First Time On Mirtazapine 15mg

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Hi all,

I've seen a lot of reviews online about this drug and thought I'd add my own two pennies' worth as the other reviews were tremendously helpful when I was researching the side effects of Mirt.

So first of all - My conditions:

1. I seem to have inherited the genetic predisposition towards depression from my mom's side of the family, and the anxiety from my dad's (thanks guys wink ) So on most days I am overwhelmed by feelings of inadequacy, lack of self worth, low mood, etc, to which some would reply: 'hey, welcome to the human race', I guess. Pair this up with anger and guilt at being who you are and you have the perfect cocktail for someone who diplomatic people would describe as 'fiery'. (My family has a different word for me and it rhymes with 'itch'!). 

2. I have the usual constant flurry of mental 'traffic' associated with anxiety: endless to-do lists of things I need to do around the house or at work or in my personal life,  over-analysing every conversation I've ever had in my entire life over and over again, finding my jaw clenched from gritting my teeth from the frustration of it all and the inability to get anything done because I am constantly distracted by things which have happened (or might still happen!).

3. I also have a form of insomnia which means that although I do fall asleep very quickly, I struggle to maintain the healthy deep sleep which you need for emotional replenishment. Nightmares are the norm as is waking up randomly at 3am or 4am and not being able to sleep again. Get up in the mornings feeling more tired than when you went to sleep. This didn't help the feelings of agitation and aggression at all.

4. On a side note, I also got migraines sometimes caused by eating rich foods or drinking or high levels of stress, but also from an old motorbike injury where I sustained some deep tissue damage to my left shoulder. The muscles along there and the neck tense up when I am stressed, which was always because I wasn't sleeping and I felt like an awful human being.

Starting the Mirtazapine:

I started on the 15mg Mirtazapine. I took it the Friday evening and was completely emotionally detached for the whole weekend thereafter. I was distant and felt fuzzy, but strangely happy at the same time. I remember thinking that everyone should be taking this stuff because there would be a lot less fighting in the world. 

By Monday I started 'feeling' again, and with that snap back to reality, I had quite an unwelcome passenger - a new ravenous appetite which I have never experienced before. As a healthy and active size 12, I was no stranger to my appetite but this was just a new level of crazy hungry. Well, not even hungry really, just greedy. I started pulling boxes of biscuits and cereal and oats which had been sitting in the cupboard for months, and devoured a lot in one sitting, a lot of times.  I remember feeling quite healthy in a way because an appetite meant I had a lust for life, right? 

If only the hunger wasn't paired with severe feelings of suicide and self-harm! Luckily I was able to rationalise these feelings as the side-effects as the medication and within a few days the feelings subsided.

The sleepiness started a few days after the appetite and initially I just put this down to bad eating but after a while I could not ignore it. People use the word 'drowsy' to describe how sleepy you get but that doesn't cut it. I was finding it almost impossible to wake up in the mornings, even after a shower and a brisk walk in the cold to get the circulation going. It took a good 2-3 hours before I could have an understandable conversation with anyone (through mouthfuls of snacks of course!). 

During my new sleeping pattern of sleeping for 11-12 hours solid (missing alarm clocks, my partner getting ready for the work, the dogs barking to be let out) I had some pretty vivid and intense dreams. No nightmares though so that suited me fine as the alternative was much more unpleasant.

1 month later…

So here we are, a month on, and I’ve noticed a few other changes. My energy levels are a bit like a steam train - difficult and slow to get going, but once I'm awake, I don't need to nap like I used to do most days, and my energy actually feels pretty level from waking up to going to sleep. So that's a massive plus for somenoe like me who's energy fluctuates with my emotions and moods.

I did get a fair bit of dry mouth from the meds but I just made sure I always had a bottle of water with me at all times and it just helped with keeping me hydrated so that's not a bad point as such.

Because I am sleeping well and feeling better, my shoulder isn't tensing up as much so I'm not getting migraines, which is great. 

Interestingly enough, because I am no longer living in my own negative emotions all the time, I am better able to identify the people around me who have actually had a negative effect on me all my life through projecting their own issues on to me. I've actively been avoiding these people and the further away I get from them, the more I see how bad their presence in my life was. (Be aware that this realisation may make you come across as 'cold' or 'distant' to the energy vampires who have been feeding off you for years. Don't be afraid to let go of these people - you don't need them!)

So, to summarise:


Better energy levels once awake

Better quality of sleep

Muscles more relaxed as not as stressed out

Not as agitated or aggressive towards people around me

Higher productivity due to ability to focus on one thing at a time (less mental 'white noise'wink

Better able to deal with issues as don't feel completely overwhelmed

Courage to break ties with energy leeches


Waking up in the mornings is like trying to play water polo in a swimming pool filled with treacle

Both Pro and Con (depending on how you look at it):

Slight emotional distance - probably not noticeable to those who aren't close to you (and those close to you know that this is still better than having an unhappy, raging hell-demon as their friend / partner / colleague!). For me this has had the unexpected side-effect of becoming more logical in my approach to problem-solving, which, as a highly sensitive person, has been a welcome break from alway having to base my arguments or thoughts on feelings (which were often irrational and a knee-jerk response to a situation which I later regretted).  

All in all, I feel better than I have done in years. I think I have covered most of the points and hope that some of it is useful to anyone out there considering starting on this anti-depressant. Feel free to post a reply in this discussion and if you have any questions I can help with, I will happily answer.

I would recommend keeping a journal of how you're feeling so you can review it if needs be. It is also a useful tool for seeing how and by how much you've changed so you are able to manage these changes and not scare the living bejesus out of those around you smile

Keep on keeping on, fellow sufferers.


P.s. I am now 10 days in to the 30mg.  I will write another post for the 30mg if anyone would like to know more about that.

 P.p.s. whoops I accidentally a book, my apologies!

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29 Replies

  • Posted

    Hi, I have suffered  with O.C.D. / Depression/ Anxiety, for more years than i care to remember, i have tried a load of Meds. but i seem to be unable to

    ​tolerate the side effects. I visited my GP early last year and was prescribed

    ​Mirtazapine 15mg, as the obsessive thoughts were interfering with my sleep, as you have said, they certainly knock you out, i did not want to get out of bed, and was eating like a horse. I did feel more relaxed for the first few days, but the longer i took them the worse the anxiety got, and it got to the point were i thought i was going crazy, having tried a couple of times with Mirt. i always get the same response, and i end up stopping the medication because of the increased anxiety, i think the longest i have taken this drug in one session is about 2 weeks, i know this is not long enough, did your anxiety increase after the first couple of days?, at the moment i am considering giving them another try but i am teriffied of the side effects. Have you any usefull advice to give me please.

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    • Posted

      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.

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  • Posted

    Wow, what a great writer and fan description that mirrors a lot of us out here. I've really enjoyed reading this as I'm on sertraline 150 and buy mirtazapine myself and up to 22.5mg purely to sleep.

    I would love to know how you progress on the 30mg, I've tried it and had nightmares and already obese and the appetite was horrendous.

    I'm quite submissive however relate to over analysis of ensuring and every conversation and sadly now quite agoraphobic, even not motivated with self care. I am a registered nurse and can't believe the mess I'm in and hope that this year improves for me but several physical health conditions have contributed to my low mood. I'm practically unable to walk from arthritis and chronic severe asthma getting the better of me.

    I've kind of backed of answering but felt compelled to answer this as I could really relate to it.

    Keep us informed, good luck and the best of wishes for this year.


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  • Posted

    Sorry some typos in my post. I also understand the increased anxiety of the second post from Baz and I'm on Pregabalin too and would love to reduce them but feel desperate for sleep each night.

    I've bought the sleeping tablets over the years but find mirtazapine the best but also worst for appetite and sedation combined with Pregabalin horrendous.

    Anyway wait for second installment on 30mg. Good luck to both Annie and Baz.

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    • Posted

      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 smile

      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?

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  • Posted

    Annie I have just read your reply to Baz and totally agree. I'm using it for depression and sleep. I can't say I have seen the great results with the combination of sertraline and mirtazapine but sleep is very good.

    I've felt like you and worked as an RMN for 30years in the NHS. I applaud your response and how you manage your condition and the improvement and as you are aware there are always the dips which I'm currently in for months.

    I wondered if you'd gained weight and if you had how you managed that. I feel you express yourself and thoughts and emotions so well which I don't have that ability. It's 'oh I feel really down' so admire your ability to express yourself and each step of depression as I think most people have similar thoughts.

    Great posts, thanks.

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    • Posted

      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 wink

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

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    • Posted

      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.


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  • Posted

    Hi Awesome Annie.

    Everything you've said makes so much sense to me....I've had so many friends say distance yourself from these people...the ones that feed off of your vulnerability and low self esteem.

    I'm just 'coming down' with side effects off going from 150...straight down to 50mgs Sertraline...under Doctors advise and monitoring. I'm signed off of work. 


    I have always had issues sleeping and added to the depression is not the best thing to suffer with. I was given a 2 week dose of was very hit and miss. So I have just been prescribed 15mg Mirtazapine today...

    The Dr did say about the increase in hunger...if that lasts too long...I'll have to go back and see him...I've never been a small size usually between 12-14 dress size...but with this recent relapse of symptoms...I'll ever already been comfort eating....partly for comfort...and because of still being awake at 02:00 get peckish...start picking at food. I'm now just getting into size 14 but had to buy some size 16 jeans the other day...huge low esteem moment ever! At least my pets don't judge me? Or maybe it's just me assuming what others may think of a bar of chocolate gets hidden under the oversized fabric in the trolley?! 😉 

    Anyway...just wanted to say hi to everyone on this forum as I will be taking my first tablet tonight.

    If anyone can help with advise about anything with depression, anxieties, low self-esteem and insomnia I'd love to hear other peoples experiences etc...

    Just finally...Awesome Annie...your post on here is so clearly written...I don't usually comment on these types of websites...but somehow your page popped up on my screen and I felt compelled to say how fab it is and made a lot of sense... probably unlike mine lol...

    Please continue writing your 'book'...

    Thanks to Annie and everyone else suffering...

    Try to keep strong...!?

    Best Wishes...Bern

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  • Posted

    Thank you for taking so much time to share your experience of Mirtazapine.  After suffering with depression for many years I have finally agreed to seek help. I am into my third day of 15mg of Mirtazapine and feeling very different.   I was about to give up when I found your discussion and now I feel totally elated.  Over the last few days I have experienced nearly every side-effect you refer to, especially the morning Water Polo/treacle feeling.

    However, now I am determined to give this medication at least a month because I am not so afraid and alone with this drug.    My family also want to say a big thank you Annie smile

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  • Posted

    Hi yesterday I was prescribed Mirtazapin after seeing my doctor about lack of sleep. I received very sad news on Friday that my mum has terminal cancer. All I felt was sheer panic. Hardly about to function for 4 days.

    Decided to see my doctor to increase my citalopram dosage (anti depressant) and get help for sleep.

    He prescribed Mirtazapin as I said which I was puzzled about as it is also an anti depressant.

    Anyway I took the first one last night. Within half an hour complete drowsiness happened. Legs were like lead weights.

    So off to bed I went. Then the strangest thing happened. My legs became really restless like my body was shaking out all the tension and sadness. It was uncomfortable in all honesty.

    I eventually did allow myself to fall asleep without waking myself up shaking my legs.

    Anyone else get this strange sensation. Starts in the back and moves down the legs?

    I'll try again tonight and see what happens. Good luck everyone

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    • Posted

      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.

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  • Posted

    I have just been put onto these tablets for depression and to help me sleep i have valid reasons for being depressed i.m not clinically depressed threw domestic violence and an auto ommune disorxer i have been left with a damage to my spine! The discs in my neck are all damaged and they want to fuse my neck restricting movement but at present i have already developed permenant nerve damage i have oesteoarthirtus and cannot cope with the cold i also lost have of my face my upper mandella having no bone in my face and i loose very painful tooth holding that denture in my prognosis is surgery is less than 50% successfull and many risks i have been told yes no yes no to the needed operation on my face i can barely eat and it has age my face considerably and tell me i.m not worth the exoense of bonegratfing and inplants the only solution to my problem ! So obviously i am depressed by what has haooened anf the recusal and insukts from meical consultants who could fix my face but tell me "i am not worth the expense " that in itself made me depressed and this has been going on for 4yrs promises cancelling promises my life on hold my life in limbo and no prostests of any operations to fix a deformy created after a bone graft done privately ! Dentist wasnt given a slap on the wtist i lost 20k and have my upper face i can only see these tablets masking a depression which is being caused by lack of medical care ! I dont want to sleep n eat all thr time or take anti depressants to madk a n awful reality shudnt the emphasid br on fixing my pine neck n face which is causing the deptession ? Any comments wud be helpul

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