citalopram Vs mirtazipine

[nicola1980]

Hi im currently taking 40mg of citalopram for panic attacks and anxiety, been on the cit since sept, doctor mentioned to me swapping over to mirtazipine completely as the cit isn't helping much, i just wondered if anyone had swapped from cit to mirt sucessfully and any positive stories on it? thanks xx

[lauz_lea]

Hi Nicola, as you know I've recently started mirt, which tappering off paroxetine (Seroxat). Paroxetine had previously worked really well for me in the past, but sadly not this time.

So far, whilst tappering (15mg of each in the evening) I haven't had any of the adverse side effects associated with SSRI's, in fact it's really helped as I am sleeping really well now and the daily vomitting stopped straight away.

The first night I took it I was asleep within half and hour, but it's now anything up to about 90mins before I'm fast asleep, the tiredness does apparently lessen with an increase in dose but I haven't changed my dose as yet so don't know.

I do get a bit hungry after taking it so tend to take a little snack to bed (but having lost so much weight on paroxetine I don't mind if I put a few pounds back on). I certainly haven't had the hunger that others have mentioned, but still taking the paroxetine could be the reason for this.

I'm seeing my GP on Monday so will no doubt have my doses changed (something I always fear), but if I was going to experience any awful side effects I would have expected these to have been apparent by now.

Oddly, one thing the paroxetine has caused this time (but has always eradicated in the past) is depersonalisation. It's more severe in the morning so I'm really hoping that once the paroxetine is lowered, the depersonalisation will lessen.

Are you cross tappering or stopping cit before starting mirt? It would probably be best to reduce the cit slowly so you don't suffer too much with withdrawal.

[nicola1980]

Hi thanks so much for your reply yeah they would crosss taper me with 20mg of cit (currently on 40mg) and 15mg of mirt for a week or so and then increase the mirt to 30mg i think without any cit?? im still undecided as what to do as cit has always worked well for me in the past and im only 3 weeks into a dose increase?? god why is it so hard i sometimes think i must have done something really bad to be tortured like this, i wouldn't wish how im feeling on my worst enemy (not that i have any......i hope!!!) xx

[lauz_lea]

I know what you mean, it's always scary starting a new med, especially if one is making you feel awful, because you're scared of feeling worse. I was petrified of starting mirt, but after a really terrible day I decided it really couldn't make me feel any worse, so thought it was worth a shot - I felt instant releif the very next day, like I had just been lifted out of the pit of depair.

I'm still suffering with depersonalisation, which is my least favourite symptom or side effect (I've suffered it as both an anx symptom and a med side effect) because it makes everything in life so hard. At least it doesn't last all day now though, just mornings until early afternoon, but it makes me dread going to bed when I feel so "me", knowing I'll wake up feeling disconnected from myself again.

---------- Post added at 21:12 ---------- Previous post was at 20:04 ----------

I haven't been keeping a "mood diary" or anything similar, but another thing I have just realised is that the doom and gloom obsessing and mind chatter has stopped - instead I now get songs stuck in my head which is far nicer.

The only thing I really "obsess" over now is the depersonalisation which subsides throughout the day as I become more active. I know I should try and motivate myself earlier in the day but I'm still finding that bit difficult but I have been going out for daily walks, something I could not have done 12 days ago so I've actually improved more than I realised.

Now if I could just get rid of the morning depersonalisation

[NoPoet]

Hi Nicola, I've written a lot about the benefits and drawbacks of citalopram. As far as I'm concerned there is no contest whatsoever, mirtazapine has been FAR easier to come onto. It hasn't increased any feelings of anxiety or depression. In fact on day one it improved my sleep, making it deeper, more restful and generally more enjoyable. It has definitely increased my appetite. On cit, I hardly wanted to eat, but I have probably never enjoyed eating as much as I have now! The meds, along with my improved mood due to CBT starting to have an effect, plus my own efforts to encourage myself, have given me more energy and I feel like I could run a hundred miles to burn off all these extra calories.

So, side effects of mirt: increased appetite, increased pleasure in eating, increased energy, vastly improved sleep duration and quality, manageable levels of tiredness.

Side effects of cit: severe headache and severe nausea for several hours after taking a dose, massively increased anxiety, loss of appetite, waking early and being unable to sleep due to constant repetitive thinking, feelings of depression.

Which would you pick?

[Ingenious]

I swapped from Citalopram (which ended up at 40mg) over to Mirtazapine 15mg and it was a life saver. Citalopram had stopped working for me and I felt I was flogging a dead horse with it. Mirtazapine had the main side effects as noted here in various posts (drowsiness to start with, vivid dreams, weight gain) but mostly physical side effects which I find easier to manage than the psychological/anxious side effects of Citalopram. For some reason with me, Citalopram just didn't work but Mirtazapine was like a magic bullet. Been on Mirtazapine for about a year now, I'd never change back, so a success story from me but I would stress everyone is different and it can be trial and error to find something that suits you. As always, don't be put off by the large number of posts about side effects - you get this with any medication of this type.