5 weeks on mirtazapine, up and down

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hi, ive been on mirtazapine for 5 weeks now - 4 weeks at 30mg, i had the usual drowsiness to begin with, though didn't get the huge appetite, i just started to get an appetite in week 3 and also felt calmer and brighter, though in the past week all of that has gone and im back to having low appetite and mood and anxiety is back - what should i do ? im sleeping well which seems to be the only bonus atm, im thinking of adding in a low dose ssri, rather than increase the dose - has this worked for anyone? any advice appreciated

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  • Posted

    just keeping going, text book good responses so far, you should be really pleased. they take so long to work, and they dont bring sudden changes. you go fowards and backwards at the moment. gradually forward, good periods get stronger and happen more often, backaward, bad, periods get weeker and happen less often. you alerternate between the two, until everything settles down. most people in general, say you should give it 12 weeks, before you reach what you can call a recovery. an increase will set off the side effects again, as most increases do. give your current dose at least another 4 weeks, to show the full effect. then you can consider an increase. too high a dose than ideal, is worse than too low a dose, so you shouldnt increase too quickly. most people that stay the course talk about recovery around 12 weeks, quite a few say even longer. a few lucky ones, sooner. you are heading in the right direction. all the best.

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    • Posted

      Nigel, you are an angel to me, you have me reassurance before at 3 weeks when i was having a wobble, thank you so much for responding to me, i was feeling like it was failing because mirtazapine is supposed to work quicker than SSris? i had such a horrible experience with sertraline where i had side effects for 12 weeks, and no relief, despite other ssris working for me in the past, thats its made me think nothing is going to work now - just so spaced out much of the time it scares me, and im reaching for my lorazepam more than i would like - still no more than 1-2mgs a day, but there are days like today when i really need it, though last week i was much better, its difficult to find success stories on here, so your words mean everything xxxxxx

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  • Posted

    just keeping going, text book good responses so far, you should be really pleased. they take so long to work, and they dont bring sudden changes. you go fowards and backwards at the moment. gradually forward, good periods get stronger and happen more often, backaward, bad, periods get weeker and happen less often. you alerternate between the two, until everything settles down. most people in general, say you should give it 12 weeks, before you reach what you can call a recovery. an increase will set off the side effects again, as most increases do. give your current dose at least another 4 weeks, to show the full effect. then you can consider an increase. too high a dose than ideal, is worse than too low a dose, so you shouldnt increase too quickly. most people that stay the course talk about recovery around 12 weeks, quite a few say even longer. a few lucky ones, sooner. you are heading in the right direction. all the best.

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  • Posted

    your welcome. you are right, it does work quicker. it also depends of the state a person is in when they start a med. we are all different, and we take different times to recover. i do know of someone who took 10 or 11 weeks on mirt to get to an okay state. try not to be in too much of a rush to go up, but then again listen to your own thoughts. if you go backwards, or have a wobbler, give the wobbler a few weeks, to see what happens. you definitely get ups and downs, that recur.

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    • Posted

      ok that's what ill do then - looking at the bigger picture the past 5 weeks have been a lot better than the previous 5 weeks so there is improvement it just feels really slow...but ive calmed down now snuggled up with my 4 year old watching movies and eating popcorn which is all i could ever want xxx

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    • Posted

      thats what you need to do, look back over past weeks, to see how youve improved. try not to think about how you feel now, or the future. when you look back, if you have stopped improving over a few weeks, and you arent happy, then you can think about an increase.

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    • Posted

      thanks Nigel, i see you're also in the venlaflexine group - so are you taking this with mirt ? i keep reading how it is such a good combination - is that your experience?

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    • Posted

      hi nigel, how are you? ive been reading through this thread as your words were so encouraging to me and i need that encouragement again, after my experience with mirt i went off all meds for 12 weeks and was still feeling awful so i decided to start escitalopram - ive now been on 10mgs for just over 2 weeks and feeling the anxiety, nausea and loss of appetite, i know this is normal for this stage in the treatment but its so hard and i just need a virtual hug, been unwell now for a year with little relief, please tell me ill get better x

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    • Posted

      hello karen. im sorry mirt didnt work out for you. i think mirt of 22.5mg or even 15mg' plus a ssri would have sorted you. im a great believer in low doses of mirt' added to either a ssri or snri. its done wonders for me' and other people i know. i tried 30mg of mirt for a week' along with a lower ven dose. i couldnt handle it. was so tense' and drowsy. dropped back down to 22.5mg' and upped ven and back to feeling good. i upped to 30mg, as i always need to know my boundaries. well ive found it now. ive reached the limit of what meds will do for me' so now im concentrating more on self help. if escit works for you, but not quite enough, think about having 7.5mg or 15mg of mirt added. i know that large numbers of people have issues with 30mg and above on mirt. no where near no of issues below it.

      so youve realised by dropping meds altogether' that you cannot cope on your own' with no meds. no shame in it' i know i cant. you have to remember this. lots of people end up believing its the meds causing their issues' they stop altogether, and they end up in a right state. you need to get the idea you can be med free out of your head.

      escit is a strong anti depressant' in that the doses involved are very small. means you increase by only 5mg at a time, possibly even 2.5mg. if i was yourself' i wouldnt be increasing by more than 2.5mg at a time, with intervals of at least 4 weeks min between increases.

      its just a waiting game for you im afraid. and you are looking at another 8 weeks as a maximum before you get an idea if its the right med for you.

      one thing i strongly believe in, is reading, particularly nice safe novels' where you get lost in the story. at least an hour a day. may be hard to do' discipline wise' but a massive help. not a question of reading because youd like to' but brain training' ie forcing yourself to do it. if you do' your anxiety will gradually reduce, 100% fact. its doing it everday' whether you want to or not. achieve an hour a day, every day' after a few weeks, you will feel better from that alone. its harder that it sounds, but its as simple as that. you need nice easygoing, fiction, to get lost in. get lost in a story for an hour everday' and your anxiety will come down.

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    • Posted

      im no good with soft encouragement really. you need something, anything, that you can get lost in. it trains your mind to focus and concentrate on something other than your personal worries.

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    • Posted

      thankyou nigel, so kind to get back to me, the mirt did start to work for me actually but i wasnt comfornable on it, read too many horror stories and decided i needed a break from meds, but i didnt feel the benefit, regret it now a bit tbh, but i am more comfortable being on something longterm that wont make me fat! so ill keep going with the escitalopram, its the nausea and low appetite that i really find hard - did you suffer from this at first? i might consider adding in mirt in 6 weeks or so if i did dont have relief, i definitely agree about reading, always have a book on the go x

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  • Posted

    hello, until a week ago, i was just on ven 337.5mg. i get few side effects from ven, even on this dose. however, after being om it 10 months getting to that dose, i felt it was lacking a bit. still found it difficult to focus and concentrate, and just be me, happy on my own, but chatty if people are around. lacked some motivation, clear thought, and wasnt chatty. ive been studying anti depressants for over a year now and listening and helping people on here..my mind picks up on anything to do with depression and anxiety. not just meds. have been looking into adding mirt for some time started just over a week ago. dropped ven to 300mg and 15mg if mirt. mood improved from the off, a little each day, tension went high each day, so dropped ven to 262.5mg, then tension started dropping. feel more normal after 10 days on it. havent found its improved sleep. it feels right, so just a case of waiting to see what happens. found lots of studies with anti depressant combos, seems mirt is most popular being mixed with ven and ssris. ven and mirt i think has highest success rate. you need to be on one for a while, so you can judge doses for each, otherwise you could end up all over the place. combos make sense to me, would say you need to be in one med for at least 3 months, before adding another. im pleasantly surprised so far, but could end up going tits up.

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    • Posted

      yes it is thanks. had some really good days. havent quite worked out best times to take ven yet, as i take that 3 times a day. get anxious at times, though i dont worry about it or things. just impatient, like most people. should have more of an idea in a few weeks. how are you doing?

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    • Posted

      hi nigel, ive felt awful this past week, the meds just arent working for me anymore and so im coming off them and see how i cope without them, i dont think i could feel worse!

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    • Posted

      karen, you should not come off them. speak to your dr, about trying another one. you havent given it no where nea long enough. you are forgetting how bad you felt, that you needed a med in the first place. what dos are you on? took 10 weeks for me to notice first sign of improvement. has taken me 10 months to get where i am. see your dr, you cant just stop taking these meds, you will end up in a worse state.

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    • Posted

      hi nigel, i hear what you're saying, but my experiencr has been over 15 years of trying different meds, with 3 over the past year, and they have all pooped out eventually - ive not been med free for that whole time and im still depressed, so in the words of einstein (i think) the definition of madness is trying the same thing over and over and expecting a different result, so its time to try something else, and i just know mirtazapine is not for me, though i think i might try sam-e, which is a 'natural' alternative that has out performed ssris in many tests, and virtually no side effects and taking lorazapam as needed, along with excercise and meditation 😃

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    • Posted

      hi nigel, hope all is well with you ? i took your advice and convinced my psychiatrist to prescribe me 15mgs of MIRT to add to my 10mgs of escitalopram. After the first few days i noticed a difference - anxiety and depression 80% gone, appetite back and nausea gone 100% - nothing short of a miracle! this lasted a glorious 3 weeks!....however in the last few days anxiety and depression have crept back in again, and it has scared me as i feel back to stage one 😕 im now 8 weeks on escitalpram and 3 weeks on mirt - so i know its still early days - so do you think this just a blip? felt so crappy last night i had a couple of glasses of wine, and then when i was going to bed and took the mirt i had horrible palpitations and these electric shock sensations which has really scared me so i wont be drinking again, any advice you can give is much appreciated.

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