Mirtazipine to Citalopram

[jimmyj]

I’ve been on 45mg of Mirtazipine for about 5 years and 200mg Sulpiride . I’m switching and my GP has told me to come straight off Sulpiride and taper the Mirtazipine to 30mg for two weeks and 15mg for one week . Does that sound about right .

[panic_down_under]

I’ve been on 45mg of Mirtazipine for about 5 years and 200mg Sulpiride . I’m switching and my GP has told me to come straight off Sulpiride and taper the Mirtazipine to 30mg for two weeks and 15mg for one week . Does that sound about right .

Sounds about right. When do you start taking citalopram?

Also, just to satisfy my curiosity, how did you come to be taking this drug combination rather than a SSRI, SNRI, or TCA?

[jimmyj]

Thanks I start taking this in about a weeks time at moment suffering from some nausea and loss of appetite is this normal . I’m not sure how I came to be on this it was what I was put on by psychiatrist after I had a stay in hospital .

[panic_down_under]

Thanks I start taking this in about a weeks time at moment suffering from some nausea and loss of appetite is this normal .

They can be withdrawal symptoms. When did you stop taking sulpiride and cut back the mirtazapine dose?

I’m not sure how I came to be on this it was what I was put on by psychiatrist after I had a stay in hospital .

You were asking here about going back onto citalopram 6 years ago. Did that cause the hospital stay?

[jimmyj]

I stopped the Sulpiride 4 days ago and started cutting down the mirtazipine nearly two weeks ago . No the citalopram didn’t make me go to hospital I had a suicide attempt

[panic_down_under]

I stopped the Sulpiride 4 days ago and started cutting down the mirtazipine nearly two weeks ago .

Then the nausea and loss of appetite are most likely withdrawal. Ginger and/or vitamin B6 are good for nausea. Your appetite will likely return soon and as some weight gain is a common initial SSRI side-effect you'll probably regain what you've lost and add a bit more.

No the citalopram didn’t make me go to hospital I had a suicide attempt

Then the combination makes a little more sense as an immediate response. Did you continue to see the psychiatrist or has your GP been managing your medication?

[jimmyj]

Thanks my GP has been monitoring my medication . The nausea is the worst how long do you think this will last

[jimmyj]

Should I also have tapered the Sulpiride rather than coming off abruptly

[jimmyj]

Decided to go back on mirtazipine and sulpuride withdrawal too bad and get appointment with psychiatry’s not go

[panic_down_under]

Decided to go back on mirtazipine and sulpuride withdrawal too bad and get appointment with psychiatry’s not go

The ginger or vitamin B6 might have made a difference, but ask the psychiatrist to prescribe an anti nausea med if you're going to attempt weaning off again. Ondansetron (Zofran) would be a good choice as it has potent anti anxiety properties. During its development phase GlaxoSmithKline considered getting it approved for anxiety/panic, but apparently there were bigger profits in marketing it for chemo and radiation treatment induced nausea.