Been on 15mg of Mirtzapine for 5 Months, thinking of upping dosage!

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What is the best dosage of mirtzapine for anxiety? I've been on 15mg once a day at bedtime for 5 months now and I feel it's starting to lose its edge. The sedative effect if had on me wore off after the first week at 15mg. but I was feeling better on it. I don't want to stop taking it I just want to find the right dosage to help with my severe anxiety. I've tried other SSRI's and I'm not a fan of them at all, this has been the best thus far and I'll also occasionally have to take Ativan at .5mg once a day, but not every day, more so recently because it seems my mirt is losing its effect or plateauing on me and I don't want to go in reverse! I suffer from severe anxiety, I worry about everything and panic, and also have moderate depression. Wondering what dosage would be best to move up to...? Whether it'd be going straight to 30mg at night or upping to 22.5 at night... Or doing 30mg but splitting them up taking one 15mg at night and next in the morning. Any insight..? Thank you.

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  • Posted

    Hi most find once the dose has been upped the sedative side of it doesn't work. I had to be given zopiclone. .
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  • Posted

    I have been on mirt now for six years and I think the most suitable  is 30mg
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    • Posted

      Hi Charles plz advise me I m suffering for 10 day go i eating 15mg nothing change plz advise me I thinking to night to start 30gm so what do u say plz tell me because u 6 years use so you have idea hopely I m waiting for your response
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    • Posted

      But before 2 day to just evening time felling little better but all day not well always my home no out side go plz advise me
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    • Posted

      Not sure if what you're saying is that you've been on 15mg for 10 days and still suffering issues, but if that's the case the medication can take 4-6weeks to fully be into your system and working, for some people it's 8 weeks. You may feel some short term side effects within the first couple weeks which will slowly start to die down with time. For me I started on the 15mg also and the first week it knocked me out at night and gave me really crazy dreams and I was so groggy the next day, sometimes for the entire day I just felt really sleepy and disconnected. But this side effect wore off for me after about a week or so and then I could take it about an hour before bed and it aided me to sleep instead of completely knocking me out cold and I didn't feel groggy the next day either. I've been on Mirtazapine since January so roughly 5 months and just recently it started to seem like it was losing its effect on me, which is why I'm looking into bumping my dosage up and started to slowly on my own by going from 15mg to 22.5, I see my doc on Friday so we will see if he thinks I should go to 30mg. I didn't take my dose last night as I was having a rough few days and thought my medications I'm supposed to be taking are interacting with each other causing me to feel so awful again! I was given Bactrim antibiotic in the ER for a UTI but man!! that seems to be causing me so much grief!!.. Including sore muscles in my thighs, dizzy, and really sleepy all the time no matter how much I sleep, I could just keep sleeping all day but I can't! So I stopped taking that yesterday morning.Not sure if that in with the combo of numbing up to 22.5 mg of Mirt was causing me all the side effects or not but it seems like the last few days my anxiety has been sky high and constant attacks all day long making me feel dizzy, shaky, heart palps, and shortness of breath! So I'm thankful I still had some Ativan left that I could take during the day until hopefully my medication levels out in my system! Hoping the dr will prescribe me more because I hear that when you up the dosage it can again take 4+ weeks for it to get on track with your brain and system again and can cause more side effects and anxiety until it levels out!
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    • Posted

      Oh thanks your replay but my frends 15mg to low I m before 6 month I use sodium valporate 100mg now my dr change 6 month stop after that's one use I don't no mey be 30mg good for me
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    • Posted

      Yeah I'd talk to your doctor to see if bumping up would do you some good. You can always do like I did and start on 22.5mg and take that for a couple weeks then go to 30mg so it's not such a dramatic change on your body all of a sudden. And also, ask about maybe getting a prescription for Ativan like I have. I take .5 mg pill once or twice a day as needed. Ativan is in the class of drugs called benzos and it helps suppress anxiety/panic attacks when you feel them coming on. I'd talk to your doctor about something like that also for you to take for a little bit to get you through the transition into a higher dose because it seems anxiety does elevate and come back once you raise your dosage of the Mirt and the Ativan really helps be through the days. Just don't abuse the Ativan because they are highly addictive and you can become addicted to them within months of steady daily usage. Only take as needed! Let me know if you have any other questions smile
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  • Posted

    Mirtazapine is not an SSRI.   I had the same symptoms as you and find that an SSRI (Sertraline) PLUS a low dose of mirt does the trick.

     

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    • Posted

      Thats grand advice Oldboy.  

      I'd be wary og going up to 30mg if I were you Jajzmama, many folk on the forum have had difficulty with going up, remember the llower doses are more sedating (having slow release sedation that lasts 24/7 for some) and the higher doses are mainly suited to treat depression

      It might be worth looking into taking Ativan for several days, and then ceasing for a day, because your body gets used to this and when it is absent you might feel the difference as anxiety possibly?

      Either way, I hope you find the mix that suits you and wish you well.

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    • Posted

      Oh I know it's not an SSRI I just meant I've tried other ones that were SSRI's and they didn't work for me at all.
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    • Posted

      Thanks Calmer. I'm currently taking the Ativan also. Once a day now. I did up my dosage but only to 22.5 mg to start the ramping up. Which today I found it easier to get out of bed I didn't feel as sluggish as I have been! So I'm going to continue with 22.5 for a week or so and taper myself up to 30mg if I have to. I'll be seeing my dr next week so I'll be discussing it more with him!
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    • Posted

      Sounds like you've got it sorted, give the 22.5mg a good try, a few weeks - yes you're right, that's the best way.

      Lower doses are more sedating, so that explains why you're not so sluggish, Mirt' works in reverse ... just to confuse us haha !

      smile

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  • Posted

    So I've been taking the 22.5mg dosage for like 4 nights now and omg the anxiety attacks I have during the day are almost constant! Feeling like I can't breath at moments and having to gasp my breath, wasn't expecting that for a gradual can change like that!! I don't think it helps that I'm taking the antibiotic bactrim also and naproxen sodium for muscle pain that the bactrim is probably causing lol. What a mess!! Anyone else ever have weird interactions when taking antibiotics with Mirt??
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    • Posted

      Hi Jajzmama

      Yes I have read of interactions of Mirt + antibiotics, you'll have to research this yourself because your GP probably won't have the knowledge.  I'll se if I can find a link & p.m. you (other web sites can't be given on this forum or the Moderator removes the post).

      The fact that you skipped a dose of Mirt has probably had an affect on your anxiety levels, I understand why you did it, but it is advisable not to skip doses, some can get away with it, looks like you can't, remember that for any time in the future.  

      Also stopping Ativan after being on them for days may well cause a reaction of withdrawal, can't win ggrrrr ... 

      How are you feeling today?  x

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    • Posted

      Yeah I figured that the antibiotics could cause something! I even asked the dr about it before leaving the ER and he said it would be fine! Apparently he was wrong lol. But up until recently u haven't taken the Ativan so it has been almost 4 months since taking it last so I don't think that has anything to do with it, but still not sure what's causing me to be so dizzy all the time and light headed. This was happening before the antibiotics or any of that and I figured maybe it was due to he Mirt not working as well anymore but who knows! I don't know what to think anymore, I stop one thing to make something better and it helps but something else comes back that wasn't right before! It's just frustrating. I've had some many scans/X-rays and blood work done and nothing can be found and all drs wanna do is blame everything on anxiety! Just an easy way out for them!
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    • Posted

      Yes of course, are you USA ?    The dizziness could be the Mirt' I think.  I definately think 15mg is best for anxiety, the lower doses are more sedating.  Going up on the doses often make folk's anx worse, I've read that many times on here.  Unless you have depression too?   

      I'd try and settle on the 15mg, and possibly think about an even lower dose, maybe going 10% lower every month and see how you feel.  7.5mg was more sedating than 15 mg for me !!  And slept even longer too.

      Best wishes

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    • Posted

      Yeah I'm in the US - in Michigan. I've been told by the dr that the lower doses like 15mg and below are geared towards sleep aide and appetite stimulate which makes sense when you read the main side effects people have at the lower doses like the sleepiness and weight gain. I did put on weight with it, about 20lbs in the first few months which was fine with me because I needed it and it was part of the reason the dr chose this as my medication because it has multiple uses! I don't have issues with sleeping though so i don't want t go any lower than where I'm at. I have 3 kids and have to be up and alert for them and he 15mg knocked me out when I first started on it, only for the first week or so but it did knock me out and made me super drowsy and sleepy during the days also. I also have Ativan also I can take for days when i have thre bad anxiety attacks come back which I haven't had in about 5 months until recently. But I'm glad I had it still because it helped calm me down pretty quick! I know not to take too much though because it's really addicting!
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    • Posted

      Sooooo true Calmer!

      Think that's happening to me. 30mg more anxiety.

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    • Posted

      Really, how long have you been at 30mg?  From 15 mg was it?  Maybe if time doesn't settle it, you could try 22.5?
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    • Posted

      I did a month on 15 i think. and a month on 30. But I intend to start tappering. Seeing GP later today.
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    • Posted

      Good luck with the GP ... ugh, hope they are more knowledgable than mine re AD's smile
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    • Posted

      Well, she agreed that I need to come off them and let ME decide how I should tapper. She said once I get to 15mgs per day for a week I can go straight on to prozac 20mgs straight away.

      I have noticed that I am feeling a bit better after reducing my meds this week of Mirt. I so hope I don't suddenly get those wd effects!! I shall try and be careful.

       

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