Page 1 of 6 123 ... LastLast
Results 1 to 10 of 51

Thread: new here looking for some advice please

  1. #1

    new here looking for some advice please

    hi i’ve been suffering with anxiety and depression for 12 years was on escitalopram which helped for a decade but pooped out on me last year i completely broke down couldn’t function tried a couple of other meds that didn’t help sertraline, amitriptyline was under the crisis team twice as i felt suicidal was put onto pregabalin and mirtazapine and am now under the community mental health since november im better than i was back to work full time and sleep ok most nights however im still suffering bad anxiety im only on 150mg pregabalin and 30mg mirtazapine having a review with psychiatrist 26th jan wondering if you think an increase in pregabalin would help? many thanks x

  2. #2
    Join Date
    Jan 2017
    Posts
    3,555

    Re: new here looking for some advice please

    Quote Originally Posted by kezza1988 View Post
    hi i’ve been suffering with anxiety and depression for 12 years was on escitalopram which helped for a decade but pooped out on me last year i completely broke down couldn’t function tried a couple of other meds that didn’t help sertraline, amitriptyline
    How much escitalopram were you on and how long did you take sertraline and amitriptyline for and at what dose?

    I'm still suffering bad anxiety im only on 150mg pregabalin and 30mg mirtazapine having a review with psychiatrist 26th jan wondering if you think an increase in pregabalin would help? many thanks x
    Increasing the pregabalin dose will probably help as 150mg is at the low end of the 150-450mg dose range for anxiety.

    However, imo pregabalin and mirtazapine are not great long-term meds for these disorders either individually, or combined though they can be useful in calming things down in situations like yours where a med, or meds have failed.
    __________________
    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

    Re: new here looking for some advice please

    thankyou for your reply i was on escitalopram 20mg for ten years then tried amitryptyline for about a month but got panic attacks was put on sertraline for a couple of weeks 50mg then went up to 100mg but i was so ill with it i thought i was dying so they referred me back to community who put me back on escitalopram to try again i gave it 3 months try again but wasn’t helping so was put on pregabalin for anxiety and mirtazapine for depression when i look up drug interactions it says the two interact which surprised me but i thought surely a psychiatrist wouldn’t prescribe if it wasn’t ok? i usually sleep ok on mirtazapine but some nights i get restless and panic as im falling asleep shortly after i’ve taken it it’s horrible x

  4. #4
    Join Date
    Jan 2017
    Posts
    3,555

    Re: new here looking for some advice please

    Quote Originally Posted by kezza1988 View Post
    thankyou for your reply i was on escitalopram 20mg for ten years then tried amitryptyline for about a month but got panic attacks was put on sertraline for a couple of weeks 50mg then went up to 100mg but i was so ill with it i thought i was dying
    ADs often make anxiety much worse at the beginning due to the immediate increase in serotonin activity (and also maybe noradrenaline, aka norepinephrine activity with amitriptyline). The trick is to start on a low dose and ramp it up by the same small amount every week or so. Having something to calm any spike in anxiety such as a benzodiazepine (BZD), beta-blocker or sedating antihistamine would also help. Ideally you should have begun amitriptyline or sertraline at 25mg and increased by 25mg every 7 days until the initial target dose is reached - typically 100mg for both.

    so they referred me back to community who put me back on escitalopram to try again i gave it 3 months try again but wasn’t helping
    If a SSRI poops-out it can take years before it becomes effective again, if at all.

    so was put on pregabalin for anxiety and mirtazapine for depression when i look up drug interactions it says the two interact which surprised me but i thought surely a psychiatrist wouldn’t prescribe if it wasn’t ok? i usually sleep ok on mirtazapine but some nights i get restless and panic as im falling asleep shortly after i’ve taken it it’s horrible x
    They are both sedating (though by different mechanisms) hence the warning. Be extra cautious when doing anything potentially hazardous, including driving, until you get a good understanding of how they are affecting you.

    The problem with pregabalin is the same as for the BZDs, tolerance and dependency, though both usually take longer to develop than with BZDs. Mirtazapine is more a very sedating antihistamine than antidepressant and is much more prone to poop-out than SSRIs. The powerful carbohydrate cravings it often triggers and subsequent weight gain can also be issues for many.

    Personally, I'd give the TCA amitriptyline another shot starting at 25mg. You could begin taking it while still on pregabalin and mirtazapine and then taper off mirtazapine as the amitriptyline dose increases, but the community mental health folk will probably say no because their guidance says, incorrectly, that there is a risk of serotonin syndrome.

    The TCAs are generally much less likely to quit than SSRIs and SNRIs. I've been taking the same one for 27 years and was on another for 8 years before that (I didn't switch because of poop-out).
    __________________
    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

    Re: new here looking for some advice please

    thankyou for your detailed response yes when i went to my GP i couldn’t get an appointment with a doctor so was seeing nurses at the time then when nothing was working they referred me to community i then ended up under the crisis team i saw a psychiatrist she asked me all the meds i had tried before and suggested pregabalin and mirtazapine as i had lost a lot of weight and had trouble sleeping also i seem to be sensitive to side effects with ssris so i think that’s why they tried me with these. i have an appointment with the community next week as a review im still having terrible anxiety and i think this is what causes me to then be depressed because i feel hopeless and will never feel myself again before i broke down last year i will see what they say may i ask which medications you now take? thankyou again

  6. #6
    Join Date
    Jan 2017
    Posts
    3,555

    Re: new here looking for some advice please

    Quote Originally Posted by kezza1988 View Post
    i saw a psychiatrist she asked me all the meds i had tried before and suggested pregabalin and mirtazapine as i had lost a lot of weight and had trouble sleeping
    In that case mirtazapine was a good choice, at least in the short term. It is usually very sedating at lower doses and can induce carbohydrate cravings so strong that some will eat sugar straight from the packaging by the tablespoon to try and ease the craving.

    may i ask which medications you now take?
    I'm on a high dose of the TCA dosulepin, aka dothiepin, which was the leading AD in Britain for many years accounting for up to 70% of sales at one time, but you're unlikely to be offered it now as it is very cardio toxic. It has been removed from the Formulary and the UK drug regulator has recommended only psychiatrists and other special-care doctors be allowed to prescribe it to new patients. I was on imipramine before that. Ironically, I switched because dosulepin supposedly produced fewer side-effects, which proved true, and was then perceived to be the safer med, decidedly untrue. Amitriptyline is the closest of the TCAs to dosulepin in its effect on neurotransmitter transporters and receptors.
    __________________
    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.

  7. #7

    Re: new here looking for some advice please

    hi i have been getting worse the last few days having to take some spare diazepam i had just to calm down i thought i had an appointment with the psychiatrist today turns out it’s just a nurse and i have to wait until march to see the psychiatrist ive not seen anyone medical for 3 months since i’ve been released from the crisis team i was praying my pregabalin would be increased today as my anxiety and racing thoughts are getting unbareable again i don’t think the nurse is going to do anything today or she’ll prob refer me to crisis team again which i really don’t want

  8. #8

    Re: new here looking for some advice please

    i saw a different psychiatrist today he agreed to increase pregabalin by 25mg and has sent a letter to my gp saying to increase again by 25mg if needed and to supply emergency diazepam he said the talking therapy is what i needed which i’ve just started privately they have discharged me from community back to my gp but can self refer back if need be

  9. #9
    Join Date
    Jan 2017
    Posts
    3,555

    Re: new here looking for some advice please

    Quote Originally Posted by kezza1988 View Post
    i saw a different psychiatrist today he agreed to increase pregabalin by 25mg and has sent a letter to my gp saying to increase again by 25mg if needed and to supply emergency diazepam
    An extra 25mg may not be enough to make a difference, 50mg might though you could need more.

    he said the talking therapy is what i needed which i’ve just started privately they have discharged me from community back to my gp but can self refer back if need be
    Sounds like a good plan.
    __________________
    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.

  10. #10

    Re: new here looking for some advice please

    thanks for reply i was disappointed when he said 25 mg because everywhere i read people are on 300 or 450mg and i’m only on lowest dose and mirtazapine 30mg he said i need the talking therapy more than anything

Page 1 of 6 123 ... LastLast

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Similar Threads

  1. Conflicting advice from doctors, feeling hopeless and looking for advice.
    By watermelon in forum General Anxiety / Generalised anxiety disorder (GAD)
    Replies: 6
    Last Post: 03-01-18, 21:35
  2. Reduced quickly....bad advice from Doctor! Advice needed please!
    By Laura1989 in forum Citalopram / Celexa
    Replies: 7
    Last Post: 27-02-13, 00:28

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •