got worse... so I was on 40mg... that was fine.... until novembelr 2011, work wasnt going to well, i was confused, making mistakes, I hated crowds still do, and my sleep pattern (went to bed early, woke in the morning still tired wanting to sleep all day, so I went back to the doctors, he put me on sick for (1 week before christmas), and he wants me to try these mirtazapine, so i had to ween myself off citalopram... I am now in the 1st week of taking mirtazapine, and im worst than ever, yeah my appettite is great and i hope i put on weight cause im a thin guy but Im having a difficult time on these, My mood is worse than ever, I blow up at the slightest thing, angry yes.... other side effects i have headache it goes from one ear to the next (its like an 2 second electric shock), im still not getting a full nights sleep ( as I wake up in the middle of the night) and in the morning still tired lack of energy) but ever since been on these I keep getting indigestion and trouble breathing... off work for a week again due to taking these things... going back to the doctors tomorrow as I cant stand taking thses anymore..... any suggestions or comments

[JT69]

Hello,

Its very early days for you at the moment and it sounds quite normal what you are experiencing...you often find you get a little worse before you start to feel better if that makes sense.

How long did you wean yourself off citalopram for?

I went from 40mg cit to 15mg mirt in 1 week and it was horrendous...I had the electric shock syndrome really bad all over my body (this can be caused by quick withdrawal from srris) as well as the side effects of the new med.

I did find I was very short tempered too when I first started taking it and would jump down peoples throats very easily...this did pass after a couple of months. I started to feel better after a 2-3 weeks and was able to return to work 2 months after starting mirtazipine.

Not sure about the indigestion and the trouble breathing unless it is panic causing it?? You may find it helpful to have a chat with your gp??

Hope you feel better soon...for me these were the best ad I have ever taken and along with pregabalin have turned my life around.

Take care.
Jo.x

[Belleblue]

Hi Markham and welcome to the forum :)
Sorry to hear that you're having such a bad time of it. It sounds as though these side effects might be more to do with you withdrawing from the citalopram than the start up effects of the mirtazapine... maybe you weaned off too fast? Don't give up on the mirt too quickly as it is a good med with generally few side effects after the first couple of weeks.

Take care and let us know how you are getting on.

Belle x

[msjo]

Been taking 30 mg now for almost 3 weeks. I too switched from 40mg of Cit to this within 3 day. I felt pretty rubbish for 1st week or so but now feeling much better. Stick with it.

[Markham40]

hi, well thank god that some others go thru the same symtoms... I went back to the doctors with my wife as backup, and wife had her say saying they were making me nasty... success I'm finally off them, im on 50mg of sertraline now, I feel ok for now, last night was bad for the electric shocks and couldnt really walk probably... today I feel fine, but still not myself... electric shocks gone, and i feel less angry and less like a short fuse.... been off work for about 5 days now sick, but i am not going back until I am fully ready.. emailed my boss today.. anyway thank you Jo & Bellxxx

[Ingenious]

I blow up at the slightest thing, angry yes.... other side effects i have headache it goes from one ear to the next (its like an 2 second electric shock), i

Just to pick up on these two points. I remember the anger side effect of Mirtazapine, it was like I had an inner force of aggression that when triggered was bottomless, I could rage like there was no tomorrow. It reminded me very much of when I used to start on hayfever medication and that made me very, very angry too (funnily enough, Mirtazapine cured my hayfever so I wonder if all this is linked to its antihistamine properties).

Friends and family noted how irritable I was - but the good news is this DOES pass, give it a few weeks. After a couple of weeks my anger had completely gone. It's just the medication getting into your system. Just warn family and friends you'll be a bit grumpy for a bit.

As for the headaches and shocks, I got this too, but I think that was more down to coming off Citalopram than from the Mirtazapine. Remember you will get some weeks of withdrawal effects from the previous meditation, just to make things worse :)