Hi everyone,
I have mostly been a lurker here but thought I would share my experience with Mirtazapine. I see a lot of bad posts about this drug and my experience with it has only ever been positive, or neutral. We'll see if that holds as I go on.
I have GAD, and about 20 years ago I had my first issue with it. I have severe somatic symptoms of anxiety upon waking, which last through the day and trail off at night. I also have terrible insomnia. And then once this starts, I worry about worrying, and not sleeping.
After some bad experiences with trying Paxil and Effexor, I was put on Mirtazapine, 15 mg. Within 4 days, my anxiety was completely gone, I was sleeping well and I was back to my old self. I stayed on the drug for about a year and then weaned off. I did gain 40 lbs on it, which wasn't good, but everything else about it was great. I ended up on 22.5 mg for the duration of my time on it, and weaning off was no issue.
15 years passed and I didn't have any issues with anxiety or insomnia. Then my husband had a heart attack and it sent me into a relapse. Insomnia, all day long anxiety, etc. I immediately tried mirtazapine and again, within 4-5 days, it was all better. I stayed on 15 mg for a year and then weaned off with no issues. I gained 10 lbs this time. I regret weaning off this second time. I should have just stayed on it.
Four months ago, I had another relapse. I'm not sure what triggered it but it was the same debilitating anxiety from the time I opened my eyes until early evening. Insomnia was crazy. I reached for the mirtazapine and after 4 days on 15 mg, the anxiety stopped... but the insomnia stayed. Then 7 days later the anxiety came back. Mirt had pooped out on me.
I stayed on the 15 mg for about 2 more weeks with no effect. Disgusted, I went down to 7.5 mg and stayed there (hoping it had SOME sleep benefit) and tried Zoloft instead, which was a resounding disaster. Insomnia got worse and my anxiety went through the roof. Doc tried amitriptyline, which also took anxiety away in about 4 days and I was very encouraged, but within 10 days I developed a condition called Postural Orthostatic Tachycardia Syndrome (POTS). No more TCAs for me.
I've tried zyprexa (meh), then gabapentin (double meh) and still no relief. I was at my wits end as this has been going on way to long and now I feel a deep depression settling in as well, and still the anxiety and insomnia.
So, the doc and I decided since I tolerate Mirtazapine well, to try a higher dose than I've ever tried before, at 30 mg. I need some depression help this time as well, and hope it will also reduce my anxiety. I don't seem to tolerate SSRIs well as they make the insomnia and anxiety worse at first and I fall apart when that happens. Fingers crossed that I'll get some relief, but I'm not gonna lie... I'm skeptical since the initial poop out!
Here is how it is going so far:
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Day 1 - 30 mg knocked me out! I didn't expect this as 15 mg didn't make me sleepy at all and I thought the higher doses were more activating, but no so much for me. I slept really well, longer than I had in months, but was very groggy until 1 pm the next day. Anxiety still present but blunted a bit I suppose as compared to usual. Stayed in bed all day.
Day 2 - Not nearly as groggy this morning. Slept well. Still had anxiety in the morning upon wake up. Mood today was terrible. Very depressed and worried I am not going to get better. Had anxiety most of the day. Stayed in bed all day wallowing in depression.
Day 3 - Grogs are pretty much gone. Slept well. Some anxiety in the morning but the type of anxiety is different. Instead of an all-out onslought of physical anxiety, I feel jittery, like too much coffee. Still unpleasant but not as bad as usual. I did take 1/2 Ativan to settle down. Mood was better today. I forced myself to get out of bed and went on a walk, went to my kid's soccer game, went to the mall and out to dinner. This is a big deal for me because the depression has been paralyzing the past week and I've had trouble even leaving the bedroom. Anxiety came back in afternoon. Tried propanolol as I don't want to take benzos too often, but it fell pretty flat. Just white knuckled it until evening.
Day 4 - Slept well. Woke up pretty anxious. Took some Ativan. Really don't want to make a habit of taking these but they are the only thing keeping me functioning until this anxiety lets up. Mood is okay so far. At least I'm not in bed. I plan to take another walk today as it helped yesterday. Feeling a little disappointed as Mirt has always eradicated my anxiety within 4 days or so and I was hoping the same would be true on this higher dose. I'm impatient.
Day 5 - Had trouble falling asleep last night. I'm trying not to blame this on the mirtazapine and hope it's just a fluke. The lack of sleep and anxiety over lack of sleep has made my mood pretty iffy today. I'm trying to stay positive. I see my pdoc today so we'll see what he has to say. Anxiety was bad this morning but more managable this afternoon.
Anyone with positive stories about Mirt or who is just starting please share your stories!!!
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