Currently on 45 mg

[scoobs]

Hey Guys,

As the title states, I am currently on 45mg of Mirt. Most of the side effects have worn off and I seem to have plateaued now. However I dont feel "happy" .. just generally there!! Still get my bouts of worry but they arent as all consuming as they were. Attending weekly one on one CBT and reading some books "The Worry Cure" which was interesting. I find in my "saner" moments that I am able to rationlise alot of the worrysome thoughts away but still struggle to get a grip when they overwhelm me .. It comes out of nowhere and bam .. back in the hole for a while. As said though these moments are less prominent.

Trying to understand however why I just cant seem to be "happy" and really "enjoy" things when I am ok .. I am not completly unemotional but dont seem to ever be in a good mood ( its hard to explain .. I just feel like I am coasting most of the time) . I was wondering if there is anything I could take alongside the Mirt to help me along. St Johns Wort ? 5htp(5-hydroxytryptophan) ?

The medical consultant I spoke to gave my Doc leave to increase meds to 60mg of Mirt and also put me on some mood stabilisers if need be, however I just dont know if that is the right path to take ?? Any experiences and advice are appreciated.

Anyone else just feel plateaued on Mirt ?? Would 60mg make me feel "happier" or just even more plateaued ??

As I side note, I dont drink Alcohol or take drugs ( the illegal ones) at all. So that isnt factoring in.

Thanks for reading.

Scoobs

[ElizabethJane]

Hi Scoobs I'm currently taking 45mg mirtazapine and 1,000mg lithium. I don't know anyone who is taking 60mg mirtazapine. That does seem very high. My psychiatrist has always used the mirtazapine to augment the lithium that I am on. I am currently stable. If I became ill again then he would add in another anti d or an anti psychotic or pregabalin. I know this because we have talked about this scenario. I do not think that taking St Johns Wort is a good idea with ssris or snris like mirtazapine and could be harmful to you. How long have you been taking 45mg? I don't know how you fill your days but it might be an idea to try something else such as gentle exercise walking and swimming are good to see if your mood lifts? Also joining a group such as the ones that 'depression alliance' run might help you too? The addition of lithium to my meds regime thirteen years ago transformed my life and it might be the way foward for you too? EJ.

[ElizabethJane]

I have no experience of 5htp it might be worth discussing with your GP before taking any supplements. I'm not sure whether I have 'plateaued' whilst taking mirtzapine. Most of the time it allows me to remain 'stable' ie on an even keel and not too high or low. The lithium helps with that too. It stops me from relapsing again. If you are in pursuit of happiness form drugs alone then you might be disappointed. When you are feeling up to it try to do some of the things that you used to enjoy and seeing friends that you used to know and see what happens....

[kibbutz83]

Hi scoobs, I'm not sure that ad's are meant to actually make us "happy"... I think they're for more of a stabilising effect? They dampen down anxiety or depression so we are better able to function from day to day. I have found that most ad's just stop me from focusing on the negatives, and maybe "lift me" slightly. My psychiatrist wants to start me on either Mirtazipine or Reboxetine for my heightened anxiety. I have recently withdrawn from venlafaxine (that was no picnic!). I think maybe you need to ask yourself the question: "Would I rather have my depression/anxiety back, or do the ad's make my life more bearable, although slightly numb"?
I don't think ad's will ever be a cure-all for our underlying issues... they will have to be faced at some point in our lives or we will never know true happiness

[scoobs]

Hey Guys,

Appreciate the comments. I guess by plateaued I mean I have hit some stability compared to what it was a few months ago. I'll have been on meds for over 11 years now and ( Seroxat for 4.5 years and Effexor for 6.5 years) so the Mirtazapine is new to me . Only been on it for the past 3 months. Starting @ 15mg and moving to 45 . I can relate to coming off the Effexor Kibbutz .. it was a nightmare period for while there. In fact I found this forum about the time I was coming off that and moving onto the Mirt. It was a good time to have stumbled onto it as I was struggling badly with withdrawal from one drug and side effects of the other. Was great to get some reassurances from people who have experienced similar.

In terms of my mood/feelings, as said, its hard for me to put into words, but it just feels different to me on this drug compared to when I was doing ok and taking the Effexor. From what I understand of the drug, it works differently so maybe thats it and I am looking to relate to previous drug effects on me ?!?!? I put the "happy" in quotes as I've noticed that I just dont seem to have any real enjoyment in life per se .. Then again, its been alot harder to get back on track this time around.

You could be right EJ in terms of me not getting out etc as I've pretty much been a hermit these past 4 months since my breakdown and have only really just started to get things moving again and getting back out and about. Social situations are a bit nerve wracking at the mo but I force myself to keep on trying

Thanks for your input guys !!

[Ingenious]

I tried 5HTP as a last attempt at having a "natural" remedy before going onto "proper" medication, it didn't do anything for me at all, and there is a concern with things like 5HTP and St John's Wort (which I have also tried) at getting a consistent dosage. Personally then I would advise against taking anything like this, particularly in conjunction with something like Mirtazapine.

Sadly in my personal experience medications don't remove the ups and downs, they just smooth them out, or limit the damage during a downer. It may be unrealistic then to hope you may be cured and feel happy on any combination of tablets.

I never went above 15mg of Mirtazapine (which I am still on) and I still get ups and downs. The downs though are quite limited now. When faced with the prospect of going up in dosage, I turned to exercise instead, I swear by this, I try and do an hour a day and it feels (to me ) like taking another 30mg of Mirtazapine with none of the side effects You also say in your post that you're a bit of a hermit, this can wear you down, have you considered getting out but avoiding social situations, for example, walking/rambling, cycling and that sort of stuff?

[jo61]

Hi, I'm on mirtazapine and lithium too. I was at 45mg mirt and have now reduced to 15mg. It was mooted that I go up to 60mg at one point when I was really struggling - this dose can be signed off by a psychiatrist but not a GP I think. The mood stabiliser is what has made the difference for me. St John's wort should not be taken in conjunction with other antidepressants as far as I know

[scoobs]

Thanks again for your responses guys. Just to clarify, I do acknowledge that the meds arent a fix it for everything. Its just that my previous experiences seemed to be more positive than this one! With my recent breakdown however ( it was a bad one) , increasing the dosage of Effexor however didnt seem to help at all, in fact it seemed to make things worse for me, hence the change of meds. Throughout the previous 6 odd years, I'd been increased then decreased at difficult times and it seemed to work for me.

Will stay away from any St Johns Wort and 5HTP, stick with my Vitamin B Complex, my CBT, Books and Self Hypnosis/Relaxation Stuff and work away at it And I'll try to get out more and get more excercise !! Will also speak to Doc also about the above and see if he has any thoughts.

Regards

Scoobs