SSRIs nonresponders have success with mirtazapine?

[Emphyrio]

Hello,

I have been suffering from severe physical anxiety symptoms for around 10 months now - generally I feel fairly panicky and restless (almost like a form of akathisia). I believe that it was partly caused by medication changes and stress in the past.

I have tried a number of SSRIs which mostly just made my restlessness worse. I'm currently taking a tiny dose of citalopram (5mg) which helps slightly with my OCD intrusive thoughts, but doesn't do anything for my physical agitation. I'm waiting for CBT as well - until I get my intrusive thoughts under control I'm reluctant to drop the medication completely.

My question is therefore: have any of you who experienced worsening of panic and agitation on SSRIs experienced relief of physical anxiety symptoms on mirtazapine? If so, what kind of dose did you need to take? I would continue to take the 5mg citalopram and hope that the mirtazapine takes care of the panic/agitation.

Thanks

[Sands]

Hi. I couldn't get on with ssri s at all. They made me extremely agitated it was so horrible I will never forget the trauma. I am on mirtazapine now and they helped me a lot. They really calmed me down and got me out of the hole I was in. I started on 15 for about a month and then 30. I didn't notice much difference with the increase so with hindsight probably should of just stuck with the 15. They worked really quickly even the next day a felt a bit brighter but really really tired. I quite enjoyed that but I know others don't.
They never entirely took the anxiety away but they did really help.
I'm coming off them now, slowely but surely I'm feeling better. I hope they help you too if u decide to go for it

[teej]

I too had a traumatic time on SSRIs. Mirtazapine has done nothing for my anxiety and after a month of being on it, my anxiety was getting worse. I'm now tapering off.

Side effect wise it was a walk in the park compared to SSRIs and they do really help me sleep well so might be worth a try though?

[Emphyrio]

I've been taking 7.5mg for a week and last night took 15mg. My anxiety has been really bad recently - hopefully the 15mg will help in this area. Until I'm stable I'm continuing to take my 5mg citalopram though - I've had too many drug changes and most of them have made me worse, so if the mirt does the same I still have the cit to cushion the blow...

If this doesn't work - maybe the next step is a mood stabiliser...

[teej]

Good luck. I'm starting Trazodone tonight. Similar to Mirt but hopefully better with the anxiety.

[Emphyrio]

Thanks Teej. Just be aware the trazodone can increase anxiety in some people due to the effects of its active metabolite.

[pulisa]

Why can't someone come up with a drug which helps take the edge off agitation yet has no addictive properties/ weight gain/blood pressure "extras"?

[hanshan]

Hi Pulisa,

I think all the research effort went into SSRIs and related drugs for some time, particularly when it was found they could also help SOME people with anxiety. However, side effects and non-response cases make them less than perfect.

Fortunately, research has now returned to specific anxiety drugs, and several are currently in trials. With luck, one might be more effective to more people with fewer side effects.

[pulisa]

That would be a huge step forward, Hanshan. Thanks for your response.

[Emphyrio]

I've been on the mirt for around 2.5 weeks in total. While my mood has lifted my anxiety has still been as bad as ever - maybe even slightly worse? Though I did have some alcohol a couple of days ago which may have contributed to this latest blip.

For those on mirt, how long did it take for you to feel a substantial decrease in anxiety/panic? And what dosage were you on? I'm just taking 15mg but I've read that higher dosages can be more stimulating - which is the last thing I need.