I have some questions about different doses of mirtazapine....

I have mild depression, probably mostly sadness. The doctor prescribed 15 mg. of mirtazapine. It made

me very sleepy. I, too, get more than 8 and half hours of sleep at night and It's hard to get out out of bed in the morning. Right now it's 3 in the afternoon and all I want to do is go back to bed for an hour. I must

make a distinction between tiredness and sleepiness. If I am out and about I have a lot of energy but

when I have no appts., etc. I want to take a nap. Because of my sleepiness complaint

the MD then prescribed Wellbutrin which I took for three days. I couldn't sleep. Insomnia, I feel, is

worse than somnolence. The doctor then told me to go back to mirtazapine but to cut the mirtazapine tablet in half and take it bedtime. I sleep well but with vivid dreams. Now that I'm on the 7.5 mg. I still feel

OK emotionally but I continue to want to nap in the afternoon but but perhaps a little less so. I've tried stopping it. The first time I stopped "cold turkey" I had withdrawal symptoms and dificulty sleeping. Never stop any antidepressant suddenly. One must wean oneself off it gradually over several days.As to your question: Would a lower dose be less effective in reducing your depression and anxiety? It has not

reduced the effectiveness in me but each person is different as we all know. And to reiterate - my depression was mild.I once visited a psychiatrist and he said I didn't have clinical depression only sadness and that I didn't need any medication even tho the GP thought the mirtazapine would help. A dear friend who has been on mirtazapine for three years - 30 mg. per day - said it saved her life. She had been very

depressed perhaps suicidal. She claims she couldn't live the normal life she now enjoys without it.

Most doctors say you have to give any antidepressant time to work. In some cases I guess that might mean a few weeks or perhaps even months.

I too find that i never really want to get out of bed in the morning, it takes me a while to properly wake up.

Sleep is paramount to me, it was torture when i was having no sleep so i have found the mirtazapine to be a good medication for me in that respect. I know that i wouldn't sleep without it because i forgot to take it one night, but thought that i had taken it, and was still awake at 5am getting annoyed that i couldn't sleep before realising i hadn't taken my tablet. So i won't ever be going cold turkey as i know what will happen.

I was very depressed and highly anxious at one point, had been harming myself and suicidal thoughts, but the mirtazapine has got rid of all those bad ideas thankfully. I am not yet 100% recovered though, i still have times when i feel quite low.

I understand that everyone is different but thanks for your experience.

Sunset, Glad that you are doing better. Best wishes for your complete recovery, even if it means taking mirtazapine. At the very least it does give us a good nights sleep.

Hello Sunset et al,

I take mirtazapine also. It was very helpful for me with managing panic attacks. In terms of doseage, I feel like I am having an effective dose without toooo many side effects at 30 mg per day, taken 8 pm each night. But I am a 200 pound male and am now back to exercising 5 days a week (to exhaustion, a whole other good story). If you are smaller / have a less active metabolism you may be over cooking ? . Because of its side effects this drug is presented as 'it's not for everyone' , but I think it might be that dose adjustment may help to maximise the good and minimise the side effects. The trickcyclist started me on half a pill for first 4 days and even then I still recall the first week as a strange one . I very much agree that I am in much better place for taking this med. Please be v. Direct with your medical folks, tell them how it affects you. The more you can explain, the better they can help. Best Wishes.

Thanks vicky, yes I am so glad of being able to sleep. It is a different tiredness that I get from mirtazapine to that which I got when I wasn't sleeping properly. I have to say that if I have to suffer one of them I much prefer the tiredness from mirtazapine.

Hi David,

Yeah I'm quite small, 5ft 6 and 140 pounds. The nurse from cmht said it might be too sedating for me, but if my dose is reduced I worry whether it will be enough to help my sleep still and to keep away depression and anxiety.

I had tried citalopram before mirtazapine and I'm getting on better with mirtazapine, I do have faith in it being a suitable medication for me. I worry about if I go back to raise issues about it with my GP, they will suggest changing it and I don't want to have to go through another change of medication, as I finally feel as if I'm getting somewhere with it.

Hmm, I understand.

Since I am a nerd I did conduct a science experiment on myself. I took take a daily note of how I felt in the morning - write it down. Then I took medication at the same time each night. Noted that down each day too. ( probably no surprise that more than once I have thought I had taken it and not, and also the reverse and taken it twice ).

Once I was confident about the routine ( all positive so far ...) I did try one night taking half a dose and noted what the next day became (any panic attacks etc). I went back to the full dose pretty quick.

In your case you might find your side effects are a bit less but the good bit remains. In my case I need all 30mg I think. Gee, and I paid a pile of pounds to the psychiatrist to set the right dose. No one said I was smart.

Anyway, your notes about how you feel will be useful I'm sure.

Together with medication, Please let me recommend a physical exercise programme and chatting with the NHS Talking Therapies folks. I think that each one positively helped me out of a very dark corner.

I am a member at a gym but I've been struggling to have the motivation to go, I keep saying to myself that I'll go when I feel I have the energy to but still haven't been. I do try to go walking occasionally though.

I'm currently waiting for one to one counselling with the nhs, because I wasn't keen on going to a group session, and I have two more appointments left with the nurse from the cmht.

Thanks for your advice.

Do they have classes at your gym Sunset? I find that it is too easy to cut short any exercises in the gym but if you are in a class such as Pilates, Body Pump etc, it is more difficult to walk out.

Yeah they do have classes, I haven't been to any yet. Yoga and zumba and all the usual.

Hi All ....... The sleepiness does eventually go, if you give it time, I'm on 45mg for last 18months am fine during the day. Always liked my sleep so prob sleep 10 hrs at night.

I do find I get sleepy about half an hour after taking it at night, which I find beneficial.

As for the weight yes that's one of the downsides...... I'd huge cravings at first especially for sweet things

Now I'm back to eating not much, as I always did........... Weight not shifting tho

Maizie

Hi Maizie

Yeah I get huge cravings for sweet things and feel hungry a lot of the time. I just drink tea now if I start feeling hungry, to try and stop myself eating so much.

I am also on 15mgs of mirtazapine, just started this week and have been tired during the day, but feel better than I did at the start of the week, I also exercise regularly, going spinning 4-5 times a week and swimming 3-4 times a week, I agree that exercise really helps, even though sometimes I really haven't wanted to go.

Hi Sunset ......what a lovely name ......

Yeah but my cravings are so strong can't stop myself, only not to have chocolate in the house.

Have yoghurts instead, I find now I'm on them awhile it's o.k

But when I take it have to make sure I'm in bed half an hour after, or I start craving.

Used to get out of bed n have cereal etc., But that's eased off now

Maizie

Ah yeah i love cereal i often get up and have a bowl of cereal in the night when i'm hungry, found myself buying the chocolatey varieties now to get a chocolate fix, and yeah i still have to eat chocolate, but like you said it was worse in the beginning, i could eat a pack of biscuits a day. It sounds like a habit smokers have but with biscuits lol!