Mirt Diary

[anxiousjomo]

Been feeling a lot better the last couple of days. Have slept relatively well the last two nights with no pills or powders or eye masks or anything else. Am finding the CBT/ACT approach very helpful. As this is all in my mind, I just had to tell my mind to stop being a silly sausage.

[anxiousjomo]

and then, of course, the inevitable blip again - had a few days of insomnia again. I find the lack of sleep a real killer, as it exacerbates the anxiety, depression and IBS and makes them much harder to deal with.

I don't think I am having any other issues with the Mirt at present, just that it no longer seems to help with sleep. I do think it is helping a bit with the anxiety, as I suspect I would be feeling much worse without it.

No issues with weight gain etc, though I have been craving chocolate biscuits in the afternoon!

[anxiousjomo]

So the insomnia has continued. Has been going on now for well over a month, with only occasional breaks of ok (but never good, and only for a night or two) sleep. I got about 1hr last night. Am not overly anxious, just cannot seem to get to sleep. All the CBT stuff keeps me relatively relaxed, but it just seems impossible for me to fall asleep. If I were withdrawing, or starting a new drug I would blame it on that, but as I am still on the same 15mg, it seems impossible that it could be what is causing the insomnia...

My anxiety and depression and obsessive thinking etc are all pretty much what they were when I was not on the meds.

So I think it is safe to say that Mirtazapine has stopped working for me. To say I am gutted would be an understatement. I had a good 2 months in there somewhere, but that was it.

I certainly dont want to go up to 30mg - I have the side effects just after taking it (restless legs etc), and can already tell that it will be too activating for me (plus even if it does work, it could well just stop working after a few months and leave me with an even worse withdrawal)

So I think my only option is to try reducing to 7.5mg. Maybe will start by just cutting a little off the edge of the pill and first and see what happens, then reduce down to half over the next week or two. Then see what happens at that level. Maybe it will help me sleep.

I don't know.

Feel really crappy, and really upset about the fact it seems to have pooped out on me.

Any help/thoughts/suggestions from anyone on here would be gratefully received.

---------- Post added at 09:36 ---------- Previous post was at 07:41 ----------

I don't know. Maybe I should not mess around with the meds. Maybe I should just stay where I am - it may be the insomnia is just something else (work stress or whatever) and I would feel worse with the anxiety and depression off the meds. I don't think I am having any side effects, and the restless legs have pretty much gone now that I take magnesium before bed.

It is so hard when I feel like this. Hard because I am so exhausted and that makes me down and anxious and I find it really difficult not to obsess over how I am feeling and what I should do. The nights are so long. And the days I feel so groggy and tired.

I just dont know.

[anxiousjomo]

Got an appointment with by GP on the 17th Oct, so will just keep on with the Mirt at the same level until then. Unfortunately, like most GP's I am not sure what real help she will be. Suspect I will just be advised to go up to 30mg (sidebar: why don't they make smaller increments? Seems nuts to me to double my dosage straight away). I suppose the worst thing that can happen is I try that, and it does not work. Maybe this insomnia is just related to my anxiety because the Mirt is too low a dosage to deal with it. Perhaps if I go up to 30mg it will help...

Anyway. Guess I just have to keep on going until next week and then see where I am.

---------- Post added at 14:57 ---------- Previous post was at 14:24 ----------

And another possibility might be to cross taper with Prozac. That worked so well for me for about 10 years, and I only really gave it 3 weeks this time (as the side effects were so brutal). Maybe the Mirt would help me get over the initial problems with Prozac and I could get back to where I was 2 years ago (happily on 20mg of Prozac with no issues and thinking I could stop taking meds as was so content. Silly old me...)

[SmilingAlbert]

Hi Anxious,

Sorry to hear this - insomnia is horrible and I've been there. As I've suggested before, 7.5mg taken around 1-2 hours before bedtime might be worth a shot - for me it's better for sleep than 15mg - but I obviously may be different from you. I doubt 22.5mg or 30mg would be better in this area. If it doesn't work, well you tried.

If that doesn't help, I suggest you talk to your doctor about Pregabalin, which I'm also on. Mirt + Preg is a very successful combination for many on these boards. 7.5mg of Mirt + 75mg of Preg an hour or two before bed is a very relaxing combination. Preg also has very limited side effects at start-up for most people - you will probably feel a bit woozy at first, and hungry, but you'll get none of that head-exploding nonsense that you get from SSRIs etc.

It's licensed for GAD in England & Wales, but not Scotland, I think - it can be expensive so some areas don't like giving it out so you may need to work at it a bit, or even get a private psych to recommend it, and then get a NHS prescription off the back of that, which is what happened to me.

Tons of positive stories on the Pregabalin board here. Like Mirt, it's not a sleeping pill per se, but creates the right mental environment to help sleep happen.

For some, it's known as the benzo you can 'take all the time', as for most its effect lasts, and as such its medically respectable to be on it for a long time. No doctor will give you a Benzo for anything more than a month or so - and neither will they give you sleeping pills long term either, for the same reason.

The solution is out there, and you will get there, sooner or later I assure you! And keep in touch here.

Best wishes,

Albert

[anxiousjomo]

Thanks Albert - and thanks for taking the time to respond.

I tried taking some melatonin last night that an american friend had with him, and slept but am today feeling a little groggy with increased depression/anxiety, so not sure if that is an answer.

I think that, as 20mg of Prozac used to work well for me, I do need to be on something that increases serotonin etc, so it may be I try going up to 22.5mg of Mirt and see what happens. If that is unpleasant, I can try going down to 7.5. I think that, as I have not really had much in the way of side effects, I should hopefully be ok. If the insomnia is coming from the anxiety, maybe if I increase the Mirt dose, and then helps with the anxiety/depression, then I will sleep better.

My pharmacist friend has suggested I try taking 5-HTP supplements, as that can help boost both serotonin and melatonin levels and that way help with both sleep and mood. So I might try a low dose of that.

It is hard because I think I am, in many ways, suffering much less than many of you on here. It is just this constant low level anxiety and obsessing over my mental health, and depression that comes partly from that....and then the not sleeping...

I guess I will just keep fighting on until next week and then see what the dr suggests.

[anxiousjomo]

I was observing myself last night (another night of maybe 3hrs sleep in total). About 45min to 1hr after taking the pill I get restless jittery legs, a wired feeling and a kind of tightness in my chest. Then pretty much all night I feel just wired. Not particularly anxious or depressed, just overly alert.

I wonder if what is happening is that, now the histamine effect has worn off, and this is the Norepinephrine effect. Certainly feels like adrenaline.

If depression was more my issue, I can see how this could be useful to get you up and moving, but I don't think it is good for my anxiety!

This also makes me think going up on the med is not the way forward.

[anxiousjomo]

So I went to see the GP today, after another night of maybe 2hrs sleep, and he is insistent that I go up to 30mg. He said that that was the usual dose, and that he thinks my sleep issue is the anxiety and depression and that I need to up the med. He said he has many patients on it, and most are on 30mg and most doing fine. As I have not been having other side effects (no grogginess, no weight gain etc) he thinks it will work.

I tried to explain my concerns, and that as I understood the way the med operated, it was more stimulating at higher doses.

He said no.

I guess I can try 30mg and see what happens. The worst thing that can happen is I feel horrible and then at least I will know for sure and can drop back down to 15 and reevaluate.

This GP is very arrogant, and I am inclined not to trust him, but feel a bit pressured into trying this.

So tonight I will take 2 pills and see how I do...

It is doubly hard because my brain immediately wants to worry about taking that much of a mind-altering drug (despite having been on 20mg prozac for about 10 years previously - I really am silly) - and about how much harder it may make withdrawal (catastrophising!)

But I feel like I need to try in order to know for sure.

I should also say that my wife thinks in general I am doing better on the med and that I should not come off it - if I can get the sleep under control and maybe a bit more assistance with mood, I think I will be on to a good thing. I suppose I should count my blessings that (as long as this insomnia does not count!) I have had no real side effects so far (and it has been over 3 months), so there is no reason why I should not be fine on an increase.

So wish me luck...

[anxiousjomo]

Day 1 of 30mg

Took 30mg at 9pm last night. By about 9.40 I was feeling quite groggy so went to bed. Had restless legs for about an hour or so while lying in bed, then fell asleep around 11 and slept till about 6.30am I think - then woken by my son at 7am.

Have been up for about an hour - feeling a bit groggy and with slightly increased anxiety. A bit shaky too. But so far nothing too horrific.

[SmilingAlbert]

Sounds like progress - 7 hrs sleep or so. Few doctors have ever been on the AD etc. meds they prescribe, and the lower-dose-sleep thing is so counter-intuitive that I'm not surprised most don't know about it.

But it's not 'fake news' - this UCLA report looks into the issue:

https://proceedings.med.ucla.edu/wp-...irtazapine.pdf

But if 30mg is working for you, stay with it!

Albert