Re: How much time to give mirtazapine?
Originally Posted by
spiral
I have scared myself that it won't work by spending too much time googling...
Googling is counterproductive. Especially when you don't understand what you're reading.
I am worrying that the Fluoxetine will be too stimulating and therefore will make me more anxious rather than less. As I read somewhere that Fluoxetine increased noradrenalin in rats in a study...
Are you referring to Bymaster FP, 2002? If so, yes, they found fluoxetine increased noradrenaline, aka norepinephrine in the extracellular fluid, not within the cells. Also, the study only examined what happens with acute administration, i.e. a single dose. It also found, as you'd expect, that there was an increase in serotonin, aka 5-HT. That happens with all SSRIs and other serotonergic ADs and is the cause of many of the initial side-effects. But with chronic dosing serotonin levels drop back to well below pretreatment levels. See, for example Caccia S, 1992. Because of the long fluoxetine half-life brain serotonin levels take weeks to rebound to pretreatment levels after the med is discontinued (Trouvin JH, 1993)
I haven't been able to find a study which tested noradrenaline levels after chronic fluoxetine administration, but I'd be surprised if they also didn't drop significantly after a few weeks. This is what happens with noradrenaline reuptake inhibitors such as desipramine, (Zangen A, 1999).
And I am worried that the reason that Mirtazapine didn't work as it was increasing my noradrenaline.
How do you know that mirtazapine was raising your brain noradrenaline levels? Stress itself greatly increases it too and also brain serotonin levels. It is one of the proofs that anxiety disorders and depression are not caused by insufficient brain serotonin, or noradrenaline.
I know I shouldn't google but it seems like a compulsion...
You're not helping yourself by doing so. Just the opposite it seems.
I am worrying that the fluoxetine will give me insomnia as I do tend toward insomnia and feel I have only been sleeping recently because of the mirtazapine .
It may do, but how does crossing bridges before you get to them help? If it happens then it can be treated. Small doses of mirtazapine being one of the remedies.
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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.