Anyone else on both Mirtazapine & Citalopram?

[crumble]

Hi all,

I'm curious to hear from anyone else who is taking both mirtazapine & citalopram and to ask how well they are sleeping?

I took citalopram about 5 years ago for a few years and while it really helped with anxiety/depression I'm pretty much convinced that it gave me my sleeping problem (of course I could be wrong). I eventually came off it as I felt much better anxiety wise.

Now I’m taking mirtazapine for my sleep problem and for anx & dep again. I’ve been on them for a few months and while I don't feel it's been working for anxiety it has helped my sleep immensely.
(I can’t win! :-) )

I have read that a side effect of citalopram is insomnia, so I really don't want this happening... again. But I'm hoping that with mirtazapine combined that I *shouldn't* have too much of a problem.

I assume that it's best to take the citalopram in the morning, and continue to take mirtazapine in the evening/night?

I’d be interested to hear other people's experiences taking both of these.

Thanks all

[john@e]

Hi Crumble,
My GP wouldn't allow me to use both. I had to come off citalopram before going onto Mirtazapine. Now on 30mg per day (4 weeks 15mg, into my 4th week 30mg) and only just starting to get into some form of sleep pattern now.
I can't really blame citalopram for insomnia as I was a total insomniac before being diagnosed with depression but found that cit. was only part effective in addressing my symptoms.
Don't know if this is the sort of feedback that is helpful to you.
Kind regards
John@e

[ReneV]

Hi Crumble, currently i'm on 10mg of escitalopram and 7.5mg of mirtz. Been on mirtz for 3 weeks currently. Also been on and off citalopram.
Escitalopram or normal citalopram has never managed to fully control my anxiety or panic, but without them I'm sure I would be a mess. Started Mirtz and the first week was a great week and i was sure I finally found a combination that worked. Joy turned to despair as the anxiety symptoms reared it's ugly face again in weeks 2 and 3. Like you said the pattern this combo is mirtz at night and escitalopram in the mornings. I have to say when I'm not exhausted or dosing ( I do think this combo makes one tired/lethargic ) my anxiety is just manageable. Sleep wise, the mirtz kinda makes you real drowsy for a few hours before I'm asleep and next thing I know it's morning. I too was suffering from insomnia also before starting the mirtz. Hope this helps.

[Belleblue]

Crumble - I was wondering how you are getting along sleep-wise on this combo?? I was thinking of trying this myself as the mirtazapine isn't really helping too much with my anxiety/depression and may be making it a little worse if anything.
I tried citalopram in the past and it caused dreadful insomnia, so I didn't stick with it, but the mirt may offset this side effect. I was also wondering is this a common combination and would I have difficulty getting my GP to prescribe it?

Belle x

[crumble]

Hi Belle,

I've been on the citalopram for about three weeks now, with just over a week of that at the full 10mg (I built up to the full dose to avoid side effects). My sleep is good, the mirtazapine still have their drowsiness effect (at 15mg) and still work within an hour or so. I get off to sleep well and seem to be getting some good sleep, that is I'm not tired like I used to be late into the morning. But I still struggle to actually wake up and have to peel myself out of bed!
My sleep isn't perfect and I do have occasions where I wake up in the night, but I tend to think that's the anxiety rather than the drugs (but I could be wrong..). However this is nothing like the constant waking I used to suffer with previously.

Citalopram really helped me a few years ago and I'm hoping it will do the same again - but without the sleep problem this time! My anxiety/depression does seem to have improved already, even at this low dose and at this early stage. I was worried that 10mg wouldn't have much of an effect and cause more issues, but I'm positive it's doing good.

It was me that suggested this combination to my doctor, and that was mostly due to what I'd read on here that other people were taking AD's combined. I did mention that I faired so well on the cit the first time and with the drowsiness effect of mirt that it might counteract any insomnia. He didn't hesitate to prescribe them whatsoever.

He did say that he'd had a few other patients that said the mirt didn't seem to be helping, which is interesting.
He also warned me of the possibility of serotonin syndrome which you can get when taking combined AD's. But he wasn't overly concerned about it and I haven't noticed any sign of it.

Hope this helps you. It would be good to hear from other people who are taking this combination and hear your experiences - come on guys and gals, don't be shy :)

x

[Belleblue]

Oh thank you so much for such a helpful reply Crumble! You're a diamond! It's so good to know that the citalopram isn't knocking out the sedative effect of the mirt. I will discuss all of this with my GP and hopefully she will be as reasonable as yours and prescribe them... I don't see why not. I will do as you have done too and titrate up slowly. The other side effect I had with them (cit) was that I felt wired all day and couldn't sit still, had to keep moving. I could have coped with that as an initial side effect if only I could have had some sleep at night. But hopefully the mirt will head off the worse of these effects.

I will see my doc in about a week's time and will post how I get on.

Take care now.

Belle x

[oldtime]

I'm doing well on this combination, citalopram gave me really bad insomnia. I now sleep a good 7 hours a night.

[Belleblue]

Crumble - I was wondering how you are now getting on with this combination - is it still working well for you?

I'll be seeing my GP on Friday and will have to make up my mind whether to go with the mirt/citalopram combination or try pregabalin. I'm worried about both for different reasons. The cit for it's bad start-up side effects and the pregabalin because it is a relatively new med which few seem to know much about. Currently I am not on any regular meds. Most days I'm ok, but because of a particular life stressor at the moment I am just about coping at times and getting physically as well as mentally run down.

Hope life is treating you kindly :)

Belle x

[nicola1980]

I asked my doc if i could take mitz aswel as my citalopram due to sleep problems but he said no he wouldn't be happy to prescribe them both together and that a physchatrist should only do that??? xx

[crumble]

Hi Belle,

I'm doing better now thanks - how are you getting on?

I'm still taking both citalopram and mirtazapine. 15mg of mirt and 10mg of cital. I've just recently increased to 20mg cital as I'm still feeling some anxiety symptoms.

I haven't experienced any bad side effects while I've been on cital and I didn't have any side effects that I noticed when I first started them. I started with a 1/4 of a tablet (2.5mg) for a week, then 1/2 a tablet (5mg) for a week, then a full tablet from then on. I take them first thing in the morning. I haven't noticed any ill effects.

I still take the mirt at night before going to bed and the sedative effect still works. I did wonder whether I should decrease the mirt since I've increased the cital, but my doctor didn't suggest it.

When I asked to increase the cital, my doctor said that I had room for manouvere in my dosage and didn't hesitate to prescribe the higher dose.

I know how you feel about being physically and mentally worn down. I wish that sometimes I could fully relax but there's always something going on, so I think I've a way to go yet. :) My mood has certainly improved since taking cital though, so I can't complain there.

Hope you find the right med for you :) Let me know how you get on.
xx

[Belleblue]

Hi Crumble, thank you for such a comprehensive reply. Strangely (or not as some others have experienced the same) my anxiety increased while I was on mirt. Apart from about three weeks when I felt really well on it, I felt a strange internal shakiness. It was on the other hand excellent for sleep. I am hoping that if I go on the cit that it will balance things out somewhat... as it seems to have done for you.

I will also start low and go slow as you have done in an effort to avoid any nastiness. I'll let you know how the GP's appointment goes and if it's decided that the mirt/cit combo is the best course of action. She has also mentioned Pregabalin in the past, so we will be discussing that option too. If only I had a crystal ball to see which might work best!

Take care now and thanks again :flowers:

Belle x