Can I take another miratzapine when I feel bad?

Hi Felix ; if you say it's minor then maybe you can wait it out till tonight's dose. Maybe after a few more hours of keeping yourself busy it will diminish.

Hope you feel better

Sorry to here you are having a wobble as they say. You can take it anytime of day if it is not sedating for you. However if you are to change your regime be sure to take it at the same time each day to keep a steady state of the drug in your system. And more importantly tell your Doc so he has all the facts.

Stu.

Thanks - I'm going to try and do that...will stay in my room for the rest of the day with my phone off.

Thanks again.

Felix

Are you on any other meds? I can relate to that feeling of shutting yourself away, however as Miami1 said keeping your mind occupied may help you stop ruminating about the issue.

Stu.

Thing to remember with Mirtazapine (and SSRI/SNRI type treatments) though is that it's not that a pill has any immediate effect which then lasts for X hours. Really taking one out of sequence will do virtually nothing for you. The effect is built up over time as it changes your brain and its chemistry a teeny bit.

It's like throwing snowballs at a wall. Some snow sticks, but most of it drops to the ground. But if you keep throwing snowballs, the patch of snow on the wall does get bigger. One snowball will make almost no visible difference on its own. What a dumb analogy, but I hope it paints a picture of how Mirtaz's effect over time works.

Correction - the sedative effect is quick acting and short-lived. If you still experience the sedative effect at all (I don't get it any more, only 2 weeks into course) be aware you'll get it as you would with your evening pill.

Plasma concentrations are at optimum level there can be a noticeable difference when dosing but it is quite a good analogy. The unique thing about a nassa (Mirtazapine) is it works to enhance neurotransmitter production aswell as inhibiting reputake of what is already in the synapse like other classes.

As Roger rightly said though it will not make much difference in the scale if things, hence why some people augment with something more effective at the time of panic symptoms or heightened anxiety.

E.g My combo is Amitriptyline (for depression and sleep, Buspirone (extra arsenal of 5htp receptor agonism) and Pregabalin (generalised anxiety and sleep architecture)

Hope this helps,

Stu.

Thanks for the information, I thought that it perhaps wouldn't have much of an effect but wondered if maybe anyone else had tried. To be honest, it's not helping me sleep better at all and it's never had the sedative affect on me. I think it has helped lift my mood a little and feel like a have an extra second to think before I react.

I like the snowball analogy - maybe I need to take something to make a little more stick because I hate days like this, I'm glad I'm not in work today.

Thanks again, I've made an appointment to see my doctor on Monday - I'm interested in perhaps trying the Pregabalin, is this a readily available med for Anxiety Stu, as in will I be able to get this?

Felix

Where are you Felix if you don't mind me asking?

Here in England and Europe it is approved for generalised anxiety. It's method of action is not the same as other anxiolytics i.e Diazepam etc. it works by binding to subunits voltage gated calcium channels calms extort neurotransmission or something similar. However there is a delay in the onset of action for most but I had almost instant results.

Mirt's sedating effects are via histaminergic action so tolerance is much like taking Benadryl in that sense.

The higher the dose the less sedating and the more activating it becomes. I think this is very unique or very rare maybe Mianserin has these odd qualities.

Stu.

excitatory neurotransmission< >

Sure - I'm in Malta so I should be able to get this. As with all I'm sure, I didn't want to take anything at all but

after the changes I can see already I'm curious to know if another drug may stop it once and for all.

Thanks a lot for all the very useful information.

I hope all is well with you.

Felix

No probs Felix. If more people helped each other on this planet it would be a far better life for all.

Was your primary reason for being prescribed Mirt depression?

Stu.

Couldn't agree more Stu, this forum has actually really helped today and I'm feeling a little better than 2 hours ago.

The primary reason was anxiety but was also for the depression. My Doctor said it should work for both, but I think I may need something else for the anxiety as I thought it might be a bit more under control by now, but I was probably expecting too much too soon.

I noticed that you didn't include Mirt in the meds you mentioned previously - is it something you've tried before?

Sorry yes I tried it for a few months, it certainly had a quicker onset of action and it did work to a degree I think. However I was already taking Ami and therefore couldn't get a clear picture as if I was taking it alone.

The Ami is worthwhile just for sleep alone as often depression anxiety and insomnia go hand in hand.

Buspirone for me is definitely a great add on although lots of people think it is a sugar pill as they expect an anxiolytic to be instantaneous. It takes a week or so to notice and I take 60mg and it boosts my other meds I find.

That and the Pregabalin you will be able to get relatively easy I think as they are non habit forming.