Has anyone tried Mirtazapine with or without venlafaxine?

Hello Denise,

My pleasure to respond. I think this is a good avenue to get some alternative views. On reading your note, it strikes me that a basic procedural mistake was made ( IMHO ). What I crave is stability, so introducing Mirtazapine should have been the only change. Once a stable result is achieved then another change could be contemplated. Given that your man was clearly suffering, I am puzzled that it was felt to be the right thing to reduce the dose of Venlaxine. David.

Hi there,

I'm currently taking venlafaxine 225mgs, mirtazapine 22.5mgs and 625mgs of lithium all for MDD and dysthymic disorder. Best combo ever. I've been on venlafaxine for 5 yrs before poop out. I did have slight serotonin syndrome from the combo but didn't get serotonin toxicity. A psychiatrist prescribed the lithium but my GP added the mirtazapine. He did however know that I would be consulting with my psychiatrist the following week. I was cranky at the shrink for not taking me off venlafaxine, but discontinuation scared her away from making any changes. But I was already having discontinuation via poop out. So my GP agreed to add the mirtazapine coz I was beside myself and not sleeping. The combo has settled down and I am not experiencing any serotonin excess. I did however reduce the lithium when it seemed I was having serotnin excess. I am lucky however as I have an anesthetist Int he family to consult with. Aside from my personal story here, I can suggest going slow anytime you're adding a medicine. And if ur worried about serotonin toxicity go to ur emergency. It's comon for some people to get serotonin toxicity on even a starting dose on ANY single antidepressant. The combo does kick some butt, so go easy. And remember serotonin syndrome is a spectral syndrome. It can be mild and go away or go the opposite direction and become dangerous. Ideally you have A psychiatrist making your medication recommendations with your approval.

Hi! Just had to say I've been on venlafaxine/mirtazapine combination for several years now with no problems and it's really worked for me. When venlafaxine alone wasn't enough, iwas afraid that I'd have to withdraw from it & start again with something new. I was very relieved to be offered the combination which started helping quite quickly. It was prescribed by psychiatrist, GP not familiar with it,& some pharmacists query it.. CBT also great help & I'm now on an even keel. All the best Marcus.