Mirtazapine - should I increase the dose?

[lostsoul]

Ok guys/girls

I´ve probably asked this question before in a round about way but I´m currently on 30mg Mirtazapine which I have been on for 7 months. I did recently feel that I was getting a little better but most days my anxiety is so bad its crippling me. I haveno life going out anywhere is an ordeal. I wake up dreading the day and feel exhausted - although thank god I sleep through the night. I cant even be at peace with myself.

In all honesty I cant sit there and relax as soon as I stop I cant breathe and my throat closes up. I fed up with playing computer games all day or doing crosswords and things just to occupy myself - i just want to be at peace. To be able to get up and feel relaxed and happy. I´ve had councilling it doesnt help as there doesnt seem to be a specific cause for the anxiety.

Most days I just dont want to be here anymore if this is what life is. I wasnt depressed at all untill all this came on at the start of the year and Ie lost my job because of it, and if it doesnt get sorted soon I´ll probably loose my wonderful girlfriend and home too.

so to cut a long story short should I increase my Mirtazapine to the max 45mg as recommended by my Phych even though I had terrible side effects when I started taking it. Are they as bad when you up the dose and hoe long does it take to notice any positive differences. Is it the whole 6 week wait thing like it is when you start a new med?

I know theres not a magic pill but the valium use is going up an up by the day and there is only so long the the docs are gonna keep upping the dose and giving me repeats and I sure its not doing me any good in the long term.

sorry for the long post

[janey50]

Dear Dave, My heart goes out to you as I am in much the same position, and also on Mirtazapine. I'm on 45mg and it doesn't seem to be doing any good, but I'd say, if you're already on it, I don't think upping the dose will make you feel particularly worse as the drug is in your system already. try and keep the Valium use down - in the long-run you're causing yourself big problems. Distraction is the only real cure for anxiety - but I know that's easier said than done as I am a victim too of crippling anxiety and half the time don't know what to distract myself with! But i think you need to practise coping with it and proving to yourself that you can handle more than you thought you could. I too lost my lovely job this Spring because of my on-going anxiety and I still grieve for it, but we have to believe there is more life up ahead for us, and better times. Wishing you a much steadier time. With all best wishes, Janey.

[lostsoul]

Janey

Thanks for your reply. Its so hard isnt it to know what to do for the best and its even harder loosing your job - I´m taking me employer to court as they were very underhand in getting rid of me - I´ve been assesed by their doctor and he confirmed that I am covered by the disability descrimination act - as have three different phychiatrists Ie seen. I on disability living allowance aswell. Thank god Ie got legal protection through my contents insurance as I´m in the process of taking them to court.

I´m a bit medicine phobic so I always seem to give myself every side effect their is! I think I will try incresing the dose - people keep telling me I feel better if I went out more but the major problem is I find it hard to spend a day indoors without panicking and feeling breathless and it only gets worse when I go out!! just seems like a vicious circle I´d love to find that wonder drug that makes me feel like me again, lots of people seem to have had success with the SSRI´s unfortunately when I tried one it gave me irregular ECG readings and I spent four days in the cardiac ward so no more of them for me. Its the agitation / Dizzyness that I´m scared of when upping the dose did you get agitation as its listed as a very rare side effect - perhaps I was just agited from the anxiety?

Do you find you sleep ok on the Mirtazapine? I sleep well all night now with it mind you I wake up feeling exhausted dont know if thats the meds of the anxiety either ....what to do what to do?

I´m so sorry to hear that you lost your job too its not fair people dont understand mental illness as they cant see anything wrong with you. I know you shouldnt but sometimes i wish all those people could experience for themselves what we have to put up with everyday then maybe they would show some more compassion.

X

[kendo59]

I don't know how good these meds are. I'm also on 45mg Mirtazapine (with 80mg Propanolol) and don't feel like it's doing anything.

[lostsoul]

Kendo

How long have you been on the meds for? they do take some time to kick in and there not the magic cure they just take the edge off from what I understand.

[janey50]

Dave - i found your response very moving. It's good you're taking your employers to court. People like us are covered by the DDA, and I too receive the DLA. In my case, I'd been off work so long, and so often actually, that it came to the stage of a 'competency hearing' and rather than put myself through that, and still lose my job, I decided to resign. It's a huge loss as I'd had my lovely job for 20 years and loved all my colleagues and clients. I hope you'll find some consolation in your legal process and get a good deal of compensation - but it doesn't make up for the blow to one's self esteem.
Re the drugs, i reckon any agitation you experience is just anxiety - you're worried about upping the drug so you're feeling more agitated. I was in hospital when I was put on Mirtazapine so experiencing a lot of anxiety anyway and can't say i can put any of it down to the drug. In any case, it would be transitory and you can promise yourself that it will not be for long. Funny that about sleeping well and waking up exhausted. That's exactly what i'm like today. Again, I think it's just stress, and I'm sure we do a lot of worrying in our sleep! It will be better for you if you get into something, get distracted, get absorbed by something outside yourself. I'm being a bit of a hypocrite here as I'm not very good at it, but I do think you have to put your toe in the water, even if it's just going for a tiny little walk. You have to take control of your anxiety somehow, so you know that although it won't go away, you are able to control it a bit. I'm in the process of learning how to do this, while my tranquillisers are being reduced - so wish me luck! I hope you begin to feel more confident soon - keep me posted! Love, Jane

[ElizabethJane]

Hello Dave .I am on mirtazapine too. I' m currently reducing from 15mg to nothing. I was originally put on it as I had a depressive relapse last year. My psychiatrist used it ot boost the other meds I'm on. The most I've ever taken is 30mg. I didn't have any problems increasing the dose unlike when I first started it and the side effects were overwhelming. I have had problems with reducing with the panic and anxiety returning. I also use valium for short term relief from anxiety as it is highly addictive. Has your psychiatrist suggested any sort of therapy for you? Unfortunatly if you stay in your house it will be harder to leave it. There are also other anti depressants that your psychiatrist could use or in conjunction with other meds. Dont give up. This is a cruel illness and you're not defeated yet.

[lostsoul]

Thank you both for your replys its good to know that there are people out there who care I´ve been abusing the diazepam quite a bit over the last two weeks 15mg a day instead of 10mg - phoned the social worker today to tell him my meds were gonna run out early he´s got me another script for 10mg to last me untill my next phych appointment and said I should try and stay at 10 but its a big drop but part of me wonders if the diazepam is actually making me worse and it might be worth going through the pain of coming off of it - they wont increase the dose of Mirtazapine either until I´ve seen the phych on the 16th :-( - it doesnt help that my girlfriend works in the same building either coz it makes her so angry going into work everyday and having to work with the people who have ruined our lives - (I was doing well got right down to 7mg of Diazepam) and returnred to work - they decided to sack me anyway because I had to much sickness and i was in my probationary period. The annoying thing is I worked for them for five years without a single days sick then I left for six months and decided to return as I didnt like my new job.

Before I left I was a manager and had received the maximum bonus every year and was a well respected member of staff, I feel so let down by them - I wont say who they are coz of the legal process but I will say they are a well known bank.

My girlfriend comes home in tears everyday and it feels like we are loosing everything and I´m powerless to pull out of it. I was seeing a councillor for 13 weeks but didnt really find it helped and that was private as I couldnt get it on the NHS.

I can go out not completely agrophobic yet - I do go to the shops to get bits and bobs and I walk everyday but I always feel so weak and dizzy I prefered it when I was agitated at least that got me out and about! gotta laugh or I´ll cry - I have not cryed once since I got ill try as I might it just wont come.

Thanks again for your kind replys - just out of interest has anyone tried hypnosis - I just got the paul Mckenna CD´s and to be honest once they start to get you relaxing by focusing on breathing it seems to freak me out more because focusing on breathing makes me panick!!!!