dosage of mirtazapine.

Thank you for your reply, I wish you all the best. take care.  chinney

 

Hi Si

You're right, you have slight withdrawal, 5mg to taking half of that for a 'few days' and stopping, is quite a lot for you to do all at once really, it obviously was too quick for you.  Are you sleeping OK, any nausea?

There are 2 options ride it out and see how you go, but if it's too much, anxiety too great, I would definately take a little step back if I were you.  

Did you say you've only been on 5 mg in total???  How did you take that as the tablets are only 15, 30, 45 mg?  Just wondering, unless you can get the 5mg where you are ??

Taking a little step back is a good idea for some if it gets too much, go back to the 5 mg, and ~WAIT~ you will settle back into this, it may take a few days, and only then do a very slow taper ... I can help if you want to work out a slow plan.

I'm interested in the 5 mg - wish we could get them, would be so much easier to taper.

Wishing you well.    Keep posting, stay with us, the anx' is horrid, but you'll be ok soon.

Hi Calmer,

Thank ou for your reply.  Sorry my mistake I was on 15mg its the Diazepam thats i'm on thats 5mg.  I was only on Matrazapine for about 5 weeks before I got fed up of feeling anxious all day.  I found cutting the dose in half reduced these feeling but after a few days they came back so I stopped altogether and felt great for a few days but now the anx is back and I'm combatting it with Diazepam.

I originally went to the docs suffering stress in my chest and no energy.  After six months of getting no where with the doc I asked if he could give me something the week before I went on holiday to pick me up a bit.  He gave me Sertraline.  4 days into that I had a panic attack in the middle of the night.  Id never had one before.  I wanted to stop taking the Sertraline but my wife whos on it for anx said keep taking it.  It was a few days before I was going on holiday and I really felt like I couldn't go.  I had visions of me freaking out on the plane and not being able to get in the taxi and loads of other negative thoughts that I'd never had before.  I also had a song from 1989 going over and over in my head that was driving me crazy.  My wife was in a right state by now thinking we had wasted a load of money on a holiday we wasnt going to go on.  I had to man up and knew if I stayed awake I wouldn't wake up having a panic attack and I had one Diazepam left to get me on the plane.  I stayed awake for 3 days and managed to get to the hotel in Las Vegas.  I told myself I'm here now and alls well and went to bed.  I woke in the early hours in a right state so I went to ask the hotel if they had a doctor which they didnt so I flipped out on the casino floor and ended up on a green 72 in a mental hospital.  What ever they gave me there was great as all I wanted to do was sleep and not care.  They eventually let me out into my wifes care and on Diazepam.  When we got home after a ruined holiday I saw my doc straight away and he put me on Amitriptyline which within two days gave me some gind of a seizure.  Back at the docs they said I was obviously have a bad reaction to the SSRI drug family and put me on mirtazapine.  I stopped having the panic attacks but was anxious all day.  So after 4 weeks the doc doubled my dose.  One in a morning and one at night.  The shrink wanted to put me on Vebladex XL 75mg but I had to have tests first as it could effect my heart problem.  When I was given the all clear I tried it, i should have given it two days off then mirtazapine before I took the Venladex but I was in such a state that afternoon after seeing the doc I took one then to see if it would calm me down.  It made me sleep then I woke up have trouble breathing and in a panic.  The docs is only a few mins walk so I managed to get round there and get help.  Thats when I decided to stop the meds so I cut the mirtazapine down to half a 15mg tablet.  I did feel great for a few days but four days later i'm anx again and taking Diazipam.

Surely after only being on the mirtazapine for 5 weeks I stand a good chance of having only small withdrawal symptoms that I can ride out?

I never had a panic attack before taking these drugs so I hope I can never have another one as I beleive they are what brought them on along with the suicidal thoughts and racing mind.  I just want to be better and drug free.

Forgot to mention yes I'm not sleeping much now but don't feel tired. and yes I feel sick every morning and sometimes into afternoon.

Si

Have suffered very similar anxiety to you - panick attacks at night, dreading going and being  on holiday, palpitations, feeling faint, sweating etc. I thought I could pull through myself - I hate taking drugs - but after months and months of trying I realised I could not manage anxiety on my own ! After one panic attack nearly fainting, sweat dripping off me amongst a  group of friends who called an ambulance, I ended up at a&e who gave me diazepam. What a wonderful drug for my symptoms and for sleeping but my doc would only give me 2 weeks supply. Coming off them was hell. Started mirtrazine a couple of weeks ago  and the intial  side effects were awful but my anxiety I hope  is becoming manageable. So I'm sure you should discuss the best medication with your doc - don't become reliant on diazepam.

So you want to be better and drug free. Don't we all.

I think you are doing the wrong thing getting off the drugs.  You sound as if you need their help!   Your problem was expecting the Sertraline to act fast.  It does not!  Your doctor should know that!   It takes many weeks and you are likely to get worse before you get better - as you found on your holiday.   A bad experience  after a few weeks does NOT indicate that  "you obviously have a bad reaction to the SSRI drug family".    

Your case is similar to mine - and Sertraline (for anxiety) plus Mirtazapine (for sleep) has given me my life back.

Life is not black and white - there are shades of grey (= gray).  

 

I was fine before I went on medication I just suffred chest pains and no energy.  Give me that over anx anyday.  Thats why I'm giving up the drugs.

But I hear what you are saying.

I was fine before I went on medication I just suffred chest pains and no energy.  Give me that over anx anyday.  Diazepam is the only drug that I get on with and don't have any problem taking.  The docs oroginally only gave me 6 tablets at a time but on my last visit i convinced them to give me 28 to see me through.

I am surprised you were put on mirt for chest pains and no energy!

I hope you are right. Best wishes.

 

Hope things go well for you - best wishes !

 

Quite a series of mine fields you've crossed there Si; I can empathise going on holiday when already suffering with stress, the holiday just made matters 10 x worse for you didn't it.

So you're saying that the start up of Mirt' gave you anxiety all day?  OR do you think that your original symptoms "stress & tight chest" increased to anxiety ... maybe?  

The song in your head, over & over again is a coping mechanism, quite a few people have this, it's actually calming you down, but you'd be better learning some other calming techniques through CBT - Cognitive Behaviour Therapy - it's not scarey, NHS waiting list a bit too long, go private if you can afford, find a therapist in your area who is B A B C P accredited - google it.  You could read up on CBT too, I think its helped me very much.  

Thinking or your original Stress, many people in the work place suffer years of stress which eventually wears them down, the "no energy" you mentioned.  Your sleep probably suffered too.  Diazapam is addictive too, but I guess you can't worry too much about that right now, first things first.  

I still say, with this withdrawal - anxiety, nausea, insomnia, you might be best to take Mirt again, and let us help with a slow plan off once settled - if you feel better about it, go back on at 12.5 mg ...... that's half a tablet + a quarter - you can buy a pill cutter in good chemists.  Take the dose an hour before bedtime, it should help you settle, Mirt is not an SSRI, it does make you have bizarre dreams but they're quite nice in a way!   Or maybe thats just my opinion.  Discuss it with your doctor, I understand you can take Diazapam with it.

If the nausea continues, ask the chemist for an anti nausea med too, no point in suffering that way, it'll only make the anxiety worse if you're going without food.

Wishing you well, hope your symptoms improve soon.

Calmer

I think your comments are spot on and very perceptive with great advice. I recognise now that the years of stress eventually took it's toll on me and it was a slippery slope once the panic attacks started. I recognised fairly quickly that I shouldn't rely on diazepam to cope and although it's early days on mirt I feel it is helping me turn the corner.

Hi Calmer,

Great advice thank you.  Yes I am saying going on Mirt gives me anx all day. Before that I was fine just stressed.  I have a customer whos a hypnoterapist, well hes done a weeks course and is now practicing and he had a session with me about a month before I had my first panic attack.  It did help but I cant help but wonder if it also caused a problem so I wont try it again.  He just put me under and told my subconcions (sorry bad spelling) that I wasn't dealing with stress very well and to try another way.

I'm self employed and my stress started when my sister messed up my bookkeeping and I was late for VAT registration and now I am VAT registered its causing more stress.  I have made changes though to reduce the stress.  I thought going on holiday and closing the business down for two weeks would help, but I guess not.  Problem now is I have a great job offer in Las Vegas and I want to be well enough to take up this job.  At the moment I don't think I am.  They want me to start in two months time.  So I see it as having two months to get better.  I saw a shrink on the NHS last week.  He didn;t want to talk about my medication problems he just told me to try a new drug Trazodone after the pronblem I had with Venladex.  I just think I was fine before I took any antidepresant so I will be better off them now.

If the Mirt had been working I would stay on it and work out a plan to get me off it.  It did make me feel happier and I had stopped crying over nothing at all.  Thats now come back now I have stopped taking Mirt.  But I just felt anx all day and when I wasn't anxious I was waiting to be anxious.  I'm writing this reply early morning because I now have to get up straight away as laying in bed just gets my mind racing and I get scared.  So I sit at my PC and take my mind into other places on screen.

The songs going round in my head are not as bad and they atleast change from day to day but the first time it happened is what was driving me mad.  They are not even songs I like!

Thank you in advance.

Drugs I have been on in the last 3 months:

Sertraline

Amitriptyline

Mirtrazapine

Venladex

Valium

Hi Si

Hope you're having a good day today.  You have a lot to consider, that good old saying "Feel the Dear & do it Anyway" could fit your present dilemma  

I suppose you will simply have to see how you are over the next few weeks.  How many days is it now since you stopped the Mirt' ??

I found myself unable to sleep last night, I turned to a simple meditation whilst lying there, it usually works well for me, but I have had to 'practice'  - it isn't something you can call upon when crisis hits.  Every day if poss, 10 to 20 minutes - twice a day.  Could you maybe try this?

There are many 'guided' mediations on the internet, it is so easy and simple to maybe use ear plugs either on lap top or preferably a hand held device (mobile phones only if its not likely to ring/text etc)!.

 

Hi Calmer

It will be a week tomorrow since I took my last one. I'm actually sleeping better off the mirt but when I wake up properly thats it I have to get up or a lay there anxious.  My wife was out last night at her xmas party, I had a late night for me 11pm and woke again about 2 and struggled with my mind and getting back to sleep.  I eventually did and woke again at 5.30 when I got up.  The Mirt never made me sleepy just anxious all the time. Yesterday I started punching myself to get the adrenaline pumping when I felt anx and it helped.

The big problem I'm having at the moment is the hot sweats in bed which is how my attacks started.  I do what I've been told to do by the doc and just let it happen and don't fit it and it passes quickly.  I just need to stay occupied at tire myself out and be around other people.  The valium is a big temptatin which I battle with everyday.  I need it there just in case, but it really is a last resort.

How are you today?

You sound like you're doing ok for someone who just 'stopped' Mirt', but be aware that sometimes it hits hard at around 2 weeks ~ sorry to say that but just be prepared with the Valium, if need be that is.  

Yes it's good to do CV exercise, run/cross trainer, anything to burn off the adreneline that the anx' creates, or even power walk through your local park really (in the rain !!! here lately).

There's the thing with Mirt' - if you miss your usual bedtime the sleep pattern gets blown, the sweats are common WD too, getting overheating in bed is really bad as then you are unable to sleep anyway, window open maybe??  Don't confuse the wd thinking your original symptoms are returning, it's the Mirt' not you.

A wise friend said to me to stay with the anxiety, feel it in and around you letting it happen, don't let it control you to a point where you are literally rushing around like a loon trying to shake it off because it just gets worse... relaxation towards the end of the day is key for better sleep, no keyboard, no blue light of Kindle or gaming.  Yes, fear of being alone/needing to be around others is common too.  Avoid alcohol, it'll just worsen things.  

We have a private facebook forum for people struggling with or coming off Mirt, I don't know if you would be interested.  There are about 25 of us, it's strictly confidential, "secret group", you can't search for it and find it, you have to be invited.  It was set up about 6 months ago by a lady called Rose from this forum ~ it's really informative and lots of good advice, have a think, let me know. 

Anxiety is a terrible thing to have to live with, if we can l;earn to avoid the triggers that build up within us when we are well, we are half way there.

I'm OK ta, have a few drinks withh friends and curry last night, hence the bad nights' sleep, but tonight will be better, and so I am not worrying.  Hope you sleep better too Si.

Hi Calmer

Your replies on this forum have been so helpful and constructive. Would appreciate your or other comment on my struggle with anxiety. Doc put me on Mirt a month ago - anxiety and insomnia were my problem - but he thought I was depressed as well. Struggled with feeling like a zombie for a few days after starting  then I thought it began to help and I was getting some sleep and calmer! but since the new year insomnia and severe anxiety has returned. Saw the Doc this morning - he wants me to continue with Mirt and has now given me diazepam 2mg 3x/day. I've lost all confidence in Mirt but Doc says I,ve not given it enough time. Has anyone on the forum experienced anything similar where Mirt appears to have stopped working (or making anxiety worse) or is it normal when taking Mirt to have periods of anxiety and sleeplessnes followed by calmer normality ? Would appreciate any comments. 

I know this is directed at Calmer, but I just wanted to tell you my experience. Mirtazapine 15mg really helped me to start with but very quickly my anxiety and depression returned. The doctor upped my dose to 30mg and then all was well again for almost four years. It then stopped working again. I didn't want to up my dose again and so I'm now tapering off the mirt. What dose are you on? It may just need increasing. I would be reluctant to use diazepam before trying a change of dosage of the mirt. The fact that you responded well to start with but then it pooped out, seems to indicate that an increase in dose is probably what you need. Mirtazapine tends to work very quickly, unlike other ADs and so it is unlikely that you just need to wait longer.

Really appreciate your reply. Am on 15mg for stress, anxiety and insomnia - Doc thought this was the best dose for this as am not really  depressed but will review in a weeks time but to take diazepam when anxiety is unbearable.  Am well aware of the problems with diazepam but coming off Mirt seems almost as difficult. Had not realised before coming on this wonderful forum how variable everyone is in their response to ADs

Hi Only, and thank you for your heart warming post.

Evergreen and I are a prime example of how 15mg can work for some and not others - I have been on 15mg for over a year and Evergreen got on a lot better with the 30mg.  Are you taking 15mg ??  Like yourself my problem was firstly Insomnia which was soon followed by anxiety, because sleep deprevation can cause anxiety, in most.  

15mg Mirt' worked immediately for me; it contains a slow release sedative at the 15mg dose which lasts pretty much all day (for me, some say it wears off during the afternoon).  However, I am now at 7.5 mg as I am tapering off, and I'm finding that even more sedating (there is a scientific explanation which is far beyond my understanding.  

The 15mg works on a different level, it is more for anxiety and insomnia, whereas the 30 mg works better for depression.  You may already know this.  

Now lets see what dose you're on now, 15mg can afterall have side effects of anxiety also, its on that scarey leaflet inside the packet - drug manufacturers have to put every possible/fraction of a chance of side effects, it's the law, doesn't mean it will happen to you or I !!

You say "since the New Year your symptoms have returned" - has there been any change in circumstances that could have done this for you I wonder.

x

Calmer - your so helpful and perceptive - really appreciate it amid the turmoil I'm in. (you would make a much better GP than mine!) Yes your right I guess my 'relapse' is because of meeting people and new stresses this week !. Yes am taking 15mg 1hr before bed but the last few nights just as I,m dropping off, I awake alert and anxious which however much I try and relax (breathing,tapes,etc) I can't sleep. This despite no coffee,tea,chocolate, using laptop - doing all the right sleepy things but my adrenaline keeps pumping.

(you've chosen the right name - just replying has calmed me down. Thank you so much)

Does Mirt' not make you feel sedated any more?  

That thing you have there "just dropping off and I awake alert and anxious" - do you think these are negative sleep thoughts that are affecting you? I have been reading around Insomnia and negative unhelpful thoughts - this is one of the biggest triggers of Insomnia !!! Someone on this forum wrote of a paradoxical technique you can use/teach yourself (it was on this forum this morning), I've found it, this could well help you: credit to Davill who posted it earlier.

If you can't sleep, have a serious talk with yourself. Convince yourself that you must not, on any account, go to sleep. Tell yourself that you must stay awake. Nine times out of ten, this paradoxical intent would see me waking to the alarm as usual.  GREAT DIFFUSER !

The worst thing for insomnia are the nagging thoughts in our head telling us that if we don't get to sleep we will be in trouble the next day, thus making our pulses race and then the adrenalin kicks in too, and the silly thing is ... we bring it on ourselves (I've done this, you're not alone).

Have a little think, there's a book on this I can recommend "Say Goodnight To Insomnia" by Dr Greg Jacobs.

x

Anxiety better today thanks ! You're absolutely  spot on again -a problem is negative sleep thoughts and yes the thought that not sleeping will create problems in getting me through the next day. Thanks for your suggestions - very helpful as usual !

I like to "be present"  In the moment, as it were.  Sometimes just knowing someone else understands helps doesn't it.  Practice some relaxation if and when you can, a little each day, simple meditation is all you need, or if that doesn't float your boat, just sitting on a chair, eyes closed, listening to calming music for 10-20 minutes, concentrating on your breathing, nothing more.

x

Dear Calmer  ' Sometimes just knowing someone else understands helps doesn't it' - these few words you wrote mean a lot !  Thank goodness I found this forum - it has been so valuable to me knowing I'm not alone ! Living in the moment - have just bought Mark Williams book on mindfulness -finding peace in a frantic world. Just reading a few lines has made me realise how I need to change - I kept running but realise now I can't hide from my problems. Despite the hell of this anxiety/depression I now am trying to think positively that perhaps I needed this to illness to change how I live. Thanks again for all your help  

Have you stayed off the mirtazapine and if so did you manage it by slowly dropping after 7.5?