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Thread: Mianserin or Tolvon

  1. #11
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    Re: Mianserin or Tolvon

    Hi thank you for your detailed reply, very interesting. It’s all a bit weird the reason how I ended up feeling so low. I was given an injection of fluanxol in early October the next day I felt a bit weird and higher anxiety then the day after I couldn’t don’t sit still but standing up I had to keep walking but very small steps I was trembling all over it ended up that I couldn’t sit or lie I was walking very slowly on my treadmill but this was just tiring me I couldn’t eat it was like my throat wouldn’t allow food it wasn’t swollen I just kept choking. I rang psychiatrist and she prescribed [COLOR=rgba(0, 0, 0, 0.870588)]Procyclidine which did help a bit with the trembling and I could sit down for 10 mins and then have to move. I was also given promethazine to try to help me sleep and they increased my Valium, I couldn’t watch the tv without the sound of the adverts putting me into a panic attack,after 10 weeks these side effects went but left me feeling as if I wasn’t me anymore,I went to my gp as my psychiatrist said the injection was out of my system and I was just overreacting...I told my gp I don’t like my music anymore,reading,my tv programs everything I liked before I did t like,I just wanted to be dead,but only as I said because I felt like I wasn’t me. The gp told me I was severely depressed and rang my psychiatrist and said I needed something I’ve tried imipramine,I tolerated it but no help on the mood,I tried duloxetine it made me sick even taking anti sickness but as I said it numbed me and my family said this isn’t right it’s like talking to a robot,so I’ve just stopped them, and this is when she offered the mianserin.... I have tried many antidepressants over the years for anxiety/depression but never had this depression where I feel I’m not even me, my psychiatrist doesn’t seem to listen. And I can’t get another one as she’s the main one where I live there are a couple others but they’re no good to me as I’ve been told. Yes so now I have this very bad depression and my anxiety is even higher but she’s saying she doesn’t know what to give me that’s why she’s probably chosen a rubbish antidepressant to shut me up for a bit. I really don’t know what to do,if I say no to this she won’t offer anything else. But I can’t live with this, music used to be like therapy to me and now I don’t even like what were my favourite songs I barely eat I’m a bit better than I was but I still choke on things, and I’ve totally isolated myself.... sorry for the long reply but just wanted to explain what had happened...thank you again for your reply,it’s nice to know someone has took notice of what I said. [/COLOR]

  2. #12
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    Re: Mianserin or Tolvon

    Quote Originally Posted by KK77 View Post
    Which begs question as to why it's still on market and being prescribed, Ian

    I think you should go back to psych and look at other options, OP.

    Have you tried Venlafaxine as side effects are usually milder than Duloxetine? There are also Tricyclics like Clomipramine and Lofepramine which might be worth considering.

    No i have not tried these medications and never been offered them. Maybe I should ask psychiatrist about them although she’s saying if I don’t try mianserin she’s not prescribing anything else

  3. #13
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    Re: Mianserin or Tolvon

    Quote Originally Posted by MyNameIsTerry View Post
    What dose of Duloxetine did you start on? For depression they prescribe 60mg but for anxiety they start at 30mg to reduce side effects. I found 30mg mostly caused nausea but 60mg was a nightmare to stick with so someone going straight onto that with anxiety could find it a bad experience.
    Started on 60mg but couldn’t handle it,so put me on 30mg it just made me sick still and very numb. After a few weeks I was upped to 60mg again and I just couldn’t handle it,so she took me off that and has offered the mianserin...

  4. #14
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    Re: Mianserin or Tolvon

    Quote Originally Posted by beautifulfreak77 View Post
    I rang psychiatrist and she prescribed Procyclidine which did help a bit with the trembling and I could sit down for 10 mins and then have to move.
    Procyclidine is prescribed for Parkinson's disease and other movement disorders. I'm surprised it was prescribed for what sounds like agitation to me.

    I was also given promethazine to try to help me sleep and they increased my Valium
    Promethazine is a sedating antihistamine with anti nausea properties.

    How long have you been taking Valium (diazepam) and what is your current dose?

    I told my gp I donít like my music anymore,reading,my tv programs everything I liked before I did t like,I just wanted to be dead,but only as I said because I felt like I wasnít me. The gp told me I was severely depressed
    Were you still on procyclidine, promethazine and the higher dose of Valium at this point? All three can be sedating so I'm wondering if the "depression" is in fact simply that you're over sedated. Are you on any other meds?

    Iíve tried imipramine,I tolerated it but no help on the mood,
    What was the maximum imipramine dose you took and how long were you on that dose?

    I tried duloxetine it made me sick even taking anti sickness but as I said it numbed me and my family said this isnít right itís like talking to a robot,so Iíve just stopped them,
    ADs can trigger nausea and detachment in the first few weeks, or for a while after dose increases, but these side-effects almost always soon diminish.

    my psychiatrist doesnít seem to listen. And I canít get another one as sheís the main one where I live there are a couple others but theyíre no good to me as Iíve been told.

    ...sheís saying she doesnít know what to give me
    It sounds like your psychiatrist has run out of ideas and I'm puzzled by some of her med choices, not least by why she would prescribe mianserin and not the newer mirtazapine. I'd give the others a shot as she's is no longer earning her keep, imho.

  5. #15
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    Re: Mianserin or Tolvon

    Quote Originally Posted by panic_down_under View Post
    Procyclidine is prescribed for Parkinson's disease and other movement disorders. I'm surprised it was prescribed for what sounds like agitation to me.

    They prescribed this as I was trembling and couldn’t even sit down,I was rushed into hospital 3 times as the doctors couldn’t understand why the injection had given me these side effects, it was a lot more than agitation I’m agitated most of the time,my heartrate was all all over the place and my blood pressure was high for me, they said I had a very bad reaction to the fluanxol injection....


    Promethazine is a sedating antihistamine with anti nausea properties.

    yes I couldn’t sleep whilst feeling like that so she prescribed them hoping I’d sleep, and wouldn’t feel sick from the injection. It’s used a lot here instead of sleeping tablets.

    How long have you been taking Valium (diazepam) and what is your current dose?

    ive took Valium on and off for years but this time for about 4 years 15mg a day 1 3 times a day...



    Were you still on procyclidine, promethazine and the higher dose of Valium at this point? All three can be sedating so I'm wondering if the "depression" is in fact simply that you're over sedated. Are you on any other meds?

    No I had stopped the meds and then the depression hit, I’m agoraphobic before the injection I had took years of work to go out locally, and after the injection I didn’t step outside apart from when the ambulance took me hospital 3 times, for 10 weeks, yes I take ompeprazole, bisoprolol , atorvastatin , co codamol folic acid opti-fibre I have a gut transit disorder,


    What was the maximum imipramine dose you took and how long were you on that dose?
    i think the highest I went to was 200mg. For 5 months. And I’ve taken it before for over a year when a gp prescribed it.



    ADs can trigger nausea and detachment in the first few weeks, or for a while after dose increases, but these side-effects almost always soon diminish.

    Yes even on the lowest dose after taking anti sickness tablets I was still sick and I have to be careful due to my stomach problems,the higher I went just made me very ill on duloxetine so my gastroenterologist said it wasn’t good for my other problems,I also have fibromyalgia,narcolepsy,irregular heartbeat seizures and as I mentioned my stomach problems. Panic disorder with agoraphobia,GAD,EUPD,depression


    It sounds like your psychiatrist has run out of ideas and I'm puzzled by some of her med choices, not least by why she would prescribe mianserin and not the newer mirtazapine. I'd give the others a shot as she's is no longer earning her keep, imho.
    yes she tells me there isn’t much left to try and I have tried mirtazapine before not when I wasn’t this badly depressed but she said if it didn’t work before it won’t when I’m this badly depressed, I can’t see any other psychiatrist she’s the main one at our mental health hospital, I guess I either live this life of sitting alone everyday getting more depressed or I end it if there’s nothing left to help me not a great choice. Thank you for your help. All I do with the psychiatrist now is say what’s the point. She doesn’t listen to what I say my gp has written a few times saying I desperately need help I have therapy psychodynamic therapy once a week she doesn’t think the psychiatrist is listening to me. But I can’t do much else I can’t afford to go private. Thanks for taking the time to read part of my story.

  6. #16
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    Re: Mianserin or Tolvon

    Sorry I dunno how you pick out different quotes from what you said so I’ve wrote under your answers it’s not just that little bit at the bottom....

  7. #17
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    Re: Mianserin or Tolvon

    Quote Originally Posted by beautifulfreak77 View Post
    I have to be careful due to my stomach problems,the higher I went just made me very ill on duloxetine so my gastroenterologist said it wasnít good for my other problems,I also have fibromyalgia, narcolepsy, irregular heartbeat seizures and as I mentioned my stomach problems. Panic disorder with agoraphobia,GAD,EUPD,depression.
    Given the stomach and gut issues SSRIs, SNRIs and serotonergic ADs are going to be problematic therefore ADs targeting noradrenaline, aka norepinephrine, are likely to be a better bet. That means either desipramine, lofepramine, or nortriptyline. UK GPs and psychiatrists seem to favour lofepramine from what I read here so it is likely to be the one you're offered.

    yes she tells me there isnít much left to try and I have tried mirtazapine before not when I wasnít this badly depressed but she said if it didnít work before it wonít when Iím this badly depressed
    If mirtazapine didn't work then why would she expect mianserin to when it is pretty much the same med developed by the same company? There may be a rational reason, but blowed if I can see it. Mianserin is a more potent noradrenaline reuptake inhibitor (NRI) than mirtazapine, albeit still only very weak, but if that was the objective then why not go for the real NRIs desipramine, lofepramine, or nortriptyline?

    I canít see any other psychiatrist sheís the main one at our mental health hospital,

    ...She doesnít listen to what I say my gp has written a few times saying I desperately need help
    I don't know enough about how the NHS works to be able to advise you, but your GP should and I think you need to pressure him to find an alternative, or prescribe something himself. This is his job after all.

  8. #18
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    Re: Mianserin or Tolvon

    Quote Originally Posted by panic_down_under View Post
    Given the stomach and gut issues SSRIs, SNRIs and serotonergic ADs are going to be problematic therefore ADs targeting noradrenaline, aka norepinephrine, are likely to be a better bet. That means either desipramine, lofepramine, or nortriptyline. UK GPs and psychiatrists seem to favour lofepramine from what I read here so it is likely to be the one you're offered.

    Yes I will try and give her a call today and see if she’ll change it to something else,although I don’t hold out much hope as she was reluctant to even offer mianserin.... But I can ask....


    If mirtazapine didn't work then why would she expect mianserin to when it is pretty much the same med developed by the same company? There may be a rational reason, but blowed if I can see it. Mianserin is a more potent noradrenaline reuptake inhibitor (NRI) than mirtazapine, albeit still only very weak, but if that was the objective then why not go for the real NRIs desipramine, lofepramine, or nortriptyline?

    would it be because my anxiety is so bad? And maybe these meds make it worse? So she’s chosen a weaker med to start me on? See how I tolerate that? I really don’t know and I really don’t understand her thinking most of the time,she changes her mind of things to often..


    I don't know enough about how the NHS works to be able to advise you, but your GP should and I think you need to pressure him to find an alternative, or prescribe something himself. This is his job after all.
    as I am under the mental health team here my gp won’t prescribe any kind of drug to help, only if the psychiatrist writes to him and says to try me on a certain drug. Our system is quite weird, and so many people with mental health problems are just being ignored, the NHS just doesn’t have the money for everything so cuts are being made everywhere....

  9. #19
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    Re: Mianserin or Tolvon

    Quote Originally Posted by beautifulfreak77 View Post
    would it be because my anxiety is so bad? And maybe these meds make it worse?
    Unfortunately, any med may make it worse, including mianserin. It is just the nature of the treatment. The diazepam should help limit the severity.

    the NHS just doesnít have the money for everything so cuts are being made everywhere
    Short termism strikes again. When will the powers-to-be finally wake up to the fact that every pound/dollar/peso/rouble spent on mental health saves many more in the long run!!

    If a definition of insanity is doing the same thing over and over again and expecting a different outcome then most governments should be on industrial strength antipsychotics administered intravenously with fire hoses.

  10. #20
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    Re: Mianserin or Tolvon

    April 2019 statistics - cost per year:

    Mianserin (30mg) - £400.66
    Lofepramine(140mg) - £223.73
    Nortiptyline (75mg) - £95.77

    Any thoughts on this situation now Ian given cost seems not to be the issue with this psychiatrist if they have discounted the others you guys on this thread have mentioned? I'll also point out Mirtazipine (30mg) is £13.91 per year and considering you say its the same drug this psychiatrist is possibly wasting money?
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