Mirtazapine sedative effect lost

[valleybear]

I have been on 15mg Mirt for nearly two years and my anxiety, depression and panic attacks are much improved. However I have severe issues with insomnia and for the first year thought I had found the much longed for answer with this drug and enjoyed a good night's sleep and no after effects. Now, however the sedative effect seems to have worn off and I am no longer sleeping again. Some nights I am awake all night and others I cannot sleep till around 4.00 or 5.00am. Otherwise Mirtazapine has been excellent, no weight gain and no significant drowsiness during the day. The lack of sleeping is now becoming chronic and I don't know whether to get Dr to change the meds or change the dosage( I understand that the lower dose is best for sleep) . Anyone found that it ceases to work? Does it kick back in ever..I am getting desperate! Thanksxxxx

[LittleMissAlone]

Hi

That's very encouraging that mirtazapine 15mg has been so effective for you regarding your anxiety and other symptoms. I've been taking the same for over 3 months and I must say my anxiety is still relatively high, though I'm sleeping very well. Sleeping has never been an issue for me.

Could you ask for sleeping tablets to take on top of the mirtazapine, to save you increasing or decreasing it? It sounds as if you have the holy grail as you have no side effects either.

Take care.

[valleybear]

Thanks. Yea, Dr gave me a few Zopiclone at one point but is reluctant to prescribe more, even though a half of the lowest dose is enough for me. Just used them when I had had a run of bad nights. Hope that you can persevere with the Mirt as I have had no problems whatsoever, except the fact that the sedative effect seems to have permanently worn off.
Good luck and hope that you see an improvement soon.xxx

[LittleMissAlone]

Oh thanks.

Because it's such a low dose I'm trying to do more alternative therapies too. The latest thing is reducing my caffeine intake. Makes sense as caffeine can make you jittery, and upset your stomach, which are my main bugbears.

Why would your gp be reluctant to prescribe something that works for you? I suppose they're worried about side effects.

Good luck.

[valleybear]

Probably NHS pressure not to supply sleeping tablets on a regular basis, or worried that they will be habit forming. The last time I had 10 Zopiclone prescribed
they lasted me for 6 months so don't think that that was too shabby! Haha! Goodness know what the GPs think. Thanks for your input. Take care.xxx

[SmilingAlbert]

Sorry to hear this Valley.

The sedative effect is related to an anti-histamine effect that the med has. This can indeed wear off over time. Have you been very stressed recently? That can certainly bring on insomnia, sadly.

It may be worth trying 7.5mg (rest in the AM), or even 3.75mg (you'll need a pill cutter) (rest in the AM) to see if that helps as short-term ideas at fixing this.

Zopiclone etc. is good for occasional insomnia certainly, but as you know they can be habit forming. If you are suffering stress, it might be good - if possible - to try and work through the reasons for that and tackling those. Easier said than done, I know!

You should talk to your doctor; some folk here (incl. me) also take Pregabalin, and this combo seems very good for overall calm, including sleep. You may need your GP to refer you to a psychiatrist to get this however if they are not familiar with it - or try and get to see a GP in same practice who is a MH specialist; there aren't enough of these, but your practise may have one.

Best wishes,

Albert

[Catsjulieanne]

I have been on Mirtazapine for 6 weeks and it has in no way helped me with sleep. Was taking 7.5mg too which is supposed to be the best dose to help with sleep, doctor added Zopiclone to it too but still no improvement with sleep. Have increased to 15mg but six weeks in, the depression is not lifting, if anything it is getting worse, which I think is largely due to the not sleeping.

[Shazamataz]

I've been on Mirt 30 mg for about 12 weeks and it's never helped with my sleep. I've been battling insomnia for months and the whole lack of sleep was very stressful.

BUT I asked the doctor for some melatonin as we can't buy over the counter here. 4th night on it and slept really well and have now had over 8 hours 3 nights ion a row! Maybe worth a try?

[LittleMissAlone]

So glad your sleep has improved Sharon! Great advice and very encouraging.

[Johnf]

Hi there new to this forum. Just wanna share my experience with mirtazapine and to see if anyone can help.
I started on 15 mg bout Feb 2016 and first nite it knocked me out I slept for hours but felt really groggy the next morning which also contributed more to my low mood as I'm not a morning person anyways. Took this for 2 weeks and I cudnt handle the feeling the next day so they tried me on citalopram 20mg. I took this on a Sunday nite and I cudnt sleep had stomach cramps was awake all nite sweating being sick blood I phoned an ambulance went to hosp waited round for ages just for someone to come talk to me and they got me in contact with a crisis team. In the mean time they gave me one diazapam while I was sat in the hospital.
I got an app with crises team went thru and explained all that had happend in my life and he prescribed me with promethazine at that that wud work and I'll be right as rain. Wrong. It didn't do out
I started to get more depressed as I want sleeping so Bak to docs they tried trazadone took this for 2 days I was really angry cudnt sleep so Bak to docs got put Bak on mirtazapine 15mgs. Again first nite knocked out and went to sleep felt really groggy the next day. I persisted with this as I wanted it to work. Started getting really good sleep which was good I liked the sedation it have u on a night also i was eating more. Then few weeks in felt like it stopped working. So they upped me to 30mg. Took this and it sedated me loads which was ok but agen groggy next day but by the afternoon I was ok. Eating loads aswell which was ok with me. Then I felt it was too much so I cut some in half for 4 days and I went backwards I had low mood agen doc sed shudnt of cut in half it don't work like that. So went Bak up to 30mg was ok for few days. Then went up to 45 mg and this is where it all happened. First day or two felt ok then the next 2 weeks have been hell been really suicidal and racing thorts of anything and everything and can't get thorts out my head like I need to do it. Phoned my doc and pschayatrist and both sed stick at it it'll go so I did and it got even worse to the point I was so close so doing something stupid. So last nite I only took 15mgs to c if I wud feel any better. Fell asleep as they say it's more sedating at lower doses woke up tossed n turned. But slept a bit. Had racing thorts agen of wots the point all time but that probs coz I was just laid there. So dragged myself out of bed and sat down stairs with my mam. Thorts Wernet as racing as on 45 mg. but I still feel a little down and a bit shaky. I read the paper and do this book thing and feel a litle better. Anyways sorry for the long post just wanted to know if anyone else felt suicidal on the 45mg. Was it too much. Plz reply soon