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Could this be a side effect of mirtazapine?

Posted , 4 users are following.

evergreen
evergreen

Lately, after being on mirt for four years, I have been having periods of insomnia. Basically, I get a kind of trembling in my chest and very frequent urination shortly after going to bed. I thought it was my heart racing but it isn't; it's a kind of vibration in my chest. I need to get up to urinate every few minutes. It isn't just the feeling that I need to pee; I actually do a reasonable amount.

I have been really happy on mirtazapine for most of the time, except that I need to really work hard not to put on weight, but now that it doesn't seem to be giving me the rest I need, I think I may need to get off it. However, one of my main symptoms before going on it was insomnia. I had to take temazepam most nights. Mirtazapine meant that I could cut temazepam down to around once a fortnight, but now it is several times a week. But I'm scared of the insomnia if I try to come off mirtazapine, and also of the other side effects. Can anyone recommend me a different AD that helps with sleep? I cannot take SSRIs. Thanks.

0 likes, 19 replies

19 Replies

  • mvwaugh
    mvwaugh evergreen

    Posted

    I know what you mean about needing to pee frequently. I take my mirtazapine about a hour before going to bed and find I need to go every quarter hour after about half a hour of taking it. However by the time I want to settle down I don't have to go more than once in the night if that. I take 45mgms, how much are you taking? A lesser amount is supposed to be good for sleep. I take 150mgs of Venlafaxine in the morning and between the two they have very significantly improved my life. I don't always drop off quickly but I do get a reasonable number of hours sleep. Hope this might be of help. Maggie
    • evergreen
      evergreen mvwaugh

      Posted

      Thanks. I take 30mg a night. My sleeping troubles are worsse on the nights when I have to delay taking it because I have to fetch my son from work 4 nights a week at around 11 pm. So I don't take my pill until I have finished driving. Then I have to be up by 7 am so going to bed later is not possible. It's causing me quite a bit of stresss to be honest mainly becaause I'm becoming more dependent on the temazepam and the doctors are reluctant to prescribe it too often.
    • mvwaugh
      mvwaugh evergreen

      Posted

      Yes I can see that this will be a problem if you are unable to take the Mirtazpine till after you have finished driving. I actually don't think it would affect my driving, needing a loo would be more problematic. I think also found that before I was put on the venlafaxine I taking Temazipan more frequently and as you say doctors don't like prescribing it. It is a pity because I never found it had any side effects. Maggie
  • betsy0603
    betsy0603 evergreen

    Posted

    It sounds like the mirt is pooping out on you, also known as tolerance withdrawal.  Taking more would't be advised because mvwaugh noted, less is supposed to be more helpful for sleep, and likewise, more can mess up sleep.  I'm not sure what to say about the peeing, since that has not been an issue for me. I did have one night, though, where I woke up and HAD to go, not normal for me!  I have also had the rare chest vibration you mentioned.  I am in the process of tapering mirt, so it is interesting that I had that as a WD symptom while you had it while taking your same dose, perhaps another indiction of tolerance withdrawal.

    At any rate, is it still helping you with the original reason for gong on it (depression?)?

    Why is it that you can't take SSRIs?  What problems did you run into?

    I was on Effexor, went off too fast last year and was eventually put on mirt because I couldn't sleep or eat, but it pooped out on me very quickly at 37.5 mg, so my doc reinstated the Effexor and within an hour I felt dramatically better, a sure sign of dependency!  Combining mirt with Effexor is known as California Rocket Fuel in the psych profession, and supposedly the two together work better than each by itself.  My goal is to taper off both because I have been on ADs for nearly 20 years want to be done with them and deal with my emotional issues in a non-drug way.  The drugs simply muted my emotions and kept me from feeling, but tolerance allowed the original issues to persist, since drugs never fix those.  

    So, if you decide to go off mirt, spend some time in the mirt withdrawal section on this site.  It is NOT a pleasant one to get off of and you would be advised to do a very slow taper, ideally 10% reductions every 3-4 weeks.  Otherwise, withdrawal causes so much suffering that people end up reinstating.  You may find that on a lower dose your sleep will get better since it is more sedating at the lower dose.  If you taper too fast, though, sleep can be greatly impacted.

    If you are able to tolerate an SNRI, it could be added to the mirt since they seem to do well together.  However, your system may be getting sensitized to where you can't tolerate any of it and have  more side effects that are unacceptable.  People in this bind end up polydrugged, since docs don't seem to understand that withdrawal symptoms can be the same as the condition the drugs were to treat originally, and so they chase the symptoms with more drugs.  Each drug causes its own side effects which the doc then chases with yet another drug.  So, beware!  You do NOT want to go down that road!

    You could try Benedryl to aid sleep.  I have had good luck with taking a magnesium glycinate supplement, which helps anxiety and is calming.  Drinking milk at bedtime can help as well, though won't improve the pee'ing problem.  In general, I would try to cut drinking anything after perhaps 8 pm.

    Try taking mirt earlier in the evening on the days you don't have to drive to see how sedating it really is.  It may be that you could stay alert enough to drive even though taking it earlier.

     

    • evergreen
      evergreen betsy0603

      Posted

      Thanks, Betsy for your detailed and helpful reply. I will look up tolerance withdrawal and see if that is what I may be having. I have tried several SSRIs and they don't help my depression one bit, plus they leave me totally numb in the sex department, which is not good for my marriage. Mirtazapine really has been a wonder drug for me and so it would be a real shame if it is pooping out. The most important thing apart from lifting my depression was that it really helped me to sleep. It has also stopped my migraines, my constant itching and allergies and enabled me to eat normally. The only downside has been the weight issue. I have to work out every day as well as stick to a rigorous diet in order to keep my figure. And I also single handedly run a horse livery yard, the housework, dog walking, and be a taxi service for my sons. So it is really hard work. If the mirt is pooping out on me then it would not be worth all the work and depriving myself of food. I am seeing a new GP on Friday so will discuss my options with him. Like you, I really like temazepam as it has no side effects for me and doesn't leave me feeling hungover in the mornings. I also suffered no withdrawals when I cut it right down after starting mirtazapine despite being on it for over ten years. So I think for some people it is not so habit forming as for others.
    • Calmer
      Calmer evergreen

      Posted

      Just one thing ... look into the "depriving myself of food", as I am totally convinced there is a massive link to this and insomnia. Certainly is for me ... many times over I've come to this conclsion when trying to lose weight the sleep problems kick in.

      Not what any of us want to hear, but yeh ... sorry about thay Evergreen.

      x

    • evergreen
      evergreen Calmer

      Posted

      Yes, I agree that being hungry can cause insomnia. However, I have been dieting like this for ten months and a few weeks ago was going great guns with no alcohol, reduced calories, increased exercise and sleeping like a baby. Nothing at all has changed but all of a sudden this terrible insomnia hit me. I haave since started drinking a small amount of alcohol again, which helped at first, but now doesn't. If I'm honest, I'd love to be totally drug free, but doubt I will ever get there.
    • betsy0603
      betsy0603 evergreen

      Posted

      I was just reading on a forum last night that some people find inositol helpful for the insomnia, so perhaps something else to try.  One thread was about PSSD and another sleep.  For the PSSD, the person of course was not on the drug anymore and was taking 15 grams a day - whew!  For sleep, the person was taking more like 5 gm a day.  You would get the bulk powder, not capsules.  Just another thing to consider.

      I'm sorry these problems have come up for on on a med that otherwise was serving you the way you liked.  The sleep from mirt certainly is was a relief when I first went on it, given I was having horrible insomnia prior.  But it pooped out really fast on me, probably because I was still withdrawing from Effexor.  The sleep continued even though the depression and disinterest in life came back.

    • Calmer
      Calmer evergreen

      Posted

      Hi again evergreen,

      Before my "episode" of insomnia started last year, which lead to acute anxiety which lead to depression (get that out the way) I had been "fortunate" enough, through exercise and diet ... to lose19 lbs, felt on top of the world, kept it up for about 9 months or so ... then the insomnia hit.

      I can only think, for me, and something to ponder over for you maybe, that the foodstuffs that promote good sleep are the foodstuffs that are commonly avoided or certainly eaten in small amounts if trying to lose weight and working to keep the weight off .  Wholemeal bread, wholemeal cereals, brown rice, nuts, seeds, avacadoes, dried fruits, oily fish, the vitamin that everyone is talking about now as a aid sleep for us poor sufferers is Magnesium - Coincidence??  Going low of this over a long period I wonder what effect it has had, worth noting anyway.

      Had talks with Nutritionist who advised that Magnesium supplements are Trace metals (also known as trace elements) (such as magnesium or zinc)and are not generally classed as vitamins even though they can only be taken in from food (you cannot synthesise a metal).

      Interesting anyway.  

      A simple bowl of porridge just before bedtime helps, may well

      you through that wakeful time of 4 a.m. I think for some of us, sticking to the necessary 1700 calories or so to maintain a certain weight is detramental to a good nights sleep.  It's an age thing, I think it probably started around 55 for me, can't win.

      Best wishes

    • evergreen
      evergreen Calmer

      Posted

      Yes. Oh to be young again! I saw my GP today and he wants to investigate my heart and has orddered another 24 hour ECG and some blood tests. He says there is a heart condition which causes insomnia due to fast heartbeat and frequent urination. He wants to rule that out before blaming it on the mirt. He's reluctant to take me off it becuse it's been such a good drug for me.
    • evergreen
      evergreen

      Posted

      Please excuse my double letter typos. It's my keyboard being super sensitive.
    • betsy0603
      betsy0603 Calmer

      Posted

      I read somewhere that a carb snack at bedtime could help sleep, probably because carbs seem to up serotonin somehow...I know I get groggy after a pasta meal!
    • Calmer
      Calmer evergreen

      Posted

      Best to rule out heart problems, may well come back to being side effects of Mirt ... hope it's nothing serious for you.  If you need to WD me & Betsy have lots of advice and I put together a good plan !!

      Best wishes, do you know when the tests will be?

       

    • evergreen
      evergreen Calmer

      Posted

      Thanks. Blood tests will be next week plus a week for results. I am awaiting a call for the heart monitor.
    • betsy0603
      betsy0603 evergreen

      Posted

      I haven't taken temazapam, someone else, but a thought occurred to me: was there a change in the medication?  People have noted that a change to a different generic brand of mirt caused withdrawal symptoms, because the binders are different between the generic makers and that affects how the active ingredient is released.  If so, you would need to find out what one you were on and if you could get it elsewhere.  Pharmacies sometimes change the generic brands they carry.
    • evergreen
      evergreen betsy0603

      Posted

      Thanks. Yes I had wondered that. I currently have two different brand packs. I have experimented with both and there does not seem to be a pattern to it. I have kept a diary and written down everything I eat and drink, exercise, the lot. There iss no pattern. I can be sleeping like a baby for a few weeks and then suddenly, whilst feeling perfectly fine, just enter a spell of insomnia. It happened for a long period around 6 months ago and I really thought the ,irt had stopped working, but then I got over it and had a good few months sleeping well again. So strange.
    • Calmer
      Calmer evergreen

      Posted

      You may think I'm joking, absurd as this may sound to some, but have you checked the moon phases at all ... quite often on a full moon people have been known to have sleep difficulty - this of course would not explain a 6 month deteriation in sleep though.

      Avoid the drink though, I know you do mostly, but recent ... nothing worse for disturbed sleep than the drink, sadly just one and I'm all over the place tossing & turning - oh for youth !!!!

      Bestest to you x

    • evergreen
      evergreen Calmer

      Posted

      Good idea. I had heard of moon phases affecting sleep. I'll check. Thanks.
    • evergreen
      evergreen betsy0603

      Posted

      Have not heard of inositol. Will have to look it up. Thanks.
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