Been on 15mgs for 2 weeks, moved up to 30mgs not feeling great should I continue?

hi nigel, it is normal to feel nausea as well? its a bit strange because i actually felt great yesterday - little anxiety and no nausea, then today i'm so ill again 

yes, its completely normal to feel good, then bad the next day. most people experience it early on, bit like mood swings. anti depressants take a long time to work. you will not experience a sudden recovery. gradually your moods and days improve, and the bad days with amxiety (the nausea) and down moods, become less often. its a bit like a sew saw slowing down. you dont need any changes for at least another 4 weeks. you just need more time on your dose, to slowly feel better. you need to try to stop looking for recovery, just get through the days, so you have more time on your dose, under your belt. always compare say a current bad day, with a lad day over the last month or so, to recognise its not as bad. for progress indicators, compare the ups and downs youve felt over last week, to those in the weeks before. it may be still to soon to notice improvements.

thanks nigel, such comforting advice, much appreciated, i had another ok day yesterday until the evening when i started getting irritable and then last night i felt like i had such a restless night because of awful nightmares but i didnt really wake up, but have been very alert since 6am - where as the night before i slept very soundly and found it very difficult to wake up - its just so up and down, i just have to keep telling myself the meds are settling and its normal.

hello karen, you need to stick to 30mg, for at least the next 6 weeks. 30mg is quite a high dose, so dont think you need a higher dose, because at the moment, you definitely do not. at the moment you are having mood swings, feeling up and down. the down days ate reactions to your good days. your brain chemistry is not yet balanced, so a good day throws it all out of what. there are hundreds of chemicals in your brain, that need balancing, as they each effect one another. these chemicals are increased and decreased by minute amounts each day, which is why recovery takes so long. there are no quick fixes, only patient and time will sort you. you can expect another couple of weeks of mood swings. then you will probably go through a couple of weeks of feeling flat, neither up or down. this may feel as bad as feeling down. after this, proper recovery starts, where the good periods last longer and happen more frequently. the bad periods get weaker, and happen less often. this process ive outlined is what most people go through, though everyone is different. so resign yourself to however you feel over the next 4 weeks. you just need to get through them, and then your revovery can start in earnest. you should not increase for at least another 4 weeks, minimum period, otherwise you will not get an accurate idea of what your correct eventual dose will be. from now on, if needed, you should only imcrease or decrease by 7.5mg, then wait a minimum of 4 weeks. i increased my owm dose like this, and told pysc afterwards for approval, and i got every increase correct. worse thing you can do is increase/decrease too soon, as you dont know where you are, and you waste too much time, correcting errors. just stick to what you are on now for next 4 weeks, then you will have a mu h better idea of how much mirt is helping you.

Hi Karen, how are you feeling now? I hope the 30mg MIRT has worked for you and you are feeling better?

hi jon, so sweet of you to check in! im feeling much better as my depression and anxiety have lifted a lot the past week, however im not sure about staying on the mirt though...ive noticed im really irritable and angry, and very conscious of putting on weight, also the nightmares every night is exhausting, not sure really - have a call with my dr on tuesday to discuss options - whats your experience ?

I must say that since i've been very impressed with Mirtazipine and i've had no trouble sleeping. On 15mg i felt a little groggy the next morning but that went away after a few days as i got used to it. On 30mg i take it about 30 mins before bed and then i'm yawning by the time i hit the sack 😉

I've been on Sertraline and 30mg Mirtazipine combination since Nov. MiRT has increased my appetite but i counteract with gym and dog walks.

yes i have had the best sleep ive had in years, and no grogginess anymore, so that is definitely a bonus, its nice to have an appetite back too and im trying to not eat too much and excercise yet i still feel like ive put on weight or all my clothes have shrunk! im interested to see you are taking with sertraline - why is that? i was on sertraline before this and hated it - 12 weeks of feeling terrible put me off any ssris - even though they had worked for me before, does one boost the other ??

i was on SERTRALINE 200mg for 16 years and completely 100% normal and then it stopped working. It's referred to as Antidepressants pooping out. Mental Health specialist recommended adding Mirtazipine as an augmentation therapy. Mirtazipine has a very good history of combining well with SSRI's like Sertraline due to the different receptors it works on on the brain.

yes ive expereinced poop out with seroxat, citalopram and fluoxetine - usually after about 3 years with me 😕 so i tried sertraline and could only manage 50mgs, which probably wasn't enough really, and i just felt awful - anxiety and nausea all day so was moved to mirtazapine - why didnt you stop taking the sertraline if it stopped working? ive defintely been feeling a bit better this week (2 weeks on 30mgs) but not 100% so i really dont know what to do - ultimtely i dont think its right for me, cant bear the thought of putting loads of weight and not being able to do anything about it...thinkinh of trying venlafexine or escitalopram ?

like i said, Sertraline and Mirtazipine have a good track record of combining so the Mirtazipine kick starts the Sertraline too. I've come down from 200mg to 100mg Sertraline. Take 100mg SERT in morning and 30mg Mirt 30 mins before bed time.

ok very interesting - i'll mention that to my doctor , ive read that doing this can also counteract the negative aspects of the mirt, so less drowsness and irritation and weightgain being the main one - has this been your experience ?

I only experienced drowsiness during first few days and have actually lost weight on Mirtazapine but that's probably as ive got more energy to walk dog and go to gym so fuels a healthy cycle of exercise which produces more good chemicals like endomorphins etc. We all metabolise drugs differently but the SERT & MIRT combo is working for me so far. Best of luck in your recovery 😃 X

right - maybe thats because you've always had sert in the mix that you didnt gain weight...im certainly going to try mixing in an ssri if my dr agrees, thanks for you help 😃

Hi Karen, how are you doing now? Hope you're feeling better? Cheers, Jon