For GAD?

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I’m about to start mirtazepine for GAD/ depression/OCD. I’ve tried several ssris, cbt, meditation, hypnosis and therapy. I’m now on pregabolin which has helped a bit but I’m still not well. I now can’t try any other ssris because I’m on pregablin (was not told this when I started) so gp given me the option of Mirtazapine.

I’m a bit unsure on how this works because it looks like it helps a lot with sleep which in turn helps with anxiety but I don’t really have an issue with sleep anymore since starting pregabolin. So will it do anything else for me? I’m feeling a bit like I’ve lost all hope of finding something that helps. 


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  • Posted

    Hi Lara , ive been on Mirtazipine for few yrs for Major Depression and it works for me. Hope it works for you. Lloyd from Oz
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  • Posted

    Hi Lara

    That’s unfortunate you have had to cycle through so many options so far but great you are having some success now.

    Given the number of medications you have tried and the complexities associated with using multiple medications at any one time, I would recommend consulting a psychiatrist who has more in-depth knowledge about poly pharmacy.

    It could also be worth seeing a natural therapist regarding supplements. Seeing you have had some success with pregablin you might find that coupling this with supplements and exercise might make a substantial difference. E.g. vitamins B12, D, iron and magnesium.

    I took mirtazapine for 18months, low dose 15mg then less and less. It has been incredibly difficult to come off and I would only use this medication as a last resort. It happened to be the second one I tried, in hindsight I would have sought other options.  It’s main benefit is the assistance with sleep - if this is not as issue for you; explore other options. 

    Keep in mind general practitioners have a limited knowledge base in this speciality. 

    All the very best in your journey!

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    • Posted

      Hi Sarah,

      I took 30mg for 2 nights and had vivid dreams and poor sleep so my psych kept me on 15mg for 18months total for post natal anxiety/ depression.  His advice was to just stop taking them at 15mg as he saw this as such a small dose.  I’m glad I took it slow!

      I bought 15mg circular tablets then reduced them by 1/4 every 2 months. Therefore, reduced by 3.75mg increments - I would recommend spending at least  4-6 weeks at each interval to let any WD symptoms surface and pass.

      Evidence shows it takes about 3 weeks for the lag of symptoms to kick in.  I was then on 3.75mg for about 8 weeks when I finally decided to stop on my sons 2nd birthday. That was my motivation.

      The first week off was barely noticeable- still sleeping like a dream; then since week two untill currently (now at 22 days) I have been waking at 1/2am with great difficulty and have been using ANYTHING to assist other than mirtazapine. E.g Nature’s Own sleep advance which is natural, melatonin, antihistamine or nitrazepam as a fall back. Meditation / relaxation apps especially via “Headspace”, essential oils and most of all intense exercise during the day are life saving!

      In hindsight, when I got to 3.75 mg, I probably should have dissolved this in a solution and incremented it even slower then every second day. You can buy soluble mirtazapine tablets and make your own liquid solution to do this.

      Let me know if you would like anymore detail.  I am a RN so have some knowledge but by no means am I an expert and everyone is different especially with psychiatric medications.


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    • Posted

      Thanks Catherine.

      I too had pnda and am on mirtazapine, venlaflaxine and diazepam. Was on olanzapine but came off that last year.

      I was on 45mg of mirt but that tapered over 6 mths to 22.5mg. I plan to taper over another year to off. I have liquid from gp. It has been ok so far but am very nervous about it all and hate being on so many meds.

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  • Posted

    I aggree with catherine only use it as a last resort.
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