Going up tonight from 30mg to 45mg Mirtazapine

Posted , 11 users are following.

Hi folks, I have been suffering from depression for almost 4 months. Citalopram has not helped, and I have been on 30mg Mirtazapine for the past 11 weeks, and although my sleep has improved, my mood remains low.

Can anyone please tell me their experiences of Mirtazapine at 45mg?

0 likes, 19 replies

19 Replies

  • Posted

    Hey! I dont have any experience about upping to 45 mg. But i am too going to 45 mg tonight! Picking up the new dose now. I am on 30 mg. I started at 7.5 in april and slowly moved up. I started having panic attacks again. Hoping this will help me!
    • Posted

      Thank you! Hopefully we can compare notes over the next few days and coming weeks as to how successful it has been!
    • Posted

      Yes! I will respond tomorrow morning. Praying that it doesnt make me wake up in a total panic attack. Lol i have ativan just in case!
  • Posted

    Hi Jason & Smit,

    I only want to say, be aware that the lower doses are more sedating, i.e. 7.5mg the most, 15mg more than 30 mg.  The lower doses are more often prescribed for anxiety and insomnia & the higher doses for depression.  You doctor is quite right to up the doses slowly as sometimes going up quickly can cause you more anx'.  Did your P.A.'s start up again when you moved up a dose Smit?  - you would be losing the sedation effect of course.

    We're all different and react differently to Mirt'; I hope it works well for you.  Do make sure, if and when you're ready, to taper very slowly should you need to at any time, dropping the dose no more than 10% every month.

    Wishing you well.

    • Posted


      When i went up to 30 mg a while back ago, the first week was hell with panic attacks,etc but then i felt great. I have had a loss in the family and i know that's why my anxiety is out of place but my doc wants to try 45 mg.

    • Posted

      Many thanks for this, hopefully I can report back soon with good news!
    • Posted

      Thanks Calmer!! That would probably explain why I couldn't wake for TWO days!!
  • Posted

    I was put on Mirtazapine and upped to 45 last May. I was not a lot better on that alone. When Venlafaxine was added in September I immediately felt a lot better. I now take 150 Venlafaxine along with the Mirtazapine. I had my gallbladder out last January and went downhill from there. I think my recovery wasn't as fast as I expected it to be and I just stressed myself out. I am 75 but expect to be able to operate like a much younger person. I feel confident now that I will be able to handle life more realistically. It is certainly being tested by the fact that I am coping with a badly torn muscle in my leg after a fall two months ago. My psychiatrist thinks I may have to continue on these meds for the rest of my life, or anyway for 2 years. Hope this may help. Maggie
  • Posted

    Hi Jason,


    I became severely anxious and depressed at the beginning of last November. I was upped from 15 mgs to 30 mgs of Mirtazapine. I stayed on 30 mgs for seven weeks. During this time, I had a couple of panic attacks; I hadn't experienced them previously. I was upped to 45 mgs just before Christmas. The 45 mgs does seem to have worked well for the depression, but I have had considerable sleep disturbance (i.e. waking up several times throughout the night) since I have been on 30 and 45 mgs, but I know of other people on this forum and others who haven't experienced any sleep problems on 30 or 45 mgs.

    I saw a psychiatrist today. He thinks the insomnia is probably caused by the Mirt, so tonight I shall start a slow taper down. I am also on 30 mgs Citalopram, which I shall slowly taper in a few weeks, in order to switch to Venlafaxine.

    If you've not had sleep problems on 30 mgs, then you may well be OK on 45 mgs. Everyone reacts differently.

    All the best.


    • Posted

      I see what you are saying. The higher the dose the less sedating?? My sleep is fine with mirtazapine its when i sleep in that i sleep a long freaking time lol. Im just so scared to take my first dose of 45 mg tonight. I always freak out when it comes to meds.

    • Posted

      Amanda hi,

      Just wondering, if you're on Mirt & Cit if you have thought of wd from Cit first as it is the easiest, but not without problems if you don't go slow, which you know already.

      Are you following the 10% every 3 to 4 weeks to come off the Mirt, which may sound slow, but oh so necessary if you want to avoid nasty withdrawal symptoms.  Sorry if you already are aware, just don't want youu to get in a anx' mess.  If you're UK youu may be able to get the liquid to help with WD of Mirt', it's easier to measure the drops.

      Best wishes 

    • Posted

      Hi Calmer,

      Thanks for getting in touch.

      I'm starting on a slow WD on the Mirt because the Psychiatrist thinks that the high dose was causing my repeated waking through the night. I dropped to 37.5 mgs (from 45 mgs) last night, and had a better night than I have had for two months. I will keep on this for three or four weeks before dropping again - I was going to give it a week on 37.5 mgs, but after reading your post, I shall keep on 37.5 mgs for three weeks at least before dropping.

      Once I've stabilised on a lower dose of the Mirt, I will look at a slow taper from Citalopram. I don't think it's a good idea to taper both Mirt and Cit at once.

      Thanks very much for getting in touch. I am in the UK, so I will investigate liquid mirt!

      Hope you're doing well.

    • Posted

      Hi Amanda

      That's great, no rush, please don't be tempted to go faster, try the kindness route by going nice and slow - what dose do you want to get to of the Mirt' ?  

      Bear in mind that withdrawal effects can take up to 2 weeks before you feel anything, although some have a wobble within 5 days or so, but you sound like you're confident.  

      As a guide you might want to read the 10% link, click on my name to follow the link within my status.

      Yes you're right, only taper one at a time, always; I like your plan, getting lower on the Mirt, stabilising then slow wd from the Cit, sounds like a good plan.

      I'm slowly tapering, got to 7.5 mg with liquid, easier to do the drops, I do 5% every 2 weeks, which is the same as 10% every 4 weeks but kinder to the nervous system.  If I get a wobble I will just stay at the dose until my system tells me it's ready/stable again, quite a lengthy plan, but I want to avoid the anx' & terrible wd than others have suffered.

      Hope youu stay well, look after yourself. x

  • Posted

    I must be unusual because I slept much better on 30mg than on 15mg. But then it stopped working for both sleep and anxiety/depression after 4 years. I had a choice of moving up to 45mg or weaning off the mirt. I chose to do the latter. I am down to 3.75mg now. My sleep did not return at any dose of mirt as I tapered down and I am now dependeant on temazepam for sleep. I know I will need to try to get off them once I am free of the mirt.
  • Posted

    Hi Jason and Evergreen,

    Jason, if you've slept OK on 30 mgs of Mirt, then you'll probably sleep OK on 45 mgs. I had no other side-effects when I increased from 30 mgs to 45 mgs.

    Evergreen, I wonder why Mirt pooped out on you, and why your sleep didn't return as you tapered? I tried Temazapam, and I found the side-effects MUCH more tolerable than those produced by Zopiclone, which I can't get on with at all: it makes me feel hung-over and depressed, and gives me memory problems if I take it for more than a couple of days, although it is the only sleeping med which will put me out for the night.

    Temazapam at 10 mgs only worked for a few days for me. Then I found myself waking up again.

    I have been put on a low dose of Trazodone at night, and it is helping at bit.

    I think you have probably done the right thing in tapering down Mirt. If it pooped out at 30 mgs, then it would probably have pooped out at 45 mgs, leaving you with a bigger hill to climb down.

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