Anxiety mirtazapine

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hi

Need advice anyone help

I took 3 nights 15mg Mirtazapine - too much.  Went down to 7.5 for. 4 days, then to 11 for for 5 days now on 15mg for  5 days.  Feeling very tired in morning and now running with anxiety.  Anyone offer advice or experienced similar.  Thanks. Ruth

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  • Posted

    Hi Ruth

    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.  

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  • Posted

    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"wink - 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. 

     

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    • Posted

      Gee I wish this had spell check - I saved it to Word, corrected it, went to repost it with typo's corrected, and it was already up! 

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    • Posted

      Hi John

      I don't know how you have coped for so long.  Is mert working for you.

      Yesterday continued to be a good day.  This morning I woke after what I think was a nightmare.  My anxiety was running so high I could not stay in bed any longer.  I also felt sick and dizzy.   This has continued and I took some diazapam a while ago and am just starting to feel a bit better.  I can only vaguely remember the dream but I thought it was more emotional than nightmare.  I still feel the anxiety is lurking underneath.  After re-reading your post I will take 15 mg again tonight as I am seeing the doctor in the morning.  Still cannot eat yet.  Thanks. Ruth

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    • Posted

      Hi Ruth sorry you're having so much trouble with mirt that medication works for some but not all I myself was on it slept well with it but down side weight gain so I got off it I also suffer from anxiety and take diazepam for it works so so but am on other meds as well living on medication is such a drag I wish you the best ??

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    • Posted

      Hi have now done 2 weeks on 15mg of Mirtazapine.  Total build up being 4 Weeks. I am only seeing very mild results still unable to eat till evening.  Anyone know how long it can take to noticeable difference.  Still running anxiety most of the day.
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  • Posted

    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! 

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  • Posted

    You definitely need to stick to one dose and ride out the side effects until your body adjusts.

    I wish you well xx

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  • Posted

    Hi all

    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

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    • Posted

      I have degenerative disc disease so i totally get the ibuprofen thing. I don't like to take those much and thankfully I don't need them too often. I just have to remember to bend and lift from the knees smile

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    • Posted

      Good for you, Ms Ruth99954

      What is a "buttie / butty"  were you so bad a place you couldn't eat due to nausea, or lack of appetite, or...? So glad you are in a better place, a phrase I use as well. It is 5 in the morning, I get up at 4.30 a.m (I have no idea why, i used to be an absolute Viking god at sleeping in - then I started getting migraines and never been the same. No idea what that is about. Psych rtold me (well, suggested) it was b/c I was becoming hyper-vigilant, from fear of migraine attacks, so when i wake, I get up, b/c I am vunerable when asleep, and the "lizard brain", the amygdala (no promises on the spelling at this time of morning) which is the primitive part of the brain, takes over. I'm not married to the idea but it sounds plausible, I guess. I repeat...what is a "buttie" (sic) ?

      So glad you are having some better days....

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    • Posted

      A buttie is a sandwich. Just feel sick in the stomach.  Like you I have never had problem with sleep until now.  Mornings for me are also very difficult.  Anticipation of the day so they say.  Do you take mert.  Hope you improve your sleep.  Have you tried Michael Slaley hypnotic videos on you tube, very good.  Ruth
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