ok I'm starting

[hanshan]

Several people have posted that they have a bumpy start at first, but it does even out over time so you can take two doses daily. If possible, for now can you divide your doses into three daily?

[Utah49er]

I am currently taking 150 three times a day. Like about 7AM, 3PM, and 11PM. The doses just seem to hit, and then fade an hour or two before the next dose, even at 3 a day.

[hanshan]

You could try 7AM, 1PM and 7PM. That would mean the level drops overnight, but it might not be noticeable if you are asleep. (I also take mirtazapine right on bedtime, and I quickly fall asleep with minimal waking during the night.) Also, the bumpy start seems to even out after the first few weeks. Good luck.

(Another approach might be to increase your daily dose by one third, and take it four times a day - say 7AM, 12 noon, 5PM and 11PM. Hopefully this would only be temporary and you could reduce the frequency of doses over time).

[Utah49er]

What is your dose of Pregabalin and Mirtazapine? Do you feel they work well together? Did you take any meds before these? I took sertraline for 8 years and was good, had a few blips, but overall I didn't even think about anxiety. I came off them in October, did great for a few months, but started to get a little anxiety creeping in, in January. Tried to go back on sertraline, but it just made it 100X worse, so did a trial of Lexapro. I am desperate for something to work, thinking my 8 years on Zoloft, and all these med trials has changed my brain so I will never feel normal again. Really frustrating cause just 4 months ago, I was a happy normal Dad of 3 kids who never thought about anxiety and loved life. Now I am barely functional, always in my head, and trying to run a business while dealing with constant crushing anxiety! Sorry for the rant, just feeling really frustrated and kind of hopeless at the moment.

[hanshan]

Hi Utah49er - I can understand your frustration, trying to run a business. Anxiety and work don't mix well, especially if you are the one in charge.

I take 600 mg pregabalin and 45 mg mirtazapine daily, which is the usual maximum prescription dose (I'm 6'1" and 195 lb). I find they work well together. I was originally given mirtazapine alone, which fixed my night-time anxiety (waking with anxiety followed by insomnia), but didn't help much during the day. When pregabalin was added, both days and nights were fine.

I've had anxiety for many years, but it would have quiet periods and then flare-ups. One AD that I had that was helpful was doxepin. During very bad times I would have courses of benzodiazepines.

Good luck with it. Try to be patient and give it time, but I know it's not easy.

[Utah49er]

Thanks for the kind words and sharing your experience Hanshan. Also good to see you have not put on weight with two drugs that have been known to cause that, one of my biggest fears on Pregabalin. I feel I am for sure better on the 450 msg of pregabalin than I was before, but still not close to where I want to be. Can it take time? I have only been on 450 for 3 days, but it seems like it might be one that how you feel right ways is as good as it gets, is that the case in your experience or what you have heard? Doc says I can go to 600 whenever I want, and I am not scared to as the side effects aren't too bad, maybe a little spacey and out of it, but nothing major. I don't really want to do that though if given time the 450 would work and get me back to where I want to be.

[hanshan]

Hi Utah49er - Actually, I did put on weight when I started mirtazapine, going up to around 220 lb, but I made a determined effort to lose weight a year or two back. I was always of a slim build, so could probably lose a bit more.

Pregabalin can take a while to fully work, or to find the right dose. There's also the "initial euphoria" effect, where people feel exceptionally good when they first take it, but the feeling fades after a day or two. Even so, the anti-anxiety effect can persist. In your case, it's worth staying on 450 mg per day for some more days to see if your anxiety is manageable at that level. But if not, you can give 600 mg a try. Good luck