Any advantage in going up to 45mg?

[ElizabethJane]

I have been to see my psychiatrist today and he wants to up my mirtazapine does from 30mg to 45mg. I have resisited this for various reasons: I am afraid that an increased dose would lead to increased sedation and increased weight problems. I do have problems in the morning with low mood and irritability but it is not as bad as when I was really ill with depression. Then I would be crying and feeling panicky and not want my husband to go to work. I am obsessed with my weight at the moment so Dr J has limited my weigh ins to once a week. He has said my BMI must not fall below 20. I am not sure whether the increased dose will affect my concentration? It might relieve my depression (of which I suffer from chronically) but at what price? I would be interested to hear from anyone who is taking 45mg of mirtazapine and whether it has affected their weight/concentration/irritability. Thanks in anticipation. Jane.

[ElizabethJane]

Anybody?

[suzy-sue]

Hi Jane ,im not taking Mirtazapine but will tell you what I know ..45mg if im correct is the max dose for Mirtazapine ? It is common to feel extra tired or thet sedated feeling when a dose has been upped ,the higher the dose more so ..It does affect people differently ..if it doesnt settle to a more unsedated effect after 8 weeks it probably wont ..I was still very sedated on 40mg of my tabs after this time ,so I reduced just a little bit 5mg and found I felt fine ..Apart from the morning ..I still feel really tired and groggy after several months .The hunger you feel usually eases off too .But you have to watch what you eat and cut down on sugar and carbs ..Hope this helps a bit and someone else replies ..All the best Sue x

[ElizabethJane]

thanks Sue it is what i expected although the psych says that 60mg is the maximum dose. Although I am well now I have experienced very bad suicidal depression ikn the past It is too much like recent history for him to take me completely seriously.. I think that he is just covering himself. I need to stay alert at work and for the many singing engagedments I have coming up. If I feel worse I will up the dose. I can just about cope with the mornings although I nearly went back to bed this morning. thanks once again

[suzy-sue]

Its a difficult choice I agree ,but you have to think about the consequences ..You obviously will know if you need to up ..Lets hope you will be ok .Fingers crossed for you Jane .x Sue

[sunshine-lady]

Hi Jane

I am taking mirtazapine 30mg (alongside other medications) at the moment, but have taken 45mg in the past when I my depression increased. I felt a little 'heady' and had a slightly sickly feeling for the first few days, but it soon passed and the extra 15mg really helped. I stayed on 45mg for several months and reduced back down to 30mg with no real adverse effects.

Hope this helps and good luck

[NoPoet]

A lot of people from the citalopram forum tell me that increasing their dose helped massively, even though they didn't want to do it at first. In fact PoppyC posted the other day to say that she went up to 40mg and her anxiety is all but gone. When she was still on 20mg, she was suffering terribly.

The point is, if you are still suffering on your current dose, there is nothing to lose by increasing the dose. Someone once said to me, "If you had a headache, would you only take one paracetamol and still have half a headache if you know that two paracetamols would fix it?"

[jo61]

I've been on 45mg for a few years now. I take lithium too. My experience on increasing was that I was no more sleepy and the weight gain was no more on the higher dose. The lithium is what has affected my waistline lately.

[ElizabethJane]

Thanks to everyone for replying. I really appreciate that. Interestingly the lithium (I am on it too) has made no difference to my waistline. I was feeling fine yesterday really upbeat. Today I fell over in D Street. I felt really giddy and someone helped me up. I got as far as M&S to spend my raffle prize and burst into tears. They managed to locate one of their first aiders who put a cold compress on my knee and had a look at my elbow. Apart from bruises I am ok. I did attract a bit of attention all highly embarassing. They offered me tea and helped me even though I hadn't fallen in their store. Well done M&S. I'll leave it a few days and see if I feel less vulnerable before upping the dose. Thanks everyone for your help.

[ElizabethJane]

the depression is really hitting hard at the moment and I have almost decided to contact Dr J tomorrow with a view to going up to 45mg of mirtazapine. I am feeling very low and day to day living has become a struggle. I'm thinking morbid thoughts and I'm not sleeping very well. I also think that people are talking about me (which they probably are) It is all to do with those old feelings of self doubt and I think it is obvious where those feelings lead to. I've written a lot about birds and music in the daily diary and it is that I can hear the birds singing but I can just not see them at the moment. I can listen to the music but I can't feel it.I'm sorry to be feeling like this again and I feel as if I have let everybody down on here as I feel as if I am one one of the more senior members now and I should know better/ have all the answers to get well. I don't.