Quote Originally Posted by Kate1970 View Post
As the title says hubby been given mertazapine for extreme stress from work, (farmer) which is causing him sleeping difficulties.
Are the 'sleeping difficulties' drowsiness and fatigue? If so this it primarily what mirtazapine does. It isn't really an antidepressant (AD), but a very sedating antihistamine. It dampens anxiety by sedation rather than tackling the problem at its source in the brain. That said, if the stress is likely going to be short-term then it might do enough to get him through it.

He suffers with ocd which was controlled with peroxitine 22 years ago for around 5 years and has been able to manage it without for the last 17.
What’s your views on Mertazapine for this type of thing? I have my doubts but thought I’d see what you guys think?
If he did well on paroxetine in the past then SSRIs are probably the better bet. However, paroxetine isn't the pick of the bunch, imo, as it has a very short half-life which can make coming off it difficult.

If hubby is just stressed and anxious then either citalopram, or escitalopram would be good initial choices. They are essentially the same med sharing the same active drug, the 'S' isomer of citalopram. The difference is that citalopram also contains a mirror image isomer which is mostly inactive biologically. They've been able to remove it in escitalopram, hence the name. However, if OCD symptoms are also becoming an issue then the older AD clomipramine (Anafranil) might be a better choice.