Mirtazapine too stimulating?

[Char56024]

Hi everyone. This is my first post. I've been taking mirtazapine for about 7 months now and I've been finding that it's now having the opposite effect when I take it just before bed. It makes me wide awake and my anxiety is high for several hours and I'm not getting to sleep enough or I wake frequently through the night. This never happened before and I have reduced my dose from 45mg down to 30mg and then down to 15mg over a few months. Now I'm finding I'm not sleeping well at all on 15mg but I'm also anxious and tearful during the day which is unusual for me. Because of this I think I should go back up to 30mg and maybe try taking it earlier in the evening. I was wondering if anyone else takes their dose earlier on in the evening because of the stimulating effect it can have in the higher doses? Also is it possible for mirtazapine to stop working? Many thanks

[SmilingAlbert]

Hi Char,

You should discuss with your doctor, but as you know Mirt is more stimulating at higher doses. So one idea might be to have a low dose (e.g. 7.5mg) in the evening, and the rest the next morning. I find this works well for me.

Mirt is an AD, and of limited use for anxiety. Consider taking a specific anti anxiety medicine like Pregabalin as well. Many people on these boards take this in combination with positive results, and Pregabalin is well tolerated by most.

Albert

[hanshan]

Hi Char,

If it was working at 45 mg per day, I would go back to that.

The "more sedating at lower doses" idea is a theoretical construct.　I take 45 mg per day, and if I take more on occasion, find it is more sedating.

[NorthernGeek]

I have also been on Mirtazapine for almost seven months now in order to treat obsessive worrying, anxiety & depression, after having previously been on Citalopram for around six months.

To be honest neither have helped with the depression, but of the two I prefer Miratazapine as my anxiety attacks are often worse at night & at least it helps me sleep.

I found Christmas quite stressful this year as after reading a depressing newspaper article on Xmas Eve, I had an anxiety attack that lasted until after Boxing Day. I didn't want to spoil Xmas for everyone else so I tried to 'bottle it up', but it was almost unbearable & it felt like my stomach was in turmoil the whole time.

Even the 'Dr Who Xmas Special' was horribly depressing, but luckily I didn't watch that on Xmas Day or I would have burst into tears.

I was already on the maximum dose of Citalopram when I had to switch because it stopped working, but for the last month it has felt like Mirtazapine is wearing off too & I am already on 45mg. I know that I need to make an appointment to see my doctor again rather than just keep renewing the presciptions, but if nothing works properly anyway then what is the point?

My family still seem to think that I can just snap myself out of it with positive thinking, but increasingly I just think that it would have been better if I had never existed at all.