Mirtazapine - side effects

[crumble]

Hi all,

I posted this in another thread but thought I'd make a new thread..

I've been taking 15mg of Mirtazapine for just over a month now and have experienced little other than side effects. I knew about the sedation/drowsiness as that was one of the reasons it was prescribed as I was experiencing poor sleep and constant waking, although oddly I found it very easy to get back to sleep! Thankfully though it's helping with that. I have noticed though that the sedation is starting to wear off slightly, or could it be that I've become more used to it and am not noticing it as much?

Weight gain is a very unwelcome side effect as I've found it very easy to put on weight in recent years. I was aware about this though and am trying to eat more healthily, and will be doing more exercise to counteract this side effect.

Apart from not sleeping very well the other reasons for being prescribed Mirt were for anxiety and depression, which I do not feel it is helping with on this dose. After taking for 4 weeks my GP advised a further 4 weeks before considering increasing the dose.

I'm not sure if some other effects or symptoms are related to taking Mirt but I find myself becoming even more easily worked up, irritable and frustrated than normal (and this is something I suffer with anyway). I noticed a few other people mentioned this - is this a known side effect? I don't remember reading about it elsewhere.

About 5 years ago I was taking 30mg Citalopram for the same reasons (except poor sleep) which I found really suited me straight away. Although ironically I believe it was this drug that ruined my sleep cycle. I wonder if I'm more suited to an SSRI than TeCA, and if there are any SSRIs that have sedation as a side effect?

Also, could I ask those that have been taking Mirt long enough to increase their dose from 15mg upwards, about the side effect of increased appetite and associated weight gain - does this side effect increase with increased dosage? I understand that the sedation side effect decreases with increased dosage, so it has me wondering. I’m thinking that this might not be the drug for me if there’s likely to be any further increase in appetite. If you can offer any personal experiences of this I’d be really grateful.

Thanks

[ash1807]

Hi Crumble.

It's great that you posted this. I too am on 15mg of Mirtz for the last 3 months. I am getting better sleep, but has not hit my low moods and anxiety. I struggle with extreme tireness too

Like you, I too was on citalopram, which worked for a number of years, but lost its potency in the last year or so, thus the change in medication.

I am still not sure whether 30mg ( which is the normal dosage for effectiveness) is going to bring in its own set of more side-effects. I am not too bothered about wweght gin, which I should be able to control, but the drowsiness and general lethargic feeling that lasts the whole day.

I am hoping that someone will chip in with ther experiences with the drug

Once again, thank you for highlighting the issues

[geejaybee]

Crumble,

I was prescribed Mirtazapine for exactly the same reasons as you. I also found that I became tolerant to it so it did not have the same effect on my sleeplessness. At 15mg you get a higher level of sedation than a higher dose but it also has little efficacy as an antidepression at that level.
When my dosage was increased to what was described as an effective antidepressant level (30mg) I found it hard to maintain as I slept more poorly but was very drowsy/dopey during the day. As a natural skinny I did not mind the increased appetite. In fact I was glad because the anxiety has just about killed it off. When I finally stopped taking mirtazapine I had very bad insomnia.

[ElizabethJane]

Hi I have been taking mirtazapine for nearly two years currently at 45mg with other meds. I have noticed no increase in daytime sedation infact the opposite as I usually start the day feeling alert. I have not noticed any increase in appetite infact my weight gain is non existent now. I am continuing a weight loss programme after initially putting on weight. Sleep continues to be a problem though and I am in a period of high stress so getting off to sleep is a problem and waking early. I am taking a low dose sleeping pill. I enjoy the benefits of the mirt ie decreased anxiety and positive mood. Mirtazapine isn't a miracle drug and it takes sometime to 'kick in' ie four to six weeks before any initial benefit is felt. Usually patients combine some sort of talking therapy with it as well such as CBT or psychotherapy. EJ.

[JT69]

Hi crumble,

I have been taking mirtazipine just over a year now. I started on 15mg, did go up to 30mg (as 15mg was not really helping with dep/anx) for a few months and currently back to 15mg hoping to wean off soon.

I found yes I gained weight (almost 2 stone of which I have now managed to lose a stone of) and I was very irritiable and snappy at times at first but this did wear off.

The benefits of this drug for me far out-weigh the negatives and as I said some do wear off. I dont think I gained any more weight being on a higher dose as it just increases appetite and if you are careful perhaps you can avoid it...not sure about that one...for me I just wanted to get to a better place mentally and didn't really worry about the weight issue at first. I guess I thought I would tackle it when I was ready to do so.

Hope this helps.

Jo.xx

[crumble]

Hi, thanks for your replies.
I'm soon to start an increased dosage of 30mg for a trial period after requesting it from my doctor. Although on the low dose of 15mg I'm staying asleep for longer I don't really feel I'm getting proper sleep which I believe is due to the anxiety. I just hope I carry on sleeping well on the higher dose, as I understand this side effect will diminish.

My doctor seemed quite unsure, almost reluctant, at one point when discussing higher doses, in that it's difficult for him to say what dose will be of benefit. While I can understand that everyone is different, I don't really understand the reluctance... anyway, at least I'm able to give them a trial.

[deepreason]

View it as exactly that: "a trial" if it doesn't work out, just revert it

[crumble]

Thanks deepreason, I'm doing just that

[crumble]

Thought I'd add an update in case anyone else is increasing their dosage from 15mg...

I've taken 30mg a day for just over 3 weeks now and I am noticing an improvement in anxiety symptoms. The sedation side effect on first taking the tablet I'm not 100% is still there as I'm still sleeping better than before. Though I'm not sure whether I'm sleeping better now because my anxiety symptoms are decreasing. But on waking I'm nowhere near as drowsy as when taking 15mg.

The increased appetite is still there and I could eat a horse at any point of the day. Thankfully me for and the horse I haven't done. So I'm still trying to work on that one!

[sunset30]

Just been prescribe Mirtazapine as Pregabalin was not doing any favours. Ive put on loads of wieght from the previous med which stresses me out and now se ethat this makes you put on wieght to. I can't be dealing with it. Is it the that it makes you compulsively eat crap or is it that it just makes your body over wieght?