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Thread: Mirtazapine unexpected side effects. Normal?

  1. #1
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    Mirtazapine unexpected side effects. Normal?

    I started Mirtazapine 4 days ago, and I have had side effects that I don't find listed as common. I have not had the droopy or tiredness from the med. Actually have had the opposite effect in that it takes me about 2 hours to fall asleep. That really doesn't bother me in that I have had that problem for years. The one that is of concern is my blood pressure. I normally check it once to twice a week. High BP runs in my family and I am on a BP med now for slightly elevated BP. My normal range is from 125/80-137/85. Since starting this med, my BP has averaged 150/90 and at the highest was 161/102. I am checking it now about 3 times a day. I am not measuring it out of anxiety or focusing on my health, more just out of curiosity. I have been "cool as a cucumber" when taking it and it still be up. On the flip side, I have gone to the ER in years past with a severe panic attack and my BP being normal.

    Is this normal for some and goes away? Or is this something I should be concerned with and maybe get off the med?

    Of course in just 4 days, I haven't seen any benefits to this med, but I am not even seeing what is very common to see in this med with the sedation even with me taking 1mg x3 a day of klonopin.

    Thanks for your input.
    Last edited by Jakemje; 03-10-21 at 18:48.
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  2. #2
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    Re: Mirtazapine unexpected side effects. Normal?

    Quote Originally Posted by Jakemje View Post
    Is this normal for some and goes away? Or is this something I should be concerned with and maybe get off the med?
    Mirtazapine most often lowers blood pressure, but there have been a few case reports of it boosting BP so it could be the cause. Usually, initial side-effects are temporary, typically diminishing within a few weeks, but there are no guarantees. If it persists I suggest you seek advice from your GP.

    Of course in just 4 days, I haven't seen any benefits to this med, but I am not even seeing what is very common to see in this med with the sedation even with me taking 1mg x3 a day of klonopin.
    Mirtazapine is more a sedative than antidepressant mostly depending on sedation to ease anxiety so your paradoxical response could indicate it might not be the med for you, but it's too early to know for sure.

    How long have you been taking clonazepam (Klonopin) and do you take that dose every day?
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    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.

  3. #3
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    Re: Mirtazapine unexpected side effects. Normal?

    Quote Originally Posted by panic_down_under View Post
    How long have you been taking clonazepam (Klonopin) and do you take that dose every day?
    I have been on it for over 5 years and it is daily. I know most of the anxiolytic effects have become less and less and may be doing nothing at all at this point, but at the time, it's not worth the withdrawals I will have to go through to get off. It would not benefit my anxiety to do so at this point. It was a last ditch effort to bring my anxiety and muscle spasms down to a manageable level after trying 20+ medications prior. Mirtazapine was me and the doctor throwing meds at a wall to see what sticks. As they say, they "practice medicine and it is not an exact science" and I fully support that statement when it comes to psychiatry. The only reason we tried it was due to it being a tetracyclic antidepressant vs the tricyclic that I have already tried along with the SSRIs/SNRIs, mood stabilizers, and others.
    Last edited by Jakemje; 04-10-21 at 17:25.
    __________________
    Trust in God and pray without ceasing

    20+ year suffer of GAD/Panic Disorder

    If they offer it, I have tried it

  4. #4
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    Re: Mirtazapine unexpected side effects. Normal?

    Quote Originally Posted by Jakemje View Post
    I have been on it for over 5 years and it is daily. I know most of the anxiolytic effects have become less and less and may be doing nothing at all at this point, but at the time, it's not worth the withdrawals I will have to go through to get off. It would not benefit my anxiety to do so at this point.
    While I agree now is not the time to begin weaning off clonazepam, it could be *exacerbating the disorder as benzodiazepines can trigger the same atrophy of the two hippocampal regions of the brain as high brain stress hormone levels which is thought to be the physical underpinning of anxiety and depression and may inhibit the effectiveness of antidepressants which work by stimulating the growth of new hippocampal brain cells (neurogenesis). They, and the connections they forge, create the therapeutic response, not the meds directly. The cognitive/behavioural/mindfulness therapies work via hippocampal neurogenesis. However, once the anxiety is under control I urge you to consider weaning off clonazepam.


    It was a last ditch effort to bring my anxiety and muscle spasms down to a manageable level after trying 20+ medications prior. Mirtazapine was me and the doctor throwing meds at a wall to see what sticks. As they say, they "practice medicine and it is not an exact science" and I fully support that statement when it comes to psychiatry. The only reason we tried it was due to it being a tetracyclic antidepressant vs the tricyclic that I have already tried along with the SSRIs/SNRIs, mood stabilizers, and others.
    I'm not a fan of mirtazapine as a primary anxiety/depression med, but I have seen it work when others have failed so it is definitely worth a shot.
    __________________
    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.

  5. #5
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    Re: Mirtazapine unexpected side effects. Normal?

    Quote Originally Posted by panic_down_under View Post
    While I agree now is not the time to begin weaning off clonazepam, it could be *exacerbating the disorder.
    Hi there; Jakemje. I think panic is right. I'm also trying (struggling) to wean/taper off of clonazepam; I've done well to cut back from x3 a day to .5 in the afternoon (my anxiety isn't too bad when I wake up), but builds in the afternoon. I usually take 1MG around 5PM because without it, I'm a basket case for some reason. So, I know its hard, but I *do* think its not helping my situation in the long-term. I admit - I'm addicted to it, and and I've struggled with addiction and alcoholism nearly all my life anyway, so I'm not shocked.

    Good luck with mirtazapine and hope you feel better soon

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