Adding mirtazapine

hi @ian90586

thank you so much for taking the time to reply i appreciate it. i have taken citalopram around 15 years ago and was only ever on 10mg and i never increased and that is what i recovered on. However, this time around 10 has done nothing although my anxiety has been much worse this time around. What do you mean sertaline to be to activating? many thanks 😃

20mg is the minimum therapeutic dose for depression and anxiety and usually that's enough for a lot of people. I spent a long time on 10mg once,but that was as a maintenance dose after being on 20mg first and then dropping down. I know lots of people seem to find things harder the second time around on Citalopram, don't know why that is,and they need to take more. You say your anxiety is much worse this time,so that's why. More activating means feeling more wound up,like drinking caffeine. I've personally found antidepressants like Sertraline,Prozac and escitalopram to be like that,while antidepressants like Paroxetine, Citalopram and Fluvoxamine to be more sedating. I would give the 20mg Citalopram a lot more time. After a dosage increase,you're going to experience a lot more anxiety and side effects for a good while until everything settles down again and you experience the benefits. My experience of that is months before you start to get the real benefit. Mirtazapine is known for making people sedated and tired and increased appetite and therefore weight gain,and taking that with Citalopram I would imagine would knock you out,but I'm not a medical expert and as I say I've never taken Mirtazapine alone or with something else. Good luck.

hi ah thank you. I definetly do not need to be more wound up 😃. I am going to give the 20 mg until xmas before making any changes hopefully it will work for me. It has worked before so praying it will again. Its nice to speak on here to other experiences and journeys as when in the middle of it all you cant imagine feeling normal ever again! Gp did say it can make you tired on mirtazapine which I cant be as have two small children to take care of and also about weight gain so I dont think it sounds very appealing! Thank you 😃

In my experience the best thing you can do is to stay on a certain dose and stick it out. As long as the dose is high enough,and 20mg is normally enough,then over time you will start feeling the benefits. It will be really tough though with plenty of highs and lows,increased anxiety and horrible side effects and everything else thrown in! Unfortunately that's what happens with all these medications without fail,I know because I've taken them all. You could be lucky, but if you're like me you will have a hard time,but over time things will settle down and the thoughts and anxiety start to fade. If you can, it's best for friends and family or support groups to get you through the hard times and not give up,increasing or swapping these types of medications usually bring more problems again, it's about staying where you are and giving your brain the maximum amount of time to heal. Keep posting on here for support if you need it, don't hesitate.

Hi Ian, I started on 10mg of Citalopram for a few weeks due to being sensitive, then increased to 15mg for another few weeks, now been on 20mg for 11 weeks. I've had 3 very good weeks, then the last week started going downhill, not as bad as before, but back in my head checking in!! Is this a setback or blip as they call them and is it normal after 11 weeks at 20mg? Thank you

Yes it is normal. Throughout recovery you might have noticed that things fluctuate from good to bad like the normal moods people experience,but much more pronounced in the negative with worse anxiety. The longer you take the medication the more the fluctuations stay in the positive and lessen in the negative. Eventually as your brain becomes accustomed to the changes the medication is making,then everything settles down and you will feel the full benefits. I'm 10 weeks into my medication and feeling worse at the moment as well,you just have to ride them out.Also,you shouldn't just rely on medications but help yourself by exercise,healthy diet and practice mindfulness and meditation and therapy if you're not already seeing someone. It all helps in your recovery,and makes you feel empowered and gives you renewed confidence and self esteem which is vital in conquering anxiety.

thank you for your advice and reassurance. I am doing cbt/counselling alongside the medication. Its good to talk to someone who isnt in your family etc. i can deal with the physical symptoms of anxiety as i know it is the anxiety making them happen I just find it so hard to deal with the intrusive thoughts. i do know it is also anxiety making this happen to but so hard just feel your constantly in your own head all the time. Is it anxiety you suffer from?

I have general and social anxiety with depression which I have to manage with antidepressants. Runs in the family unfortunately. I'm currently on an SSRI I've never taken before called Fluvoxamine. The intrusive,dark, negative thoughts and depression are what come with chronic anxiety and stress when you're at your worst. They are particularly upsetting and you can feel like you're going crazy when they occur, but with continuous use of the Meds they do slowly fade away as you recover and get replaced by happier,more positive thoughts and you find yourself getting calmer alongside that as well. unfortunately it can be a long and treacherous road to recovery,but you will get there. If you need reassurance and support don't hesitate to get in touch or post again. What you will find is that when recovery happens,you will move on with your life and forget about anxiety and all the bad times. Take care.

Thank you for the reassurance, it's just nice to hear. I've had CBT sessions which I try and implement, watch my diet and walk quite a bit. I think I became a bit complacent after feeling good for 3 weeks, silly me!! Your right when you feel good you forget about the anxiety and get on with life. I'm just going to have to ride this one out. 😦

Talking about complacency and I know it's some way off, but just as important in the future, don't take your recovery for granted. I've fallen into the trap of thinking I'm fine after a very long period of taking the meds,thinking I'm fine and why am I taking a little pill every day, going through the process of tapering off completely and then several months later relapsing and having to go through the whole nasty process again. I never learnt,and done that many times over the years. The last big mistake I made and cost me a lot,is messing about and constantly swapping and searching for a non pharmaceutical cure,and now I'm back to meds again. When you feel good for a long time, remember the meds are still doing their job,and though it's good to be med free,be aware and reduce with caution. But you got to get better first 🌞.

Once I feel completely better, I think I'll take these meds forever lol I don't want to take the risk of crashing. As you've said I couldn't go through all this crap again and it's only 1 little pill. Thank you for your input, I've been out today Xmas shopping, I felt iffy this morning but once out I never thought of how I felt, at least not until I came home, then I started thinking " Its never bothered me while I've been out" " so why am I thinking about it now" Do you think it's just habit, because I've checked in so many time of how I'm feeling? 🙂

Anxiety is 100% a habit. A very bad habit. But in a way that's good to know, because that means you can change a bad habit into a good one. You feel better when you're out shopping because you distracted your thoughts from anxiety thoughts,and then concentrated back to the anxiety habit when you're home which you are now associating with being anxious and where you overthink. What you concentrate your mind on will flourish and grow like flowers in a garden,what you ignore will wither and die like weeds. If you accept the anxious thoughts, and give them no power over you they will wither and die. When you concentrate on them,they increase and increase until you end up in panic. Knowing you can accept the thoughts and that they won't bother you anymore is the path to more confidence and being anxiety free!

Yes, that's exactly it, when I'm out and about and mind is occupied I can forget. But I don't trust myself when I'm home alone, because that's when I start to check in again and monitor how I'm feeling, that's the bad habit lol I've read a few books and it's all about accepting how you feel for the time being and let time pass, which is easier said than done, its bloody hard going!!

Nothing in life is easy,otherwise I wouldn't be back on meds again myself,lol. When the stress and the anxiety become too much, and the intrusive thoughts take over etc. then the meds are needed,but we should use the meds as a springboard to changing the way we think and act and rewire our brains to a non anxious way of thinking. If we do that,then the meds are no longer needed. That's the plan for me anyway. 😄

This was great thread to read, Ian speaks so much sense and i think i needed this today. Was on 20mg celexa a few years ago, 1st time on a med and stayed on it for 1 year was good and went 2 plus years of no meds and little to no anxiety..

Fast forward to this summer and it comes back, decided to go back on meds and was put on lexapro this time around.. I stayed on it for 7 weeks and felt awful, while it seemed to help with anxiety i started getting days of feeling down, overwhelmed feeling which is new to me.. I got switched to celexa 3 weeks ago and has been ok, first week not to bad, 2nd week awful, the past week definite improvements but then had another 2 days of feeling my old self, waves of emotions, negative thoughts, hard to descrbe. My doc wanted me to go up to 30mg last week but i decided not to just yet, id rather stay on 20mg but i also want to get better soon, its like 10 weeks on meds total and im still so so..

thank you @denise1306 and @ian90586 its really reassuring to hear other people who are going through the same sort of thing! I really think if you havent been through it or going through it you cannot understand what it is like. I even think gps and cbt therapists do not understand unless they have taken medication or suffered with anxiety or depression themselves. This is why these forums are so good as its brilliant to speak to people who are on the same journey! Its also lovely to hear success stories. I so look forward to being recovered, feeling like me again and living life without horrible anxiety hanging over you 24/7. Denise I myself have had weeks on each dose I have taken that I have felt quite normal and think that thats me feeling better then boom i feel right back at the start again. I hate being alone at the moment with anxiety however i know this avoidance so trying to spend some time alone but i hate it. i used to wish for time alone now im scared of it! Such a rough old journey! wish for us all to feel great again soon 😃

Never feel on your own on your journey to recovery from anxiety. There are many many people going through exactly the same thing at this very moment, including me! I'm also in a group on Facebook for Fluvoxamine,my current meds,and people round the world are going through a similar thing all the time. When you're struggling, message me or reply or post again, don't feel alone.

Same here, I'm on 30 mg for 6 weeks now. I have moments of feeling like my old self and then bam anxiety pops up bad again for a few days. It gets frustrating because you think you are back to square one. I can't wait until this is over. It gets so exhausting and it becomes annoying after awhile.

hi jessica how are you feeling now? were you on 20 long before you moved to 30?

hello. I was on 20 mg for 6 weeks. It wasn't helping for my sleep or appetite. so my doctor upped me to 30 mg my appetite is back and my sleep. I've been on 30 mg for about 3 months now I think. I still have anxiety but my depression is gone too!! But I still go about my days even when my anxiety is high. Thats all we can do is live our life. 😊 it eventually gets easier doing so. Before you know it this will be a thing of the past. We will all get there. Takes time, patience and a lot of strength. Try to remember, anxiety is just a feeling. No matter how hard and uncomfortable it becomes it will not kill us. We just have to accept it.

hi @jessica61856

how are you feeling now? i have been on 20 now for 9 weeks and still not much improvement i dont know wether to increase to 30, stick with 20 for longer or change medication. so frustrating as citalopram has worked for me before but hasnt done much this time at all so far. hope your feeling good and looking forward to christmas. leigh x

@jessica61856 sorry meant to ask did you move straight to 30 or 25 then 30 and were side effects bad x