GAD - Mirtazipine and Sertraline Advice

Posted , 2 users are following.

Looking for advice and similar experiences. Sertraline 200mg pooped out after 16 years of working brilliantly. with no life event triggers. I am normally a happy go lucky person (as most of us, the last person in a friends group that you predict would suffer from anxiety and depression). Initially, GP recommended through liaison with Mental Health specialist (pysch) to add Mirtazipine as it has a good track record working in combination and complementing with SSRI's (e.g. Sertraline) in kick starting them again.

Since September last year i have been on a roller coaster ride with doseage trial and error and it is completely obvious that my GP is unable to support as they just seem to agree with whatever i state based on my symptoms that i have been tracking through a spreadsheet.

I have been referred by my GP multiple times for an antidepressant medication review with a psych but i keep getting referred to the Wellbeing Team and talk based therapies. I am already undergoing online CBT calls with Wellbeing Team and using the online CBT Silvercloud service. However, despite repeated attempts from my GP to refer me to a Mental health specialist qualified to discuss medication, i am refrerred back to the same wellbeing team through their single point of access. I've now raised a complaint through PALS (Patients and Liaison Service) to intervene and arrange a session for me to meet with a qualified specialist to discuss my medication as i feel like i am going round in circles and the current system / referral process is failing me.

My latest self medication has been to gradually reduce Sertraline and maintain Mirtazipine at 30mg. I am at a point now where i am not sure whether to continue with Sertraline reduction, e.g. move down to 25mg Sertraline or reduce Mirtazipine. The evidence suggests i should reduce the serraline as i had a significant bad reaction for a number of weeks the last time i went below 30mg Mirtazipine so my gut feeling is to reduce sertraline. I have also suffered no signficantly bad reaction at all since reducing from 200mg sertraline through 150, 100, 75 and more recently 50.

I'm thinking of reducing the 50 to 25 this week and then see how i go on 30 Mirt and 25 Sert combined. I get the feeling it's still going to be a while before i get to speak to a pysch on the NHS.

All i can say is thank god i have loving family and friends to support me. God only knows what it must be like to navigate our underfunded / underresourced alone without any support. My GP told me that the triage lisaison decision making progress above is all due to underfunding for mental health support. The quick fix is drug and talk based therapies but you never seem to be able to speak to anyone with a specialist background in medication (e.g. psych)

Thanks X

0 likes, 6 replies

Report / Delete

6 Replies

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up