Struggling

[Istherehope?]

Hi, so as previously posted I have been on Mirtazipine since 9 October. I week at 15 mg, 6 1/2 weeks at 30mg and 12 days so far at 45mg. I'm really struggling though. Mirt has helped me sleep which is really good, however I feel much lower these days. Previously I had extremely high anxiety, which may be slightly better, but it's still quite overwhelming. Now though I also feel very depressed. It seems very dark and I just want to sleep and never wake up. I feel as if I've entered a nightmare parallel universe and I don't know if it's the mirtazipine or the illness making me feel this way... I'm speaking to a doctor tomorrow and wondering if I need a referral to the crisis team. Is it still early days on Mirt? Feeling desperate now....

[sandie]

I think it important that you see not only the GP but actually ask for a referral to either a crisis team and / or a therapist/counsellor.

By my reckoning you have now been on Mirtazapine for around 9 weeks - which is still relatively early days, and you have only been on the highest dose for less than 2 weeks. BUT perhaps you also need the support of therapy actually backing up the meds.

It may be that Mirt doesn't suit you - and only your GP can advise you on this. It is very important that you speak honestly to your GP about your feelings and tell him that you have had some dark thoughts.

Unsure if this is your first time on ADs, but if Mirt doesn't suit you then perhaps one of the other ADs is more appropriate, but do be careful if considering a swap.

Mirtazapine has done nothing for me - in fact it has made me more anxious, and I do not get any sleep. I was started on 15 mg and two weeks later upper to 30 mgs, where I have been for around 6 weeks. I barely function on around 2-3 hours sleep each night and have the most awful night sweats so I am currently weaning and tapering down from Mirt, with the hope that I shall be meds-free within 4-6 weeks.

Let us know how you get on with your GP.

[Istherehope?]

Thanks for the reply Sandie, it helps me to hear from people.

I will be very honest tomorrow but unfortunately, because I had a very bad response to Citalopram before being switched to Mirtazipine my GP doesn't have much confidence prescribing for me. She urgently referred me to a psychiatrist 12 days ago....but said she had no idea how long the wait would be.

It's so hard all of this isn't it? It sounds like you've got it pretty bad too, hardly any sleep and night sweats on top of difficult days is really unpleasant. I really hope the tapering down means you avoid any worsening of symptoms. Keep posting on how you're doing xx

[A63]

Hi,

I am in a very similar position. I have been on 30 mgs of Mirt since the end of October; I typically get three hours of sleep a night max. My anxiety has decreased a bit but, like you, I am now very depressed and, like you, I feel I am existing in a nightmare parallel universe. Like you, I don't know if it's the Mirt or the illness that is doing this.

I had a visit from my local Community Mental Health Team a fortnight ago. This was prompted by a minor overdose of old sleeping pills: I felt desperate. The visit was pretty much a waste of time, unfortunately; they advised me to look online and to try Tesco Sleep Tea! It really can seem that, unless you are sitting in a corner with your head between your legs spouting gibberish, then they're not interested.

I am seeing my doc on Wednesday and I shall insist on a referral to a psychiatrist - I feel a complete review of my meds and overall position is called for now.

You have my complete sympathy. The very best of luck tomorrow.

[Istherehope?]

Thanks A....it does sound like your experience is very similar. While it's nice to feel a bit less alone, it's horrible that you're going through it too. I can't believe how hard it is to get access to medical support for mental health issues. I really hope you get that referral as I'm fairly sure Tesco don't have the answers!!

[A63]

Hi Struggling,

Yes, I totally agree: If I'd broken my arm, I'm sure things would be quite different. My GPs - can't usually see the same one, unfortunately - are good, but they are not specialists in mental health. I think if I can't get a referral to a psychiatrist tomorrow I will see one privately: can't really afford it, but will use savings. In my case, I think the meds need a real overhaul.

I'm really sorry you're having such a similar experience! Very best of luck with the doc today.

[Istherehope?]

Spoke with a lovely doctor today but as it was a telephone appointment (no others available) she couldn't refer me to the crisis team so has booked a face to face appointment for tomorrow. She said it was still early days on Mirtazipine at full dose so I get the impression they will be keen for me to just hang on until the psychiatrist appointment comes through...which makes sense but is a bit tough. Felt maybe the tiniest bit better today than yesterday, but so hard to tell...thinking of you seeing the GP tomorrow A, hope s/he is helpful xx

[A63]

Hi Is There Hope,

I hope you've had a good and fruitful face-to-face meeting with the doc today.

Mine went very well: I went in with a list of questions. She agreed with me re. the 'inefficiency' of the two Community Psychiatric Nurses who paid me a visit and promptly discharged me just over two weeks ago. I am, again, going to be referred to a psychiatrist, and this time I won't be fobbed off.

She suggested paroxetine as a good anti-depressant for someone such as myself who experiences both severe anxiety and depression. I am currently on a low dose of Citalopram in addition to 30mgs of Mirtazapine. I have taken anti-depressants for about 18 years now, although I've only been taking two different types for two or three years. I have found that they generally work well for depression, but don't really touch the anxiety. There is a drug called Pregabalin for anxiety, which I have seen many people on this forum and also on Patient UK highly recommend. I've never been prescribed anything for the anxiety.

I know I can't just rely on pills, and that I have to keep working on myself, but I have reached the point where I am open to all medication possibilities, because virtually anything is better than severe anxiety and depression.

I hope everything went well today. All the very best, A xx

[pulisa]

Be careful with the paroxetine if you have severe anxiety and make sure you half the starting dose. Personally I'd wait until you have seen a mental health specialist before you change your meds- I'm sure your GP has your best interests at heart but a psychiatrist may choose a better alternative drug?

[A63]

Hi Pulisa,

Many thanks for your post.

Yes, I agree with your comments. I will wait and see what the psychiatrist recommends. It seems to be very difficult to get the right balance.

Some years ago, I attempted to come off Citalopram - it was all I was on for some years, and worked well for me at 40 mgs. I was fine until I hit zero, and then I crashed out big-time.

I won't be coming off Mirtazapine and Citalopram until a viable alternative is on offer.

Thanks once again for your comments.