From Sertraline to Mirtazapine...

[teej]

For the last 10 years I've been through SSRI hell with citalopram, escitalopram and then sertraline, fighting the paradoxical effects they have on me (worsening anxiety, co-morbid depression and late onset alcoholism) and fighting the severe side effects.

I've finally seen a different doctor who had the sense to take me off 100mg sertraline (which I did in an inpatient effective detox setting) and I'm now on 15mg Mirtazapine which I've been on 7 days tomorrow.

I've seen a much appreciated increase in appetite (I was so nutrient starved when I arrived in hospital due to the sickness and nausea and the comorbid alcoholism and I developed an eating disorder last year) and I'm sleeping like a baby (I had huge anxiety about sleeping and waking in the middle of the night).

The sedation has brought me down from being a complete nervous wreck and whilst the the dizziness at the beginning was a bit weird it seems to have subsided.

I feel like this drug has turned my life around in a week but seeing all the negatives here has really put me off, and having been through SSRI hell (and the fact I'm a hypochondriac ) is really making me think twice now whether I should go med-free.

Any thoughts anyone?

Thanks

T

[hanshan]

It seems that mirtazapine is having beneficial effects for you - sedation, improved sleep and appetite, without any serious side effects (which mostly turn up early), so perhaps it could be time that something has worked for once. It does happen, occasionally.

The daytime sedation will probably decrease over time, and it's still best to start monitoring your weight, because it can go past what you are comfortable with.

Good luck with mirtazapine. I think it's a bit different from the other ADs, and may be suited to you. Obviously, it doesn't work for everyone, but that's no reason not to give it a try.

[teej]

Thanks Hanshan!

I monitor my weight and food intake like a hawk normally because of the eating disorder but I just feel like I have a normal appetite now, as opposed to going whole days not eating. To be honest though - gaining even a stone over the hell I went through on the SSRIs would be preferable.

I'm a bit of an exercise nut too so once I feel better I'd imagine I'll be back on my bicycle.

Good to know the worst side effects turn up early because I really feel like I've turned a corner. Might go an do a little dance somewhere now!

[xrachykinsx]

Mirtazapine works great for a lot of people. Despite the fact I'm tapering down as I don't like some of the side effects, I should still give it some credit as I'm much improved now than 6months ago. It has deffo helped me get my sleep routine back

[aprilmoon]

Glad to hear its working well for you teej
It certainly helped me out of a deep depression.

[teej]

Thanks for the replies guys. Still enjoying the sleep and the rest and having an appetite.

I have noticed I've added a few kgs this week but then I have been eating with what I consider an utter reckless abandon - adding extra meals, eating whole pizzas but damn it feels good to have an appetite. I think I'm going to cut back on the eating a bit and see what happens on that department! I need to get back to some serious exercise soon too.

I do feel a bit fuzzy in the mornings but it's nothing compared to rolling with the stinking hangovers I used to have - I'm quite used to operating in a haze!

As for my anxiety? Having been through everything I've been through in the last few months it seems to have gone, only to be replaced by a depression which seems to be lifting - perhaps thanks to the mirt.

Next serious anxiety attack (they normally last a few days and occur 3/4 times a year) I'm going to tackle with lorazepam or valium.

Interestingly enough I do feel the effectiveness of the mirt seems to be linked to what I eat. I definitely feel down before I eat my breakfast!

[aprilmoon]

Hey teej
That's an interesting point you've just made then, about the mirt working better when you eat.
I wonder if that's something that helps you get the best results from it?

[valleybear]

Just thought I would add a word of encouragement.I also was on Sertraline and the side effects were not good. Worst of all was the insomnia and panic attacks out of the blue.After 5 weeks my Dr changed me to Mirtazapine and the difference was amazing. I sleep well, have not had a panic attack since starting on the Mirt and my depression has lifted. I am into my 7th week and have not gained any weight.. I was a healthy weight at the start. I truthfully cannot detect any adverse effects and am so grateful to the Dr for changing from the SSRIs which were making me suffer so much. If you feel that the Mirtazapine is helping please consider staying with it as I have nothing negative to report about it in my case. Good luck. Xx

[aprilmoon]

Hi Valleybear!
So glad to hear you're still doing well

[teej]

The eating thing is interesting.

I've gained 2 kg in 9 days since I was admitted to hospital but I had literally barely struggled to eat a meal in the month before and therefore was very deficient in minerals and vitamins and underweight for where I feel comfortable (about 76kg). In the last 9 days I have eaten with what I consider utter reckless abandon - whole pizzas, take out, biscuits, sweets, chips - the lot - maybe 5 - 6 big meals a day.

I overshot the mark and ended up at 78kg as of yesterday and was feeling very uncomfortable, so yesterday I cut the carbs out and am down to 77kg this morning. I think carbs bloat me something terrible and I know I was eating terribly.

I'm going to do the same again tonight and go out for a run today so I'm hoping to get back down to 76kg by Sunday.

As for cutting the carbs - I don't think the Mirt was as effective last night. I'm still suffering terribly with the discontinuation from the Sertraline (I did a 4 day taper before going cold turkey), and last night I woke up at 0330 and struggled to sleep again which was very odd. Maybe the carbs are promoting the production of serotonin in the gut?

I did read an interesting article about Mirt supressing the cortisol hormone which elevates insulin levels (insulin being the fat storage hormone!) so as well as not giving my body any sugars to store I threw a few mugs of filter coffee into the game as well to boost my cortisol levels.

Anyway - we'll see. So far I don't think I could have handled coming off the sertraline without the mirt!

---------- Post added at 10:42 ---------- Previous post was at 10:14 ----------

Just thought I would add a word of encouragement.I also was on Sertraline and the side effects were not good. Worst of all was the insomnia and panic attacks out of the blue.

Amen. I had exactly this with citalopram, escitalopram and sertraline.