Anxiety mirtazapine

Sorry to read of your suffering.

The first few days or up to a week you may well feel very fatigued with Mirtazapine; once it gets into your system and you are settled it will be less so.  

Mirtazapine contains a slow release sedative that can last 24/7 for some (and me) not everyone, some say it wears off a few hours after waking.

Unfortunately you cannot take different dosages every night, I think you are experiencing the anxiety as your nervous system is being switched about with different amounts of the active ingredient.  I could be wrong, see how you go, but stay at the same dosage, let your system stabilise.

Wishing you well.  

My thoughts go out to you in your suffering - damn lo0nely illness, depression is, and sometimes the drugs make the loneliness worse in the beginning. However, reply from Calmer of three hours ago is pretty much right about iniating Mirtazapine (hereforto referred to as "mirt" - based on my two years of taking it - it started of as a " I am not sure about this"  drug - , as most of the anti-depressants (AD's)  tend to be. And mirt has the wonderful complication of having an increasing sedative effect when the dose is lowered, for goodness sake! I have been in treatment for depression for 28 years now. "Treatment Resistant" is how it is lablelled.  Some AD's are really not well tolerated in the first week to ten days, and mirt is must be in the top ten of them. The "double action" of its pharmacokinetics has the brain (and, BTW, the stomach - it is responsible for a lot of the serotonin production in one's body) in quite an upheaval - it has a much faster response time (good or bad) than, say, the SSRI's, and this is dose dependant. With some people a higher dose is better tolerated as an induction dose than a lower dose - just to be counterintuitive. Fiddling with the dose will confuse the body / brain, and make an appropiate assesment by the physican all the more difficult  (I am of the opinion that people starting AD's should be seen by the doctor, or someone with clinical skills for evaluating the patient's response to AD's like mirt, every two days in the first ten if there are negative side effects - which might seem a lot of drama, but gee it would save a lot anguish and time from people stopping it, starting it, which increases the time between induction and people starting to feel better - I am sure a cost / benefit analysis might be warranted...I digress) and really patients need to be counselled about the first few days of mirt before starting. It can be a very effective, efficacious treatment for imsomnia / anxiety / depression but the first week or so can -  er...suck. The initial side effects can stop people taking it after two days, even though after five the side effects would be gone, or at least diminished and on the way to minimal. These side effects, harrowing as they are, can be confused for "non-tolerance" or "adverse event"(ie, the patient just can't use this drug). Usually the presentation of non-tolerance is well defined and apparent in well less than 48 hours - oedema, rash, swelling of the tongue and throat, and the patient should be made acutely aware that this means straight to the hospital, rare as this happens. I am lucky, had no issues with mirt after a few days (except nightmares on the lower dose - they were freaking me out, and lead me to being more sleep deprived than before). Mirt does leave many people feeling very fatigued in the first week, and this effect disappears, or can be managed by taking the tablet earlier in the night, or increasing the dose. However, I am not a believer in "the patient failed treatment", seriuosly, you can find this phrase in some doctor's reports - good grief.... if you feel it isn't for you, talk to your doctor, but scattering the dose in the first week isn't going to help.  The C.M.I (Consumer Medical Information) should be read in front of a doctor, specialised nurse or pharmacist, with explanation given. That ten minutes can save a lot of anguish and doubt - I think it might save a few lives as well. Best of luck to you Ruth. I will look out for your updates and hope to read of your improvement soon. 

Yes, follow your doctor's instructions. Don't mess with the dosage on your own. Mirtazapine's side effects are MUCH more pronounced at low doses, and at 7.5mg all it is is a sleeping pill. At that dose it does very little for anxiety and literally nothing for depression. There is a reason mirtazpaine is always started at 15mg in cases of anxiety and depression.

Good luck! Keep us posted! 

I wish you well xx

Many thanks for your support.  Did start on 7.5 and went up with help from doctors.  I had taken amitriptyline just before that and it after a week I wAs not in a good place, gave me a very nasty experience.  I have never taken much medication over the years only a few ibruprophen fir disc problems.  After a bad start today I can say things got better and Was even able to have 2 butties for lunch.  Thank you all so much for your support.  Will post later.  Again many thanks. Ruth