Can Mirtazapine help with insomnia?

Posted , 11 users are following.

Hi everyone, I am suffering with depression, anxiety and insomnia. Had been taking citalopram since November but this week doctor has changed me to 30mg Mirtazapine due to their being no improvement in my insomnia and little improvement in my other symptoms.

I find that I am very tired all of the time but have difficulty falling off to sleep. When I do get to sleep I find that I can sleep for a long time (over 10 hours) but still feel tired when I wake up and throughout the day.

I find that having all this extra sleep is not the reason that I find it difficult to fall asleep because even when I set my alarm to wake up early every morning and have a usual amount of hours asleep (6-8 hours) and stick to a sleep schedule I still have difficulty falling asleep at night and feel tired throughout the day.

Has anyone else experienced insomnia of this description and has Mirtazapine helped?

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29 Replies

  • Posted

    That's parr for the course with mirtazipine, I have had trouble sleeping and then sleeping for hours and still feeling shattered, Sunday night I took a sleeping pill which work a treat, but after being still awake two hours later I gave up waiting, I was still wide awake until 10.30pm Monday night 35 hours without sleep, it was like being a chef again but without the ski full of booze. Since I started taking these I can hear my eyes move, pulsing though the centre of my head like a tens machines electric shock. I can't wait to see the shrink tomorrow and tell her where she can stick her mirtazipine.
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  • Posted

    Hi itssofluffy,

    The best dose for sleeping issues is 15 mg. At 30 mg it dose the opposite. Give it some time

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  • Posted

    Hi Waza, thanks for your reply, I think my GP wanted to get me started on a higher dose of 30mg to make sure something starts happening to improve all of my symptoms. I was unsure of changing to another medication but I suppose I thought I would have to give it a try, fed up of constantly feeling tired. Will have to wait to see if I need to change to 15mg.

    Have to go for a blood test today =( GP said it could be a thyroid problem that is causing the tiredness.

    I do feel abnormally tired, never felt tiredness like this before.

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  • Posted

    Hi Alan, it's a shame to hear the Mirtazapine hasn't worked for you, maybe something else will. I hate taking tablets to help me sleep. GP prescribed me zopiclone in november but I was only allowed a weeks worth, it worked really well though, they should put that stuff in chocolate!!
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  • Posted

    Hi first time here is any one else tapering with migraine?
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  • Posted

    Hi long, I have been taken off 20mg citalopram and only taking 30mg Mirtazepine now, I'm on day 5 now.
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  • Posted

    Waza, hit the nail on the head, if your using this to aid sleep primarily, mirtazapine has what's called a curvilinear dose-response curve, this means the more you take, the less sedative effects it has on the body in most cases, doses higher have an effect on androgenic receptors meaning it actually makes you feel wired and alert.

    However that tired feeling during the day is something that I find usually wears off after around 2 weeks or so.

    I was put on it as an antidepressant in the past and found it to be more effective for me versus SSRI OR SNRI's, however I stopped because I gained weight (it quite often stimulates appetite).

    However now I'm on it for sleep, and I now NEED something to stimulate my appetite, and mirtazapine has been found to be an anti-emetic which is useful for me.

    Try and stick with it, because the other options (like zopiclone and benzodiazepines) are only for short term use only 2 week supply usually max, and they cause rebound insomnia within days, as soon as you stop taking, u won't sleep a wink. Also as I'm sure you know, addictive, and tolerance forming very rapidly so they are no longer effective. Personally with mirtazapine I've found it not to be the case.

    May I also ask what time you are taking them ? Have you tried taking your tablet earlier perhaps, I've found this to make the next day grogginess easier to deal with.

    And also google 'sleep hygiene', there's some useful tips to be had online.

    Hope this helps smile chin up

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  • Posted

    Hi Alex,

    Thankyou for taking the time to reply, you have been very informative. The difficulty falling to sleep and excessive tiredness during the day was something that I was experiencing whilst taking citalopram. Since changing to mirtazapine I am actually surprised at how much both of these problems have improved.

    From the first day I was able to fall asleep fairly quickly after going to bed and the during the day I no longer feel unable to get out of bed. This week is the first time that I have actually had energy and wanted to do something with my days, instead of feeling constantly exhausted. I am surprised that I have experienced this improvement so rapidly as GP did say it could take 2 weeks to start feeling the effects of the tablets, so perhaps it is a psychological thing that believing they are going to help me sleep has helped me sleep.

    Have been prescribed mirtazapine as an alternative to citalopram to treat anxiety, depression and insomnia, so not primarily to treat insomnia. Although lack of sleep worsens my symptoms of anxiety and depression so GP suggested treating insomnia could be first step to improving everything.

    GP did say about how mirtazapine could cause weight gain, but at the moment this would not be a problem for me as I have lost weight as a result of the depression.

    Can I ask what dose of mirtazapine you are on now that you are taking it for sleep and to increase appetite?

    I take my tablet at about 10.30pm and this seems to work well for me, although I don't wake particularly early the next day. This is not a problem at the moment as I am currently off work sick, but I think I will try to start taking my tablet a little earlier in the evening to start getting into a routine of waking up earlier for when I return to work. What time do you take your tablet?

    Yeah I have read lots about 'sleep hygiene' and getting into a routine before but it has never helped me. This week though I have had some success in sticking to a routine and do think it is working for me. I have also found that simply thinking that I am not going to fall asleep and worrying about not sleeping has a huge effect on me, and think I am doing well to solve this too.

    Thankyou smile I'm so happy to be sleeping smile.

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  • Posted

    Hi, it's no trouble at all if I help you out.

    The dose I'm on is 15mg, and your GP is right about giving it two weeks for improving depression/anxiety, but as a sleep aid it works approx 45 mins after taking a tablet, however this is sometimes sooner for some people.

    At the moment, if I plan on going to sleep around 10.00pm-1030pm, I take my dose at around 9.00pm.

    It's worth mentioning though, that I found it a great help for anxiety and depression, even at the 15mg dose that some people say isn't enough. And I had been on citalopram,fluoxetine,venlafaxine and not really responded to any of them, and I didn't find the 'telephone counselling' very helpful either.

    As for your weight, that is great, just keep an eye on it every couple of weeks, most pharmacies have a set of scales in private, I find this useful using the same scales each time, and not having any in my house otherwise ill end up on them all the time lol

    May I ask though, do you believe that your condition is anxiety influencing your depression, or rather depression causing anxiety, because although they are two sides of the same coin, treatment options are usually different. For instance, when generalised anxiety was my main symptom I was prescribed a drug called pregabalin (an anti-convulsant and nerve painkiller) which is also prescribed quite recently approved for anxiety.

    I'm really glad that it seems to be helping you, and it may well be starting to work already, so fingers crossed things should only get better for you! Citalopram is a horrible drug and everyone I know has had side effects that outweigh any benefit of the drug, but the GP's have to prescribe an SSRI as first like treatment in their guidelines.

    For the record, the sleep hygiene didn't help me either!

    Something I would recommend, if you can afford it, is speaking to a therapist, I've found one that offers me a concession (£15 vs £35) , and as much as I was always against any 'crap like that', I've found it to be a massive help, and a fully trained therapist will be able to advise you. Generally (in my area at least) the NHS offerings are crap for therapy.

    I don't know if it's an option for you or not, but believe me, it's not like what you see on TV.

    This website lets you find one near you and you can see what they look like, their qualifications and specialities.

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  • Posted

    I have posted a reply for you, but it's awaiting approval because I included a website in there for you... Watch this space smile
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  • Posted

    Thanks Alex, yeah you are being a great help, it is good to hear the experience of someone who has been through the same thing. Obviously I know everyone's reactions to medications can be different, but it seems like you have had a similar response to treatment as I am having, with the citalopram not working for you.

    I already have a set of scales in my house but I don't check my wait constantly. My weight tends to fluctuate 3 or 4 lbs here and there, as sometimes I can have a huge appetite and other times I don't eat as much, but it won't really bother me about putting on weight unless I go over more than what I like my weight to be.

    I believe that when it started I was suffering from depression that caused anxiety and insomnia. (This was back in October that I first started as though things weren't right). However for about the last 3 weeks I feel that the depression has subsided and that anxiety is my main symptom. I rarely feel sad now, but I still have anxiety and this was causing the insomnia.

    I have been referred for counselling with the NHS but I am still waiting to receive any. I heard from them a couple of weeks before christmas but there was a long waiting list so I am expecting my first appointment at the end of January. It is something that I am not really looking forward to and that I'm not sure that I really want. I have been trying not to think about the approaching appointment but everyone seems to think I should try it and that it will benefit me, and I know they will be disappointed in me if I don't go. I can't think of anything worse than talking through everything with someone, just talking to my doctor is bad enough. I dread any appointments with my doctor and if I'm not crying and shaking before I go in (which I usually am) I'm always crying and shaking when I come out. It's embarrassing when there is a waiting room full of people sad. Also I feel like they are going to be lecturing me and I don't want that, so I do have quite negative views about the counselling.

    Ok thanks I will check out the website though. Thanks again for being so helpful smile.

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  • Posted

    Give it a go, but tread with caution, you seem pretty switched on, and if they are indeed that busy, then I wouldn't put it past them to perhaps not give you the level of care that you deserve, simply to meet the pressure that is down on them for capacity.

    A proper therapist will build up a true trust with you and will only go as quick or as slow as you would like to go, they don't pry into things to deep unless u feel ready, there is a hell of a lot of training to become one and it's something I've looked into myself. And it's even better if it's one of your chosing, yeah have a look, but the end decision is always yours !

    You may end up being fine with just the Mirtazapine, but do not just stop taking it because your feeling a little better (even after a few months), this type of medication needs to be taken for 6-8 months, or the chance of relapse into depression is very high before this time.

    It really makes me happy I can help, I mean I do what I can, but in this world, uttering "morning" to someone make you a weirdo haha

    Any more questions, or if you find anything on google that is a bit tough to ingest, don't hesitate to post back, and I will reply ASAP

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  • Posted

    Thanks smile that's really nice of you.

    Yeah I do get the impression that they would prefer me to not need the appointment, even on the first letter they sent me to inform me of my appointment date they said "if by the date of the appointment you find that you no longer require our services please telephone the surgery to cancel your appointment" so they can give my appointment to someone else who needs it. I feel that they will be thinking I am wasting their time because I think I need the counselling as much now as I did when I was first referred for it. I have calmed down a lot in myself over the last few weeks enough to get through the days.

    A friend of mine still says that I should try the counselling because it can resolve any psychological issues that may affect me in the future, but I am still unsure of it. I checked out the counselling directory, there were quite a few, it's just the cost issue. I think I will have to decide if I definately want to try it to begin with.

    Yes GP has told me about how you have to continue treatment of antidepressants even after symptoms have improved. I will do anything to never have to feel how I first did again.

    Thanks for your help smile it's good to just talk with someone about it. I hope I can help people too.

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  • Posted

    Glad your feeling a bit better, keep on at it, see if you can find a new hobby or rekindle an old one, I find personally that it can help (providing you have the oomph to do so, which is often the hardest part)

    yeah there's no rush just decide in your own time, you never want to go to a counsellor and say "I'm here because so-and-so told me to come", but it's all down to self-worth, I often feel I shouldn't even need a counsellor because there are so many people that have it aLOT worse than me in any sense of the word, but it's completely polar opposite to that, anyone is worth it.

    Keep me updated! Take care, get yourself some relaxation, and whilst you aren't working perhaps do some research on vitamins, they also have a great effect on the mind, as can probiotics also.

    Obviously be careful with those miracle herbs out there they can be dangerous, but in my opinion, a good regime of balanced vitamin supplementation, coupled with a varied diet can work to support the mirtazapine.

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