First Time On Mirtazapine 15mg

Hi Baz, first of all I am sorry to hear that you're going through such a hard time. I must admit that my own conditions tend to lean more towards the depression side than the anxiety side, so I can only imagine how tough it is for you. I'm by no means a GP and I know very little about the drug's effect on anxiety apart from my own experience with it, so I wouldn't like to offer any medical advice for those reasons. 

What I can share with you in more detail is that during the first few days my thoughts about suicide increased to the point where I was actually considering it (not the 'stand at the top of a building cry for help' sort of suicide but the 'quietly so no one will notice because I am not worth their time' type). This really scared me because I've never seriously considered it in that way before. 

I've read on a few other forums that the Mirt exacerbates your negative feelings for the first few days or weeks, and after that the positive effects start. I don't know if this also applies to feelings of anxiety. The way I rationalised the suicidal thoughts was that I viewed myself at the time as someone who wasn't me, if that makes sense. I tried to create some distance between this person who was thinking these suicidal thoughts, and the person inside that who was trying to heal and grow away from the endless cycle of bad thoughts. There's probably a term for that active separation and I'm not sure it's the 'right' way of doing things, but it's how I got through it.

By the sounds of it your biggest challenge if you do decide to go back on Mirt will be to overcome your fear of the potentially increased anxiety for the first few days, and actually allow the drug the time it needs to kick in fully and do it's thing.

I can't say that I fully understand what it's like to live in the grip of anxiety for a large part of your life but I do know this: at some point in your life you get so sick and tired of being depressed / anxious / suicidal that you know something has to change. For me it was recently just before I started the Mirt, I had never been so low in my whole life before. So if you're at that point now, you need to find the strength in you (or the people around you) to power through the fear and terror. You don't need to live your whole life as a slave to your thoughts and emotions (sorry if this sounds trite, it is meant sincerely).

Good luck to you Baz, let us know how you get on.

Dear Lynn, thank you for taking the time to reply and for your kind words. I didn't spot any typos so if there are any, I think your secret is safe on this forum

I wish there was something I could do to help you because your situation sounds so overwhelming. All I can think of saying is that I really do hope things get better for you and that you manage to find a way to break the cycle. 

I will write a separate post in about 2 weeks' time giving an update on the Mirtazapine 30mg.

Until then, take care of yourself as best as you are able at the moment. As a registered nurse you must have given so many people comfort and reassurance in your lifetime, isn't it only fair to treat yourself as gently as you did them?

Sorry Lynn, just saw your reply now. 

It's funny how many people take good sleep for granted, isn't it? I think it's only once you've been deprived of good sleep for months or years at a time that you would give almost anything for a restful night's sleep. I'm glad to hear you're having good sleep and I hope that in time, this will contribute positively towards your own healing (apologies if that sounds a bit left-wing but I am also referring to the physical healing which takes place during sleep). 

As you say, there are always dips and if you are aware of them, it helps you to deal with them as and when they come. At the same time, I wouldn't wish a dip which has been going on for months on my worst enemy so I'm sorry to hear that that is where you are now. I won't patronise you with empty platitudes along the lines of 'why don't you look on the bright side of life instead' as I'm sure you've heard / read it a million times before and all it does is make you feel guilty that you're not able to share in the joy that other people seem to have in such abundance. All I can say is that I really hope the better quality of sleep will help this for you.

With regards to weight gain, I've put on a good stone and a half but that is partially because I started taking Mirt just before December and I work in an office which has a thriving 'cake culture'. As you can imagine, during the month of December it was pretty much cake-topia in there! There were many days that I opted to eat donuts and biscuits instead of the healthy lunch I had packed for myself, so it's no mystery to me where the extra pounds came from.

It might be worth noting at this point that I come from a family where almost all the women are overweight or obese so I'm relatively familiar with the mindset that goes along with it. This is going to be an unpopular view I know, but I still maintain that no matter how large your appetite, you and you alone are responsible for what you eat. I have seen too many instances of people not taking responsibility for their consumption, and in a way I can understand it because there is that predisposition towards depression which usually means lack of sleep which usually means your body is craving quick-release foods high in carbs and sugar, which means extra weight which means you're drowsy again now from all the sugar crashes and pounds you're piling on. It is a nasty habit to have to break but quite honestly, that is what you need to do if you want to have any hope at all of improving.

I was actually pondering this specific point this morning because all too often I read threads about mental health where the sole focus is which meds you are taking and if you are seeing a psych or not. I find this quite baffling because the brain is another organ and yet we don't seem to want to connect the impact of our diets to the damage we are causing it. If someone has a heart disease or diabetes or a bad liver, they would take medication for sure but they would also be careful of what they eat. And yet there are very few threads that I've come across which talk about the meds used for mental illness plus the foods / drinks consumed at the same time. You are changing your brain chemistry with these drugs but no one talks about breaking bad food habits which have accumulated over a lifetime – why aren’t we talking about this more?

To me the two are intrinsically linked and the more I think about it like that, the less I can justify to myself choosing to eat something which has no nutritional value over something which actually nourishes me. I am munching on some baby cucumbers (so cute!)  as I type this, and the rest of my lunchbox for today looks similar (apart from a few small ‘naughty’ things like dark chocolate buttons topped with trail mix on top which I made last night with my new-found level energy J). There are so many resources online these days showing quick and easy recipes or snack ideas for food which is good for you but still tastes nice – it’s just a case of re-educating yourself about food in a way I guess.

In short, I fully intend to fit back into my original wardrobe but I’m not going on some crazy detox or exercising myself to death over it. There is no quick fix and all things taken into consideration, it’s going to come down to your own willpower over your cravings. I am sorry I can’t give more constructive advice on this point but for me there really is no other way to beat the cravings other than to simply not give in to them, or make sure I have things like carrots and baby cucumbers lying around at all times to keep my mouth busy. You’re just going to have to stay strong J

As for being able to articulate my thoughts and emotions – I won’t tell you how many times I’ve deleted and re-written each paragraph

Keep me posted on your progress and good luck in the meantime!

I think you are so accurate I've spent my time not going out much as you know researching the effects of anticholinergic drugs long term effects.

Thankfully mirtazapine isn't really bad, however some like amitriptyline and the likes of Piriton are number 3. They are classed as 1, 2 and 3 in the anticholinergic burden scale and are considered to have detrimental effect on the brain long term ie predisposed to dementia so its called the 'ABC anticholinergic burden'. So if people are prescribed several from number 3 list its not great.

I once self referred myself to the local community mental health team as my depression became worse, just last year. I've spent 30 years in the NHS, teaching student nurses and newly qualified and distance learning tutor. I saw a young nurse who stopped all my medication as I was prescribed Tramadol for osteoarthritis, saying I had serotonin syndrome.

I told her it was extremely rare and think she needed to research the anticholinergic burden.

I quickly had the dark thoughts you eloquently described and thankfully my GP put me back onto the antidepressants and I sent a complaint and lots of printed academic evidence advising her to research and enhance her knowledge and reflect on this lol.

It took a lot of courage to go as I'd taught many of the staff there. Needless to say I won't return.

I struggle with the eating and have put on lots of weight however I'm a great believer in sleep healing the body too, that why I find mirtazapine great for sleep. I might go up to 30mg but I'll wait for your update.

X

First took Mirtazapine last night. My doctor prescribed 30mg which is strange as everyone here seems to be starting on 15mg. I had the same side effect. Restless legs. I was tossing and turning for about an hour. My sciatica was really intense. Anyway I eventually got to sleep and slept quite well. Woke up this morning feeling really groggy. I will stick with it and hopefully get used to it.