I started taking escitalopram last week, cross tapering with mirtazapine. I am taking this mainly for panic attacks, agoraphobia and constant severe anxiety. I am supposed to stay on 15mg mirtazapine for now whilst very slowly building up the dose of escitalopram, with the aim of eventually coming off the mirtazapine altogether.

For four days last week, I split the 5mg tabs in half and took just 2.5mg each day along with the mirt. Didn't notice anything much good or bad! At the weekend I went up to a whole 5mg tablet, sort of felt OK for the first 2 or 3 days but a couple of days ago I started to feel like I had flu, and also felt a bit sick on and off. I managed to cope with this until last night when I was just about to go to bed and really suddenly, within minutes, I felt extremely ill. First of all I got very, very hot to the point where I thought I would never cool off, sweating loads all over, and feeling a bit light-headed and faint. I also felt like I could literally throw up at any moment. After a few minutes I gradually cooled off and the heat was replaced by feeling very cold and shivery with quite violent shivering, teeth chattering etc. I continued to feel quite sick for about an hour, thought I would never sleep but suddenly I was exhausted and did fall asleep in the end.

Today I feel better than I did last night, just back to the flu-like feelings but also very anxious about what this could be and that it might happen again. I'm guessing it's some kind of side effect but I'm concerned that because I'm still taking the mirtazapine this could be serotonin syndrome and I REALLY don't want to keep taking the new pills... I've only managed to find one or two reports of people feeling like this on escitalopram or citalopram alone - can anyone help?