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Thread: Starting on Mirtazipine and diary

  1. #11
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    Re: Starting on Mirtazipine and diary

    Hi there,
    I'm just wondering how you're getting on with Mirtazipine? I hope the side effects are settling down and it's starting to work for you.
    I'm in one of the worst HA spirals I've ever had. It's come to the stage where I really can't take it anymore.
    I think the only option I have is to go back to my doctor and ask for medication. I was thinking of asking her about Mirtazapine because I can't tolerate any SSRIs - have tried many of them but the side effects were too much for me.
    Anyway, would love to know how you're finding this medication?

  2. #12
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    Re: Starting on Mirtazipine and diary

    Quote Originally Posted by BrokenGirl View Post
    I was thinking of asking her about Mirtazapine because I can't tolerate any SSRIs - have tried many of them but the side effects were too much for me.
    A TCA like amitriptyline might be a better bet. The TCAs tend to produce fewer initial side-effects than the SSRIs anyway, but they are also available in very low dose tablets compared to their therapeutic dose range which makes it much easier to start at a low dose and ramp it up by the same small amount to limit the severity of any initial side-effects. The trade off may be some ongoing side-effects such as dry-mouth and constipation which can usually be well managed.
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  3. #13
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    Re: Starting on Mirtazipine and diary

    Quote Originally Posted by panic_down_under View Post
    A TCA like amitriptyline might be a better bet. The TCAs tend to produce fewer initial side-effects than the SSRIs anyway, but they are also available in very low dose tablets compared to their therapeutic dose range which makes it much easier to start at a low dose and ramp it up by the same small amount to limit the severity of any initial side-effects. The trade off may be some ongoing side-effects such as dry-mouth and constipation which can usually be well managed.
    I'm actually on amitriptyline, have been for about 10 years. But it's a very low dose, 10mg a day. I'm taking them for migraine prevention.
    Severe migraines is one of the major side effects I've had with SSRIs.
    I remember my doctor upped my dose a few years back so it would work as an anti depressant. I stuck with it for a good few weeks but eventually brought the dose down again due to the side effects. I think it was the tiredness got to me in the end. I was a complete zombie all day every day. Was hoping it would wear off but it didn't.
    But maybe I could talk to the doctor about it again (different doctor this time).
    Thanks for suggesting it - it had totally slipped my mind that amitriptyline is also an AD in a higher dose.

  4. #14
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    Re: Starting on Mirtazipine and diary

    Quote Originally Posted by BrokenGirl View Post
    I'm actually on amitriptyline, have been for about 10 years. But it's a very low dose, 10mg a day. I'm taking them for migraine prevention.
    Severe migraines is one of the major side effects I've had with SSRIs.
    I remember my doctor upped my dose a few years back so it would work as an anti depressant. I stuck with it for a good few weeks but eventually brought the dose down again due to the side effects. I think it was the tiredness got to me in the end. I was a complete zombie all day every day. Was hoping it would wear off but it didn't.
    But maybe I could talk to the doctor about it again (different doctor this time).
    Thanks for suggesting it - it had totally slipped my mind that amitriptyline is also an AD in a higher dose.
    There is another AD similar to Amitriptyline but without such harsh side effects called Lofepramine. Not sure whether a GP would prescribe it but worth looking into and discussing with your doc anyway.
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  5. #15
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    Re: Starting on Mirtazipine and diary

    Quote Originally Posted by BrokenGirl View Post
    I remember my doctor upped my dose a few years back so it would work as an anti depressant. I stuck with it for a good few weeks but eventually brought the dose down again due to the side effects. I think it was the tiredness got to me in the end. I was a complete zombie all day every day. Was hoping it would wear off but it didn't.
    Mirtazapine is likely to be far more sedating than amitriptyline, although some do have paradoxical reactions.

    Arguably the best med to try for HA is clomipramine (Anafranil) as it has a good track record for OCD (HA is in the OCD spectrum), but it is a very potent serotonin reuptake inhibitor so might trigger some of the same issues you've had with SSRIs, although this isn't necessarily a given. It would definitely be worth trying if you and your GP are willing to experiment. If not imipramine might be the better bet. Usually much less sedating than amitriptyline (I've taken up to 350mg and no issues), but a little more potent as an AD, thought not as potent as clomipramine.

    Alternatively, you could try lofepramine, as KK77 has suggested, or nortriptyline which is the active metabolite of amitriptyline. Both primarily inhibit noradrenaline, aka norepinephrine, reuptake having only a modest effect on serotonin and histamine H1 receptors so are unlikely to prove sedating.
    __________________
    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  6. #16

    Re: Starting on Mirtazipine and diary

    Hi BrokenGirl - I have I only just seen your message on this post and have sent you a private message - really hope all is well and panic_down_under always offers some excellent advice

  7. #17
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    Re: Starting on Mirtazipine and diary

    HI Deedee33,

    Just wondering if youre stll on Mirt and how you are doing?

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