Has anyone experienced long term Mirt use making their sleep worse?
Posted , 4 users are following.
I've been taking Mirt for 18 months, prescribed for an episode of primary insomnia where I didn't sleep at all for nearly a week. It was a life saver at that point. I've been doing a slow taper pretty much ever since (10% a month) but due to bumps in the road with my sleep have somehow ended up on a higher dose than I started (currently on about 26mg of the liquid).
Over the last 6 months I have started getting a type of insomnia that I've never had in my whole life - where I go to sleep fine but wake up at about midnight or 1am and can't get back to sleep at all. I have this odd feeling that the Mirt might at least be contributing to this new problem. I am falling asleep on the sofa at 9pm (before I've even taken the Mirt) - it's literally impossible to keep myself awake, even when I sit up, like being drugged. I push it as much as I can then go to bed about 10:30pm, take the Mirt and go to sleep straight away. But then wake up at midnight or 1am and don't get back to sleep. It feels as though my body isn't somehow going through it's natural sleep cycle and I'm wondering if the Mirt is somehow contributing to this. Has anyone experienced anything like this or heard of it? It didn't happen for the first 12 months that I took it, it's just developed over the last 6 months or so. xx
0 likes, 9 replies
Liam36009 gillian62018
Posted
Hi Gillian. I think it could be the case that the sedation from the mirt has worn off for you. It can happen to some people. But usually the drug still works as long as it's taken because insomnia is the biggest problem when withdrawing from mirt but not while on it. If the sleep issues you are having are having a big impact on you then talking to a doctor would be a good idea. If you haven't already tried it I've heard from a few people that Trazodone can be a decent antidepressant drug that has a sedative effect. So maybe ask for that? Not sure where you live but here in the UK I believe it's a bit more expensive to prescribe Trazodone on the NHS compared to some other antidepressants which is why it isn't prescribed all that often but it's worth a try.
gillian62018 Liam36009
Posted
Thanks for the reply Liam 😃
The strange thing is that I feel it is still having some affect on me, because it's definitely making me fall asleep more quickly than I would naturally. It's just odd that over the last 6 months I seem to be then waking up at midnight or 1am. I guess perhaps the sedation isn't as strong anymore, so it's not keeping me asleep. I had also wondered if perhaps the Mirt sort of initially drugs me - a bit like hypnotics do - but I'm not entering my normal sleep cycle and then wake up once the effect lessons. But who knows....
I'm in the UK too and yes Trazadone is something I had considered, I read quite a bit about it. Unfortunately it will take me forever to taper off the Mirt to be able to get onto the Trazadone - I have to do the 10% a month reduction of Mirt otherwise I get the insomnia withdrawal. But definitely for the future that's what I plan to try xx
joshuapryce1987 gillian62018
Posted
Mental health drugs promote healthy sleep, but in return, the body lets the drugs have control over the system. They do not usually make sleep worse, unless you try to go cold turkey. I went cold turkey on olanzapine, but the problem is i overthink as part of my mental health condition. If i didnt severely overthink, i would go cold turkey myself. All the best.
gillian62018 joshuapryce1987
Posted
Thanks Joshua. I am pretty sure that the Mirt is now at least contributing to my problem. Drugs for sleep are good at first - but when you've been on them for several years the effect is nowhere near like it was at the start. The Mirt still makes me extremely drowsy in the evenings (before I've even taken it) so I'm ending up going to sleep earlier than I would naturally and being "tranquilised" to sleep initially but it doesn't last all night and because I'm also not sleep cycling naturally (because I've been drugged to sleep instead of falling into my natural rhythm) I'm waking up at 1/2/3/4am unable to get back to sleep. Unfortunately I'm stuck in a catch 22 as I have to taper down super slowly off of it in order not to get withdrawal.
marius1976 gillian62018
Posted
Something similar is valid for my case but during withdrawal. First four months sleeping was something I only desired but not getting too much (from 0 to 4 hours a night), but later I also developed a common pattern: usually falling asleep naturally around 9:30 to 10:00 and then just waking up after two or three complete sleep cycles of one hour and a half. Just like a robot, or electrical circuit. Then nothing till the next evening. I read a study saying that mirtazapine is blocking somehow the normal cortisol production during night and it is messing with the REM phase of the sleep but both mechanism are not fully understood. As a consequence during withdrawal your cortisol receptors are having a disproportionate reaction and tend to alarm the body to wake up even a the lowest level of cortisol pump. Also during REM the brain is not resetting itself.
In your case it might be possible that different doses during time led to a situation in which the drowsing effect is still present early in the evening due to having the antihistamine receptors still blocked by mirtazapine, but starting with the 4th sleep cycle during REM the cortisol release is too much and the brain gives the wake up signal.
Ten months after quitting mirtazapine I still have this pattern, but at least now I fall asleep again after the night middle break (which lasts from 30 minutes in better case to 3 hours in worst) and I have in total around 7, 8 hours of sleep (the second part is mostly REM and not so restorative as the first part).
gillian62018
Posted
Thanks for the insight Marius, that's very interesting. I had my cortisol levels tested after about 4 months on Mirt and they were completely non existent! Totally flat lined, so I know it definitely does effect your cortisol (it hadn't been like that a few months earlier pre Mirt). I think there are multiple things going on with me and sleep but what I suspect is happening with the Mirt is that it makes me drowsy (SO drowsy) in the evenings (even before I've taken it) and it's been causing me to go to bed too early, drug myself with my next dose of Mirt and kind of "pre jump" my natural sleep cycle. Once the initial hit of Mirt wears off in a couple of hours I then wake up. I have no idea if there is any science behind this, I can only share what it feels like in my body. I am trying my hardest now to fight fight fight the sick with drowsiness feeling at 8pm/9pm and make it till at least 10pm which is a bit more in tune with my natural sleep.
gillian62018
Posted
Hi Marius - not sure if you'll see this but I wondered if you could share a link to the study on the connection between Mirtazapine and Cortisol that you mention? I am still struggling periodically with this waking up wide awake at 1am and not getting back to sleep and I feel sure that the Mirt is somehow contributing to it, even though I can't find any evidence to back this up, it's just a gut feeling I have. I'm considering what you mentioned about cortisol and would like to find out more about it- thank you!
gillian62018
Posted
What I should have added is that it's not all the time- it happens for a period of a few days every 2 weeks or so. Outside of that time i sleep fine and despite waking up most nights for the loo it is a totally different feeling to the nights when I wake up and don't go back to sleep. On a normal night I wake up, stagger to the bathroom and back again and fall straight back to sleep, still half asleep. On these other nights I wake suddenly and feel completely wide awake and know instantly the difference between when I'll get back to sleep or not, it's a very different feeling. I am wondering if like you said there could be something going on with my cortisol...
gillian62018
Posted
I thought I'd just update on this thread that I think I may have worked out what's going on... I think the reason I'm waking at 1/2am (which is very unusual for me - never been an issue before) is because of the vivid dreams/nightmares and accompanying night sweats and I think Mirt is at least significantly contributing to that, if not the reason behind it altogether (as these are known side effects). When I'm having the 1/2am wakenings I am always drenched in sweat and my sheets are wet (it's grim - and I am not naturally a sweaty person!). I looked back at my calendar and realised that when I increased upwards of 15mg that these side effects started to increase. So I don't think the Mirt itself is causing me to wake per se, it's the nightmares and night sweats and the raise in core body temperature which will always trigger you to wake from sleep. Unfortunately I have to taper really slowly so it'll be 6 months before I'm back down to 15mg, but I'm going to just keep plodding on. And invest in an expensive Bed Jet in the meantime!!