30 or 45mg mirtazipine

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I have been on mirt for 5 months for anx which came on overnight last yr.I was on 15 for 1 months + now on 30 for 4 months.I was great for about 3 months .Problem is recently ,every 2 weeks i feel crap for a few days then back to my new self again -i feel uptight and on edge with a bit of anx thrown in.it was so bad on wed i nearly left work.On fri i still was still rough and anx went thro roof on finding that my wife's sister and wifes son were popping in for 10 mins.it was the worst i've felt for 6 months.I did calm down but it took about an hour.On my last visit to doc we discussed going up to 45 but left it at 30 as where do i go after 45? - answer is to start again ! -My worst nightmare.SSRI's send me up the wall.Like everyone I want continuity .Do i stay on 30 or go up to 45? I had no side effects when starting

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  • Posted

    Hi Sugarloaf,l

    I think that 45 mg is usually the top dose of Mirtazipine, but you can check  with d your doctor. I would suggest that you avoid worrying about what comes next. It sounds like to can increase your dosage to 45mg and see what that does.

    Please remember that there is an arsenal of medications out there, and it can take a fair bit of time and frustration before your doc finds the right one (s) for you.  Good luck to you.

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  • Posted

    Karin makes a good point re. there being a 'arsenal' of variants/options out there; meaning it is often a 'suck n see' process before one eventaully arrves at the RIGHT 'MEDS' and RIGHT DOSE' for them!

    Have you ever heard of Propananol? (In my humble and non-qualified opinion a better option than Mirtazapine). Reason I ask it that I'm somewhat confused ..even suprised that your GP put you onto ADs and particularly Mirtazapine, AND at such a high dose relatively straight off the bat (as from what you say you have anxiety only ..and it came on 'overnight' as opposted developing over time and/or a component of clinical depression). I would have thought Mirtazapine (esp. at such a high dose) would be better suited to those sufferring with Depression AND Anxiety or maybe a longstanding history of anxiety and say incessant insomnia - What are your and other peoples thoughts?

    Also, do you not find that 30mg of Mirtazapine 'zombifies' (make you very lethargic) for work? (many do report a strong 'knocking out' tranquilising effect)

    Best wishes and a peaceful Easter!

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  • Posted

    Hi again,

    I just read Karl's post and think that he makes a strong point by questioning the use of Mirtazapine for aniexty. Are you suffering from depression too? I didn't comment earlier as I live in Canada and don't see many people on Mirtazapine except for sleep disorder and mild depression. From this forum I assume that it is prescribed more often in the UK for depression. 

    I've been on it Mirtazpine for a sleep disorder and depression for close to 15 years - it continues to work while. If I could find another medication (not benzodyazapines) I would gladly switch, I hate the weight  gain and grogginess in the morning. 

    For extreme anxiety, I take Clonzapam (as needed), is in the benzo class of drugs and they tend to build dependancy. There are a number of drugs to treat anxiety, check them out on this site or online.  You may need to get a referal to a psychiatrist, they are often better at diagnoses and medicationst .  I  suggest that you chart your mood, meds & sleep, that's usually helpful to whatever doc you see. 

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  • Posted

    Again Karin offers good thoughts and insight in my humble opinion ...

    Resonating particularly with me are:

    COMMENT #1 ..."I hate the weight  gain and grogginess in the morning"... Can definately relate to this. The 'grogginess' along with what were for me unrelenting torcherous negative adrenaline fuelled thoughts immediately on awaking proved major in my deciding to 'ween' myself off the drug (process currently underway as I write). By the way I have moderate - severe anxiety plus agitated depression plus underactive thyroid plus moderate to acute chronic lower back pain.

    ***Keep in mind, its its a case of what suits one person, may not suit someone else; therefore clinical/medical advice should be sought and caution should be always exercised before making any decisions etc.

    COMMENT #2 ..."There are a number of drugs to treat anxiety, check them out on this site or online.  You may need to get a referal to a psychiatrist, they are often better at diagnoses and medicationst .  I  suggest that you chart your mood, meds & sleep, that's usually helpful to whatever doc you see"... Well put and arguably very sound and useful advice in my opinion!

    Much peace n enlightenment to all.


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