Insomnia from Mirtazapine?

[elkjaerrasmus]

Hi, I'm new here. My name is Rasmus and I live in Denmark. I have an anxiety disorder, an alcohol problem (not a huge issue for me anymore) and a problem with insomnia which has just been getting worse and worse over the years. I was on Quetiapine for about two years, but it never really worked properly for me. Sure I got a good nights sleep, but it made me really sleepy and hungry the day after. I already wanted to quit after the first 6 months, but quitting entirely proved extremely difficult. I did manage to quit taking it entirely by the middle of December last year, but I've had problems sleeping and been more or less depressed ever since. So last week my doctor decided to let me try Mirtazapine (15 mg) as an alternative, and I've been taking that for 7 days now. It's still not working for me though, and I seem to have the reverse effect from this drug as most other people are having. It makes me feel a little bit drugged and sleepy at first but it also elevates my heart rate and actually makes it harder for me to sleep, so I feel tired and moody the day after. Is there anyone else here who've had this problem with Mirtazapine? Does it get better eventually? How long should I wait?

[SmilingAlbert]

Sorry to hear this.

Many believe that Mirt is more sedating at lower doses; discuss with your doctor, but one idea might be to take 7.5mg at night, and the rest in the AM (if that dose also makes you sleepy, drink coffee in the AM (but not after lunch as it may impact your sleep later)

Best wishes,

Albert

[elkjaerrasmus]

Sorry to hear this.

Many believe that Mirt is more sedating at lower doses; discuss with your doctor, but one idea might be to take 7.5mg at night, and the rest in the AM (if that dose also makes you sleepy, drink coffee in the AM (but not after lunch as it may impact your sleep later)

Best wishes,

Albert

I did try to talk to my doctor about it yesterday, and he just said that it's still too early to say whether it's gonna work for me or not, and that I should just continue to take 15 mg at bedtime until next time I see him, which is two weeks from now...I've experimented with upping the dosage to 30 mg, which of course only made the sleeping problem worse. I also tried taking 15 mg in the morning, but that just made me more tired and moody. I have considered dividing up the dosage, and taking 7.5 mg morning and evening, as a next possible step...breaking pills in half just makes me a little uneasy...but I guess I could try it.

[hanshan]

Hi Rasmus,

I don't know what shape your pills are, but try placing them on a hard, flat surface like a table-top, and press down with two fingers, one on each side of the score mark (if any) facing up. The pill should neatly snap into two pieces, and your finger pressure should stop the pieces from skittling off somewhere.

Don't worry about tiny size variations of the two halves. They won't have much effect. Good luck

[elkjaerrasmus]

Hi Rasmus,

I don't know what shape your pills are, but try placing them on a hard, flat surface like a table-top, and press down with two fingers, one on each side of the score mark (if any) facing up. The pill should neatly snap into two pieces, and your finger pressure should stop the pieces from skittling off somewhere.

Don't worry about tiny size variations of the two halves. They won't have much effect. Good luck

Thanx for the tip...that worked really well

[MyNameIsTerry]

Some advice I posted elsewhere on pill cutting for you:

The thing is, the NHS has no policy on pill splitting so GP's will only taper based on the dosages they can actually prescribe and these are just what the manufacturers make and are not based on varying patient needs. It's irresponsible and political, but the GP's are just following the NHS on this. Pill splitting is approved in Germany and they do it in the US too plus the reason a manufacturer even puts a score line down the middle of the pill is to say you can split it if you wish. There are rules to pill splitting though which you have to follow e.g. the pill must be homogenised (all with a score line are, but many without are too), never split it down the side edges (pills are layered so the active drug will be in it's own layer and splitting down the side will effect this), never split a timed release med (it can cause overdose), never split enteric coated meds (can cause irritation) and never split capsules (the capsule is often to protect from irritation).

There are research docs out there about pill splitting. Breaking by hand is not the best, although dependant on the pill if you don't lose much as hanshan says you should be fine. If you do crush and lose more, just get a sharp thin blade (like a Stanley knife) and cut down the line. Even losing a little is hardly comparable to the big drops our doctors tell is out of ignorance (the psychiatrists tell people to taper slowly and in small % for longer term users).

[elkjaerrasmus]

Yeah that's one of the big problems with psychiatry. For a sensitive guy like me, even the smallest available dosage often doesn't work properly because it's too much, and unfortunately many psychiatrists will just give you a higher dosage if the present dosage isn't working for you. It causes a lot of harm, and it has made much of the public highly skeptical of using psychiatric drugs...I don't remember how low the smallest available dosage of Quetiapine used to be (I think it was 15 mg), but for some reason it was discontinued. Now the lowest dosage is 25 mg, and it only comes in the form of tiny, red, disc-shaped tablets without a score line. I think it might have worked fairly well for me if I could have just gotten a dose closer to 10 mg. But unfortunately that's not possible...So anyway now I'm taking 7.5 mg of Mirtazapine before bedtime which doesn't impact my nightly sleep quite as negatively as the 15 mg dose. But at the same time it also makes me feel more drugged, sleepy and lazy during the day. So I'm still not sure whether this drug is for me or not, but I'm gonna give it at least a couple of more weeks to show me what it can do.

[Catsjulieanne]

How are you coping now? I have been taking Mirtazapine for 6 weeks and it was prescribed in part as I wasn't sleeping or eating. Well the eating has increased but the sleep has shown no improvement at all. Existing on 2, 3 hours at most.

[wadey1]

Hi I have been taking Mirtazapine for 10 weeks now I started on 15mg still could not sleep doc put it up to 30mg still no sleep then he put it up to 45mg only took them for two nights seemed to make things worse I have only just joined and only just read this post think I might have to cut it down and try that

[Shazamataz]

Mirtazapine has not helped my sleep after 3 months. I am on 30 mg. The doc insisted I needed to stay on this dose and that perhaps I could split it and take half at night and half during the night (I wake up frequently). I found that if I took the second half any later than about 4 I felt drugged all the next day.

I've also been having trouble, not so much with palpatations but with a pounding heart when I lie down and wonder if the Mirt can be causing it.

I've only just started to sleep okay after starting melatonin at night. May be worth looking in to?