Venlafaxine and mirtazapine combo again!

[Steve Stacey]

Hi

I've been on ADs for >30 years for depression/anxiety. With one or two exceptions I've been able to work throughout this time.

I've been taking Venlafaxine on and off for a good while but now since 2008. In 2011 I was also prescribed Mirtazapine. So far so good but in last week I've felt really ill. A combination of very palpable "nervy type" symptoms (these best described as neuralgia type pain in arms and legs and feeling massively on edge) and mental confusion. The latter is characterized by confusion and difficulty when trying to have a conversation etc.

I've read all there is about California rocket fuel etc. My main concern now is not knowing whether this relapse is the underlying depression getting worse or some sort of poop put.

Your views would be much appreciated.

Thanks for your time.

Simon

---------- Post added at 20:16 ---------- Previous post was at 17:30 ----------

The other thing I forgot to mention about the physical dimension was that tremors had increased.

Thanks

[dedalus]

Hi there,

I take both these drugs and olanzapine also. I have been taking mirtazapine for several months now and venlafaxine for many years. The olanzapine was added maybe a couple of months back. Incidentally, according to my diary of symptoms and treatments (recorded on patientslikeme.com which I would recommend) the mirtazapine alone hasn't really had a positive effect on my mood or my anxiety levels. It looks like the olanzapine has though.

That isn't really answering your question of course. I haven't experienced the current extreme symptoms that you are describing since I started mirtazapine.

It sounds like you have been taking mirtazapine and venlafaxine together for at least 4 years now. Am I right? Have there been any changes to the doses of either recently? Or perhaps something else has been added?

I will finish by saying that I am not a doctor and my knowledge of these drugs is limited. I just wonder if there is something that might be triggering these symptoms. It may not be related to your medication at all. Especially if there haven't been any recent changes and you have been tolerating them well so far. I just wouldn't be able to offer advice though, not being a doctor.

[nicola1980]

Hi I take ven at a dose of 187.5mg which works great for my anxiety. What doses are you on of the ven and the mirt? It is supposed to be a very good effective combo, I had a second opinion with another physc as I wasn't happy with mine and mirt was actually what he recommended to augment with the ven but my physc wpa having none of it...she's a funny bugger as it is and doesn't like being told what to do!! It could be that you just simply having a blip which we all get even people who aren't on any meds have bad days too. I'd give it a little while to see if it calms down and if not you doses may need tweaking slightly XX

[Steve Stacey]

Hi

Many thanks for these helpful responses.

Responding to questions asked:

1. Yes, been on both for about 4 years but probably off and on Ven for many years in total.
2. Mirtazapine 30mg and Ven 150mg. Been on these doses for 4 years. Once tried to increase Ven to 225 mg but couldn't tolerate it. No change to dose recently.
3. GP useless when it comes to ADs so have seen various Psychs privately over the years and a very expensive business as you know. Beleive it or not it was the Pharmacist that recommended Mirt and combo as she'd taken it previously!!

There has definitely been a distinct change and not for the better. The mental anguish is not just confined to struggling to have conversations etc. It's there most of the time. You wake up and it's like your brain is tying itself in knots and there is a sort of tightening feeling.

I'll end there as you'll end up charging me for a consultation if I take up too much of your time.

Good to speak to you and thanks again.