Mirtazapine increase to 30mg... worried

[WembleyBear]

After being put on Mirtazapine 15mg for severe morning anxiety in February it seemed to work well to begin with. I slept and felt better, but recently the effect seems to have worn off. My father died at the start of April and since then I've gone downhill rapidly. I take the Mirt at 11pm, sleep for a bit, then wake around 4am, agitated (literally cannot stay in bed) and then work myself up into a state where I'm crying uncontrollably, retch and feel like I can't cope with anything, and get generally very distressed - I seem unable to calm or soothe myself and going back to sleep is impossible. I could stand it no more after weekend so went back to GP and blubbed embarrassingly (43 yr old man) in her office. She has now upped the Mirt to 30mg at night and given me Propanolol to try as needed for the physical symptoms. Now worried that restlessness & agitation will get worse as have read on here the higher dose is more activating (not what I need at all!). Can anyone shed any good light on this increase?

I'm still annoyed that I was stable for over 10 years on Dosulepin 75mg at night, until it was pulled last year (too easy to OD fatally, apparently) and I can't find another med that works for me (SSRI all make me agitated as well).

Am booked to see an ACT therapist though, starting Friday so hoping this will help too.


Martyn

[aprilmoon]

Hi
I had exactly the same thing happen with the 15mg of mirt and after a very short time of euphoria also collapsed in a blubbering heap at the doctors!
When I went onto the 30 things steadily improved and ive been on that dose for about 2 months.
I still get anxiety though, but dot want to go higher,although I've been told I could.
I'm also on venlafaxine in the morning

[WembleyBear]

Thanks, that's good to know. I hope it will help me too as I don't really know where else to go medication-wise. I'm hoping the ACT (like CBT, I think) will help as well. Have you tried CBT?

[aprilmoon]

I've been on a waiting list for months.
I think you will feel more stable on the 30.I still find I get a great nights sleep on it.

---------- Post added at 14:44 ---------- Previous post was at 14:41 ----------

What worries me is that it will "poop out" like the 15mg did.Its a constant fear because I know how your body can get used to meds.
I think that's why I'm holding out with the 45,its my last resort "go to".

[WembleyBear]

Yes, it's a bit like that around here. I had to almost beg the GP to refer me to the Access Team, and all I got was a telephone consultation and put on Mirt.

So I've decided to pay privately for the CBT, I can't really afford it, but if it helps and I'm able to keep working, I guess it's worth it.

Hope you manage to get in soon and Mirt continues to work for you as well.

[aprilmoon]

Thanks.
I'm going to the doctors tomorrow to say that the wait till Aug for my next psych visit is ridiculous. I only want to chat about med changes and get some support.
I think you've done the right thing in going private,its wrong you should have to,but sometimes you have to.Good luck.

[SADnomore]

Aprilmoon, in order to postpone going to 45, could it help to up your venlaxafine instead?
Marie xx

[aprilmoon]

Hi Marie!
I never thought of that!
The doctor prob won't have a clue if I ask her,but I could phone the psych.
Just remembered,last time the room was spinning when I did that!
How are you today!

[SADnomore]

Doing okay, thanks hun. I do find I'm a bit testy these days so I am looking forward to increasing from 75 mg of the venlaxafine, I think ... Then again, it could be that it is STILL SNOWING HERE IN NORTHERN ALBERTA! Ugh! Haven't seen more than a quick glimspe of sun for a week or more ... Just what a person with SAD doesn't need :P

Mind you, it's going to be a good 6 weeks more before I can look forward to an increase, and I still don't know if he will okay the mirtazapine too. I guess it depends on if we get into a Mexican stand-off again when it comes time to refill my zopiclone! ... So, I read there where Hanshan has gone up as high as 60 with the mirtazapine, albeit as a solo drug. Does it make you feel a bit more confident knowing that 45 isn't the absolute ceiling for mirt? OR, is it the sedating effects you want, in which case you were musing about going down a bit rather than up? xx
Marie

[aprilmoon]

Hi Marie!
I'm not sure,I feel a bit spacey,and its that feeling that I don't really want,but I don't want to rock the boat too much!
I'm thinking that 22 half might be enough,but the only way is obviously to try it,and see.
Its definitely seen the depression off,which is amazing really given how I was,I'd just like to feel a bit more normal,whatever that is.......
It must be so hard for you,not hardly seeing the sun.... I'll send you a hug
When you can't get to see the psych for months on end,its difficult to make the decisions that they leave up to you!!!
You take care my friend.xx